Study of SO-C101 and SO-C101 in Combination With Pembro in Adult Patients With Advanced/Metastatic Solid Tumors

• ClinicalTrials.gov Identifier: NCT04234113
• Recruitment Status: Active, not recruiting
• First Posted: January 21, 2020
• Last Update Posted: March 7, 2024
• Sponsor: SOTIO Biotech AG
• Collaborator: SOTIO Biotech a.s.
• Information provided by (Responsible Party): Sotio Biotech Inc. ( SOTIO Biotech AG )

Study Description

Brief Summary:

A multicenter open-label phase 1/1b study to evaluate the safety and preliminary efficacy of SO-C101 as monotherapy and in combination with pembrolizumab in patients with selected advanced/metastatic solid tumors

Condition or disease	Intervention/treatment	Phase
Thyroid; Renal Cell Carcinoma; Non Small Cell Lung Cancer; Small-cell Lung Cancer; Bladder Cancer; Melanoma; Merkel Cell Carcinoma; Skin Squamous Cell Carcinoma; Microsatellite Instability High; Triple Negative Breast Cancer; Mesothelioma; Thymic Cancer; Cervical Cancer; Biliary Tract Cancer; Hepatocellular Carcinoma; Ovarian Cancer; Gastric Cancer; Head and Neck Squamous Cell Carcinoma; Anal Cancer	Drug: SO-C101; Drug: pembrolizumab	Phase 1

Detailed Description:

This study will assess the safety and tolerability of SO-C101 administered as monotherapy and in combination with an anti-PD-1 antibody (pembrolizumab) in patients with selected relapsed/refractory advanced/metastatic solid tumors (renal cell carcinoma, non-small cell lung cancer, small-cell lung cancer, bladder cancer, melanoma, Merkel-cell carcinoma, skin squamous-cell carcinoma, microsatellite instability high solid tumors, triple-negative breast cancer, mesothelioma, thyroid cancer, thymic cancer, cervical cancer, biliary track cancer, hepatocellular carcinoma, ovarian cancer, gastric cancer, head and neck squamous-cell carcinoma, and anal cancer).

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 200 participants
• Allocation: Non-Randomized
• Intervention Model: Sequential Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Multicenter Open-label Phase 1/1b Study to Evaluate the Safety and Preliminary Efficacy of SO-C101 as Monotherapy and in Combination With Pembrolizumab in Patients With Selected Advanced/Metastatic Solid Tumors
• Actual Study Start Date: June 13, 2019
• Estimated Primary Completion Date: August 2024
• Estimated Study Completion Date: November 2024

Arms and Interventions

Arm	Intervention/treatment
Experimental: Experimental: Part A (SO-C101 Monotherapy); Drug: SO-C101	Drug: SO-C101; SO-C101; Other Name: SOT101
Experimental: Experimental: Part B (SO-C101 combined with pembrolizumab); Drug: SO-C101 Drug: pembrolizumab	Drug: SO-C101; SO-C101; Other Name: SOT101; Drug: pembrolizumab; pembrolizumab
Experimental: Experimental: Part A1 (SO-C101 divided dosing, Monotherapy); Drug: SO-C101, twice a day as 2 divided doses (50%:50%)	Drug: SO-C101; SO-C101; Other Name: SOT101
Experimental: Experimental: Part B1 (SO-C101 divided dosing, combined with pembrolizumab); Drug: SO-C101, twice a day as 2 divided doses (50%:50%) Drug: pembrolizumab	Drug: SO-C101; SO-C101; Other Name: SOT101; Drug: pembrolizumab; pembrolizumab
Experimental: Experimental: Part D (SO-C101 Monotherapy, dose expansion at the RP2D identified in Part A); Drug: SO-C101 Indications: Relapsed/refractory advanced/metastatic renal cell carcinoma, relapsed/refractory advanced/metastatic skin squamous-cell carcinoma, and relapsed/refractory advanced/metastatic melanoma.	Drug: SO-C101; SO-C101; Other Name: SOT101
Experimental: Part D1 (SO-C101 divided dosing, Monotherapy, dose expansion at RP2D identified in Part A1); Drug: SO-C101, twice a day as 2 divided doses (50%:50%) Indications: Relapsed/refractory advanced/metastatic renal cell carcinoma, relapsed/refractory advanced/metastatic skin squamous-cell carcinoma, and relapsed/refractory advanced/metastatic melanoma.	Drug: SO-C101; SO-C101; Other Name: SOT101

