Tato stránka byla automaticky přeložena a přesnost překladu není zaručena. Podívejte se prosím na anglická verze pro zdrojový text.

Testování kombinace nového protirakovinného léku peposertib s avelumabem a radiační terapií pro pokročilé/metastatické solidní nádory a hepatobiliární malignity

1. října 2026 aktualizováno: National Cancer Institute (NCI)

Studie fáze I/II M3814 a avelumabu v kombinaci s hypofrakcionovaným zářením u pacientů s pokročilým/metastatickým solidním nádorem a hepatobiliárními malignitami

This phase I/II trial studies the best dose and side effects of peposertib and to see how well it works with avelumab and hypofractionated radiation therapy in treating patients with solid tumors and hepatobiliary malignancies that have spread to other places in the body (advanced/metastatic). Peposertib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as avelumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Hypofractionated radiation therapy delivers higher doses of radiation therapy over a shorter period of time and may kill more tumor cells and have fewer side effects. Giving peposertib in combination with avelumab and hypofractionated radiation therapy may work better than other standard chemotherapy, hormonal, targeted, or immunotherapy medicines available in treating patients with solid tumors and hepatobiliary malignancies.

Přehled studie

Postavení

Aktivní, ne nábor

Podmínky

Intervence / Léčba

Detailní popis

PRIMARY OBJECTIVES:

I. To determine the safety and tolerability and recommended phase 2 dose (RP2D) of peposertib (M3814) in combination with hypofractionated radiation and avelumab in patients with advanced/metastatic solid tumors. (Phase I) II. To determine the efficacy of the combination of hypofractionated radiation, peposertib (M3814), and avelumab as compared to the combination of hypofractionated radiation and avelumab in patients with advanced/metastatic hepatobiliary tumors by objective response rate (ORR) in non-irradiated lesions within 12 weeks following initiation of study treatment. (Phase II)

SECONDARY OBJECTIVES:

I. To observe and record anti-tumor activity. (Phase I) II. To characterize the pharmacokinetic (PK) profile of peposertib (M3814) in combination with avelumab. (Phase I) III. To determine the efficacy and safety of the combination of hypofractionated radiation, peposertib (M3814), and avelumab as compared to hypofractionated radiation and avelumab by measurement of disease control rate (DCR), duration of response (DOR), progression free survival (PFS), PFS outside the irradiated field, and overall survival (OS) in patients with advanced/metastatic hepatobiliary tumors. (Phase II) IV. To determine if baseline deoxyribonucleic acid (DNA) repair defects inherent to some cholangiocarcinomas correlate with a more dramatic response to radiation compared to those without as measured by gamma H2AX, phosphorylated (p)NBS1 and pKAP1 immunofluorescence (IFA) with beta CATN segmentation assay. (Phase II) V. To characterize the pharmacokinetic (PK) profiles of peposertib (M3814) and avelumab. (Phase II)

EXPLORATORY OBJECTIVES:

I. To perform molecular profiling assays on malignant and normal tissues, including, but not limited to, whole exome sequencing (WES), ribonucleic acid (RNA) sequencing (RNAseq), mass cytometry (CyTOF), multiplexed ion beam imaging (MIBI), and T cell receptor sequencing in order to:

Ia. To determine if baseline tumor mutation burden and pattern, and neoantigen burden correlate with response; Ib. To determine if combination therapy results in changes in the immune landscape in both the tumor and the host that correlate with response; Ic. To determine if baseline defects in deoxyribonucleic acid (DNA) damage repair in some cholangiocarcinomas correlate with an increased response.

OUTLINE: This is a phase I, dose-escalation study of peposertib followed by a phase II study.

PHASE I:

Patients with advanced/metastatic malignant solid tumors undergo 8 fractions of hypofractionated radiation therapy (RT) every day (QD) on days -17 to -7. Patients also receive peposertib orally (PO) twice daily (BID) on days 1-28, and avelumab intravenously (IV) over 60 minutes on days 1 and 15. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo computed tomography (CT), biopsy, and collection of blood samples during screening and on study.

PHASE II: Patients with advanced/metastatic cholangiocarcinoma/gallbladder cancer are randomized to 1 of 2 arms.

ARM A: Patients undergo 8 fractions of hypofractionated RT QD on days -17 to -7. Patients also receive avelumab IV over 60 minutes on days 1 and 15. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT, biopsy, and collection of blood samples during screening and on study.

