Small Cell Lung Cancer
Conditions
Keywords
Small Cell Lung Cancer, SCLC, Lung Cancer, AMG 757, AMG 404, Tarlatamab
Brief summary
The main purpose of this study is to evaluate the safety, tolerability, and recommended phase 2 target dose of tarlatamab in combination with AMG 404.
Interventions
Tarlatamab will be administered as an intravenous (IV) infusion.
AMG 404 will be administered as an intravenous (IV) infusion.
Sponsors
Study design
Eligibility
Inclusion criteria
* Participant has provided informed consent/assent prior to initiation of any study specific activities/procedures * Age greater than or equal to 18 years old at the same time of signing the informed consent * Participants with histologically or cytologically confirmed Small Cell Lung Cancer (SCLC) who progressed or recurred following at least 1 platinum-based regimen * Eastern Cooperative Oncology Group (ECOG) 0 to 1 * Participants with treated brain metastases are eligible provided they meet defined criteria * Adequate organ function as defined in protocol
Exclusion criteria
* History of other malignancy within the past 2 years with exceptions * Major surgery within 28 days of first dose of tarlatamab * Untreated or symptomatic brain metastases and leptomeningeal disease * Prior anti-cancer therapy, including anti-PD1 or anti-PDL1 antibody therapy: at least 28 days must have elapsed between any prior anti-cancer therapy and the first planned dose of tarlatamab Exceptions: * Participants who received prior chemotherapy must have completed at least 14 days before the first dose of tarlatamab and all treatment-related toxicity resolved to grade ≤ 1. * Participants who received prior palliative radiotherapy must have completed at least 7 days before the first dose of tarlatamab * Participants who received prior tarlatamab therapy or prior delta-like ligand 3 (DLL3) x cluster of differentiation 3 (CD3) bispecific therapy are not eligible * Participants who experienced recurrent grade 2 pneumonitis or severe or life-threatening immune-mediated adverse events or infusion-related reactions including those that lead to permanent discontinuation while on treatment with immuno-oncology agents * History of any immune-related colitis. Infectious colitis is allowed if evidence of adequate treatment and clinical recovery exists and at least 3 months interval observed since diagnosis of colitis * Participants with evidence of interstitial lung disease or active, non-infectious pneumonitis * Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of tarlatamab * History of solid organ transplantation * History of hypophysitis or pituitary dysfunction * Active autoimmune disease that has required systemic treatment (except replacement therapy) within the past 2 years or any other diseases requiring immunosuppressive therapy while on study. Participants with Type I diabetes, vitiligo, psoriasis, hypo- or hyper-thyroid disease not requiring immunosuppressive treatment are permitted
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Part 1: Number of Participants Who Experienced Dose-limiting Toxicity (DLT) | First dose of tarlatamab up to 28 days | A DLT was any of the following during the DLT window, assessed by Common Terminology Criteria for Adverse Events v4.0: * Grade 3 adverse event (AE) except for fatigue lasting \< 7 days, Grade 3 nonfebrile neutropenia that improved to ≤ Grade 1 within 3 weeks, endocrinopathies if managed with replacement therapy, Grade 3 nausea/vomiting or diarrhea for \< 72 hours, Grade 3 amylase or lipase values not associated with pancreatitis, Grade 3 hematologic laboratory abnormalities not clinically relevant, or Grade 3 electrolyte abnormality up to 72 hours. * Grade 4 AE except for Grade 4 nonfebrile neutropenia lasting ≤ 7 days, Grade 4 electrolyte abnormality lasting up to 72 hours, Grade 4 amylase or lipase values not associated with pancreatitis, or Grade 4 hematologic laboratory abnormalities no clinically relevant. * Grade 5 AE * Recurrent Grade ≥ 2 pneumonitis * Any other toxicity requiring permanent discontinuation of AMG 404. |
| Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any TEAEs: From first IP dose up to last dose + 65 days or EOS, median duration was 4.2 months; TEAEs for EP: From last dose + 65 days up to snapshot date (15 November 2024), death, or last dose + 145 days or EOS, median duration was 2.6 months | An AE was defined as any untoward medical occurrence in a clinical trial participant. A TEAE was an AE that started on or after the first dose of investigational product (IP; tarlatamab) up to 65 days after the last dose of tarlatamab or AMG 404 or the end of study (EOS), whichever was earlier. A TEAE for the EP was an AE that occurred after the 65th day after the last dose of tarlatamab or AMG 404 up to 145 days after the last dose of tarlatamab or AMG 404 or end of study, whichever was later. A treatment-related AE was any TEAE where there was a reasonable possibility that the TEAE could have been caused by tarlatamab or AMG 404. Any clinically significant changes in vital signs, physical examinations, electrocardiograms, and clinical laboratory tests were included as TEAEs. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disease Control Rate Per Modified RECIST v1.1 | From first dose of IP up to a minimum of last dose date + 65 days or EOS; median (min, max) duration was 4.2 (0.4, 25.4) months | The disease control rate was defined as the percentage of participants with a best overall response of a confirmed response (CR/PR) or stable disease (SD) while on the study as defined by modified RECIST v1.1. CR: complete disappearance of all lesions and pathologic lymph nodes reduced in short axis to \< 10 mm. PR: decrease in tumor burden of ≥ 30% relative to baseline, or complete disappearance of all index lesions with the presence of non-index lesions. Confirmation scans were required within 4 weeks of the first documented response of CR or PR SD: Index lesions not meeting the criteria for CR, PR, or PD or the persistence of one or more non-index lesions. Exact 95% CIs were calculated using the Clopper-Pearson method. |
| Progression-free Survival Per Modified RECIST v1.1 | From first dose of IP up to a minimum of EOS or death; median (min, max) time was 9.4 (0.4, 25.5) months | Progression-free survival was defined as the interval from the earlier date of the first dose of IP to the earlier of PD per modified RECIST v1.1 or death due to any cause, estimated via Kaplan-Meier methods. PD: radiologic detection of ≥ 20% increase in tumor burden to nadir and ≥ 5 mm absolute increase, or unequivocal progression of non-index lesions, or the presence of new lesions. Confirmation scans were required within 4 weeks of the first documented response of CR or PR, and 4-6 weeks for PD. 95% CIs were calculated using the Brookmeyer and Crowley method. |
| Overall Survival | From first dose of IP up to a minimum of EOS or death; median (min, max) time was 9.4 (0.4, 25.5) months | Overall survival was defined as the interval from the earlier date of the first dose of IP to the event of death due to any cause, estimated via Kaplan-Meier methods. Participants who were still alive were censored at the date last known to be alive. If the date last known to be alive was after the data cutoff date, the participant was censored at the analysis trigger date. 95% CIs were calculated using the Brookmeyer and Crowley method. |
| Objective Response Rate Per Modified Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 | From first dose of IP up to a minimum of last dose date + 65 days or EOS; median (min, max) duration was 4.2 (0.4, 25.4) months | The objective response rate was defined as the percentage of participants with a confirmed best overall response of complete response (CR) or partial response (PR) based on the modified RECIST v1.1. CR: complete disappearance of all lesions and pathologic lymph nodes reduced in short axis to \< 10 mm. PR: decrease in tumor burden of ≥ 30% relative to baseline, or complete disappearance of all index lesions with the presence of non-index lesions. Confirmation scans were required within 4 weeks of the first documented response of CR or PR. Exact 95% confidence intervals (CIs) were calculated using the Clopper-Pearson method. |
