A Study of MEDI1191 in Sequential and Concurrent Combination With Durvalumab in Subjects With Advanced Solid Tumors

• ClinicalTrials.gov Identifier: NCT03946800
• Recruitment Status: Completed
• First Posted: May 13, 2019
• Last Update Posted: October 31, 2023
• Sponsor: MedImmune LLC
• Information provided by (Responsible Party): MedImmune LLC

Study Description

Brief Summary:

To evaluate MEDI1191 administered intratumorally in sequential and concurrent combination with intravenous durvalumab in patients with solid tumors.

Condition or disease	Intervention/treatment	Phase
Solid Tumors; Cancer	Biological: MEDI1191; Biological: Durvalumab	Phase 1

Detailed Description:

This is a multicenter, open-label study to evaluate MEDI1191 delivered by intratumoral injection in sequential and concurrent combination with intravenous durvalumab to subjects with solid tumors. The study has a dose escalation design using mTPI-2 to evaluate a range of doses.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 61 participants
• Allocation: Non-Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Phase 1, Open-label, Dose-escalation and Expansion Study of MEDI1191 Administered Intratumorally as Monotherapy and in Combination With Durvalumab in Subjects With Advanced Solid Tumors
• Actual Study Start Date: May 8, 2019
• Actual Primary Completion Date: August 24, 2023
• Actual Study Completion Date: August 24, 2023

Arms and Interventions

Arm	Intervention/treatment
Experimental: MEDI1191 escalation in combination with durvalumab; MEDI1191 escalation in sequential and concurrent combination with durvalumab	Biological: MEDI1191; Subjects will receive MEDI1191 (at least twice); Biological: Durvalumab; Subject will receive durvalumab every 4 weeks
Experimental: MEDI1191 expansion in combination with durvalumab; MEDI1191 expansion in concurrent combination with durvalumab	Biological: MEDI1191; Subjects will receive MEDI1191 (at least twice); Biological: Durvalumab; Subject will receive durvalumab every 4 weeks

Outcome Measures

Primary Outcome Measures :

1. Number of subjects with adverse events (AEs) serious adverse events (SAEs) and dose limiting toxicities (DLTs). [ Time Frame: From time of informed consent until 90 days after the last dose of investigational product (MEDI1191 or durvalumab). ]
   The occurrence of DLTs will be used to establish the maximum tolerated dose (MTD) of MEDI1191.
2. Objective response rate (ORR) in patients within expansion arms. [ Time Frame: Estimated to be from time of informed consent up to 3.5 years. ]
   The ORR is defined as the proportion of subjects with confirmed response (CR) or confirmed partial response (PR).

Secondary Outcome Measures :

1. Number of advanced solid tumor subjects with adverse events (AEs) serious adverse events (SAEs) and dose limiting toxicities (DLTs). [ Time Frame: From time of informed consent until 90 days after the last dose of investigational product (MEDI1191 or durvalumab). ]
   The occurrence of DLTs will be used to establish the maximum tolerated dose (MTD) of MEDI1191.
2. Objective response rate (ORR) in advanced solid tumor subjects. [ Time Frame: Estimated to be from time of informed consent up to 3.5 years. ]
   The ORR is defined as the proportion of subjects with confirmed response (CR) or confirmed partial response (PR).
3. Disease Control Rate (DCR). [ Time Frame: Estimated to be from time of informed consent up to 3.5 years. ]
   The DCR will be estimated by the proportion of disease control. Disease control is defined as CR, PR or stable disease.
4. Duration of Response (DoR). [ Time Frame: Estimated to be from time of informed consent up to 3.5 years. ]
   The DoR is defined as the duration from the first documentation of objective response to the first documented disease progression or death due to any cause, whichever occurs first.
5. Time To Response (TTR). [ Time Frame: Estimated to be from time of informed consent up to 3.5 years . ]
   The TTR is defined as the time from the start of treatment with any investigational product until the first documentation of a subsequently confirmed objective response.
6. Progression Free Survival (PFS). [ Time Frame: Estimated to be from time of informed consent up to 3.5 years. ]
   PFS will be measured from the start of treatment with any investigational product until the first documentation of disease progression or death due to any cause, whichever occurs first.
7. Overall Survival (OS). [ Time Frame: Estimated to be from time of informed consent up to 3.5 years. ]
   OS will be measured from the start of treatment with investigational product until death due to any cause.
8. Maximum observed concentration (Cmax) of MEDI1191 and durvalumab [ Time Frame: From first dose of MEDI1191 through to 30 days after last dose of investigational product. ]
   The endpoints for assessment of PK of MEDI1191 and durvalumab include individual MEDI1191 and durvalumab concentrations in serum at different timepoints after administration.
9. Area under the concentration-time curve (AUC) of MEDI1191 [ Time Frame: From first dose of MEDI1191 through to 30 days after last dose of investigational product. ]
   The endpoints for assessment of PK of MEDI1191 include MEDI1191 concentrations in serum at different timepoints after administration.
10. Clearance of MEDI1191 [ Time Frame: From first dose of MEDI1191 through to 30 days after last dose of investigational product. ]
    The endpoints for assessment of PK of MEDI1191 include MEDI1191 concentrations in serum at different timepoints after administration.
11. Immunogenicity of MEDI1191 [ Time Frame: From first dose of MEDI1191 through to 3.5 years after last dose of investigational product. ]
    The endpoints for assessment of immunogenicity of MEDI1191 include the number and percentage of subjects who develop detectable anti-drug antibodies (ADAs).