ARM B: Patients undergo 8 fractions of hypofractionated RT QD on days -17 to -7. Patients also receive peposertib PO BID on days 1-28, and avelumab IV over 60 minutes on days 1 and 15. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT, biopsy, and collection of blood samples during screening and on study

After completion of study treatment, patients are followed up at 30 days, every 3 months for 1 year, every 6 months for year 2, then annually thereafter.

Typ studie

Intervenční

Zápis (Odhadovaný)

103

Fáze

Fáze 2
Fáze 1

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

Spojené státy
- California
  - Duarte, California, Spojené státy, 91010
    - City of Hope Comprehensive Cancer Center
  - Irvine, California, Spojené státy, 92612
    - UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
  - La Jolla, California, Spojené státy, 92093
    - UC San Diego Moores Cancer Center
  - Orange, California, Spojené státy, 92868
    - UC Irvine Health/Chao Family Comprehensive Cancer Center
  - Sacramento, California, Spojené státy, 95817
    - University of California Davis Comprehensive Cancer Center
- Colorado
  - Aurora, Colorado, Spojené státy, 80045
    - UCHealth University of Colorado Hospital
- Connecticut
  - Derby, Connecticut, Spojené státy, 06418
    - Smilow Cancer Hospital-Derby Care Center
  - Fairfield, Connecticut, Spojené státy, 06824
    - Smilow Cancer Hospital Care Center-Fairfield
  - Glastonbury, Connecticut, Spojené státy, 06033
    - Smilow Cancer Hospital Care Center at Glastonbury
  - Greenwich, Connecticut, Spojené státy, 06830
    - Smilow Cancer Hospital Care Center at Greenwich
  - Guilford, Connecticut, Spojené státy, 06437
    - Smilow Cancer Hospital Care Center - Guilford
  - Hartford, Connecticut, Spojené státy, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - New Haven, Connecticut, Spojené státy, 06520
    - Yale University
  - New Haven, Connecticut, Spojené státy, 06510
    - Smilow Cancer Center/Yale-New Haven Hospital
  - North Haven, Connecticut, Spojené státy, 06473
    - Yale-New Haven Hospital North Haven Medical Center
  - Stamford, Connecticut, Spojené státy, 06902
    - Smilow Cancer Hospital Care Center at Long Ridge
  - Torrington, Connecticut, Spojené státy, 06790
    - Smilow Cancer Hospital-Torrington Care Center
  - Trumbull, Connecticut, Spojené státy, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterbury, Connecticut, Spojené státy, 06708
    - Smilow Cancer Hospital-Waterbury Care Center
  - Waterford, Connecticut, Spojené státy, 06385
    - Smilow Cancer Hospital Care Center - Waterford
- District of Columbia
  - Washington D.C., District of Columbia, Spojené státy, 20007
    - MedStar Georgetown University Hospital
  - Washington D.C., District of Columbia, Spojené státy, 20016
    - Sibley Memorial Hospital
- Florida
  - Aventura, Florida, Spojené státy, 33180
    - UM Sylvester Comprehensive Cancer Center at Aventura
  - Coral Gables, Florida, Spojené státy, 33146
    - UM Sylvester Comprehensive Cancer Center at Coral Gables
  - Deerfield Beach, Florida, Spojené státy, 33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Miami, Florida, Spojené státy, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Miami, Florida, Spojené státy, 33176
    - UM Sylvester Comprehensive Cancer Center at Kendall
  - Plantation, Florida, Spojené státy, 33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
- Georgia
  - Atlanta, Georgia, Spojené státy, 30308
    - Emory University Hospital Midtown
  - Atlanta, Georgia, Spojené státy, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, Spojené státy, 30342
    - Emory Saint Joseph's Hospital
- Illinois
  - Chicago, Illinois, Spojené státy, 60611
    - Northwestern University
- Michigan
  - Detroit, Michigan, Spojené státy, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Farmington Hills, Michigan, Spojené státy, 48334
    - Weisberg Cancer Treatment Center
- New Jersey
  - New Brunswick, New Jersey, Spojené státy, 08903
    - Rutgers Cancer Institute of New Jersey
- New York
  - New York, New York, Spojené státy, 10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - New York, New York, Spojené státy, 10065
    - NYP/Weill Cornell Medical Center
  - New York, New York, Spojené státy, 10016
    - Laura and Isaac Perlmutter Cancer Center at NYU Langone
  - New York, New York, Spojené státy, 10016
    - Bellevue Hospital Center
- Pennsylvania
  - Pittsburgh, Pennsylvania, Spojené státy, 15232
    - UPMC Hillman Cancer Center
- Rhode Island
  - Westerly, Rhode Island, Spojené státy, 02891
    - Smilow Cancer Hospital Care Center - Westerly
- Tennessee
  - Nashville, Tennessee, Spojené státy, 37232
    - Vanderbilt University/Ingram Cancer Center
- Utah
  - Salt Lake City, Utah, Spojené státy, 84112
    - Huntsman Cancer Institute/University of Utah
- Virginia
  - Richmond, Virginia, Spojené státy, 23298
    - VCU Massey Comprehensive Cancer Center
- Wisconsin
  - Madison, Wisconsin, Spojené státy, 53792
    - University of Wisconsin Carbone Cancer Center - University Hospital
  - Madison, Wisconsin, Spojené státy, 53718
    - University of Wisconsin Carbone Cancer Center - Eastpark Medical Center

