A First-in-Human Study of CAN04 in Patients With Solid Malignant Tumors (CANFOUR)
An Open Label, Dose Escalation Followed by Dose Expansion, Safety and Tolerability Trial of CAN04, a Fully Humanized Monoclonal Antibody Against IL1RAP, in Subjects With Solid Malignant Tumors
This study will evaluate the safety, tolerability, and preliminary antitumor activity of CAN04 both as a monotherapy and in combination with standard of care treatment in subjects with solid cancer tumors.
Following completion of the first part, the dose escalation cohorts, and determination of maximum tolerated dose or recommended phase 2 dose (MTD/RP2D), safety and tolerability will be further evaluated in an expanded cohort of subjects with pancreatic or lung cancer, as monotherapy or in combination with the standard of care treatment and to identify the RP2D of CAN04 in combination with standard of care. In addition, early signs of efficacy during treatment with CAN04 will be investigated.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
CAN04 is a first-in-class fully humanized and ADCC enhanced monoclonal antibody, targeting the Interleukin 1 Receptor Accessory Protein (IL1RAP).
The CAN04 strategy is to attack the IL1RAP target molecule using an effective antibody-based cancer treatment. In preclinical (in vitro and in vivo) studies, CAN04 has shown two distinct mechanisms of action:
- By blocking the intracellular signals from the IL1RAP target molecule, thereby impairing the cancer cells' ability to secrete tumor stimulating cytokines, in turn reducing tumor inflammation and tumor progression.
- Through antibody dependent cellular cytotoxicity (ADCC) against IL1RAP expressing tumor cells where CAN04 stimulates natural killer (NK) cells to attack the tumor cells.
The study is a combined phase 1/2a, open-label, dose-escalation followed by dose expansion, safety and tolerability clinical trial, in patients with relapsed or refractory solid tumors. It consists of two parts.
In Part I (Dose Escalation - DE), the intention is to include patients with any of the four solid tumor types: Non-Small Cell Lung Cancer (NSCLC), Pancreatic Ductal Adenocarcinoma (PDAC), Triple Negative Breast Cancer (TNBC) or Colorectal Cancer (CRC). In this part of the study safety and tolerability will be documented and the MTD/ RP2D will be determined. Patients will stay on CAN04 treatment until disease progression, unacceptable toxicity, or discontinuation for any other reason. [Completed December 2018]
In Part II (Expansion Cohort - EC), safety and tolerability will be further evaluated in an expanded cohort of subjects with PDAC or NSCLC to identify RP2D of CAN04 in combination with standard of care. In addition, early signs of efficacy during treatment with CAN04 will be investigated, as monotherapy or in combination with the standard of care.
Patients will stay on treatment until disease progression, unacceptable toxicity, or discontinuation for any other reason. [Enrollment to all arms completed]
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Ignacio Garcia-Ribas, MD, PhD
- Phone Number: +46 46 2756260
- Email: clinicaltrials@cantargia.com
Study Contact Backup
- Name: Susanne Magnusson, PhD
- Email: clinicaltrials@cantargia.com
Study Locations
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Salzburg, Austria, 5020
- Landeskrankenhaus Salzburg
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Vienna, Austria, A-1090
- Medizinische Universitat Wien
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Brussels, Belgium, 1000
- Institut Jules Bordet
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Leuven, Belgium, 3000
- University Hospital Gasthuisberg
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Liège, Belgium, B-4000
- CHU de Liège
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Aalborg, Denmark, 9000
- Aalborg University Hospital
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Copenhagen, Denmark, 2100
- Rigshospitalet, Department of Oncology
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Herlev, Denmark, 2730
- Herlev og Gentofte Hospital
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Odense, Denmark, 5000
- Odense University Hospital
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Tallinn, Estonia, 11312
- East Tallinn Central Hospital
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Tartu, Estonia, 50406
- Tartu University Hospital
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Berlin, Germany, 10117
- Charité Universitätsmedizin Berlin
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Hamburg, Germany, 227 63
- Asklepios Klinik Altona
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Ulm, Germany, 89081
- Universitatsklinikum Ulm
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Riga, Latvia, 1002
- Pauls Stradins Clinical University Hospital
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Riga, Latvia, 1079
- Riga East Clinical University Hospital
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Kaunas, Lithuania, 50161
- The Hospital of Lithuanian University of Health Sciences
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Vilnius, Lithuania, 08660
- National Cancer Institute
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Amsterdam, Netherlands, 1066 CX
- Netherlands Cancer Institute
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Rotterdam, Netherlands, 3015 CE
- Erasmus University Medical Center, Department of Medical Oncology
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Oslo, Norway, 0379
- Oslo University Hospital, Radiumhospitalet
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Madrid, Spain, 28041
- Hospital 12 de Octubre
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Madrid, Spain, 28223
- Hospital Universitario Quirónsalud Madrid
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Oviedo, Spain, 33011
- Hospital Universitario Central de Asturias
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Stockholm, Sweden, 171 64
- Karolinska University Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 year.