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 101 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• ECOG 0 to 1.
• Adequate organ function within 2 weeks of starting study treatment.
• Prior to the first dose of MEDI1191, subjects with central nervous system (CNS) metastases must have been treated and must be asymptomatic.
• Cessation of systemic corticosteroids at doses exceeding 12 mg/day prednisone or equivalent, methotrexate, azathioprine, ustekinumab (Stelara®), and tumor necrosis factor (TNF)-α/IL-6 blockers for at least 7 days prior to the first dose of MEDI1191.
• Subjects must have at least one lesion suitable for intratumoral dosing for superficial lesions but at least two lesion suitable for intratumoral dosing for deep-seated lesions.
• Subjects must have at least one non-injected lesion that can be measured by RECIST v1.1.
• Histologic or cytologic confirmation of advanced solid tumor.
• Received and have progressed on or refractory to at least 1 line of standard systemic therapy in the recurrent/metastatic setting.
• Highly effective method of contraception from screening, and must agree to continue using such precautions for 3 months after the final dose of investigational product.
• Nonsterilized male subjects who are sexually active with a female partner of childbearing potential must use a male condom with spermicide from Day 1 through 3 months after receipt of the final dose of investigational product.

Exclusion Criteria:

• Subjects who have received prior IL-12 either alone or as part of a treatment regimen.
• Subjects who were administered any live attenuated vaccines within 30 days prior to first MEDI1191 injection.
• Known allergy or hypersensitivity to any component of MEDI1191 or durvalumab formulations.
• Active or prior documented autoimmune disorders within the past 5 years prior to the first scheduled dose of study treatment except alopecia, hypothyroidism (stable of hormone replacement), chronic skin condition (does not require systemic therapy), and celiac disease (controlled by diet alone).
• Immune-deficiency states - myelodysplastic disorders, marrow failure states, human immunodeficiency virus infection, history of solid organ transplant, bone marrow allograft, or active tuberculosis.
• History of coagulopathy resulting in uncontrolled bleeding or other bleeding disorders.
• Require continuous anticoagulation or antiplatelet therapy (except for ≤ 100 mg acetylsalicylic acid [ASA]) which cannot be interrupted for more than 7 days for IT delivery of MEDI1191.
• Any concurrent chemotherapy, radiotherapy, immunotherapy, biologic or hormonal therapy for cancer.

• Receipt of any conventional or investigational anticancer therapy within 21 days or palliative radiotherapy within 7 days prior to the first dose of study treatment. For subjects who have received prior immunotherapy, the following additional exclusion criteria apply:

  1. Received only one dose of prior immunotherapy agent alone or as part of a combination regimen
  2. Experienced a toxicity that led to permanent discontinuation of prior immunotherapy
  3. All AEs while receiving prior immunotherapy did not resolve to ≤ Grade 1 or baseline prior to screening for this study.
  4. Experienced a ≥ Grade 3 AE (including pneumonitis) or neurologic, ocular, or cardiac AE of any grade while receiving prior immunotherapy.
  5. Required the use of additional immunosuppression other than corticosteroids for the management of an AE, or experienced recurrence of an AE if re-challenged, or is currently requiring a maintenance dose of > 12 mg prednisone or equivalent per day.
• Any toxicity from prior therapy that has not completely resolved to ≤ Grade 1 or baseline at the time of consent.
• Current or prior use of immunosuppressive medication within 14 days prior to the first dose of MEDI1191, except intranasal, topical, inhaled corticosteroids, local steroid injections, systemic corticosteroids at physiologic doses not to exceed 12 mg/day of prednisone or equivalent, or steroids as premedication for hypersensitivity reactions.
• Cardiac exclusions: New York Heart Association Class 3 or 4 congestive heart failure, uncontrolled hypertension, acute coronary syndrome within 6 months.
• Any condition that would interfere with evaluation of the investigational product or interpretation of subject safety or study results.
• Uncontrolled intercurrent illness.
• Untreated, active hepatitis B or C.
• Major surgery within 4 weeks prior to first dose of MEDI1191 or still recovering from prior surgery.
• Subjects with untreated active major depression with suicidal ideation and/or plan.
• Female subjects who are pregnant, lactating, or intend to become pregnant during their participation in this study.

Contacts and Locations

Locations

United States, California

Research Site

La Jolla, California, United States, 92093

Research Site

Los Angeles, California, United States, 90025

Research Site

Los Angeles, California, United States, 90089

United States, New York

Research Site

Bronx, New York, United States, 10461

Research Site

New York, New York, United States, 10029

United States, Rhode Island

Research Site

Providence, Rhode Island, United States, 02903

United States, Texas

Research Site

Houston, Texas, United States, 77030

Spain

Research Site

Barcelona, Spain, 08035

Research Site

Madrid, Spain, 28027

Research Site

Pamplona, Spain, 31008

Sponsors and Collaborators

MedImmune LLC

Investigators

• Study Director: MedImmune LCC; MedImmune LLC

More Information

• Responsible Party: MedImmune LLC
• ClinicalTrials.gov Identifier: NCT03946800
• Other Study ID Numbers: D8510C00001; 2020-005784-31 ( EudraCT Number )
• First Posted: May 13, 2019
• Last Update Posted: October 31, 2023
• Last Verified: October 2023

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Yes

Plan Description

Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment:

https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.

• Time Frame: AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
• Access Criteria: When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
• URL: https://astrazenecagroup-dt.pharmacm.com/DT/Home

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by MedImmune LLC:

MEDI1191; Durvalumab; MEDI4736; Imfinzi

Additional relevant MeSH terms:

Neoplasms; Durvalumab; Antineoplastic Agents, Immunological; Antineoplastic Agents