The Efficacy and Safety of PRTX007-003 Combined With Pembrolizumab in Resectable Stage III Melanoma (INFLECTION-003)
A Phase 2 Study to Investigate the Activity of Neoadjuvant PRTX007 Combined With Pembrolizumab in Participants With Stage III Melanoma (INFLECTION-003)
This Phase 2, multi-center, single-arm study evaluates the safety, tolerability, and activity of neoadjuvant PRTX007 in combination with pembrolizumab in participants with resectable Stage III melanoma. Neoadjuvant immunotherapy has demonstrated improved clinical outcomes compared with adjuvant-only approaches, but there remains a need to enhance pathologic response rates without significant added toxicity.
Participants will receive oral PRTX007, a Toll-like receptor 7 (TLR7) agonist prodrug, administered in combination with intravenous pembrolizumab prior to surgical resection. The primary objective is to determine the major pathologic response (MPR) rate following neoadjuvant therapy. Secondary objectives include evaluation of safety, pathologic complete response, event-free survival, overall survival, pharmacokinetics, and immune-related biomarkers.
This study aims to determine whether the addition of PRTX007 to pembrolizumab improves antitumor immune responses and clinical outcomes in patients with Stage III melanoma.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
This study investigates whether combining the TLR7 agonist PRTX007 with pembrolizumab enhances immune-mediated tumor response in the neoadjuvant setting for Stage III melanoma, with the goal of improving pathologic response rates and clinical outcomes while maintaining an acceptable safety profile.
Design This is a Phase 2, multi-center, open-label, single-arm study conducted in Australia. The study will enroll approximately 48 participants with resectable Stage III melanoma.
The study consists of two parts:
- Part A: 24 participants will be enrolled, including an initial dose-escalation safety run-in using a 3+3 design to evaluate tolerability and dose-limiting toxicities.
- Part B: An additional 24 participants will be enrolled if sufficient activity is observed in Part A.
Treatment Plan
Participants will receive neoadjuvant therapy consisting of:
- PRTX007: Oral administration for 3 days on and 4 days off per week for 9 cycles (7-day cycles)
- Pembrolizumab: 200 mg intravenous infusion every 3 weeks for 3 cycles Following completion of neoadjuvant therapy, participants will undergo definitive surgical resection.
Post-surgical treatment will be response-adapted:
- Participants achieving MPR may receive observation or pembrolizumab alone
- Participants without MPR will receive adjuvant PRTX007 in combination with pembrolizumab
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Gunjan Mody
- Telefonnummer: +61 2 9199 9596
- E-mail: gunjan.mody@novotech-cro.com
Studiesteder
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New South Wales
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Waratah, New South Wales, Australien, 2298
- Rekruttering
- Calvary Mater Newcastle
-
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Queensland
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Cairns, Queensland, Australien, 4870
- Ikke rekrutterer endnu
- Cairns And Hinterland Hospital And Health Service
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Greenslopes, Queensland, Australien, 4120
- Ikke rekrutterer endnu
- Gallipoli Medical Research
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Woolloongabba, Queensland, Australien, 4102
- Ikke rekrutterer endnu
- Princess Alexandra Hospital
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Victoria
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Melbourne, Victoria, Australien, 3000
- Ikke rekrutterer endnu
- Peter MacCallum Cancer Centre
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Western Australia
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Nedlands, Western Australia, Australien, 6009
- Ikke rekrutterer endnu
- Sir Charles Gairdner Hospital
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Nedlands, Western Australia, Australien, 6009
- Rekruttering
- One Clinical Research Pty Ltd
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Adults aged 18 years or older
- Histologically confirmed, resectable Stage III cutaneous melanoma.
- Candidate for curative-intent surgical resection
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
- Adequate organ function
- Able to provide written informed consent
Exclusion Criteria:
- Prior systemic therapy for melanoma, including immunotherapy
- Uveal melanoma or mucosal melanoma.
- Active autoimmune disease requiring systemic treatment
- Primary immunodeficiency or use of systemic immunosuppressive therapy
- Women who are pregnant or breastfeeding
- Recent treatment with another investigational therapy
- Any condition that, in the opinion of the investigator, would interfere with study participation or safety
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Neoadjuvant PRTX007 + Pembrolizumab (Response-Adapted Adjuvant Therapy)
Participants with resectable Stage III melanoma will receive neoadjuvant treatment with PRTX007 in combination with pembrolizumab prior to definitive surgical resection.
