Study of Maplirpacept (PF-07901801) in Combination With PLD in Patients With Platinum-Resistant Ovarian Cancer

NCT05261490TerminatedPHASE1, PHASE2INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Pfizer

Enrollment

10

Start Date

2022-08-01

Completion Date

2023-10-11

Study Type

INTERVENTIONAL

Official Title

A Phase Ⅰ/Ⅱ Study of TTI-622 in Combination With Pegylated Liposomal Doxorubicin in Patients With Platinum-Resistant Ovarian Cancer

Interventions

maplirpacept (PF-07901801)Pegylated Liposomal Doxorubicin (PLD)

Conditions

Ovarian CancerOvarian NeoplasmsOvarian CarcinomaFallopian Tube CancerEpithelial Ovarian CancerPrimary Peritoneal Carcinoma

Eligibility

Age Range

18 Years+

Sex

FEMALE

Key Inclusion Criteria:

* Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1
* Histologically-confirmed epithelial ovarian cancer (EOC), fallopian tube carcinoma (FTC) or primary peritoneal carcinomas (PPC).
* Platinum-resistant recurrent (disease progression ≤6 months after the most recent platinum-based treatment regimen (date calculated from the last administered dose of platinum) or the participant is no longer able to receive.

or declined treatment with platinum-based chemotherapy.

* Progression with standard of care therapies, including platinum-based therapies, poly ADP ribose polymerase (PARP) inhibitors or bevacizumab in the platinum-sensitive setting or intolerability to such therapies or patient refusal
* Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1
* Adequate organ and hematologic function
* No more than four prior treatment regimens for platinum-resistant disease
* All adverse events from prior treatment must be the Common Terminology Criteria for Adverse Events (NCI CTCAE) v5 Grade ≤ 1, except alopecia and stable neuropathy, which must have resolved to Grade ≤ 2 or baseline.

Key Exclusion Criteria:

* Platinum-refractory disease (defined as progression on or within 3 months of completing primary first-line platinum-based treatment)
* Non-epithelial histology, including malignant mixed Mullerian tumors
* Ovarian tumors with low malignant potential (i.e., borderline tumors), low grade serous ovarian cancer or carcinosarcoma
* History of acute coronary syndromes.
* History of or current Class II, III, or IV heart failure.
* History or evidence of known central nervous system (CNS) metastases or carcinomatous meningitis.
* Significant bleeding disorders, vasculitis or a significant bleeding episode from the Gastrointestinal (GI) tract.
* History of severe hypersensitivity reactions to antibodies.
* Systemic steroid therapy.
* History or autoimmune disease that has required systemic treatment with disease-modifying agents, corticosteroids, or immunosuppressive drugs.
* Prior organ transplantation including allogenic or autologous stem cell transplantation
* Prior treatment with anti-cluster of differentiation 47 (CD47) or anti-SIRPα therapy.

Outcome Measures

Primary Outcomes

Phase 1: Number of Participants With Dose Limiting Toxicities (DLTs)

DLT was defined as hematologic and/or non-hematologic treatment-emergent adverse event (TEAE) that occurred during the 28-day Cycle 1 and were judged by the investigator as related to Maplirpacept or the combination of Maplirpacept and PLD. Adverse events (AEs) that were in the opinion of the investigator attributable exclusively to intravenous infusion of PLD or any PLD prophylaxis medication were not considered a DLT.

Time frame: Cycle 1 (28 days)

Secondary Outcomes

Phase 1: Number of Participants With TEAEs, Serious TEAEs, >=3 Grade TEAEs, Treatment Related TEAEs, Treatment Related Serious TEAEs and >=3 Grade Treatment Related TEAEs

AE: untoward medical occurrence or the worsening of a pre-existing medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to study treatment. TEAEs: event that occurred or worsened on or after start of Maplirpacept up to 30 days (+5) after last dose of study treatment or 1 day before starting day of new anti-cancer drug therapy; includes serious and all non-serious AEs. Serious AE: AE resulting in any of following outcomes or deemed significant for any other reason: death; initial or prolonged in participant hospitalization; life-threatening experience; persistent or significant disability/incapacity; congenital anomaly. AEs' severity graded using common terminology criteria for AEs (CTCAE) v 5.0; grade 3= severe; grade 4= life-threatening; grade 5= death. Treatment-related AE: untoward medical occurrence attributed to study drug in a participant who received study drug. Relatedness to drug was assessed by investigator.

