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A Study of MM-121 in Combination With Paclitaxel in Patients With Advanced Gynecologic and Breast Cancers

A Phase 1, Pharmacologic and Pharmacodynamic Study of MM-121 in Combination With Paclitaxel in Patients With Advanced Gynecologic and Breast Cancers

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01209195
Enrollment
41
Registered
2010-09-27
Start date
2010-10-31
Completion date
2014-07-31
Last updated
2016-09-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Locally Advanced/Metastatic or Recurrent Ovarian Cancer, Fallopian Tube Cancer,, Primary Peritoneal Cancer or Endometrial Cancer, Locally Advanced/Metastatic Her2 Non Overexpressing Breast Cancer

Keywords

Ovarian cancer, HER-2 negative breast cancer, Breast cancer, Fallopian tube cancer

Brief summary

This study was a Phase 1 and pharmacologic open-labeled dose-escalation trial of MM-121 in combination with paclitaxel using a 3+3 design.

Detailed description

Successive cohorts of three or more patients were treated at escalating doses until a maximum tolerated dose/recommended phase 1 dose was identified. Once the maximum tolerated dose was identified, an Expansion Cohort was enrolled at that dose to further characterize safety and to explore pharmacodynamic endpoints.

Interventions

DRUGMM-121

increasing doses of MM-121 IV QW

DRUGPaclitaxel

Paclitaxel - 80 mg/m2 IV QW

Sponsors

Sanofi
CollaboratorINDUSTRY
Merrimack Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Cytological or histological confirmation of locally advanced/metastatic or recurrent epithelial ovarian cancer, fallopian tube cancer, primary peritoneal cancer or endometrial cancer; OR, cytological or histological confirmation of locally advanced /metastatic Her2 non-overexpressing breast cancer * Eighteen years of age or above * Candidates for chemotherapy * Able to understand and sign an informed consent (or have a legal representative who is able to do so) * Measurable disease according to RECIST v1.1 * ECOG Performance Score (PS) of ≤ 2 * Willing to abstain from sexual intercourse or to use an effective form of contraception during the study and for 90 days following the last dose of MM-121

Exclusion criteria

* Prior radiation therapy to \>25% of bone marrow-bearing areas * Evidence of any other active malignancy * Active infection or fever\> 38.5°C during screening visits or on the first scheduled day of dosing * Symptomatic CNS disease * Known hypersensitivity to any of the components of MM-121 or who have had hypersensitivity reactions to fully human monoclonal antibodies * Received treatment, within 30 days prior to the first scheduled day of dosing, with any investigational agents that have not received regulatory approval for any indication or disease state * Pregnant or breast feeding

