A Study of the Safety and Pharmacokinetics of AGS-22M6E in Subjects With Malignant Solid Tumors That Express Nectin-4

A Phase 1 Study of the Safety and Pharmacokinetics of Escalating Doses of AGS-22M6E or ASG-22CE Given as Monotherapy Followed by Expansion Cohorts in Subjects With Malignant Solid Tumors That Express Nectin-4

A study examining the safety of AGS-22M6E or ASG-22CE administered as monotherapy therapy in subjects with malignant solid tumors that express Nectin-4.

Study Overview

• Status: Completed
• Conditions: Neoplasms; Tumors; Medical Oncology
• Intervention / Treatment: Drug: AGS-22M6E; Drug: ASG-22CE

Detailed Description

AGS-22M6E and ASG-22CE are fully human monoclonal antibody conjugated to a cytotoxic agent monomethyl auristatin E (MMAE) targeting Nectin-4 (Agensys code name AGS-22). The main difference between AGS-22M6E and ASG-22CE is the change in cell line for antibody production. AGS-22M6E and ASG-22CE will be administered at mg/kg doses based on the subjects weight at baseline and doses will not change unless the subjects weight changes by ≥ 10% from their baseline weight or the investigational product Dosage Assessment criteria is met.

Subjects will be prescreened for Nectin-4 expression prior to undergoing screening procedures for the main study. Subjects with tumors positive for Nectin-4 expression may be screened for eligibility into the main study. The dose escalation period is estimated to take between 12 and 18 months depending on whether 3 or 6 subjects are enrolled in a given dose cohort, and the availability of consenting subjects.

Subjects will be treated in the dose escalation phase of the study until the maximum tolerated dose (MTD) and recommended dose for expansion (RDE) has been determined by the data review team (DRT). After the RDE has been determined, subjects will be enrolled into 1 of 3 expansion cohorts. There will be 3 expansion cohorts, each targeting a specific cancer (i.e.,Breast, Bladder and Lung plus other solid tumor cancers). The DRT may recommend stopping the study, adjusting the dose or amending the trial at any time.

The clinical bridging to the ASG-22CE involves treating the subjects with ASG-22CE, irrespective of cancer type, at the next lowest dose level previously determined to be safe for AGS-22M6E. After the initial subjects are treated at the bridging dose with ASG-22CE and have completed the safety assessment, future subjects will only be treated with ASG-22CE throughout the remainder of the study.

A disease assessment will be performed by the investigator at Week 8 (± 14 days). Subjects without evidence of disease progression may continue to receive treatment until disease progression or intolerability.

• Study Type: Interventional
• Enrollment (Actual): 34
• Phase: Phase 1

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Edmonton, Alberta, Canada, T6G 1Z2
      • Cross Cancer Institute
• United States
  • California
    • San Francisco, California, United States, 94115
      • UCSF Helen Diller Family Comprehensive Cancer Center
  • Colorado
    • Aurora, Colorado, United States, 80045
      • University of Colorado, Denver-Aurora
  • Georgia
    • Atlanta, Georgia, United States, 30322
      • Emory University
  • Massachusetts
    • Boston, Massachusetts, United States, 02115
      • Dana-Farber Cancer Institute
  • Michigan
    • Detroit, Michigan, United States, 48201
      • Karmanos Cancer Institute
  • New York
    • Buffalo, New York, United States, 14263
      • Roswell Park Cancer Institute
    • New York, New York, United States, 10021
      • Memorial Sloan Kettering Cancer Center
  • North Carolina
    • Chapel Hill, North Carolina, United States, 27599
      • University of North Carolina, Chapel Hill

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria: (For Dose Escalation and Dose Expansion)

• Subjects must have a tumor positive for Nectin-4 expression (as measured by central laboratory using primary or metastatic tumor tissue
• Histologically confirmed malignant solid tumors (excluding sarcoma) that have failed all FDA approved therapies indicated for the type of metastatic cancer and line of therapy or for which they were not a candidate to receive treatment

• Measurable disease according to RECIST criteria (version 1.1) (Eisenhauer, et. al.) defined as tumor lesions that are accurately measured in at least one dimension (longest diameter in the plane of measurement is to be recorded) with a minimum size of:

  • 10mm by CT scan (CT scan slice thickness no greater than 5mm
  • 10 mm caliper measurement by clinical exam (lesions which cannot be accurately measured with calipers should be recorded as nonmeasurable
  • 20 mm by chest X-ray
  • ≥ 15 mm in short axis for lymph nodes when assessed by CT scan (CT scan slice thickness recommended to be no greater than 5 mm)

Note: bone lesions, ascites, and pleural effusions are not considered measurable lesions

• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• Negative pregnancy test (women of childbearing potential)

• Hematologic function, as follows:

  • a. Absolute neutrophil count (ANC) ≥ 1.0 x109 /L
  • b. Platelet count ≥ 100 x 109/L
  • c. Hemoglobin ≥ 8.5 g/dL
• Renal function, as follows: serum creatinine ≤ 2.0 mg/dL, or measured 24 hour creatinine clearance of ≥ 45 mL/min
• Total bilirubin ≤1.5 x upper limit of normal (ULN)
• Serum albumin > 2.5 g/dL
• Aspartate aminotransferase (AST) ≤ 1.5 x ULN
• Alanine aminotransferase (ALT) ≤ 1.5 x ULN
• Gamma GT ≤1.5 ULN
• International normalized ratio (INR) < 1.5 (or ≤ 3 if on warfarin or other medications for therapeutic anticoagulation)
• Women and men of childbearing potential must be advised and agree to practice effective methods of contraception during the course of the study