Time frame: From start of treatment up to 30 days (+5) after last dose of study treatment or 1 day before starting day of new anti-cancer drug therapy whichever occurred first (up to approximately 33 weeks; maximum exposure of study treatment = 32 weeks)

Phase 1: Change From Baseline in Diastolic and Systolic Blood Pressure (BP) at End of Treatment

BP was measured in millimeter of mercury (mmHg).

Time frame: Baseline (prior to the start of study treatment on Day 1 Cycle 1), End of treatment (maximum up to 32 weeks)

Phase 1: Change From Baseline in Respiratory Rate at End of Treatment

Respiratory rate was measured in breaths per minute (breaths/ min).

Time frame: Baseline (prior to the start of study treatment on Day 1 Cycle 1), End of treatment (maximum up to 32 weeks)

Phase 1: Change From Baseline in Pulse Rate at End of Treatment

Pulse rate was measured in beats per minute (beats/min).

Time frame: Baseline (prior to the start of study treatment on Day 1 Cycle 1), End of treatment (maximum up to 32 weeks)

Phase 1: Change From Baseline in Temperature at End of Treatment

Temperature was measured in degree Celsius (C).

Time frame: Baseline (prior to the start of study treatment on Day 1 Cycle 1), End of treatment (maximum up to 32 weeks)

Phase 1: Change From Baseline in Weight at End of Treatment

Weight was measured in kilogram (kg).

Time frame: Baseline (prior to the start of study treatment on Day 1 Cycle 1), End of treatment (maximum up to 32 weeks)

Part 1: Number of Participants With Clinically Significant Electrocardiogram (ECG) Abnormalities

Standard 12-lead ECGs utilizing limb leads were used to interpret normal and abnormal results, QT interval. ECG was performed after the participant had rested quietly for at least 10 minutes in a supine position. Clinical significance of ECG abnormalities were determined by the investigator.

Time frame: During study treatment, (maximum up to 32 weeks)

Phase 1: Phase 1: Number of Participants With Shift to Grade 3/4 in Serum Chemistry Parameters Abnormalities From Baseline to Post-baseline During the Study Treatment

Serum chemistry tests included determination of the following parameters: glucose, sodium, potassium, calcium, chloride, phosphate, bicarbonate, blood urea nitrogen or urea, creatinine, total protein, albumin, alkaline phosphatase, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, indirect bilirubin, uric acid, calcium, magnesium, and lactate dehydrogenase (LDH). The serum chemistry parameters were graded using CTCAE version 5.0. The intensity was assigned a grade of 1-5 using the following CTCAE guidelines: grade 1= mild; grade 2= moderate; grade 3= severe; grade 4= life-threatening; grade 5= death. In this outcome measure number of participants with at least 1 event of shift to grade 3 or 4 in serum chemistry parameters abnormalities from baseline to post-baseline during study treatment are reported.

Time frame: Baseline to post-baseline during study treatment (maximum up to 32 weeks)

Phase 1: Number of Participants With Shift to Grade 3/4 in Hematology Parameters Abnormalities From Baseline to Post-baseline During the Study Treatment

Hematology tests included determination of the following parameters: hemoglobin, hematocrit, platelets, white blood cells (WBC), neutrophils, lymphocytes, eosinophils, basophils, monocytes, WBC with automated 5-part differential, red blood cells (RBC), absolute reticulocytes, reticulocytes percentage (%), erythrocyte mean corpuscular hemoglobin (MCH), erythrocyte mean corpuscular volume (MCV), and red cell distribution width (RDW). Clinical significance was determined by the investigator. The hematology parameter was graded using CTCAE version 5.0. The intensity was assigned a grade of 1-5 using the following CTCAE guidelines: grade 1= mild; grade 2= moderate; grade 3= severe; grade 4= life-threatening; grade 5= death. In this outcome measure number of participants with at least 1 event of shift to grade 3 or 4 in hematology parameters abnormalities from baseline to post-baseline during study treatment are reported.

Time frame: Baseline to post-baseline during study treatment (maximum up to 32 weeks)

Phase 1: Number of Participants With Dose Delay

Dose delay was the difference between the actual time between two consecutive non-zero doses and the planned time between the same two consecutive non-zero doses. In this outcome measure number of participants with any event of dose delay are reported.