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let a starší (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion Criteria:

PHASE 1: Patients must have a histologically confirmed metastatic or locally advanced unresectable solid tumor that has progressed on or after available standard of care therapy or for which no acceptable standard of care therapy exists, or in which the patient declines standard of care therapy (each patient that declines standard of care therapy will be documented in the case report form)
PHASE 2: Patients must have a histologically confirmed metastatic or locally advanced unresectable cholangiocarcinoma/gallbladder carcinoma that has progressed on gemcitabine, cisplatin, and durvalumab/pembrolizumab
Age >= 18 years
- Because no dosing or adverse event data are currently available on the use of peposertib (M3814) in combination with avelumab in patients < 18 years of age
Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60%)
Patients with at least 1 index lesion to irradiate for whom palliative radiation treatment is indicated (including but not limited to pain and/or symptom control, prevention of disease -related complications, and preservation of organ function). Lung and liver lesions are preferred, though alternate lesions may be considered after discussion with trial principal investigator (PI). Up to 2 lesions may be considered for irradiation provided at least 1 lesion will receive the study treatment of total of 60 Gy and all prescribed irradiation will be completed within the radiation window
Patients with at least 1 Response Evaluation Criteria in Solid Tumors (RECIST) measurable lesion (to be unirradiated) (defined as those accurately measured in at least one dimension, with the longest diameter to be recorded for non-nodal lesions and the shortest diameter for nodal lesions). Measurable is defined as at least 10 mm in longest diameter for solid tumors, at least 15 mm in shortest diameter for lymph nodes
Patients must be willing to undergo fresh biopsies at baseline (as opposed to using archival tissue), in the event their baseline tissue was obtained > 12 months prior to study consent and/or they are randomized to the gamma H2AX, pNBS1 and pKAP1 IFA with beta CATN segmentation assay
Absolute neutrophil count (ANC) >= 1,500/mcL
Platelet count >= 100,000/mcL
Hemoglobin >= 9.0 g/dL
Serum creatinine =< 1.5 x upper limit of normal (ULN) OR calculated serum creatinine clearance (glomerular filtration rate [GFR] can be used in place of creatinine or creatinine clearance) >= 60 mL/min for participants with creatinine levels > 1.5 x institutional ULN
- Calculate serum creatinine clearance using the standard Cockcroft-Gault formula
Serum total bilirubin =< 1.5 x ULN or direct bilirubin =< ULN for participants with total bilirubin > 1.5 x ULN
- Patients with known Gilbert disease with serum bilirubin level =< 3 x ULN are eligible
Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x ULN or =< 5.0 x ULN for patients with hepatobiliary tumors/liver metastases
Albumin >= 2.8 g/L
International normalized ratio (INR) or prothrombin time (PT) or activated partial thromboplastin time (aPTT) =< 1.5 x ULN
- This applies only to patients not receiving therapeutic anticoagulation; patients receiving therapeutic anticoagulation should be on a stable dose
Participants must have the ability to swallow and retain oral medication and not have any clinically significant gastrointestinal abnormalities that might alter absorption
Female patients of childbearing potential must have a negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. The effects of peposertib (M3814) and avelumab on the developing human fetus are unknown and there is the potential for teratogenic or abortifacient effects. For this reason, women and men of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study treatment, and for 6 months after completion of peposertib (M3814) and avelumab administration. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with peposertib (M3814) and avelumab, breastfeeding should be discontinued if the mother is treated with peposertib (M3814) and avelumab
Ability to understand and the willingness to sign a written informed consent document. Participants with impaired decision-making capacity (IDMC) who have a close caregiver or legally authorized representative (LAR) and/or family member available will also be eligible