Outcome Measures

Primary Outcome Measures :

1. Part A;Number of Participants With Dose-Limiting Toxicities (DLT): [ Time Frame: Through Cycle 1 (a cycle is 21 days] ]

   DLT was defined as any of the following AEs occurring in the first cycle of treatment which were attributable to the study drug: •Grade 5 events not clearly related to disease progression or any other causes, grade 3 or higher non-hematologic toxicity regardless of duration, and Hy's law cases will be considered DLTs.

   .•Grade 3 AST, ALT, or bilirubinemia that lasts >5 days •Grade 4 neutropenia or thrombocytopenia lasting >7 days

   • Febrile neutropenia
   • Grade 3 or higher thrombocytopenia with bleeding
   • Grade 4 immune-related AEs regardless of duration
   • Grade 3 or grade 4 non-infectious pneumonitis regardless of duration
   • Grade 3 immune-related AEs, excluding colitis, hepatitis, and pneumonitis, that do not downgrade to grade ≤2 within 3 days after onset of the event despite maximal supportive care including systemic corticosteroids or downgrade to grade 1 or baseline within 14 days
   • Grade 2 pneumonitis that does not resolve to grade 1 within 3 days of care
   • Grade 3 colitis
2. Part A;Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) [ Time Frame: Cycle 1, Day 1 (each cycle is 21 days) through study completion an average of 1 year ]
   An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant and jeopardized the participants or required treatment to prevent other AE outcomes for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent AEs are events which occurred between first dose of study drug and up to 90 days after last dose that were absent before treatment or that worsened relative to pre-treatment state.
3. Part A;Number of Participants With Treatment Related Adverse Events (AEs) and Serious Adverse Events (SAEs [ Time Frame: assessed in average of 7 months ]
   An AE was any untoward medical occurrence in a participant who received study drug. An SAE was an AE resulting in any of the following outcomes or deemed significant and jeopardized the participants or required treatment to prevent other AE outcomes for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent AEs are events which occurred between first dose of study drug and up to 90 days after last dose that were absent before treatment or that worsened relative to pre-treatment state
4. Part A;Number of Participants With Adverse Events (AEs) According to Severity of Grade 3 or Higher Severity Based on NCI CTCAE Version 5.0 [ Time Frame: assessed in average of 7 months ]
   An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant and jeopardized the participants or required treatment to prevent other AE outcomes for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. AEs were graded according to the Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0 and coded using the Medical Dictionary for Regulatory Activities (MedDRA) as Grade 3: Severe, Grade 4: Life threatening, Grade 5: Death related to AE. Participants were counted once according to the maximum grade observed
5. Part A;Number of Participants With Laboratory Test Abnormalities of Grade 3 or Higher Severity Based on NCI CTCAE Version 5.0: Biochemistry and Hematology [ Time Frame: Cycle 1 Day 1 (each cycle is 21 days) through study completion, an average of 1 year ]
   Laboratory parameters included hematological and biochemistry includes Na, Cl, ALT, AST, bilirubin (direct, total), alkaline phosphatase, lactate dehydrogenase, creatinine, glucose (preferably fasting) for hyper- or hypoglycemia, urea or blood urea nitrogen, cholesterol, triglyceride, CRP, uric acid, amylase, and lipase, hypercalcemia, hyperkalemia, hypermagnesemia, hypernatremia, hypoalbuminemia, hypocalcemia, hypokalemia, hypomagnesemia, hyponatremia, hypophosphatemia. Hematology parameters included anemia, hemoglobin increased, lymphocyte count increased, lymphopenia, neutrophils (absolute), platelets and white blood cells Hematology panel will include hemoglobin, glycated hemoglobin HbA1c at study entry, hematocrit, red blood cell count (for anemia), reticulocytes, WBC count (with full differentiation for leukopenia, neutropenia and etc)), ALC (lymphopenia), and platelet count assessment of for thrombocytopenia.
6. Part A;Number of Participants With Laboratory Test Abnormalities: Urinalysis [ Time Frame: Cycle 1 Day 1, (each cycle is 21 days) through study completion, an average of 1 year ]

