advanced or recurrent solid tumors or lymphomas
Conditions
Interventions
Patients will receive either CX-072, CX-072 in combination with ipilimumab or
CX-072 in combination with vemurafenib
Substudy:
Patients will receive 89Zr-CX-072 either alone or in combination with u
Sponsors
CytomX Therapeutics
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: All pts must have histologically confirmed diagnosis of metastatic or locally advanced unresectable tumors that progressed or are intolerant to standard therapy. Inclusion criteria for subjects in each specific Part: ;• Part A: any metastatic or advanced unresectable solid tumor or lymphoma, measurable or nonmeasurable disease allowed, no further SOC therapy available; o Immunotherapy naive, including PD-1/PD-L1 and CTLA-4 inhibitor therapy naive (where there is no immunotherapy or PD-1/PD-L1 and CTLA-4 inhibitor therapy available for their specific disease in the country where they are being treated); and o Subjects participating in the imaging substudy must meet both main study and substudy entry criteria to be enrolled in the study; ;• Part A2: any metastatic or advanced unresectable solid tumor or lymphoma (at least 2 subjects in each cohort with thymic epithelial tumor, thymoma, or thymic carcinoma), measurable disease allowed, no further SOC therapy available; o TPS >= 1% membranous staining based on the DAKO PD-L1 IHC 22C3 pharmDx; o Immunotherapy naive, including PD-1/PD-L1 and CTLA-4 inhibitor therapy naive (where there is no immunotherapy or PD-1/PD-L1 and CTLA-4 inhibitor therapy available for their specific disease in the country where they are being treated); and o Agreement to participate in biomarker analysis and have a tumor site that is safe to biopsy; ;• Part B1: any metastatic or advanced unresectable solid tumor or lymphoma (excluding thymic epithelial tumor, thymoma, or thymic carcinoma), measurable or nonmeasurable disease allowed, no further SOC therapy available; o Immunotherapy naive, including PD-1/PD-L1 and CTLA-4 inhibitor therapy naive (where there is no immunotherapy or PD-1/PD-L1 and CTLA-4 inhibitor therapy available for their specific disease in the country where they are being treated); ;• Part B2: any metastatic or advanced unresectable solid tumor or lymphoma (excluding thymic epithelial tumor, thymoma, or thymic carcinoma) with measurable disease allowed, no further SOC therapy available; o Previous treatment with a PD-1/PD-L1 inhibitor; o Discontinued treatment with PD-1/PD-L1 inhibitor for reasons other than toxicity; o Naive to treatment with a CTLA-4 inhibitor; and o Agreement to participate in biomarker analysis and have a tumor site that is safe to biopsy (only in cohorts receiving CX-072 + 3 mg/kg ipilimumab [but not 6 or 10 mg/kg ipilimumab]); ;• Part C: metastatic or advanced unresectable melanoma with BRAF V600E mutation-positive as detected by a diagnostic approved test (in the region where the pt is treated), measurable or nonmeasurable disease allowed; o Naive to treatment with BRAF-inhibitor; and o Immunotherapy naive, including PD-1/PD-L1 and CTLA-4 inhibitor therapy naive ;• Part D: measurable disease is required; * Must be willing to provide a blood sample at Screening for hTMB testing; and * Immunotherapy naive, including PD-1/PD-L1 and CTLA-4 inhibitor therapy naive (where there is no available life-prolonging immunotherapy or PD-1/PD-L1 and CTLA-4 inhibitor therapy to the pt available for their specific disease in the country where they are being treated) of the following tumor types: o UPS; * Metastatic or advanced unresectable UPS; * TPS >= 1% membranous staining or unknown PD-L1 status; and * Subjects must have had SOC surgery and/or radiation for their UPS; subjects with metastatic
Exclusion criteria
Exclusion criteria: 1. Prior therapy with a chimeric antigen receptor (CAR) T-cell containing regimen;;2. Baseline QTc is > 470 ms or taking any medication known to prolong the QT interval; ;3. Prior history of myocarditis irrespective of the cause;;4. Treatment with strong cytochrome P450 (CYP) 3A4 inhibitors or inducers, as well as use of CYP1A2 substrates with a narrow therapeutic window assigned to the vemurafenib treatment arm. http://medicine.iupui.edu/clinpharm/ddis/main-table/; ;5. History of severe allergic or anaphylactic reactions to human mAb therapy or known hypersensitivity to any Probody therapeutic; ;6. Active or history of uveal, mucosal, or ocular melanoma is excluded in Parts B2 and C;;7. History of interstitial lung disease for patients with TET are