Exclusion Criteria:

PHASE I: Patients who have received prior anti-CTLA-4, anti-PD-1, anti-PD-L1 or other immune checkpoint inhibitor therapeutic antibodies or pathway-targeting agents
PHASE II: Patients who have received prior anti-CTLA-4, anti-PD-1, anti-PD-L1 or other immune checkpoint inhibitor therapeutic antibodies or pathway-targeting agents with the following exceptions:
- Patients who have only received previous durvalumab (anti-PD-L1) in combination with gemcitabine +/- cisplatin as part of first line therapy (TOPAZ-1 regimen) are eligible
- Patients who have only received previous pembrolizumab (anti-PD-1) in combination with gemcitabine +/- cisplatin as part of first line therapy (KEYNOTE-966 regimen) are eligible
Patients who have had chemotherapy, definitive radiation, biological cancer therapy, or investigational agent/device within 21 days of first planned dose of study therapy (within 14 days for palliative radiation). Previously irradiated lesions may be re-irradiated provided there is disease progression in the irradiated lesion and the prescribed radiation dosage can safely be re- administered
Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities > Common Terminology Criteria for Adverse Events [CTCAE] grade 1) with the exception of alopecia
Patients with untreated/uncontrolled central nervous system (CNS)/leptomeningeal disease. Patients with asymptomatic, treated CNS disease are eligible if the treating physician determines that immediate CNS specific treatment is not required and is unlikely to be required during the first cycle of therapy and the following criteria are met:
- Radiographic demonstration of clinical stability upon the completion of CNS-directed therapy and no evidence of interim progression between the completion of CNS-directed therapy and the screening radiographic study done >= 4 weeks from completion of radiotherapy and >= 2 weeks from discontinuation of corticosteroids
- No stereotactic radiation or whole-brain radiation within 28 days prior to randomization
Patients with active autoimmune disease requiring systemic corticosteroids greater than the equivalent of prednisone 10 mg daily including but not limited to: systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, colitis, vascular thrombosis associated with antiphospholipid syndrome, Wegener's granulomatosis, Sjogren's syndrome, Bell's palsy, Guillain-Barre syndrome, multiple sclerosis, autoimmune thyroid disease, vasculitis, or glomerulonephritis, with the following exceptions:
- Patients with a history of autoimmune hypothyroidism on a stable dose of thyroid replacement hormone are eligible
- Patients with controlled type 1 diabetes mellitus on a stable insulin regimen are eligible
- Patients with eczema, psoriasis, lichen simplex chronicus of vitiligo with dermatologic manifestations only who require only low potency topical steroids (e.g., hydrocortisone 2.5%, hydrocortisone butyrate 0.1%, fluocinolone 0.01%, desonide 0.05%, alclometasone dipropionate 0.05%) are eligible
Patients receiving treatment with systemic immunosuppressive medications (including, but not limited to, prednisone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor [TNF] agents) within 6 weeks must discontinue these medications prior to starting peposertib (M3814) and avelumab, with the exception of:
- Patients with active autoimmune disease managed with systemic corticosteroids less than the equivalent of prednisone 10 mg daily
- Patients who have received acute, low dose, systemic immunosuppressant medications (e.g., a one-time dose of dexamethasone for nausea)
- The use of inhaled corticosteroids and mineralocorticoids (e.g., fludrocortisone) for patients with orthostatic hypotension and adrenocortical insufficiency
Patients who have undergone prior solid organ or bone marrow transplant with the exception of patients with prior renal transplant for whom dialysis may be employed in the event of graft rejection
Patients with uncontrolled intercurrent illness (e.g., including but not limited to uncontrolled hypertension [HTN] [systolic blood pressure (BP) > 150, diastolic BP > 100], symptomatic congestive heart failure [CHF], unstable angina pectoris, ischemic myocardial infarction [MI] within 6 months, cardiac arrhythmia, transient ischemic attack [TIA or cerebrovascular accident (CVA)]) within 6 months
