A Clinical Study of PD-L1 Antibody ZKAB001(Drug Code) in Recurrent or Metastatic Cervical Cancer

NCT03676959UNKNOWNPHASE1INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Lee's Pharmaceutical Limited

Enrollment

101

Start Date

2018-08-16

Completion Date

2022-05-15

Study Type

INTERVENTIONAL

Official Title

An Open-label, Dose-escalation, Bi-weekly Phase I Clinical Trial in Treating Patients With Recurrent or Metastatic Cervical Cancer

Interventions

ZKAB001 5mg/kgZKAB001 10mg/kgZKAB001 15mg/kg

Conditions

Cervical Cancer

Eligibility

Age Range

18 Years+

Sex

FEMALE

Inclusion Criteria:

1. The subject voluntarily gives written informed consent to participate in the study.
2. Female subjects aged≥18 years.
3. Recurrent or metastatic cervical cancer was diagnosed by histopathology or cytology and received first-line platinum-containing regimens that failed or could not be tolerated. The definition of first-line failure: progress during adjuvant therapy or within 6 months after the end of treatment, and the first progress after palliative treatment.
4. Based on RECIST1.1, imaging evaluation confirmed that there was at least one measurable disease.
5. Eastern Cooperative Oncology Group(ECOG) performance status of 0 or 1, with estimated life expectancy of at least 3 months.
6. Adequate blood routine, hepatic and renal function:

1\) Absolute neutrophil count(ANC)≥109/L 2) Platelets ≥100x109/L 3) Hemoglobin ≥9g/dL 4) Serum albumin ≥2.8g/dL 5) Bilirubin ≤1.5x Upper limit of normal(ULN) 6) ALT and AST ≤1.5xULN, if If liver metastases are present, alanine transaminase(ALT) and aspartate transaminase(AST) should be ≤5xULN 7) Creatinine clearance rate ≥50ml/min (Cockcroft-Gault equation) 7.Female reproductive subjects should take effective contraception during the study period and within 3 months after the study treatment period. The serum or urine human chorionic gonadotropin (HCG)examination must be negative within 7 days before the subject is enrolled.

Exclusion Criteria:

1. There are known active or suspected autoimmune diseases. Those who are in a stable state and do not need systemic immunosuppressive therapy can be included.
2. Patients are using immunosuppressive agents, or systemic, or absorbable topical corticosteroid medications to achieve immunosuppressive purposes (doses \>10mg/day prednisone or equivalent), which is ongoing 2 weeks before enrollment.
3. Have received any form of organ transplantation, including allogeneic stem cell transplantation.
4. Known allergy to macromolecular protein inhibitors or any of the components of ZKAB001.
5. Suffering from other malignant tumors other than this diseases in 5 years except for skin basal cell and squamous cell carcinoma.
6. Central nervous system metastases with clinical symptoms (such as cerebral edema and brain metastases requiring corticosteroid intervention). Previous treatment with brain or meningeal metastasis, such as clinical stabilization (MRI) less than 2 months, or systemic corticosteroid (dose \>10mg/day prednisone or equivalent) less than 2 weeks.
7. Patients with clinical symptoms or diseases of the heart that cannot be well controlled, such as heart failure above New York Heart Association ( NYHA ) 2 grade, unstable angina pectoris, myocardial infarction in 1 year, and clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention, have left ventricular ejection fraction \< 50% at rest in the ultrasound cardiogram.
8. Patients who had received radiotherapy, chemotherapy, surgery or molecular targeted therapy before, were given less than 4 weeks.
9. Within 14 days before the first use of the drug, any active infection requiring systematic anti-infective treatment.
10. Human immunodeficiency virus (HIV) positive, untreated active hepatitis (hepatitis B surface antigen positive and peripheral blood HBV-DNA titer ≥ 500IU/ml or positive copy number detected by the research center; hepatitis C virus antibody positive)
11. There is a history of active pulmonary tuberculosis within 1 year before entering the group.
12. The patient is participating in other clinical studies or is less than 1 month away from the end of the previous clinical study.
13. Patients may need to receive other systemic cancer treatment during study period.
14. Received blood transfusion and hematopoietic stimulating factors, such as colony stimulating factor, erythropoietin, thrombopoietin, etc., within 14 days before screening.
15. Prior therapy with an anti-PD 1, anti-PD L1, or anti-CTLA-4 (Cytotoxic T lymphocyte Antigen-4) antibody (or any other agents that target immunoregulatory receptor).
16. Subjects who received live vaccine within 4 weeks before screening.
17. History of mental drug abuse, alcohol abuse or drug abuse.
18. Pregnant or lactating women.
19. Any mental condition that prevents the understanding or provision of an informed consent.
20. It is determined by the investigator that the patient has other factors that may lead to the termination of the study, such as other serious diseases or serious laboratory test abnormalities or other factors that may affect the safety of the patients, family or social factors that may affect the study data and sample collection.

