Locally Advanced/Metastatic or Recurrent Ovarian Cancer, Fallopian Tube Cancer,, Primary Peritoneal Cancer or Endometrial Cancer, Locally Advanced/Metastatic Her2 Non Overexpressing Breast Cancer
Conditions
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
increasing doses of MM-121 IV QW
Paclitaxel - 80 mg/m2 IV QW
Sponsors
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| 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 weeks | 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. |
| To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Level | From date of first dose to 30 days after termination, the longest 163 weeks | 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 |
| To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: Paclitaxel Dose Level | From date of first dose to 30 days after termination, the longest 163 weeks | 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 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate | patients were assessed for response during their time on study, the longest of which was 163 weeks | 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. |
| Immunogenicity | 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 | Samples 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 Paclitaxel | 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 | 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). |
| 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 1 | 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. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| 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 |
| Total | 41 |
Baseline characteristics
| Characteristic | MM-121 + Paclitaxel: Expansion Cohort | MM-121 + Paclitaxel: Dose Escalation | Total |
|---|---|---|---|
| Age, Continuous | 55.5 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 Participants | 1 Participants | 11 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 21 Participants | 9 Participants | 30 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Black or African American | 3 Participants | 0 Participants | 3 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 5 Participants | 0 Participants | 5 Participants |
| Race (NIH/OMB) White | 22 Participants | 10 Participants | 32 Participants |
| Region of Enrollment United States | 31 participants | 10 participants | 41 participants |
| Sex: Female, Male Female | 31 Participants | 10 Participants | 41 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 10 / 10 | 31 / 31 |
| serious Total, serious adverse events | 4 / 10 | 12 / 31 |
Outcome results
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
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Dose Escalation: Cohort 1 | 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) | 0 participants reporting DLTs |
| Part 1: Dose Escalation: Cohort 2 | 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) | 1 participants reporting DLTs |
| Part 2: Expansion Cohort 1 | 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) | 0 participants reporting DLTs |
| Part 2: Expansion Cohort 2 | 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) | 0 participants reporting DLTs |
| Part 2: Cohort 3 | 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) | 0 participants reporting DLTs |
| Part 2: Cohort 4 | 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) | 0 participants reporting DLTs |
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
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Part 1: Dose Escalation: Cohort 1 | To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Level | one-time loading dose | 40 mg/kg |
| Part 1: Dose Escalation: Cohort 1 | To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Level | maintenance dose | 20 mg/kg |
| Part 1: Dose Escalation: Cohort 2 | To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Level | one-time loading dose | 40 mg/kg |
| Part 1: Dose Escalation: Cohort 2 | To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: MM-121 Dose Level | maintenance dose | 20 mg/kg |
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
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Dose Escalation: Cohort 1 | To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: Paclitaxel Dose Level | 80 mg/m2 |
| Part 1: Dose Escalation: Cohort 2 | To Determine the Maximum Tolerated Dose (MTD) of MM-121 in Combination With Paclitaxel: Paclitaxel Dose Level | 80 mg/m2 |
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
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Dose Escalation: Cohort 1 | Immunogenicity | NA |
| Part 1: Dose Escalation: Cohort 2 | Immunogenicity | NA |
| Part 2: Expansion Cohort 1 | Immunogenicity | NA |
| Part 2: Expansion Cohort 2 | Immunogenicity | NA |
| Part 2: Cohort 3 | Immunogenicity | NA |
| Part 2: Cohort 4 | Immunogenicity | NA |
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.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Part 1: Dose Escalation: Cohort 1 | Pharmacokinetic Parameters (AUClast) | 39252.9 hr* ug/mL | Geometric Coefficient of Variation 40.3 |
| Part 1: Dose Escalation: Cohort 2 | Pharmacokinetic Parameters (AUClast) | 77137.6 hr* ug/mL | Geometric Coefficient of Variation 31.1 |
| Part 2: Expansion Cohort 1 | Pharmacokinetic Parameters (AUClast) | 102263.1 hr* ug/mL | Geometric Coefficient of Variation 35.6 |
| Part 2: Expansion Cohort 2 | Pharmacokinetic Parameters (AUClast) | 96043.0 hr* ug/mL | Geometric Coefficient of Variation 25.9 |
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
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Dose Escalation: Cohort 1 | To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate | 1 participants with objective response |
| Part 1: Dose Escalation: Cohort 2 | To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate | 2 participants with objective response |
| Part 2: Expansion Cohort 1 | To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate | 3 participants with objective response |
| Part 2: Expansion Cohort 2 | To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate | 3 participants with objective response |
| Part 2: Cohort 3 | To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate | 3 participants with objective response |
| Part 2: Cohort 4 | To Characterize the Efficacy of the Combination of MM-121 and Paclitaxel Using Objective Response Rate | 2 participants with objective response |
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.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Part 1: Dose Escalation: Cohort 1 | To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With Paclitaxel | 445.7 ug/mL | Geometric Coefficient of Variation 39.6 |
| Part 1: Dose Escalation: Cohort 2 | To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With Paclitaxel | 903.5 ug/mL | Geometric Coefficient of Variation 31.5 |
| Part 2: Expansion Cohort 1 | To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With Paclitaxel | 1081.1 ug/mL | Geometric Coefficient of Variation 73.1 |
| Part 2: Expansion Cohort 2 | To Determine the Pharmacokinetics (PK) of MM-121 When Administered in Combination With Paclitaxel | 1134.5 ug/mL | Geometric Coefficient of Variation 18.6 |