Patients with serious active infection (e.g. requiring hospitalization and/or intravenous [IV] antibiotics) within 4 weeks prior to starting peposertib (M3814) and avelumab, or signs/symptoms of infection or receiving oral or IV antibiotics for the treatment of active systemic infection within 2 weeks prior to starting peposertib (M3814) and avelumab. Patients receiving prophylactic antibiotics are eligible
Patients with known chronic hepatitis B virus (HBV) infection must have an undetectable viral load on suppressive therapy if indicated. Patients with known chronic hepatitis C (HCV) infection must have been treated and cured. Patients who are currently on curative treatment are eligible if they have an undetectable HCV viral load
Patients with known human immunodeficiency virus (HIV) are allowed on study provided they have:
- A stable regimen of highly active anti-retroviral therapy (HAART)
- No requirement for concurrent antibiotics or antifungal agents for the prevention of opportunistic infection
- A CD4 count above 250 cells/mcL
- An undetectable HIV viral load on standard polymerase chain reaction (PCR)-based testing
Patients with history of idiopathic pulmonary fibrosis, pneumonitis (including drug induced), organizing pneumonia (e.g., bronchiolitis obliterans, cryptogenic organizing pneumonia), or evidence of active pneumonitis on screening chest computed tomography (CT) scan
Patients with known concurrent malignancy that is expected to require active treatment within two years, or may interfere with the interpretation of the efficacy and safety outcomes of this study in the opinion of the treating investigator. Superficial bladder cancer, nonmelanoma skin cancers, and low-grade prostate cancer not requiring cytotoxic therapy should not exclude participation in this trial. Patients with chronic lymphocytic leukemia (CLL) may be enrolled if they do not require active chemotherapy and their hematologic, renal and hepatic function meets criteria previously mentioned
Patients with psychiatric illness/social situations that would limit compliance with study requirements
History of allergic reactions attributed to compounds of similar chemical or biologic composition to peposertib (M3814) or avelumab
Patients unable to discontinue medications or substances that are potent inhibitors, inducers or sensitive substrates of CYP3A4/5 or CYP2C19 prior to starting peposertib (M3814) and avelumab are ineligible. Medications or substances that are strong inhibitors of CYP3A4/5 or CYP2C19 must be discontinued at least 1 week prior to first peposertib (M3814) dose. Strong inducers of CYP3A4/5 or CYP2C19 must be stopped at least 3 weeks prior to the first dose. Drugs mainly metabolized by CYP3A with a narrow therapeutic index as judged by the investigator must stop at least 1 day prior to first peposertib (M3814) dose. Because the lists of these agents are constantly changing, it is important to regularly consult a frequently updated medical reference. As part of the enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product. The primary elimination mechanism of avelumab is proteolytic degradation, thus there are no contraindicated medications with respect to avelumab
Patients who cannot discontinue concomitant proton-pump inhibitors (PPIs) prior to starting peposertib (M3814) and avelumab. These must be discontinued >= 5 days prior to starting peposertib (M3814) and avelumab. Patients do not need to discontinue calcium carbonate. H2 blockers are allowed provided they are taken at least 2 hours after peposertib (M3814) dose
Patients receiving sorivudine or any chemically related analogues (such as brivudine) and not able to discontinue prior to starting peposertib (M3814) and avelumab are excluded
Pregnant and lactating women are excluded from this study because peposertib (M3814) and avelumab are agents with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with peposertib (M3814) and avelumab, breastfeeding should be discontinued if the mother is treated with peposertib (M3814) and avelumab
Patients who have received live vaccination within 30 days before starting peposertib (M3814) and avelumab