Outcome Measures

Primary Outcomes

RP2D

Recommended phase II dose.

Time frame: 28 days after first dose

Objective response rate

The proportion of subjects who achieved the best objective response rate (PR or CR).

Time frame: 2 years

Tolerance

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Time frame: 2 years

Secondary Outcomes

Effect of ZKAB001 on T cell function and cytokine expression

The response of CD4+ and CD8+ cells to tumor at baseline and after each administration will be detected by flow cytometry.

Time frame: through study completion, an average of 2 years

The number of subjects presenting detectable anti drug antibodies (ADAs)

To evaluated the number of subjects presenting detectable anti drug antibodies (ADAs).

Time frame: through study completion, an average of 2 years

Receptor occupancy

Monocytes will be isolated from peripheral blood before each cycle of administration, and the receptor occupancy of PD-L1 on CD3+T cells will be determined.

Time frame: through study completion, an average of 2 years

PD-L1 expression

Detection of PD-L1 expression in tumor tissues.

Time frame: through study completion, an average of 2 years

progression free survival(PFS)

Evaluate the PFS of the study population

Time frame: through study completion, an average of 2 years

overall survival

Evaluate the OS of the study population

Time frame: through study completion, an average of 2 years

duration of response

Evaluate the DOR of the study population

Time frame: through study completion, an average of 2 years

best of response

Evaluate the BOR of the study population

Time frame: through study completion, an average of 2 years

Locations

Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Linked Papers

Efficacy and Safety of the Anti–PD-L1 mAb Socazolimab for Recurrent or Metastatic Cervical Cancer: a Phase I Dose-Escalation and Expansion Study

Abstract Purpose: This study (ClinicalTrials.gov identifier, NCT03676959) is an open, phase I dose-escalation and expansion study investigating the safety and efficacy of the recombinant, fully human anti–programmed death ligand 1 (PD-L1) mAb socazolimab in patients diagnosed with recurrent or metastatic cervical cancer. Patients and Methods: Patients received socazolimab every 2 weeks until disease progression. The study was divided into a dose-escalation phase and a dose-expansion phase. Safety and tolerability were primary endpoints of the dose-escalation phase. The primary endpoints of the dose-expansion phase were safety and the objective response rate (ORR) of the 5 mg/kg dose. Efficacy was assessed by the third-party independent review committee (IRC) using the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Results: 104 patients were successfully enrolled into the study. Twelve patients were included in the dose-escalation phase, with one complete response and two partial responses in the 5 mg/kg treatment group. Ninety-two patients (5 mg/kg) were enrolled in the dose-expansion phase. Fifty-four patients (59.3%) had baseline PD-L1–positive tumor expression (combined positive score ≥1). ORR was 15.4% [95% confidence interval (CI), 8.7%–24.5%]. Median PFS was 4.44 months (95% CI, 2.37–5.75 months), and the median OS was 14.72 months (95% CI, 9.59–NE months). ORR of PD-L1–positive patients was 16.7%, and the ORR of PD-L1–negative patients was 17.9%. No treatment-related deaths occurred. Conclusions: Our study demonstrates that socazolimab has durable safety and efficacy for the treatment of recurrent or metastatic cervical cancer and exhibits a safety profile similar to other anti–PD-1/PD-L1 mAbs.