| Trough Concentration (Ctrough) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 15 (pre-dose) | Ctrough was obtained at the end of a dosing interval or just before the administration of the next planned dose using noncompartmental analysis, which was performed for tarlatamab PK parameter estimation. PK analysis is presented per dose received as pre-specified. |
| Area Under the Concentration-time Curve From Time 0 to 336 Hours (AUC0-336) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 1 (pre-dose up to 7 days post-dose); Cycle 2 Day 15 (pre-dose up to 14 days post-dose) | AUC0-336 was defined as the actual body exposure to the drug over time following administration of a dose, calculated from time zero to 336 hours post-dose using noncompartmental analysis, which was performed for tarlatamab PK parameter estimation. PK analysis is presented per dose received as pre-specified. |
| Maximum Observed Concentration (Cmax) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 1 (pre-dose up to 7 days post-dose); Cycle 2 Day 15 (pre-dose up to 14 days post-dose) | Cmax was obtained using noncompartmental analysis, which was performed for tarlatamab PK parameter estimation. PK analysis is presented per dose received as pre-specified. |
| Duration of Response Per Modified RECIST v1.1 | From first dose of IP up to a minimum of last dose date + 65 days or EOS; median (min, max) duration was 4.2 (0.4, 25.4) months | The duration of response was defined as the time from first evidence of CR or PR to progressive disease (PD) or death due to any cause, whichever occurred first, estimated via Kaplan-Meier methods. CR: complete disappearance of all lesions and pathologic lymph nodes reduced in short axis to \< 10 mm. PR: decrease in tumor burden of ≥ 30% relative to baseline, or complete disappearance of all index lesions with the presence of non-index lesions. Confirmation scans were required within 4 weeks of the first documented response of CR or PR. PD: radiologic detection of ≥ 20% increase in tumor burden relative to nadir and ≥ 5 mm absolute increase, or unequivocal progression of non-index lesions, or presence of new lesions. 95% CIs were calculated using the Brookmeyer and Crowley method. |
Countries
Austria, Belgium, Japan, Singapore, Taiwan, United States
Participant flow
Recruitment details
Participants were enrolled at 10 research centers in Belgium, Japan, Singapore, Taiwan, and the United States between 27 September 2021 and 11 September 2024. The final analysis data is presented.
Pre-assignment details
Adults with confirmed diagnosis of small cell lung cancer who progressed or recurred following ≥1 platinum-based treatment regimen were enrolled into sequential dose-exploration (Part 1) and dose-expansion (Part 2) cohorts to receive tarlatamab + AMG 404. Tarlatamab doses ranged from Dose A to Dose D (lowest to highest). The primary outcome measures have been updated, as 1 participant was found post-database lock to have been misclassified in Part 1 (Cohort 3) instead of Part 2.
Participants by arm
| Arm | Count |
|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 Participants received tarlatamab administered IV with 1-step dosing: Dose A on cycle 1 day 1 followed by Dose B on cycle 1 day 8 and cycle 1 day 15, and Dose B Q2W thereafter. Each cycle was 28 days.
Participants also received a fixed dose short-term infusion of AMG 404 every 28 days. | 7 |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 Participants received tarlatamab administered IV with 1-step dosing: Dose A on cycle 1 day 1 followed by Dose C on cycle 1 day 8 and cycle 1 day 15, and Dose C Q2W thereafter. Each cycle was 28 days.
Participants also received a fixed dose short-term infusion of AMG 404 every 28 days. | 5 |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 Participants received tarlatamab administered IV with 1-step dosing: Dose A on cycle 1 day 1 followed by Dose D on cycle 1 day 8 and cycle 1 day 15, and Dose D Q2W thereafter. Each cycle was 28 days.
Participants also received a fixed dose short-term infusion of AMG 404 every 28 days. | 3 |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 Participants received tarlatamab administered IV with 1-step dosing: Dose A on cycle 1 day 1 followed by Dose B on cycle 1 day 8 and cycle 1 day 15, and Dose B Q2W thereafter. Each cycle was 28 days.