excluded in Part B1 and B2.;8. Human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS)-related illness, acute or chronic hepatitis B or C; patients with HIV that have an undetectable viral load and a CD4 cell count > 400/mL and who remain on antiretroviral regimen will be eligible for enrollment into anal SCC cohorts in Parts D and E and hTMB cohorts cohorts in Part D; ;9. History of or current active autoimmune diseases, including but not limited to inflammatory bowel diseases, rheumatoid arthritis, autoimmune thyroiditis, autoimmune hepatitis, systemic sclerosis, systemic lupus erythematosus, autoimmune vasculitis, autoimmune neuropathies, type 1 insulin dependent diabetes mellitus or myasthenia gravis. ;10. History of syndrome or medical condition(s) that requires systemic steroids (> 10 mg daily prednisone equivalents) or immunosuppressive medications; ;11. History of allogeneic tissue/solid organ transplant, prior stem cell or bone marrow transplant; ;12. Chemotherapy, biochemotherapy, radiation or immunotherapy within 14 days prior to receiving study drug; radiation therapy within 3 months prior to receiving study medication (except for radiotherapy for the purposes of palliation confined to a single field that is not the target lesion). ;13. Patients in Part C cannot have a glomerular filtration rate 1 (or baseline, whichever is greater) from prior anti-cancer therapy. Alopecia and other nonacute toxicities are acceptable; ;16. History of malignancy that is active within the previous 2 years except for localized cancers that are not related to the current cancer being treated and considered to have been cured and, in the opinion of the Investigator, present a low risk for recurrence. These exceptions include, but are not limited to, basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the prostate, cervix or breast; ;17. Received a live vaccine within 30 days prior to first dose of study drug;;18. Known pre-existing condition of age-related macular degeneration;;19. Intercurrent illness, including, but not limited to, symptomatic congestive heart failure (i.e., New York Heart Association Class III or IV), unstable angina pectoris, clinically significant and uncontrolled cardiac arrhythmia, nonhealing wound or ulcer, or psychiatric illness/social situations that would limit compliance with study requireme
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Evaluate the safety and tolerability of multiple doses of CX-072, administered as monotherapy or in combination with ipilimumab or vemurafenib to subjects with metastatic or locally advanced unresectable solid tumors or lymphomas. 2. Determine the maximum tolerated dose (MTD) and dose limiting toxicities (DLTs) of: • CX-072 as a monotherapy administered to PD-1/PD-L1 naïve subjects, • CX-072 in combination with ipilimumab (concomitant schedule) administered to PD-1/PD-L1 and CTLA-4 inhibitor naïve subjects, • CX-072 in combination with ipilimumab (phased schedule) administered to subjects that have had prior treatment with a PD-1/PD-L1 inhibitor, and • CX-072 in combination with vemurafenib administered to PD-1/PD-L1 naïve subjects. Substudy: Whole body 89Zr-CX-072 distribution | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Obtain preliminary evidence of anti-cancer activity on the basis of objective responses in subjects treated with CX-072 as monotherapy or when administered in combination with ipilimumab or vemurafenib: • Objective response rate by the Response Evaluation Criteria in Solid Tumors (RECIST 1.1 and irRECIST), • Objective response rate by modified immune-related response criteria as defined in the Common Core Document or Modified Cheson/Lugano Classification for Lymphomas, • Time to response (TTR) • Duration of response (DOR) • Progression-free survival (PFS) Obtain preliminary evidence of anti-cancer activity on the basis of objective responses in subjects treated with CX-072 as monotherapy in advanced or metastatic gastric and undifferentiated pleomorphic sarcoma (UPS) tumors 2. Characterize the incidence of anti-drug antibodies (ADA) against CX-072 and ipilimumab 3. Characterize the single and multi-dose pharmacokinetic profile of CX-072 when administered alone, and CX-072, ipilimumab, and vemurafenib when administered in combination 4. Assess overall survival (OS) in subjects receiving CX-072 Substudy: Tumor and immune cell PD-1 and PD-L1 expression analysis in a fresh baseline biopsy, correlated to 89Zr-CX-072 tumor uptake | — |
Countries
Netherlands
Outcome results
None listed