Cancer, Lung Cancer

Phase 1

Interventional Study

A Study of Safety and Efficacy of KFA115 Alone and KFA115 in Combination With Tislelizumab in Patients With Select Advanced Cancers

Sponsor

Novartis Pharmaceuticals

Start Date

26/10/2022

Completion Date

12/09/2025

Sex

ALL

Enrollment

220

Ages From

18

Healthy Volunteers?

Yes

Contact

Novartis Pharmaceuticals,

Location

Novartis Investigative Site

Trial Details

Brief Summary

The purpose of this study is to characterize the safety and tolerability of KFA115 and KFA115 in combination with tislelizumab in patients with select advanced cancers, and to identify the maximum tolerated dose and/or recommended dose.

Official Title

A Phase I, Open-label, Multi-center Study of KFA115 as a Single Agent and in Combination With Tislelizumab in Patients With Select Advanced Cancers

Detailed Description

This is a phase I, open-label, multi-center study of KFA115 as a single agent and in combination with tislelizumab. The study consists of a dose escalation part, followed by dose expansion part(s) for single-agent KFA115 and KFA115 in combination with tislelizumab. The escalation parts will characterize safety and tolerability. After the determination of the maximum tolerated dose (MTD) / recommended dose (RD), the dose expansion parts will assess the preliminary anti-tumor activity in defined patient populations and further assess the safety and tolerability at MTD/RD.

Selection Criteria

Eligibility Inclusion Criteria

Non-small cell lung cancer with historic PD-L1 ≥ 1%, as determined locally using a clinically accepted assay. Patients must have experienced benefit from previous anti-PD(L)1-containing therapy for at least 4 months based on investigator-assessed disease stability or response prior to developing documented disease progression.
Renal cell carcinoma, clear cell histology, previously treated with anti-PD(L)1-containing therapy and a VEGF targeted therapy as monotherapy or in combination. Patients should have documented disease progression following anti-PD(L)1-containing therapy.
Cutaneous melanoma, previously treated with anti-PD(L)1-containing therapy. Patients should have documented disease progression following anti-PD(L)1-containing therapy.
Ovarian cancer, high-grade serous histology, naive to anti-PD(L)1 therapy, no more than 3 prior lines of systemic therapy for recurrent/metastatic disease.
Nasopharyngeal carcinoma, non-keratinizing locally advanced recurrent or metastatic, naive to anti-PD(L)1 therapy.
Locally advanced unresectable or metastatic anal cancer (squamous), thymic carcinoma, MSI-H CRC, esophagogastric cancer, mesothelioma, and HNSCC, all naive to anti-PD(L)1 therapy.
Patients must have a site of disease amenable to biopsy, and be a candidate for tumor biopsy according to the treating institution's guidelines. Patient must be willing to undergo a new tumor biopsy at screening, and during therapy on the study, if medically feasible. Exceptions may be considered after documented discussion with Novartis. Patients with archival tumor tissue obtained ≤ 6 months prior to study treatment initiation do not need to undergo a new tumor biopsy at screening, if the patient has not received any anti-cancer therapy since the biopsy was taken, and if adequate tissue is available.
Patients must have body weight > 36 kg.

Eligibility Exclusion Criteria

Impaired cardiac function or clinically significant cardiac disease.
Use of agents known to prolong the QT interval unless they can be permanently discontinued for the duration of study.
History of severe hypersensitivity reactions to any ingredient of study drug(s) and other mAbs and/or their excipients.
Active, known or suspected autoimmune disease. Patients with vitiligo, type I diabetes, residual hypothyroidism only requiring hormone replacement, psoriasis not requiring systemic treatment or conditions not expected to recur may be considered. Patients previously exposed to anti-PD-1/PD-L1 treatment who are adequately treated for skin rash or with replacement therapy for endocrinopathies should not be excluded.
Any evidence of interstitial lung disease (ILD) or pneumonitis, or a prior history of ILD or non-infectious pneumonitis requiring high-dose glucocorticoids.
Patients who discontinued prior anti-PD-(L)1 therapy due to an anti-PD-(L)1-related toxicity (applicable to the KFA115 in combination with tislelizumab treatment arms).
Patients with symptomatic peripheral neuropathy limiting instrumental activities of daily living.
Other protocol-defined inclusion/exclusion criteria may apply