Participants also received a fixed dose short-term infusion of AMG 404 every 28 days. | 8 |
| Total | 23 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Overall Study | Death | 2 | 1 | 2 | 2 |
| Overall Study | Decision by sponsor | 1 | 1 | 0 | 0 |
| Overall Study | Lost to Follow-up | 1 | 1 | 0 | 0 |
| Overall Study | Withdrawal by Subject | 0 | 2 | 0 | 3 |
Baseline characteristics
| Characteristic | Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Total |
|---|---|---|---|---|---|
| Age, Continuous | 65.3 years STANDARD_DEVIATION 5.9 | 60.4 years STANDARD_DEVIATION 12.7 | 59.3 years STANDARD_DEVIATION 18.4 | 55.9 years STANDARD_DEVIATION 12.6 | 60.2 years STANDARD_DEVIATION 11.6 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 6 Participants | 4 Participants | 1 Participants | 4 Participants | 15 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 1 Participants | 1 Participants | 2 Participants | 4 Participants | 8 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 1 Participants | 2 Participants | 4 Participants | 8 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 6 Participants | 4 Participants | 1 Participants | 4 Participants | 15 Participants |
| Sex: Female, Male Female | 3 Participants | 3 Participants | 1 Participants | 5 Participants | 12 Participants |
| Sex: Female, Male Male | 4 Participants | 2 Participants | 2 Participants | 3 Participants | 11 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk |
|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 1 / 7 | 1 / 6 | 1 / 5 | 0 / 1 | 1 / 3 | 1 / 1 | 2 / 4 | 0 / 8 |
| other Total, other adverse events | 7 / 7 | 1 / 6 | 5 / 5 | 0 / 1 | 2 / 3 | 0 / 1 | 1 / 4 | 8 / 8 |
| serious Total, serious adverse events | 5 / 7 | 1 / 6 | 3 / 5 | 0 / 1 | 2 / 3 | 1 / 1 | 0 / 4 | 5 / 8 |
Outcome results
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
An AE was defined as any untoward medical occurrence in a clinical trial participant. A TEAE was an AE that started on or after the first dose of investigational product (IP; tarlatamab) up to 65 days after the last dose of tarlatamab or AMG 404 or the end of study (EOS), whichever was earlier. A TEAE for the EP was an AE that occurred after the 65th day after the last dose of tarlatamab or AMG 404 up to 145 days after the last dose of tarlatamab or AMG 404 or end of study, whichever was later. A treatment-related AE was any TEAE where there was a reasonable possibility that the TEAE could have been caused by tarlatamab or AMG 404. Any clinically significant changes in vital signs, physical examinations, electrocardiograms, and clinical laboratory tests were included as TEAEs.
Time frame: Any TEAEs: From first IP dose up to last dose + 65 days or EOS, median duration was 4.2 months; TEAEs for EP: From last dose + 65 days up to snapshot date (15 November 2024), death, or last dose + 145 days or EOS, median duration was 2.6 months
Population: The safety analysis set included all participants who received at least 1 dose of tarlatamab or AMG 404. For any TEAEs, categories included those that occurred before or during the EP. For the EP, data are presented for participants who entered the EP. Participants with snapshot date (15 November 2024) or death or EOS within the last dose date + 65 days were excluded from the EP.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any tarlatamab-related TEAE | 1 Participants |
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any TEAE | 2 Participants |
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any TEAE | 7 Participants |
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any AMG 404-related TEAE | 6 Participants |
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any tarlatamab-related TEAE | 6 Participants |
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any AMG 404-related TEAE | 1 Participants |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any tarlatamab-related TEAE | 0 Participants |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any AMG 404-related TEAE | 4 Participants |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any TEAE | 0 Participants |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any tarlatamab-related TEAE | 5 Participants |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any AMG 404-related TEAE | 0 Participants |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any TEAE | 5 Participants |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any AMG 404-related TEAE | 1 Participants |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any tarlatamab-related TEAE | 0 Participants |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any tarlatamab-related TEAE | 3 Participants |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any TEAE | 1 Participants |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any AMG 404-related TEAE | 0 Participants |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any TEAE | 3 Participants |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any AMG 404-related TEAE | 6 Participants |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any tarlatamab-related TEAE | 0 Participants |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any TEAE | 8 Participants |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any AMG 404-related TEAE | 0 Participants |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | Any tarlatamab-related TEAE | 8 Participants |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | EP: Any TEAE | 1 Participants |
Part 1: Number of Participants Who Experienced Dose-limiting Toxicity (DLT)
A DLT was any of the following during the DLT window, assessed by Common Terminology Criteria for Adverse Events v4.0: * Grade 3 adverse event (AE) except for fatigue lasting \< 7 days, Grade 3 nonfebrile neutropenia that improved to ≤ Grade 1 within 3 weeks, endocrinopathies if managed with replacement therapy, Grade 3 nausea/vomiting or diarrhea for \< 72 hours, Grade 3 amylase or lipase values not associated with pancreatitis, Grade 3 hematologic laboratory abnormalities not clinically relevant, or Grade 3 electrolyte abnormality up to 72 hours. * Grade 4 AE except for Grade 4 nonfebrile neutropenia lasting ≤ 7 days, Grade 4 electrolyte abnormality lasting up to 72 hours, Grade 4 amylase or lipase values not associated with pancreatitis, or Grade 4 hematologic laboratory abnormalities no clinically relevant. * Grade 5 AE * Recurrent Grade ≥ 2 pneumonitis * Any other toxicity requiring permanent discontinuation of AMG 404.