Inclusion Criteria for Dose Expansion Only:

In addition to the inclusion criteria listed above, the following criteria will also be required for each expansion cohort:

Expansion Cohort 1: Breast Cancer

• Subjects with Histologically or cytologically diagnosed metastatic breast cancer

Expansion Cohort 2: Bladder Cancer

• Histologically or cytologically confirmed bladder cancer with visceral metastases

Expansion Cohort 3: Lung plus other solid tumor cancer

• Histologically or cytologically confirmed metastatic non-small cell lung cancer (NSCLC) or any other solid tumor cancer

Exclusion Criteria:

• Preexisting neuropathy Grade ≥ 3 or motor neuropathy Grade ≥ 2
• Uncontrolled brain or epidural spinal metastases
• Use of any investigational drug within 14 days or 5 half-lives prior to first dose of study drug
• Any anticancer therapy including: small molecules, immunotherapy, chemotherapy, monoclonal antibody therapy, radiotherapy or any other agents to treat cancer within 28 days prior to first dose of study drug
• Active angina or Class III or IV Congestive Heart Failure (New York Heart Association CHF Functional Classification System) or clinically significant cardiac disease within 12 months of the first dose of study drug, including myocardial infarction, unstable angina, grade 2 or greater peripheral vascular disease, congestive heart failure, uncontrolled hypertension, or arrhythmias not controlled by medication
• Known HIV or AIDS
• Decompensated liver disease as evidenced by clinically significant ascites refractory to diuretic therapy, hepatic encephalopathy, or coagulopathy
• History of thromboembolic events and bleeding disorders ≤ 3 months (e.g.,deep vein thrombosis ( DVT) or pulmonary embolism ( PE)) prior to first dose of study drug
• Major surgery within 28 days prior to first dose of study drug
• Active infection requiring treatment ≤7 days prior to first dose of study drug
• Anti-androgen therapy initiated within 28 days of enrollment (for prostate cancer patients only)
• Positive Hepatitis B surface antigen test
• Positive Hepatitis C antibody test

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

9

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: AGS-22M6E-11-1 Dose Level 1	Drug: AGS-22M6E; IV Infusion
Experimental: AGS-22M6E-11-1 Dose Level 2	Drug: AGS-22M6E; IV Infusion
Experimental: AGS-22M6E-11-1 Dose Level 3	Drug: AGS-22M6E; IV Infusion
Experimental: AGS-22M6E-11-1 Dose Level 4	Drug: AGS-22M6E; IV Infusion
Experimental: AGS-22M6E-11-1 Dose Level 5	Drug: AGS-22M6E; IV Infusion
Experimental: AGS-22M6E-11-1 Dose Level 6	Drug: AGS-22M6E; IV Infusion
Experimental: ASG-22CE Expansion Cohort 1; Breast Cancer	Drug: ASG-22CE; IV Infusion
Experimental: ASG-22CE Expansion Cohort 2; Bladder Cancer	Drug: ASG-22CE; IV Infusion
Experimental: ASG-22CE Expansion Cohort 3; Lung plus other solid tumor cancers	Drug: ASG-22CE; IV Infusion

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of adverse events		Up to 28 days after the last dose of study drug
Composite of Pharmacokinetics: Ceoi or Cmax, Ctrough, Tmax, AUC0-21, t½, CL, Vss	Concentration at the end of infusion (Ceoi) or Cmax, trough concentration (Ctrough), Tmax, partial AUC after first dose (AUC0-21), terminal or apparent terminal half-life (t1/2), systemic clearance (CL), volume of distribution at steady state (Vss)	Up to 28 days after the last dose of study drug

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of anti-drug antibody formation		Up to 28 days after the last dose of study drug
Objective tumor response rate	Incidence of a tumor response is defined as a complete or partial response per Response Criteria for Solid Tumors (RECIST version 1.1)	Every 8 weeks (± 14 days)
Disease Control Rate		Every 8 weeks (± 14 days)

Collaborators and Investigators

• Sponsor: Astellas Pharma Inc
• Collaborators: Seagen Inc.; Agensys, Inc.
• Investigators: Study Director: Medical Monitor, Agensys, Inc.

Publications and helpful links

Helpful Links

• Link to results and other applicable study documents on the Astellas Clinical Trials website
• Link to plain language summary of the study on the Trial Results Summaries website

Study record dates

Study Major Dates

• Study Start (Actual): July 11, 2011
• Primary Completion (Actual): April 27, 2015
• Study Completion (Actual): April 27, 2015

Study Registration Dates

• First Submitted: July 29, 2011
• First Submitted That Met QC Criteria: August 2, 2011
• First Posted (Estimated): August 4, 2011

Study Record Updates

• Last Update Posted (Actual): March 12, 2024
• Last Update Submitted That Met QC Criteria: March 11, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Safety; Cancer; ASG-22CE; ASG-22ME; Nectin 4 protein, humans; Clinical Trial, Phase 1; Pharmacokinetics of ASG-22CE; Pharmacokinetics of AGS-22M6E; AGS-22M6E; ASG-22C3
• Additional Relevant MeSH Terms: Neoplasms
• Other Study ID Numbers: AGS-22M6E-11-1