- Measurable disease in accordance to iRECIST by computed tomography (CT) or magnetic resonance imaging (MRI) scan, no more than 6 weeks prior to screening.
- At least 4 weeks since the last dose of radiation therapy, immunotherapy, or surgery; at least 6 weeks for therapy which is known to have delayed toxicity; at least 4 weeks since treatment with biologic/targeted therapies.
- Eastern Cooperative Oncology Group (ECOG) performance status ≤1.
Histologically or cytologically confirmed diagnosis of unresectable stage III or stage IV squamous or non-squamous NSCLC (applicable Part II, Combination - NSCLC (NCG) arm only).
- Subjects must be eligible to receive first line standard chemotherapy regimen with cisplatin/gemcitabine or a second line standard chemotherapy regimen with cisplatin/gemcitabine after relapsing from first line with pembrolizumab monotherapy.
- Subjects with actionable mutations (EGFR, ALK, ROS) can be enrolled if they have previously progressed to all approved standard of care targeted therapies and the next line of standard therapy is a platinum doublet.
Histologically or cytologically confirmed diagnosis of unresectable stage III or stage IV non-squamous NSCLC (applicable Part II, Combination - non-squamous NSCLC NCP arm only).
- Subjects must be eligible to receive first line standard chemotherapy regimen with carboplatin/pemetrexed or a second line standard chemotherapy regimen with carboplatin/pemetrexed after relapsing from first line with pembrolizumab monotherapy.
- Subjects with actionable mutations (EGFR, ALK, ROS) can be enrolled if they have previously progressed to all approved standard of care targeted therapies and the next line of standard therapy is a platinum doublet.
Newly diagnosed, treatment naїve, histologically confirmed, unresectable, locally advanced or metastatic (stage III or stage IV) PDAC (applicable Part II, Combination - PDAC arms only).
- Subjects must be eligible to receive treatment with nab-paclitaxel and gemcitabine.
Exclusion Criteria:
- Subjects receiving live vaccination, etanercept or other TNF-α inhibitors or any other investigational agents during or just prior to (within 28 days of first study drug administration) participation in this study.
- Clinical evidence of an active metastatic second malignancy.
- Subjects with a life expectancy <12 weeks.
- Uncontrolled or significant cardiovascular disease defined as New York Heart Association Classification III, or IV.
- Immunocompromised subject currently receiving systemic therapy.
- Other medical conditions that in the opinion of the investigator disqualify the subject for inclusion.
Applicable Part II, Combination - NSCLC (NCG and NCP) arms only
- Prior lines of treatment with anti-cancer medication other than pembrolizumab administered as 1st line.
- Known tumor EGFR mutation, unless contraindication to EGFR-directed therapy or if the subject has progressed to all approved anti-EGFR therapies.
- Known tumor ALK rearrangements, unless contraindication to ALK-directed therapy or ALK-directed therapy not available or if the subject has progressed to all approved anti-EGFR therapies.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Dose escalation
Cohorts of 3 subjects will receive once weekly (Q1W) treatment with CAN04.
The Dose Limiting Toxicity (DLT) observation period for each dose level will be the first 21 days of treatment with CAN04.
[Completed December 2018]
|
A fully humanized monoclonal immunoglobulin G1 (IgG1) antibody (hmAb) in aqueous solution administered by i.v.
infusion.
|
|
Experimental: Monotherapy (Q1W)
Subjects with either PDAC or NSCLC, will receive treatment with CAN04 monotherapy once weekly (Q1W).
|
A fully humanized monoclonal immunoglobulin G1 (IgG1) antibody (hmAb) in aqueous solution administered by i.v.
infusion.
|
|
Experimental: Monotherapy (Q1W/Q2W)
Subjects with either PDAC or NSCLC, will receive treatment with CAN04 monotherapy once weekly (Q1W) for the first 6 weeks followed by treatment every second week (Q2W).
|
A fully humanized monoclonal immunoglobulin G1 (IgG1) antibody (hmAb) in aqueous solution administered by i.v.
infusion.
|
|
Experimental: Combination - PDAC
Subjects with PDAC will receive treatment with CAN04 once weekly (Q1W) for the first 6 weeks followed by treatment every second week (Q2W) in combination with standard-of-care therapy (nab-paclitaxel/gemcitabine).
|
A fully humanized monoclonal immunoglobulin G1 (IgG1) antibody (hmAb) in aqueous solution administered by i.v.
infusion.