Time frame: First dose of tarlatamab up to 28 days
Population: The DLT analysis set included all enrolled participants who received at least 1 dose of tarlatamab or AMG 404 during the dose exploration part of the study with an evaluable DLT endpoint. DLT evaluable endpoints included: 1. participant experienced a DLT; or 2. participant did not experience a DLT and received tarlatamab or AMG 404 treatment as planned in cycle 1 and had been followed for safety events a minimum of 28 days from the date of first dose administration of tarlatamab.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Part 1: Number of Participants Who Experienced Dose-limiting Toxicity (DLT) | 0 Participants |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Part 1: Number of Participants Who Experienced Dose-limiting Toxicity (DLT) | 1 Participants |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Part 1: Number of Participants Who Experienced Dose-limiting Toxicity (DLT) | 1 Participants |
Area Under the Concentration-time Curve From Time 0 to 336 Hours (AUC0-336) of Tarlatamab in Combination With AMG 404
AUC0-336 was defined as the actual body exposure to the drug over time following administration of a dose, calculated from time zero to 336 hours post-dose using noncompartmental analysis, which was performed for tarlatamab PK parameter estimation. PK analysis is presented per dose received as pre-specified.
Time frame: Cycle 2 Day 1 (pre-dose up to 7 days post-dose); Cycle 2 Day 15 (pre-dose up to 14 days post-dose)
Population: PK analysis set included all participant who had received at least 1 dose of tarlatamab and had at least 1 PK sample collected. Participants with data available at each timepoint are presented.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Area Under the Concentration-time Curve From Time 0 to 336 Hours (AUC0-336) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 1 | 378 hours*micrograms per milliliter | Geometric Coefficient of Variation 39 |
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Area Under the Concentration-time Curve From Time 0 to 336 Hours (AUC0-336) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 15 | 336 hours*micrograms per milliliter | Geometric Coefficient of Variation 37 |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Area Under the Concentration-time Curve From Time 0 to 336 Hours (AUC0-336) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 1 | 1060 hours*micrograms per milliliter | Geometric Coefficient of Variation 31 |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Area Under the Concentration-time Curve From Time 0 to 336 Hours (AUC0-336) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 15 | 621 hours*micrograms per milliliter | Geometric Coefficient of Variation 72 |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Area Under the Concentration-time Curve From Time 0 to 336 Hours (AUC0-336) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 1 | 4180 hours*micrograms per milliliter | — |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Area Under the Concentration-time Curve From Time 0 to 336 Hours (AUC0-336) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 15 | 3950 hours*micrograms per milliliter | — |
Disease Control Rate Per Modified RECIST v1.1
The disease control rate was defined as the percentage of participants with a best overall response of a confirmed response (CR/PR) or stable disease (SD) while on the study as defined by modified RECIST v1.1. CR: complete disappearance of all lesions and pathologic lymph nodes reduced in short axis to \< 10 mm. PR: decrease in tumor burden of ≥ 30% relative to baseline, or complete disappearance of all index lesions with the presence of non-index lesions. Confirmation scans were required within 4 weeks of the first documented response of CR or PR SD: Index lesions not meeting the criteria for CR, PR, or PD or the persistence of one or more non-index lesions. Exact 95% CIs were calculated using the Clopper-Pearson method.