   Urinalysis parameter includes: pH, glucose, protein, bilirubin, urobilinogen. Microscopic examination: red blood cell count, WBC, epithelial cells, bacteria.

   In case of proteinuria ≥100 mg/dL at screening, a 24-hour urine analysis will have to be performed (prior to the start of SO-C101 treatment) to document 24-hour proteinuria levels and a urine test will continue during the treatment period. In case of increase of proteinuria with ≥300 mg/dL (at any time), a 24-hour urine analysis will be performed.

   Test abnormalities was defined as deviation from normal range: Urine blood/hemoglobin abnormality was defined as presence and absence of blood/hemoglobin in urine of participants

7. Part A;Number of Participants With Clinically Significant Change From Screening in Vital Signs [ Time Frame: Screening, through study completion, an average of 1 year ]
   Vital signs included blood pressure, pulse rate, respiratory rate and weight. Change from screening values which are considered to be clinically significant based on investigator's judgement
8. Part A; Number of Participants With Eastern Cooperative Oncology Group [ECOG] Performance Status Score [ Time Frame: Screening, through study completion, an average of 1 year ]
   ECOG performance status was used to assess how disease affect the daily living abilities of a participant. It was measured on a scale ranging from 0 to 4, where 0=fully active (able to carry on all pre-disease activities without restriction); 1=restricted in physically strenuous activity but ambulatory (able to carry out light/sedentary work); 2=ambulatory and capable of all self-care but unable to carry out any work activities (for more than 50% of waking hours); 3=capable of limited self-care, confined to bed or chair (for >50% of waking hours); 4=completely disabled, not capable of any self-care, totally confined to bed or chair. Higher scores signified =more functional impairment of a participant.
9. Part B: Number of Participants With Dose-Limiting Toxicities (DLT): Dose Finding Phase [ Time Frame: Cycle 1 Day 1 to Cycle 2 Day 1 21 days ]

   DLT was defined as any of the following AEs occurring in the first cycle of treatment which were attributable to the study drug: •Grade 5 events not clearly related to disease progression or any other causes, grade 3 or higher non-hematologic toxicity regardless of duration, and Hy's law cases will be considered DLTs.

   .•Grade 3 AST, ALT, or bilirubinemia that lasts >5 days •Grade 4 neutropenia or thrombocytopenia lasting >7 days