Standard of care treatment
Standard of care treatment
|
|
Experimental: Combination - PDAC (1 mg/kg)
Subjects with PDAC will receive CAN04 on Day 1 and 15 in cycles of 28 days in combination with standard-of-care therapy (nab-paclitaxel/gemcitabine).
During first cycle CAN04 also to be administered on Day 8.
|
A fully humanized monoclonal immunoglobulin G1 (IgG1) antibody (hmAb) in aqueous solution administered by i.v.
infusion.
Standard of care treatment
Standard of care treatment
|
|
Experimental: Combination - PDAC (2,5 mg/kg)
Subjects with PDAC will receive CAN04 on Day 1 and 15 in cycles of 28 days in combination with standard-of-care therapy (nab-paclitaxel/gemcitabine).
During first cycle CAN04 also to be administered on Day 8.
|
A fully humanized monoclonal immunoglobulin G1 (IgG1) antibody (hmAb) in aqueous solution administered by i.v.
infusion.
Standard of care treatment
Standard of care treatment
|
|
Experimental: Combination - NSCLC (NCG)
Subjects with NSCLC will receive treatment with CAN04 once weekly (Q1W) for the first 6 weeks followed by treatment every second week (Q2W) in combination with standard-of-care therapy (cisplatin/gemcitabine).
|
A fully humanized monoclonal immunoglobulin G1 (IgG1) antibody (hmAb) in aqueous solution administered by i.v.
infusion.
Standard of care treatment
Standard of care treatment
|
|
Experimental: Combination - non-squamous NSCLC (NCP)
Subjects with non-squamous NSCLC will receive CAN04 on Day 1 and 8 in cycles of 21 days in combination with standard-of-care therapy (carboplatin/pemetrexed).
|
A fully humanized monoclonal immunoglobulin G1 (IgG1) antibody (hmAb) in aqueous solution administered by i.v.
infusion.
Standard of care treatment
Standard of care treatment
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability)
Time Frame: From the first dose until the last subject has completed their end of trial visit or the last enrolled subject has completed 6 months of treatment, whichever occurs first
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The incidence of Grade 3 or higher adverse events (AEs) related to CAN04 administration and according to the National Cancer Institute - Common Terminology Criteria for Adverse Events (CTCAE, version 4.03).
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From the first dose until the last subject has completed their end of trial visit or the last enrolled subject has completed 6 months of treatment, whichever occurs first
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Maximum concentration (Cmax)
Time Frame: 5 weeks
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Maximum plasma concentration of CAN04
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5 weeks
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Terminal half-life (t1/2)
Time Frame: 5 weeks
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Terminal half-life of CAN04
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5 weeks
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Clearance (CL)
Time Frame: 5 weeks
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Plasma clearance of CAN04
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5 weeks
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Apparent volume of distribution during the terminal phase (VZ)
Time Frame: 5 weeks
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Apparent volume of distribution of CAN04 during the terminal phase
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5 weeks
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Area under the curve from time 0 to infinity (AUC0-∞)
Time Frame: 5 weeks
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Area under the plasma concentration curve from time 0 to infinity
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5 weeks
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Anti-drug antibodies (ADA) against CAN04
Time Frame: Through study completion, an average of 6 months
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Immunogenicity of CAN04 after repeated administrations, assessed by ADA titers in serum.
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Through study completion, an average of 6 months
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Preliminary signs of efficacy as assessed by tumor response
Time Frame: One year
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Tumor response (irRC Part I Part II Monotherapy arms; iRECIST Part II Combination arms)
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One year
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Ahmad Awada, Professor, Jules Bordet Institute, Brussels, Belgium
Publications and helpful links
Helpful Links
- Poster presentation at ESMO 2018
- Oral presentation at ASCO annual meeting 2019
- Poster presentation at ESMO 2021
- Poster presentation at ASCO annual meeting 2022
- Poster presentation at ASCO annual meeting 2022
- Poster presentation at AACR annual meeting 2023
- Poster presentation at ASCO annual meeting 2023
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Skin Diseases
- Neoplasms
- Neoplasms by Site
- Breast Diseases
- Breast Neoplasms
- Triple Negative Breast Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Folic Acid Antagonists
- Carboplatin
- Paclitaxel
- Pemetrexed
- Gemcitabine
Other Study ID Numbers
Other Study ID Numbers
- CAN04CLIN001
- 2017-001111-36 (EudraCT Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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