Time frame: During study treatment, (maximum up to 32 weeks)

Phase 1: Number of Participants Who Discontinued Study Treatment Due to TEAE

In this outcome measure number of participants who discontinued study treatment due to TEAE are reported. TEAEs: event that occurred or worsened on or after start of Maplirpacept up to 30 days (+5) after last dose of study treatment or 1 day before starting day of new anti-cancer drug therapy; includes serious and all non-serious AEs.

Time frame: During study treatment, (maximum up to 32 weeks)

Phase 1: Progression Free Survival (PFS), Per Response Evaluation Criteria in Solid Tumors (RECIST) Version (v)1.1

PFS: time from the first Maplirpacept infusion (Cycle 1 Day 1) to disease progression (PD) or death of any cause, whichever occurred first. Participants who completed or discontinued the study without PD or death, as well as participants who received alternate anti-cancer therapy prior to PD, were censored at their last adequate response assessment date or last adequate assessment prior to the start date of alternate anti-cancer therapy. If date of progression occurred on the same date as the start of new anticancer therapy, the progression was counted as an event. PD per RECIST v1.1: at least a 20% increase in the sum of longest diameter (LD) of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeter (mm). The appearance of 1 or more new lesions. Analysis was performed using Kaplan-Meier method.

Time frame: From first Maplirpacept infusion till PD or death or censoring date, whichever occurred earlier (maximum up to 32 weeks)

Phase 1: Overall Survival (OS)

OS was defined as the time from the first Maplirpacept infusion (Cycle 1 Day 1) to death of any cause. Participants without death date at the time of analysis were censored at their last known alive date. Analysis was planned to be performed using Kaplan-Meier method. However, the study was terminated prior to achieving meaningful number of events, hence Kaplan-Meier analysis was not conducted. In this outcome measure number of days from first Maplirpacept infusion until death for each participant (who had death as an event) is reported individually.

Time frame: From first Maplirpacept infusion till death or censoring date, whichever occurred earlier (maximum up to 32 weeks)

Phase 1: Phase 1: Disease Control Rate (DCR), Per RECIST v1.1

DCR: percentage of participants who had achieved complete response (CR), partial response (PR), or stable disease (SD) lasting at least 12 weeks. According to RECIST v1.1 criteria: CR = disappearance of all target lesions, any pathological lymph nodes (whether target or on-target) must have reduction in short axis to \<10 mm; PR = at least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD; SD = neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started; PD = at least a 20% increase in the sum of LD of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of 1 or more new lesions.

Time frame: From first Maplirpacept infusion till PD or death or censoring date, whichever occurred earlier (maximum up to 32 weeks)

Phase 1: Duration of Response (DOR)

DOR: for participants who achieved a confirmed CR or PR; defined as time from the date of first documented response (CR or PR) to the date of documented progression or death of any cause after achieving response. Participants who completed or discontinued the study without PD or death, as well as participants who received alternate anti-cancer therapy prior to PD, was censored at their last adequate response assessment date or last adequate assessment prior to start date of alternate anti-cancer therapy. CR=disappearance of all target lesions, any pathological lymph nodes must have reduction in short axis to \<10 mm; PR=at least 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD; PD= at least 20% increase in the sum of LD of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of 1 or more new lesions.

Time frame: From time of first documented CR or PR to progression or death or censoring date, whichever occurred earlier (maximum up to 32 weeks

Locations

Sarcoma Oncology Research Center, Santa Monica, United States

Baptist Hospital of Miami, Miami, United States

Miami Cancer Institute at Baptist Health, Inc., Miami, United States

Orlando Health Cancer Institute Gynecologic Cancer Center, Orlando, United States

Orlando Health Cancer Institute, Orlando, United States

Michigan Healthcare Professionals PC, Dearborn, United States

Michigan Healthcare Professionals PC, Farmington Hills, United States

Michigan Healthcare Professionals PC, Royal Oak, United States

Michigan Healthcare Professionals PC, Sterling Heights, United States

Cleveland Clinic taussig Cancer Center Investigational Pharmacy, Cleveland, United States

Cleveland Clinic Fairview Hospital, Cleveland, United States

Cleveland Clinic, Cleveland, United States

Cleveland Clinic Hillcrest Hospital, Mayfield Heights, United States

Oklahoma Cancer Specialist and Research Institute. LLC, Tulsa, United States

Magee-Womens Hospital of UPMC, Pittsburgh, United States

UPMC Hillman Cancer Center-Investigational Drug Services, Pittsburgh, United States

Avera Cancer Institute, Sioux Falls, United States

oncology Consultants, P.A., Houston, United States