Time frame: From first dose of IP up to a minimum of last dose date + 65 days or EOS; median (min, max) duration was 4.2 (0.4, 25.4) months
Population: The safety analysis set included all participants who received at least 1 dose of IP (tarlatamab or AMG 404).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Disease Control Rate Per Modified RECIST v1.1 | 57.1 percentage of participants |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Disease Control Rate Per Modified RECIST v1.1 | 60.0 percentage of participants |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Disease Control Rate Per Modified RECIST v1.1 | 66.7 percentage of participants |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Disease Control Rate Per Modified RECIST v1.1 | 50.0 percentage of participants |
Duration of Response Per Modified RECIST v1.1
The duration of response was defined as the time from first evidence of CR or PR to progressive disease (PD) or death due to any cause, whichever occurred first, estimated via Kaplan-Meier methods. CR: complete disappearance of all lesions and pathologic lymph nodes reduced in short axis to \< 10 mm. PR: decrease in tumor burden of ≥ 30% relative to baseline, or complete disappearance of all index lesions with the presence of non-index lesions. Confirmation scans were required within 4 weeks of the first documented response of CR or PR. PD: radiologic detection of ≥ 20% increase in tumor burden relative to nadir and ≥ 5 mm absolute increase, or unequivocal progression of non-index lesions, or presence of new lesions. 95% CIs were calculated using the Brookmeyer and Crowley method.
Time frame: From first dose of IP up to a minimum of last dose date + 65 days or EOS; median (min, max) duration was 4.2 (0.4, 25.4) months
Population: The safety analysis set included all participants who received at least 1 dose of IP (tarlatamab or AMG 404). Data is presented for participants who achieved a best overall response of PR or CR.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Duration of Response Per Modified RECIST v1.1 | NA months |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Duration of Response Per Modified RECIST v1.1 | 6.0 months |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Duration of Response Per Modified RECIST v1.1 | 8.1 months |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Duration of Response Per Modified RECIST v1.1 | 11.2 months |
Maximum Observed Concentration (Cmax) of Tarlatamab in Combination With AMG 404
Cmax was obtained using noncompartmental analysis, which was performed for tarlatamab PK parameter estimation. PK analysis is presented per dose received as pre-specified.
Time frame: Cycle 2 Day 1 (pre-dose up to 7 days post-dose); Cycle 2 Day 15 (pre-dose up to 14 days post-dose)
Population: The pharmacokinetic (PK) analysis set included all participant who had received at least 1 dose of tarlatamab and had at least 1 PK sample collected. Participants with data available at each timepoint are presented.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Maximum Observed Concentration (Cmax) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 1 | 2.98 micrograms per milliliter | Geometric Coefficient of Variation 37 |
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Maximum Observed Concentration (Cmax) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 15 | 3.29 micrograms per milliliter | Geometric Coefficient of Variation 40 |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Maximum Observed Concentration (Cmax) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 1 | 8.12 micrograms per milliliter | Geometric Coefficient of Variation 28 |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Maximum Observed Concentration (Cmax) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 15 | 5.54 micrograms per milliliter | Geometric Coefficient of Variation 64 |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Maximum Observed Concentration (Cmax) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 1 | 28.1 micrograms per milliliter | — |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Maximum Observed Concentration (Cmax) of Tarlatamab in Combination With AMG 404 | Cycle 2 Day 15 | 21.2 micrograms per milliliter | — |
Objective Response Rate Per Modified Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
The objective response rate was defined as the percentage of participants with a confirmed best overall response of complete response (CR) or partial response (PR) based on the modified RECIST v1.1. CR: complete disappearance of all lesions and pathologic lymph nodes reduced in short axis to \< 10 mm. PR: decrease in tumor burden of ≥ 30% relative to baseline, or complete disappearance of all index lesions with the presence of non-index lesions. Confirmation scans were required within 4 weeks of the first documented response of CR or PR. Exact 95% confidence intervals (CIs) were calculated using the Clopper-Pearson method.