Design outcomes

Primary

MeasureTime frameDescription
Dose Escalation: To Evaluate the Safety and Tolerability of Escalating Doses of the MM-121 Plus Paclitaxel Combination Via Reporting of Dose-limiting Toxicity (DLT)From date of first dose to 30 days after termination, the longest 163 weeksTo establish the safety of escalating doses of MM-121 in combination with paclitaxel in order to determine the recommended phase 2 dose. Dose-escalation conducted using standard 3+3 model to determine maximum tolerated dose. Reports of Dose-Limiting Toxicities (DLTs) were assessed to determine the MTD.
To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose LevelFrom date of first dose to 30 days after termination, the longest 163 weeksUsing a 3+3 dose escalation model, the maximum tolerated dose of each combination was determined by assessing dose-limiting toxicities in each cohort. Part 1 Cohort 1: MM-121: 20 mg/kg loading dose followed by 12 mg/kg QW IV )20/12) + Paclitaxel: 80mg/m2 IV QW Part 1 Cohort 2: MM-121: 40 mg/kg loading dose followed by 20 mg/kg QW IV (40/20) + Paclitaxel: 80mg/m2 QW IV Part 2 Cohort 1: MM-121: 40/20 mg/kg IV + Paclitaxel: 80mg/m2 QW IV Part 2 Cohort 2: MM-121 20 /12 mg/kg IV QW + Paclitaxel: 80 mg/m2 QW IV Part 2 Cohort 3: MM-121 40mg/kg IV QOW + Paclitaxel: 80 mg/m2 QW IV Part 2 Cohort 4: MM-121 - 40 mg/kg loading dose followed by 20 mg/kg weekly IV for 3 weeks, followed by one week of rest + Paclitaxel: 80mg/m2 weekly IV for 3 weeks, followed by one week of rest
To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: Paclitaxel Dose LevelFrom date of first dose to 30 days after termination, the longest 163 weeksUsing a 3+3 dose escalation model, the maximum tolerated dose of each combination was determined by assessing dose-limiting toxicities in each cohort. Part 1 Cohort 1: MM-121: 20 mg/kg loading dose followed by 12 mg/kg QW IV )20/12) + Paclitaxel: 80mg/m2 IV QW Part 1 Cohort 2: MM-121: 40 mg/kg loading dose followed by 20 mg/kg QW IV (40/20) + Paclitaxel: 80mg/m2 QW IV Part 2 Cohort 1: MM-121: 40/20 mg/kg IV + Paclitaxel: 80mg/m2 QW IV Part 2 Cohort 2: MM-121 20 /12 mg/kg IV QW + Paclitaxel: 80 mg/m2 QW IV Part 2 Cohort 3: MM-121 40mg/kg IV QOW + Paclitaxel: 80 mg/m2 QW IV Part 2 Cohort 4: MM-121 - 40 mg/kg loading dose followed by 20 mg/kg weekly IV for 3 weeks, followed by one week of rest + Paclitaxel: 80mg/m2 weekly IV for 3 weeks, followed by one week of rest

Secondary

MeasureTime frameDescription
To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Ratepatients were assessed for response during their time on study, the longest of which was 163 weeksTo determine the number of patients reporting an objective response using RECIST v 1.1 where a Partial Response (PR) is defined as \>20% decrease in tumor burden from baseline and a Complete Response (CR) is defined as complete disappearance from tumor burden from baseline. Objective Response is presented as the total # patients with PR or CR.
ImmunogenicitySamples were collected for all patients pre-dose on all cycles for duration of treatment, the longest of which was 163 weeks, and a collection was made post-infusion in any case of infusion reactionSamples were collected to determine the presence of an immunologic reaction to MM-121 (i.e. human anti-human antibodies).
To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With PaclitaxelCollections taken at for all patients at Cycle 1, Week 1 (pre-treatment/pre-infusion, at the end of the infusion, and 2.5, 4, 6 and 24 hours after starting the infusion of MM-121) and pre-treatment at Cycle 1, Week 3 and Cycle 2, Week 1Pharmacokinetic (PK) evaluation was performed on plasma samples obtained weekly for the first cycle of the study and then on day 1 of each additional cycle to assess pre-treatment trough concentrations of MM-121. Non-compartmental analysis (NCA) was performed to calculate standard PK parameters, including the maximum observed concentration (Cmax). Serum levels of MM-121 were measured at a central lab using an enzyme-linked immunosorbent assay (ELISA). Data is presented per dose level of MM-121 (20/12 mg/kg weekly, 40/20 mg/kg weekly, 40 mg/kg Q2W, or 40/20 mg/kg QW x 7 plus a rest week).
Pharmacokinetic Parameters (AUClast)Collections taken at for all patients at Cycle 1, Week 1 (pre-treatment/pre-infusion, at the end of the infusion, and 2.5, 4, 6 and 24 hours after starting the infusion of MM-121) and pre-treatment at Cycle 1, Week 3 and Cycle 2, Week 1Pharmacokinetic (PK) evaluation was performed on plasma samples obtained weekly for the first cycle of the study and then on day 1 of each additional cycle to assess pre-treatment trough concentrations of MM-121. Non-compartmental analysis (NCA) was performed to calculate standard PK parameters, including the maximum observed concentration (Cmax). Serum levels of MM-121 were measured at a central lab using an enzyme-linked immunosorbent assay (ELISA). Data is presented per dose level of MM-121 (20/12 mg/kg weekly, 40/20 mg/kg weekly, 40 mg/kg Q2W, or 40/20 mg/kg QW x 7 plus a rest week). Immunogenicity data is not available.