   • Febrile neutropenia
   • Grade 3 or higher thrombocytopenia with bleeding
   • Grade 4 immune-related AEs regardless of duration
   • Grade 3 or grade 4 non-infectious pneumonitis regardless of duration
   • Grade 3 immune-related AEs, excluding colitis, hepatitis, and pneumonitis, that do not downgrade to grade ≤2 within 3 days after onset of the event despite maximal supportive care including systemic corticosteroids or downgrade to grade 1 or baseline within 14 days
   • Grade 2 pneumonitis that does not resolve to grade 1 within 3 days of care
   • Grade 3 colitis
10. Part B: Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events [ Time Frame: Cycle 1 Day 1, up to 90 days after last dose of study drug (assessed in average of 7 months ]
    An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant and jeopardized the participants or required treatment to prevent other AE outcomes for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent AEs are events which occurred between first dose of study drug and up to 90 days after last dose that were absent before treatment or that worsened relative to pre-treatment state
11. Part B: Number of Participants With Treatment Related Adverse Events (AEs) and Serious Adverse Events [ Time Frame: Cycle 1 Day 1, up to 90 days after last dose of study drug (assessed in average of 7 months ]
    An AE was any untoward medical occurrence in a participant who received study drug. An SAE was an AE resulting in any of the following outcomes or deemed significant and jeopardized the participants or required treatment to prevent other AE outcomes for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent AEs are events which occurred between first dose of study drug and up to 90 days after last dose that were absent before treatment or that worsened relative to pre-treatment state
12. Part B: Number of Participants With Adverse Events (AEs) According to Severity of Grade 3 or Higher Severity Based on NCI CTCAE Version 5.0 [ Time Frame: Cycle 1 Day 1, (each cycle is 21 days) through study completion, an average of 1 year ]
    An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant and jeopardized the participants or required treatment to prevent other AE outcomes for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. AEs were graded according to the Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0 and coded using the Medical Dictionary for Regulatory Activities (MedDRA) as Grade 3: Severe, Grade 4: Life threatening, Grade 5: Death related to AE. Participants were counted once according to the maximum grade observed.
13. Part B: Number of Participants With Laboratory Test Abnormalities of Grade 3 or Higher Severity Based on NCI CTCAE Version 5.0: Biochemistry and Hematology [ Time Frame: Cycle 1 Day 1, (each cycle is 21 days) through study completion, an average of 1 year ]
    Laboratory parameters included hematological and biochemistry parameters. Biochemistry parameters includes Na, Cl, ALT, AST, bilirubin (direct, total), alkaline phosphatase, lactate dehydrogenase, creatinine, glucose (preferably fasting) for hyper- or hypoglycemia, urea or blood urea nitrogen, cholesterol, triglyceride, CRP, uric acid, amylase, and lipase, hypercalcemia, hyperkalemia, hypermagnesemia, hypernatremia, hypoalbuminemia, hypocalcemia, hypokalemia, hypomagnesemia, hyponatremia, hypophosphatemia. Hematology parameters included anemia, hemoglobin increased, lymphocyte count increased, lymphopenia, neutrophils (absolute), platelets and white blood cells Hematology panel includes hemoglobin, glycated hemoglobin HbA1c at study entry, hematocrit, red blood cell count (for anemia), reticulocytes, WBC count (with full differentiation for leukopenia, neutropenia and etc)), ALC (lymphopenia), and platelet count assessment of for thrombocytopenia.
14. Part B: Number of Participants With Laboratory Test Abnormalities: Urinalysis [ Time Frame: Screening, through study completion, an average of 1 year ]

    Urinalysis parameter includes: pH, glucose, protein, bilirubin, urobilinogen. Microscopic examination: red blood cell count, WBC, epithelial cells, bacteria.

    In case of proteinuria ≥100 mg/dL at screening, a 24-hour urine analysis will have to be performed (prior to the start of SO-C101 treatment) to document 24-hour proteinuria levels and a urine test will continue during the treatment period. In case of increase of proteinuria with ≥300 mg/dL (at any time), a 24-hour urine analysis will be performed.

    Test abnormalities was defined as deviation from normal range: Urine blood/hemoglobin abnormality was defined as presence and absence of blood/hemoglobin in urine of participants

15. Part B: Number of Participants With Clinically Significant Change From Screening in Vital Signs [ Time Frame: Screening, through study completion, an average of 1 year ]
    Vital signs included blood pressure, pulse rate, respiratory rate and weight. Change from screening values which are considered to be clinically significant based on investigator's judgement.
16. Part B: Number of Participants With Eastern Cooperative Oncology Group [ECOG] [ Time Frame: Screening, through study completion, an average of 1 year ]
    ECOG performance status was used to assess how disease affect the daily living abilities of a participant. It was measured on a scale ranging from 0 to 4, where 0=fully active (able to carry on all pre-disease activities without restriction); 1=restricted in physically strenuous activity but ambulatory (able to carry out light/sedentary work); 2=ambulatory and capable of all self-care but unable to carry out any work activities (for more than 50% of waking hours); 3=capable of limited self-care, confined to bed or chair (for >50% of waking hours); 4=completely disabled, not capable of any self-care, totally confined to bed or chair. Higher scores signified =more functional impairment of a participant.