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

Primární účel: Léčba
Přidělení: Randomizované
Intervenční model: Paralelní přiřazení
Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm Skupina účastníků / Arm Skupina nebo podskupina účastníků klinické studie, která podle protokolu studie dostává konkrétní intervenci/léčbu nebo žádnou intervenci.	Intervence / Léčba Intervence / Léčba Proces nebo akce, na které se klinická studie zaměřuje. Intervence zahrnují léky, zdravotnická zařízení, postupy, vakcíny a další produkty, které jsou buď zkoušené nebo již dostupné. Intervence mohou také zahrnovat neinvazivní přístupy, jako je edukace nebo úprava stravy a cvičení.
Aktivní komparátor: Arm A (hypofractionated RT, avelumab) Patients undergo 8 fractions of hypofractionated RT QD on days -17 to -7. Patients also receive avelumab IV over 60 minutes on days 1 and 15. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo biopsy, CT, and collection of blood on the trial.	Postup: Biospecimen Collection Undergo collection of blood samples Ostatní jména: Sběr biologických vzorků Odebrán biovzorek Sbírka vzorků Postup: Computed Tomography Undergo CT scan Ostatní jména: ČT KOČKA CAT skenování Počítačová axiální tomografie Počítačová tomografie CT vyšetření tomografie Počítačová axiální tomografie (postup) Počítačová tomografie (CT). Diagnostické skenování CAT Typ služby diagnostického skenování CAT Postup: Biopsy Procedure Undergo biopsy of tumor Ostatní jména: Bx BIOPSY_TYPE Biopsie Lék: Avelumab Given IV Ostatní jména: Bavencio MSB-0010718C MSB0010718C MSB 0010718C Záření: Hypofractionated Radiation Therapy Undergo hypofractionated RT Ostatní jména: Hypofrakcionovaná radioterapie hypofrakcionace Záření, hypofrakcionované Hypofrakcionovaný
Experimentální: Arm B (hypofractionated RT, peposertib, avelumab) Patients undergo 8 fractions of hypofractionated RT QD on days -17 to -7. Patients also receive peposertib PO BID on days 1-28, and avelumab IV over 60 minutes on days 1 and 15. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo biopsy, CT, and collection of blood on the trial.	Postup: Biospecimen Collection Undergo collection of blood samples Ostatní jména: Sběr biologických vzorků Odebrán biovzorek Sbírka vzorků Postup: Computed Tomography Undergo CT scan Ostatní jména: ČT KOČKA CAT skenování Počítačová axiální tomografie Počítačová tomografie CT vyšetření tomografie Počítačová axiální tomografie (postup) Počítačová tomografie (CT). Diagnostické skenování CAT Typ služby diagnostického skenování CAT Lék: Avelumab Given IV Ostatní jména: Bavencio MSB-0010718C MSB0010718C MSB 0010718C Záření: Hypofractionated Radiation Therapy Undergo hypofractionated RT Ostatní jména: Hypofrakcionovaná radioterapie hypofrakcionace Záření, hypofrakcionované Hypofrakcionovaný Lék: Peposertib Given PO Ostatní jména: MSC2490484A 3-Pyridazinmethanol, alfa-(2-Chlor-4-fluor-5-(7-(4-morfolinyl)-4-chinazolinyl)fenyl)-6-methoxy-, (alfaS)- M 3814 M-3814 M3814 MSC 2490484A MSC-2490484A Nedisertib
Experimentální: Phase I (hypofractionated RT, peposertib, avelumab) Patients with advanced/metastatic malignant solid tumors undergo 8 fractions of hypofractionated RT QD on days -17 to -7. Patients also receive peposertib PO BID on days 1-28, and avelumab IV over 60 minutes on days 1 and 15. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT, biopsy, and collection of blood samples during screening and on study.	Postup: Biospecimen Collection Undergo collection of blood samples Ostatní jména: Sběr biologických vzorků Odebrán biovzorek Sbírka vzorků Postup: Computed Tomography Undergo CT scan Ostatní jména: ČT KOČKA CAT skenování Počítačová axiální tomografie Počítačová tomografie CT vyšetření tomografie Počítačová axiální tomografie (postup) Počítačová tomografie (CT). Diagnostické skenování CAT Typ služby diagnostického skenování CAT Postup: Biopsy Procedure Undergo biopsy of tumor Ostatní jména: Bx BIOPSY_TYPE Biopsie Lék: Avelumab Given IV Ostatní jména: Bavencio MSB-0010718C MSB0010718C MSB 0010718C Záření: Hypofractionated Radiation Therapy Undergo hypofractionated RT Ostatní jména: Hypofrakcionovaná radioterapie hypofrakcionace Záření, hypofrakcionované Hypofrakcionovaný Lék: Peposertib Given PO Ostatní jména: MSC2490484A 3-Pyridazinmethanol, alfa-(2-Chlor-4-fluor-5-(7-(4-morfolinyl)-4-chinazolinyl)fenyl)-6-methoxy-, (alfaS)- M 3814 M-3814 M3814 MSC 2490484A MSC-2490484A Nedisertib

Co je měření studie?