Countries

United States

Participant flow

Participants by arm

ArmCount
MM-121 + Paclitaxel: Dose Escalation
MM-121 plus Paclitaxel: Cohort 1: MM-121 - 20 mg/kg loading dose followed by 12 mg/kg weekly IV Paclitaxel - 80mg/m2 weekly IV Cohort 2: MM-121 - 40 mg/kg loading dose followed by 20 mg/kg weekly IV Paclitaxel - 80mg/m2 weekly IV Intermediate doses between cohorts 1 and 2 may also be considered.
10
MM-121 + Paclitaxel: Expansion Cohort
MM-121 - 40 mg/kg loading dose followed by 20 mg/kg weekly IV Paclitaxel - 80mg/m2 weekly IV
31
Total41

Baseline characteristics

CharacteristicMM-121 + Paclitaxel: Expansion CohortMM-121 + Paclitaxel: Dose EscalationTotal
Age, Continuous55.5 years
STANDARD_DEVIATION 10.43
57.4 years
STANDARD_DEVIATION 9.62
56.45 years
STANDARD_DEVIATION 10.025
Ethnicity (NIH/OMB)
Hispanic or Latino
10 Participants1 Participants11 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
21 Participants9 Participants30 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Black or African American
3 Participants0 Participants3 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
5 Participants0 Participants5 Participants
Race (NIH/OMB)
White
22 Participants10 Participants32 Participants
Region of Enrollment
United States
31 participants10 participants41 participants
Sex: Female, Male
Female
31 Participants10 Participants41 Participants
Sex: Female, Male
Male
0 Participants0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
10 / 1031 / 31
serious
Total, serious adverse events
4 / 1012 / 31

Outcome results

Primary

Dose Escalation: To Evaluate the Safety and Tolerability of Escalating Doses of the MM-121 Plus Paclitaxel Combination Via Reporting of Dose-limiting Toxicity (DLT)

To establish the safety of escalating doses of MM-121 in combination with paclitaxel in order to determine the recommended phase 2 dose. Dose-escalation conducted using standard 3+3 model to determine maximum tolerated dose. Reports of Dose-Limiting Toxicities (DLTs) were assessed to determine the MTD.

Time frame: From date of first dose to 30 days after termination, the longest 163 weeks

ArmMeasureValue (NUMBER)
Part 1: Dose Escalation: Cohort 1Dose Escalation: To Evaluate the Safety and Tolerability of Escalating Doses of the MM-121 Plus Paclitaxel Combination Via Reporting of Dose-limiting Toxicity (DLT)0 participants reporting DLTs
Part 1: Dose Escalation: Cohort 2Dose Escalation: To Evaluate the Safety and Tolerability of Escalating Doses of the MM-121 Plus Paclitaxel Combination Via Reporting of Dose-limiting Toxicity (DLT)1 participants reporting DLTs
Part 2: Expansion Cohort 1Dose Escalation: To Evaluate the Safety and Tolerability of Escalating Doses of the MM-121 Plus Paclitaxel Combination Via Reporting of Dose-limiting Toxicity (DLT)0 participants reporting DLTs
Part 2: Expansion Cohort 2Dose Escalation: To Evaluate the Safety and Tolerability of Escalating Doses of the MM-121 Plus Paclitaxel Combination Via Reporting of Dose-limiting Toxicity (DLT)0 participants reporting DLTs
Part 2: Cohort 3Dose Escalation: To Evaluate the Safety and Tolerability of Escalating Doses of the MM-121 Plus Paclitaxel Combination Via Reporting of Dose-limiting Toxicity (DLT)0 participants reporting DLTs
Part 2: Cohort 4Dose Escalation: To Evaluate the Safety and Tolerability of Escalating Doses of the MM-121 Plus Paclitaxel Combination Via Reporting of Dose-limiting Toxicity (DLT)0 participants reporting DLTs
Primary