Time frame: From first dose of IP up to a minimum of last dose date + 65 days or EOS; median (min, max) duration was 4.2 (0.4, 25.4) months
Population: The safety analysis set included all participants who received at least 1 dose of IP (tarlatamab or AMG 404).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Objective Response Rate Per Modified Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 | 57.1 percentage of participants |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Objective Response Rate Per Modified Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 | 20.0 percentage of participants |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Objective Response Rate Per Modified Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 | 66.7 percentage of participants |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Objective Response Rate Per Modified Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 | 37.5 percentage of participants |
Overall Survival
Overall survival was defined as the interval from the earlier date of the first dose of IP to the event of death due to any cause, estimated via Kaplan-Meier methods. Participants who were still alive were censored at the date last known to be alive. If the date last known to be alive was after the data cutoff date, the participant was censored at the analysis trigger date. 95% CIs were calculated using the Brookmeyer and Crowley method.
Time frame: From first dose of IP up to a minimum of EOS or death; median (min, max) time was 9.4 (0.4, 25.5) months
Population: The safety analysis set included all participants who received at least 1 dose of IP (tarlatamab or AMG 404).
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Overall Survival | NA months |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Overall Survival | NA months |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Overall Survival | 6.5 months |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Overall Survival | NA months |
Progression-free Survival Per Modified RECIST v1.1
Progression-free survival was defined as the interval from the earlier date of the first dose of IP to the earlier of PD per modified RECIST v1.1 or death due to any cause, estimated via Kaplan-Meier methods. PD: radiologic detection of ≥ 20% increase in tumor burden to nadir and ≥ 5 mm absolute increase, or unequivocal progression of non-index lesions, or the presence of new lesions. Confirmation scans were required within 4 weeks of the first documented response of CR or PR, and 4-6 weeks for PD. 95% CIs were calculated using the Brookmeyer and Crowley method.
Time frame: From first dose of IP up to a minimum of EOS or death; median (min, max) time was 9.4 (0.4, 25.5) months
Population: The safety analysis set included all participants who received at least 1 dose of IP (tarlatamab or AMG 404).
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Progression-free Survival Per Modified RECIST v1.1 | 6.5 months |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Progression-free Survival Per Modified RECIST v1.1 | 3.8 months |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Progression-free Survival Per Modified RECIST v1.1 | 6.5 months |
| Part 2 Dose Expansion Cohort: Tarlatamab Dose A/Dose B + AMG 404 | Progression-free Survival Per Modified RECIST v1.1 | 7.4 months |
Trough Concentration (Ctrough) of Tarlatamab in Combination With AMG 404
Ctrough was obtained at the end of a dosing interval or just before the administration of the next planned dose using noncompartmental analysis, which was performed for tarlatamab PK parameter estimation. PK analysis is presented per dose received as pre-specified.
Time frame: Cycle 2 Day 15 (pre-dose)
Population: PK analysis set included all participant who had received at least 1 dose of tarlatamab and had at least 1 PK sample collected. Participants with data available are presented.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Part 1 Cohort 1: Tarlatamab Dose A/Dose B + AMG 404 | Trough Concentration (Ctrough) of Tarlatamab in Combination With AMG 404 | 0.380 micrograms per milliliter | Geometric Coefficient of Variation 27 |
| Part 1 Cohort 2: Tarlatamab Dose A/Dose C + AMG 404 | Trough Concentration (Ctrough) of Tarlatamab in Combination With AMG 404 | 0.893 micrograms per milliliter | Geometric Coefficient of Variation 37 |
| Part 1 Cohort 3: Tarlatamab Dose A/Dose D + AMG 404 | Trough Concentration (Ctrough) of Tarlatamab in Combination With AMG 404 | 6.59 micrograms per milliliter | — |