Primární výstupní opatření

Měření výsledku	Popis opatření	Časové okno
Maximum tolerated doses and recommended phase 2 dose of peposertib (M3814) in combination with hypofractionated radiation and avelumab (Phase 1) Časové okno: Up to 28 days	Will be determined by the occurrence of dose-limiting toxicities defined as the occurrence of one or more grade 3 adverse events that delays treatment for more than 7 days, or any grade 4-5 adverse events.	Up to 28 days
Objective response rate (Phase 2) Časové okno: Within 12 weeks following initiation of study treatment	Defined as best overall response (compete response [CR] and partial response [PR] in non-irradiated lesions as opposed to stable disease [SD] or progressive disease) within 12 weeks following initiation of study treatment by Response Evaluation Criteria in Solid Tumors (RECIST 1.1).	Within 12 weeks following initiation of study treatment

Sekundární výstupní opatření

Měření výsledku	Popis opatření	Časové okno
Pharmacokinetics of avelumab (Phase 1) Časové okno: Day 7: predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8 and 24 hours; Day 21: predose, 0.5, 1, 1.5, 2, 3, 4, 6, and 8 hours	Will determine concentrations of plasma avelumab using enzyme-linked immunosorbent assay.	Day 7: predose, 0.5, 1, 1.5, 2, 3, 4, 6, 8 and 24 hours; Day 21: predose, 0.5, 1, 1.5, 2, 3, 4, 6, and 8 hours
Pharmacokinetics of M3814 (Phase 1) Časové okno: Day 21: predose	Will determine concentrations of plasma M3814 using liquid chromatography-mass spectrometry (MS)/MS.	Day 21: predose
Disease control rate (Phase 2) Časové okno: Up to 12 months	Defined as proportion of patients achieving a CR, PR, or SD in non-irradiated by RECIST 1.1 criteria. Will be analyzed by Kaplan-Meier estimates.	Up to 12 months
Progression free survival (PFS) (Phase 2) Časové okno: From randomization until disease progression or death, assessed up to 12 months	Will be analyzed by Kaplan-Meier estimates.	From randomization until disease progression or death, assessed up to 12 months
PFS outside the irradiated field (Phase 2) Časové okno: From randomization until disease progression outside the irradiated field or death, assessed up to 12 months	Will be analyzed by Kaplan-Meier estimates.	From randomization until disease progression outside the irradiated field or death, assessed up to 12 months
Overall survival (Phase 2) Časové okno: From randomization until death from any cause, assessed up to 12 months	Will be analyzed by Kaplan-Meier estimates.	From randomization until death from any cause, assessed up to 12 months
Incidence of adverse events (Phase 2) Časové okno: Up to 12 months	Defined by Common Terminology Criteria for Adverse Events version 5.0.	Up to 12 months
Pharmacokinetics of M3814 and avelumab (trough levels) (Phase 2) Časové okno: M3814 and avelumab: Day 21 (Predose)	Correlated with pharmacodynamics (e.g. toxicity). Will compare trough values between patients with and without toxicity, and/or response if warranted, with non-parametric testing.	M3814 and avelumab: Day 21 (Predose)
Defects in deoxyribonucleic acid (DNA) damage repair Časové okno: Up to 12 months	Assessed by the gamma H2AX phosphorylated (p)NBS1 multiplex immunofluorescence assay (IFA). The association of baseline DNA repair defects, scored as present or absent, with the response rate to treatment will be evaluated using Fisher's exact test.	Up to 12 months
Differential response to therapy (Phase 2) Časové okno: Up to 12 months	Assessed by the gamma H2AX pNBS1 multiplex IFA. The association of baseline DNA repair defects, scored as present or absent, with the response rate to treatment will be evaluated using Fisher's exact test.	Up to 12 months