Following surgery, participants will receive response-adapted adjuvant therapy based on pathologic response.
Participants achieving a major pathologic response (MPR) may receive observation or pembrolizumab alone, while participants without MPR will receive adjuvant PRTX007 in combination with pembrolizumab.
|
PRTX007 is an orally administered prodrug of PRX034, a Toll-like receptor 7 (TLR7) agonist designed to activate innate and adaptive immune responses. NEOADJUVANT REGIMEN
ADJUVANT REGIMEN (IF NO MPR)
Pembrolizumab is a programmed cell death protein-1 (PD-1) blocking antibody administered by intravenous infusion NEOADJUVANT REGIMEN
ADJUVANT REGIMEN
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Major Pathologic Response (MPR) Rate
Tidsramme: At time of surgical resection (approximately 9 weeks after initiation of treatment)
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Major pathologic response (MPR) is defined as ≤10% residual viable tumor cells in the resected tumor specimen following completion of neoadjuvant therapy, as assessed by central pathology review.
|
At time of surgical resection (approximately 9 weeks after initiation of treatment)
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Incidence of Adverse Events (AEs), Serious Adverse Events (SAEs), Immune-Related AEs (irAEs), and Dose-Limiting Toxicities (DLTs)
Tidsramme: From first dose of study treatment through end of study (approximately up to 52 weeks)
|
Number and severity of adverse events, serious adverse events, immune-related adverse events, and dose-limiting toxicities, graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 6.0.
|
From first dose of study treatment through end of study (approximately up to 52 weeks)
|
|
Number of participants with abnormal physical examination findings, abnormal vital signs, abnormal Eastern Cooperative Oncology Group (ECOG) performance status, and abnormal clinical laboratory parameters
Tidsramme: Baseline through end of study (approximately up to 52 weeks)
|
Baseline through end of study (approximately up to 52 weeks)
|
|
|
Pathologic Complete Response (pCR) Rate
Tidsramme: At time of surgical resection (approximately 9 weeks after initiation of treatment)
|
Pathologic complete response (pCR) is defined as the absence of residual viable tumor cells (0%) in the resected tumor specimen following neoadjuvant therapy, as assessed by central pathology review.
|
At time of surgical resection (approximately 9 weeks after initiation of treatment)
|
|
Event-Free Survival (EFS)
Tidsramme: From first dose up to 1 year
|
Event-free survival (EFS) is defined as the time from first dose of study treatment to any of the following events: disease progression or toxicity preventing surgery during neoadjuvant treatment; recurrence of disease after surgery; failure to achieve complete resection (R0 or R1); or death from any cause.
|
From first dose up to 1 year
|
|
Overall Survival (OS)
Tidsramme: From first dose through end of study (approximately up to 52 weeks or longer if followed)
|
Overall survival is defined as the time from first dose of study treatment to death from any cause.
|
From first dose through end of study (approximately up to 52 weeks or longer if followed)
|
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Pharmacokinetics of PRTX007
Tidsramme: During treatment period (multiple time points from baseline through approximately 9 weeks and selected later time points)
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Plasma concentrations of PRTX007 and its active metabolite will be measured to characterize pharmacokinetic parameters using validated analytical methods.
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During treatment period (multiple time points from baseline through approximately 9 weeks and selected later time points)
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Changes in cytokine, chemokine and soluble PD-1/PD-L1 biomarkers
Tidsramme: Baseline through treatment period (up to approximately 9 weeks and selected later time points)
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Baseline through treatment period (up to approximately 9 weeks and selected later time points)
|
|
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Changes in mRNA expression
Tidsramme: Baseline through treatment period (up to approximately 9 weeks and selected later time points)
|
Baseline through treatment period (up to approximately 9 weeks and selected later time points)
|
|
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Changes in immune cell activation and proliferation markers
Tidsramme: Baseline through treatment period (up to approximately 9 weeks and selected later time points)
|
Baseline through treatment period (up to approximately 9 weeks and selected later time points)
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- PRTX007-003
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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