To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Level

Using a 3+3 dose escalation model, the maximum tolerated dose of each combination was determined by assessing dose-limiting toxicities in each cohort. Part 1 Cohort 1: MM-121: 20 mg/kg loading dose followed by 12 mg/kg QW IV )20/12) + Paclitaxel: 80mg/m2 IV QW Part 1 Cohort 2: MM-121: 40 mg/kg loading dose followed by 20 mg/kg QW IV (40/20) + Paclitaxel: 80mg/m2 QW IV Part 2 Cohort 1: MM-121: 40/20 mg/kg IV + Paclitaxel: 80mg/m2 QW IV Part 2 Cohort 2: MM-121 20 /12 mg/kg IV QW + Paclitaxel: 80 mg/m2 QW IV Part 2 Cohort 3: MM-121 40mg/kg IV QOW + Paclitaxel: 80 mg/m2 QW IV Part 2 Cohort 4: MM-121 - 40 mg/kg loading dose followed by 20 mg/kg weekly IV for 3 weeks, followed by one week of rest + Paclitaxel: 80mg/m2 weekly IV for 3 weeks, followed by one week of rest

Time frame: From date of first dose to 30 days after termination, the longest 163 weeks

Population: NOTE: MTD of paclitaxel when administered with MM-121 provided in separate endpoint entry

ArmMeasureGroupValue (NUMBER)
Part 1: Dose Escalation: Cohort 1To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Levelone-time loading dose40 mg/kg
Part 1: Dose Escalation: Cohort 1To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Levelmaintenance dose20 mg/kg
Part 1: Dose Escalation: Cohort 2To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Levelone-time loading dose40 mg/kg
Part 1: Dose Escalation: Cohort 2To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Levelmaintenance dose20 mg/kg
Primary

To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: Paclitaxel Dose Level

Using a 3+3 dose escalation model, the maximum tolerated dose of each combination was determined by assessing dose-limiting toxicities in each cohort. Part 1 Cohort 1: MM-121: 20 mg/kg loading dose followed by 12 mg/kg QW IV )20/12) + Paclitaxel: 80mg/m2 IV QW Part 1 Cohort 2: MM-121: 40 mg/kg loading dose followed by 20 mg/kg QW IV (40/20) + Paclitaxel: 80mg/m2 QW IV Part 2 Cohort 1: MM-121: 40/20 mg/kg IV + Paclitaxel: 80mg/m2 QW IV Part 2 Cohort 2: MM-121 20 /12 mg/kg IV QW + Paclitaxel: 80 mg/m2 QW IV Part 2 Cohort 3: MM-121 40mg/kg IV QOW + Paclitaxel: 80 mg/m2 QW IV Part 2 Cohort 4: MM-121 - 40 mg/kg loading dose followed by 20 mg/kg weekly IV for 3 weeks, followed by one week of rest + Paclitaxel: 80mg/m2 weekly IV for 3 weeks, followed by one week of rest

Time frame: From date of first dose to 30 days after termination, the longest 163 weeks

Population: note: MTD of MM-121 when administered in combination with paclitaxel provided in separate endpoint entry

ArmMeasureValue (NUMBER)
Part 1: Dose Escalation: Cohort 1To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: Paclitaxel Dose Level80 mg/m2
Part 1: Dose Escalation: Cohort 2To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: Paclitaxel Dose Level80 mg/m2
Secondary

Immunogenicity

Samples were collected to determine the presence of an immunologic reaction to MM-121 (i.e. human anti-human antibodies).

Time frame: Samples were collected for all patients pre-dose on all cycles for duration of treatment, the longest of which was 163 weeks, and a collection was made post-infusion in any case of infusion reaction

ArmMeasureValue (NUMBER)
Part 1: Dose Escalation: Cohort 1ImmunogenicityNA
Part 1: Dose Escalation: Cohort 2ImmunogenicityNA
Part 2: Expansion Cohort 1ImmunogenicityNA
Part 2: Expansion Cohort 2ImmunogenicityNA
Part 2: Cohort 3ImmunogenicityNA
Part 2: Cohort 4ImmunogenicityNA
Secondary

Pharmacokinetic Parameters (AUClast)

Pharmacokinetic (PK) evaluation was performed on plasma samples obtained weekly for the first cycle of the study and then on day 1 of each additional cycle to assess pre-treatment trough concentrations of MM-121. Non-compartmental analysis (NCA) was performed to calculate standard PK parameters, including the maximum observed concentration (Cmax). Serum levels of MM-121 were measured at a central lab using an enzyme-linked immunosorbent assay (ELISA). Data is presented per dose level of MM-121 (20/12 mg/kg weekly, 40/20 mg/kg weekly, 40 mg/kg Q2W, or 40/20 mg/kg QW x 7 plus a rest week). Immunogenicity data is not available.