Další výstupní opatření

Měření výsledku	Popis opatření	Časové okno
Tumor mutation burden Časové okno: Baseline	Assessed by whole exome sequencing (WES). Correlates will be summarized using descriptive statistics. The association of tumor mutation scored as high or low, with response rates to treatment will be evaluated using Fisher's exact test.	Baseline
Tumor mutation burden Časové okno: Baseline	Assessed by ribonucleic acid sequencing (RNAseq). Correlates will be summarized using descriptive statistics. The association of tumor mutation scored as high or low, with response rates to treatment will be evaluated using Fisher's exact test.	Baseline
Tumor pattern Časové okno: Baseline	Assessed by WES. Correlates will be summarized using descriptive statistics. The association of tumor mutation scored as high or low, with response rates to treatment will be evaluated using Fisher's exact test.	Baseline
Tumor pattern Časové okno: Baseline	Assessed by RNAseq. Correlates will be summarized using descriptive statistics. The association of tumor mutation scored as high or low, with response rates to treatment will be evaluated using Fisher's exact test.	Baseline
Neoantigen burden Časové okno: Up to 12 months	Assessed by WES. Correlates will be summarized using descriptive statistics. The association of neoantigen burdens, scored as high or low, with response rates to treatment will be evaluated using Fisher's exact test.	Up to 12 months
Neoantigen burden Časové okno: Up to 12 months	Assessed by RNAseq. Correlates will be summarized using descriptive statistics. The association of neoantigen burdens, scored as high or low, with response rates to treatment will be evaluated using Fisher's exact test.	Up to 12 months
Defects in DNA damage repair Časové okno: Baseline up to 12 months	Assessed by WES. Immune-response gene expressions will be measured pre- and post-therapy, and be compared using a paired t-test, or a Wilcoxon signed rank test where appropriate.	Baseline up to 12 months
Differential response to therapy Časové okno: Baseline up to 12 months	Assessed by WES. Immune-response gene expressions will be measured pre- and post-therapy, and be compared using a paired t-test, or a Wilcoxon signed rank test where appropriate.	Baseline up to 12 months
Tumor infiltrating lymphocyte quantification and characterization Časové okno: Up to 12 months	Assessed by multiplexed ion beam imaging in both the tumor and the host.	Up to 12 months
Circulating T lymphocyte quantification and characterization Časové okno: Up to 12 months	Assessed by mass cytometry in both the tumor and the host.	Up to 12 months
T cell receptor (TCR) clonality Časové okno: Up to 12 months	Assessed by TCR sequencing in both the tumor and the host.	Up to 12 months

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

National Cancer Institute (NCI)

Vyšetřovatelé

Vrchní vyšetřovatel: Kristen R Spencer, Laura and Isaac Perlmutter Cancer Center at NYU

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

7. dubna 2020

Primární dokončení (Odhadovaný)

1. července 2027

Dokončení studie (Odhadovaný)

1. července 2027

Termíny zápisu do studia

První předloženo

15. srpna 2019

První předloženo, které splnilo kritéria kontroly kvality

23. srpna 2019

První zveřejněno (Aktuální)

28. srpna 2019

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

2. října 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

1. října 2026

Naposledy ověřeno

1. září 2026

Více informací

Termíny související s touto studií

Další relevantní podmínky MeSH

Další identifikační čísla studie

NCI-2019-05373
UM1CA186644 (Grant/smlouva NIH USA)
UM1CA186716 (Grant/smlouva NIH USA)
NCI-2019-05373 (Identifikátor registru: CTRP (Clinical Trial Reporting Program))
052002
10276 (Jiný identifikátor: Dana-Farber - Harvard Cancer Center LAO)
10276 (Jiný identifikátor: CTEP)

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

ANO

Popis plánu IPD

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ano

Studuje produkt zařízení regulovaný americkým úřadem FDA

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

Testování kombinace nového protirakovinného léku peposertib s avelumabem a radiační terapií pro pokročilé/metastatické solidní nádory a hepatobiliární malignity

Studie fáze I/II M3814 a avelumabu v kombinaci s hypofrakcionovaným zářením u pacientů s pokročilým/metastatickým solidním nádorem a hepatobiliárními malignitami

Přehled studie

Postavení

Podmínky

Intervence / Léčba

Detailní popis

Typ studie

Zápis (Odhadovaný)

Fáze

Kontakty a umístění

Studijní místa

Kritéria účasti

Kritéria způsobilosti

Věk způsobilý ke studiu

Přijímá zdravé dobrovolníky

Pohlaví způsobilá ke studiu

Popis

Studijní plán

Jak je studie koncipována?

Detaily designu

Počet zbraní

Zbraně a zásahy

Skupina účastníků / Arm

Intervence / Léčba

Co je měření studie?

Primární výstupní opatření

Měření výsledku

Popis opatření

Časové okno

Sekundární výstupní opatření

Měření výsledku

Popis opatření

Časové okno

Další výstupní opatření

Měření výsledku

Popis opatření

Časové okno

Spolupracovníci a vyšetřovatelé

Sponzor

Vyšetřovatelé

Termíny studijních záznamů

Hlavní termíny studia

Začátek studia (Aktuální)

Primární dokončení (Odhadovaný)

Dokončení studie (Odhadovaný)

Termíny zápisu do studia

První předloženo

První předloženo, které splnilo kritéria kontroly kvality

První zveřejněno (Aktuální)

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

Naposledy ověřeno

Více informací

Termíny související s touto studií

Další relevantní podmínky MeSH

Další identifikační čísla studie

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

Popis plánu IPD

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Studuje produkt zařízení regulovaný americkým úřadem FDA