Secondary Outcome Measures :

1. Part A PK parameters [ Time Frame: assessed in average of 2 months ]
   Assess plasma concentration of SO-C101 at various timepoints
2. Part A Objective response rate (ORR) [ Time Frame: assessed in average of 5 months ]
   based on investigator review of radiographic images according to iRECIST
3. Part A Best overall response (BOR) [ Time Frame: assessed in average of 5 months ]
   BOR by iRECIST
4. Part A Duration of Response (DOR) [ Time Frame: assessed in average of 5 months ]
   DOR by iRECIST
5. Part A Clinical benefit rate (CBR) [ Time Frame: assessed in average of 5 months ]
   CBR by iRECIST
6. Part A Progression-Free Survival (PFS) [ Time Frame: assessed in average of 5 months ]
   PFS by iRECIST
7. Part A Immunogenicity analysis to assess antibodies to SO-C101 in human serum [ Time Frame: assessed in average of 4 months ]
   to assess antibodies to SO-C101 in human serum
8. Part B PK parameters of SO-C101 administered in combination with pemrolizumab [ Time Frame: assessed in average of 2 months ]
   Assess plasma concentration of SO-C101 (administered in combination with pembrolizumab) at various timepoints
9. Part B Objective response rate (ORR) [ Time Frame: assessed in average of 5 months ]
   SO-C101combined with pemrolizumab based on investigator review of radiographic images according to iRECIST
10. Part B Best overall response (BOR) of SO-C101 [ Time Frame: assessed in average of 5 months ]
    combined with pemrolizumab by iRECIST
11. Part B Duration of Response (DOR) [ Time Frame: assessed in average of 5 months ]
    of SO-C101 combined with pembrolizumab by iRECIST
12. Part B Clinical benefit rate (CBR) [ Time Frame: assessed in average of 5 months ]
    of SO-C101 combined with by iRECIST
13. Part B Progression-Free Survival (PFS) [ Time Frame: assessed in average of 5 months ]
    of SO-C101combined with pemrolizumab by iRECIST
14. Immunogenicity analysis to assess antibodies to SO-C101 [ Time Frame: assessed in average of 4 months ]
    SO-C101 in human serum

Eligibility Criteria

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

Criteria

Inclusion Criteria:

• Patients with selected histologically or cytologically confirmed advanced and/or metastatic solid tumors who are refractory to or intolerant of existing therapies known to provide clinical benefit for their condition.
• ECOG performance score 0-1. Patients with ECOG is 2 to be discussed with the sponsor's medical monitor to be agreed for inclusion.
• Estimated life expectancy of ≥3 months
• Washout periods: 4 weeks for chemotherapy, 4 weeks or 5 half-lives (whichever shorter) for biologic agents including immuno-oncology therapy and 4 weeks from major surgeries, definitive radiotherapy and 2 weeks after palliative radiotherapy
• At least one measurable lesion per iRECIST in a non-irradiated port. If in a previously irradiated port, must have demonstrated progression since best response to radiation therapy.
• Have fully recovered from previous treatment to grade ≤1 toxicity (excluding alopecia) or have stable grade 2 neuropathy
• Adequate organ system function
• Negative serum pregnancy test, if woman of child-bearing potential (WOCBP; non-childbearing is defined as greater than one year postmenopausal or surgically sterilized).
• Accessible tumor tissue available for fresh biopsy

Exclusion Criteria:

• Key exclusion criteria (Part A and B)