ARMS & Interventions

PARTICIPANT GROUP ARMINTERVENTION TREATMENT
Experimental: Single-agent KFA115 KFA115 monotherapyDrug: KFA115 Immunomodulatory agent Other Names: NVP-KFA115
Experimental: KFA115 run-in (1 cycle) + tislelizumab 1-cycle KFA115 run-in followed by addition of tislelizumabDrug: KFA115 Immunomodulatory agent Other Names: NVP-KFA115 Drug: tislelizumab Anti-PD-1 antibody Other Names: VDT482 BGB-A317
Experimental: KFA115 + tislelizumab KFA115 + tislelizumab combination given concurrentlyDrug: KFA115 Immunomodulatory agent Other Names: NVP-KFA115 Drug: tislelizumab Anti-PD-1 antibody Other Names: VDT482 BGB-A317

Primary Outcome

MeasuresMeasure DescriptionMEASURE TIME FRAME
Incidence and severity of dose limiting toxicities (DLTs) during the DLT evaluation period of single-agent KFA115 (dose escalation only)A DLT is defined as an adverse event or abnormal laboratory value that occurs during the DLT evaluation period where the relationship to study treatment cannot be ruled out, and is not primarily related to disease, disease progression, intercurrent illness, or concomitant medications and meets the criteria defined in the study protocol28 days
Incidence and severity of dose limiting toxicities (DLTs) during the DLT evaluation period of KFA115 in combination with tislelizumab (dose escalation only)A DLT is defined as an adverse event or abnormal laboratory value that occurs during the DLT evaluation period where the relationship to study treatment cannot be ruled out, and is not primarily related to disease, disease progression, intercurrent illness, or concomitant medications and meets the criteria defined in the study protocol56 days
Incidence and severity of adverse events (AEs) and serious adverse events (SAEs)Incidence and severity of adverse events and serious adverse events, including changes in laboratory values, vital signs, and electrocardiograms qualifying and reported as AEs35 months
Frequency of dose interruptions, reductionsNumber of dose interruptions of KFA115 and tislelizumab, and number of dose reductions of KFA11535 months
Dose intensityDose intensity of KFA115 and tislelizumab is defined as the ratio of actual cumulative dose received and actual duration of exposure35 months

Secondary Outcome

MEASURESMEASURE DESCRIPTIONMEASURE TIME FRAME
Best overall response (BOR) per RECIST v1.1BOR is defined as the best response recorded from the start of the treatment until disease progression/recurrence35 months
Progression free survival (PFS) per RECIST v1.1PFS is defined as the time from date of start of treatment to the date of event defined as the first documented progression or death due to any cause35 months
Duration of response (DOR) per RECIST v1.1DOR is defined as the time from the date of the first documented response (CR or PR) to the date of the first documented progression as per RECIST v1.1 or death due to underlying cancer35 months
Time to progression (TTP) per RECIST v1.1TTP is defined as the time from date of start of treatment to the date of event defined as the first documented progression or death due to underlying cancer35 months
Area under the concentration time curve (AUC) of KFA115 or tislelizumabArea under the concentration time curveDuring the first 168 days of treatment for single-agent KFA115 and 35 months for KFA115 in combination with tislelizumab
Peak plasma or serum concentration (Cmax) of KFA115 or tislelizumabThe maximum (peak) observed plasma or serum drug concentration after single dose administrationDuring the first 168 days of treatment for single-agent KFA115 and 35 months for KFA115 in combination with tislelizumab
Minimum plasma or serum concentration (Cmin) of KFA115 or tislelizumabThe minimum observed plasma or serum drug concentration reached during the time interval between two dose administrationsDuring the first 168 days of treatment for single-agent KFA115 and 35 months for KFA115 in combination with tislelizumab
Time to reach peak plasma or serum concentration (Tmax) of KFA115 or tislelizumabThe time to reach maximum (peak) plasma or serum drug concentration after single dose administrationDuring the first 168 days of treatment for single-agent KFA115 and 35 months for KFA115 in combination with tislelizumab
Elimination half-life (T1/2) of KFA115 or tislelizumabThe elimination half-life associated with the terminal slope of a semi logarithmic concentration-time curveDuring the first 168 days of treatment for single-agent KFA115 and 35 months for KFA115 in combination with tislelizumab
The number of participants with anti-drug antibodies (ADA)Immunogenicity of tislelizumab when dosed in combination with KFA11535 months for KFA115 in combination with tislelizumab

Other Outcome

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