Time frame: Collections taken at for all patients at Cycle 1, Week 1 (pre-treatment/pre-infusion, at the end of the infusion, and 2.5, 4, 6 and 24 hours after starting the infusion of MM-121) and pre-treatment at Cycle 1, Week 3 and Cycle 2, Week 1

Population: All patients. Data presented per dose level of MM-121 and not per cohort. The same dose was used in multiple cohorts, and those data were combined.~NOTE: two patients are not included in the analysis due to incorrectly collected or processed samples.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Part 1: Dose Escalation: Cohort 1Pharmacokinetic Parameters (AUClast)39252.9 hr* ug/mLGeometric Coefficient of Variation 40.3
Part 1: Dose Escalation: Cohort 2Pharmacokinetic Parameters (AUClast)77137.6 hr* ug/mLGeometric Coefficient of Variation 31.1
Part 2: Expansion Cohort 1Pharmacokinetic Parameters (AUClast)102263.1 hr* ug/mLGeometric Coefficient of Variation 35.6
Part 2: Expansion Cohort 2Pharmacokinetic Parameters (AUClast)96043.0 hr* ug/mLGeometric Coefficient of Variation 25.9
Secondary

To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate

To determine the number of patients reporting an objective response using RECIST v 1.1 where a Partial Response (PR) is defined as \>20% decrease in tumor burden from baseline and a Complete Response (CR) is defined as complete disappearance from tumor burden from baseline. Objective Response is presented as the total # patients with PR or CR.

Time frame: patients were assessed for response during their time on study, the longest of which was 163 weeks

ArmMeasureValue (NUMBER)
Part 1: Dose Escalation: Cohort 1To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate1 participants with objective response
Part 1: Dose Escalation: Cohort 2To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate2 participants with objective response
Part 2: Expansion Cohort 1To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate3 participants with objective response
Part 2: Expansion Cohort 2To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate3 participants with objective response
Part 2: Cohort 3To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate3 participants with objective response
Part 2: Cohort 4To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate2 participants with objective response
Secondary

To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With Paclitaxel

Pharmacokinetic (PK) evaluation was performed on plasma samples obtained weekly for the first cycle of the study and then on day 1 of each additional cycle to assess pre-treatment trough concentrations of MM-121. Non-compartmental analysis (NCA) was performed to calculate standard PK parameters, including the maximum observed concentration (Cmax). Serum levels of MM-121 were measured at a central lab using an enzyme-linked immunosorbent assay (ELISA). Data is presented per dose level of MM-121 (20/12 mg/kg weekly, 40/20 mg/kg weekly, 40 mg/kg Q2W, or 40/20 mg/kg QW x 7 plus a rest week).

Time frame: Collections taken at for all patients at Cycle 1, Week 1 (pre-treatment/pre-infusion, at the end of the infusion, and 2.5, 4, 6 and 24 hours after starting the infusion of MM-121) and pre-treatment at Cycle 1, Week 3 and Cycle 2, Week 1

Population: All patients. Data presented per dose level of MM-121 and not per cohort. The same dose was used in multiple cohorts, and those data were combined.~NOTE: two patients are not included in the analysis due to incorrectly collected or processed samples.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Part 1: Dose Escalation: Cohort 1To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With Paclitaxel445.7 ug/mLGeometric Coefficient of Variation 39.6
Part 1: Dose Escalation: Cohort 2To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With Paclitaxel903.5 ug/mLGeometric Coefficient of Variation 31.5
Part 2: Expansion Cohort 1To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With Paclitaxel1081.1 ug/mLGeometric Coefficient of Variation 73.1
Part 2: Expansion Cohort 2To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With Paclitaxel1134.5 ug/mLGeometric Coefficient of Variation 18.6

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026