  • Patient with untreated CNS metastases and/or leptomeningeal carcinomatosis (see list of all exclusion criteria for details)
  • Known additional malignancy that is progressing and/or requires active treatment.
  • Prior exposure to drugs that are agonists of IL-2- or IL-15-like but not limited to rhIL-15 (NCI), ALT-803 (ALTOR), NKTR-214 (Nektar)
  • History of and current interstitial lung disease or fibrosis and pneumonitis; patients with clinically significant or oxygen requiring COPD or any chronic inflammatory disease (sarcoidosis etc.)
  • Has received a live vaccine within 30 days of planned start of study therapy (see list of all exclusion criteria for details)
  • Absolute WBC count ≤ 2.0 ×109/L;
  • ALC ≤0.5×109/L
  • Absolute neutrophil count ≤1.0 ×109/L
  • Platelet count ≤100×109/L
  • Pregnant or breastfeeding women
  • Any active autoimmune disease or a documented history of autoimmune disease, poorly controlled asthma, or history of syndrome that required systemic steroids (except the allowed doses) or immunosuppressive medications, except for patients with vitiligo or resolved childhood asthma/atopy (see list of all exclusion criteria for details)
  • Specific co-morbidities (see list of all exclusion criteria for details)
  • Is hypersensitive to any of the ingredients of pembrolizumab drug product (KeytrudaTM)
  • History of solid organ transplantation or hematopoietic stem cell transplantation

Contacts and Locations

Locations

United States, Connecticut

Yale Cancer Center

New Haven, Connecticut, United States, 06520

United States, Pennsylvania

University of Pittsburgh

Pittsburgh, Pennsylvania, United States, 15216

United States, Texas

MD Anderson Cancer Center

Houston, Texas, United States, 77030

Czechia

Masarykův Onkologický Ústav Brno Klinika komplexní onkologické péče

Brno, Czechia, 65653

France

Centre Léon Bérard

Lyon, France, 69379

Hôpitaux Universitaires de Marseille Timone

Marseille, France, 13005

Hopital Saint Louis

Paris, France, 75010

Institut Gustave Roussy

Paris, France, 94805

Institut de Cancerologie de L'Ouest

Saint Herblain, France, 44805

Institut Claudius Regaud

Toulouse, France, 31059

Spain

Vall d'Hebron Institute of Oncology

Barcelona, Spain, 08035

University Hospital Sanchinarro

Madrid, Spain, 28050

Sponsors and Collaborators

SOTIO Biotech AG

SOTIO Biotech a.s.

More Information

• Responsible Party: SOTIO Biotech AG
• ClinicalTrials.gov Identifier: NCT04234113
• Other Study ID Numbers: SC103
• First Posted: January 21, 2020
• Last Update Posted: March 7, 2024
• Last Verified: September 2023

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

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

Keywords provided by Sotio Biotech Inc. ( SOTIO Biotech AG ):

thyroid cancer; Renal Cell Carcinoma; Non Small Cell Lung Cancer; Small-cell Lung Cancer; Bladder Cancer; Melanoma; Merkel Cell Carcinoma; Skin Squamous Cell Carcinoma; Microsatellite Instability High; Triple Negative Breast Cancer; Mesothelioma; Thymic Cancer; Cervical Cancer; Biliary Tract Cancer; Hepatocellular Carcinoma; Ovarian Cancer; Gastric Cancer; Head and Neck Squamous Cell Carcinoma; Anal Cancer

Additional relevant MeSH terms:

Carcinoma, Merkel Cell; Carcinoma; Lung Neoplasms; Carcinoma, Non-Small-Cell Lung; Melanoma; Carcinoma, Squamous Cell; Carcinoma, Hepatocellular; Ovarian Neoplasms; Stomach Neoplasms; Uterine Cervical Neoplasms; Urinary Bladder Neoplasms; Carcinoma, Renal Cell; Small Cell Lung Carcinoma; Triple Negative Breast Neoplasms; Mesothelioma; Mesothelioma, Malignant; Squamous Cell Carcinoma of Head and Neck; Biliary Tract Neoplasms; Anus Neoplasms; Thymus Neoplasms; Microsatellite Instability; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Breast Neoplasms; Neoplasms by Site; Breast Diseases; Skin Diseases; Respiratory Tract Neoplasms; Thoracic Neoplasms