RecruitingPhase 1Phase 2NCT04143711

Study of DF1001 in Patients with Advanced Solid Tumors

A Phase I/II, First-In-Human, Multi-Part, Open-Label, Multiple-Ascending Dose Study to Investigate the Safety, Tolerability, Pharmacokinetics, Biological, and Clinical Activity of DF1001 in Patients with Locally Advanced or Metastatic Solid Tumors, and Expansion in Selected Indications


Sponsor

Dragonfly Therapeutics

Enrollment

378 participants

Start Date

Nov 11, 2019

Study Type

INTERVENTIONAL

Conditions

Summary

DF1001-001 is a study of a new molecule that targets natural killer (NK) cells and T-cell activation signals to specific receptors on cancer cells. The study will occur in two phases. The first phase will be a dose escalation phase, enrolling patients with various types of solid tumors that express human epidermal growth factor receptor 2 (HER2). The second phase will include a dose expansion using the best dose selected from the first phase of the study. Multiple cohorts will be opened with eligible patients having either HER2 activated non-small cell lung cancer, hormone receptor (HR) positive HER2 negative metastatic breast cancer, or HER2 positive metastatic breast cancer. DF1001-001 will be administered as monotherapy or in combination; combinations are DF1001 + nivolumab, DF1001 + Nab paclitaxel, and DF1001 + sacituzumab govitecan-hziy.


Eligibility

Min Age: 18 Years

Inclusion Criteria60

  • Signed written informed consent.
  • Male or female patients aged ≥ 18 years.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at study entry and an estimated life expectancy of at least 3 months.
  • Baseline Left Ventricular Ejection Fraction (LVEF) ≥ 55% measured by echocardiography (preferred) or multigated acquisition (MUGA) scan.
  • Adequate hematological function.
  • Adequate hepatic function.
  • Adequate renal function.
  • Effective contraception for women of child bearing potential (WOCBP) patients as defined by World Health Organization (WHO) guidelines for 1 "highly effective" method or 2 "effective" methods.
  • Have progression of unresectable locally advanced or metastatic NSCLC after last systemic therapy (as confirmed by investigator) or be intolerant of last systemic therapy.
  • Have HER2 overexpression status (IHC 2+ or 3+), or ERBB2 amplification, or HER2 activating mutation
  • Have recurrent or progressive disease during or after platinum doublet-based chemotherapy.
  • Have received and progressed on or after anti-PD-(L)1 therapy.
  • Documented evidence of HR+ metastatic breast cancer
  • Documented evidence of HER2- status.
  • Disease progression or recurrence after prior therapy.
  • Have histologically confirmed HER2+ breast cancer.
  • Have received prior treatment with trastuzumab, pertuzumab, ado-trastuzumab emtansine (T-DM1), or trastuzumab deruxtecan (T-DXd).
  • Have progression of unresectable locally advanced metastatic breast cancer after last systemic therapy or be intolerant of last systemic therapy.
  • Evidence of objective disease, but participation does not require a measurable lesion.
  • Locally advanced or metastatic solid tumors, for which no standard therapy exists, or standard therapy has failed.
  • HER2 expression by immunohistochemistry and/or erbb2 amplification and/or erbb2 activating mutations.
  • Eligible to receive nivolumab per its label for a malignancy of epithelial origin; or
  • Have no standard therapy available, or standard therapy has failed, and must not have received nivolumab prior to joining the study.
  • HER2 expression by immunohistochemistry and/or ebb2 amplification and/or erbb2 activating mutations must be documented on either archival tissue or fresh tumor biopsy.
  • Patients must be eligible for treatment with nab-paclitaxel per its label, or have no standard therapy available, or standard therapy has failed.
  • HER2 expression by immunohistochemistry and/or erbb2 amplification and/or erbb2 activating mutations must be documented on either archival tissue or fresh tumor biopsy.
  • Fresh tumor biopsy must be obtained during the screening window.
  • HER2 expression by immunohistochemistry (IHC).
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1.
  • Histologically or cytologically documented locally advanced or metastatic transitional cell carcinoma of the urothelium (including renal pelvis, ureters, urinary urothelial, urethra).
  • Patients must have received a platinum containing chemotherapy and an anti PD-1 or anti PD-L1 for the treatment of urothelial bladder cancer.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1
  • Histologically documented (metastatic or locally advanced) breast cancer.
  • Absence of erbb2 amplification by ISH and/or HER2 IHC of 0, 1+, or 2+.
  • Patient must have progressed after one line of systemic chemotherapy.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1
  • Histologically documented (metastatic or locally advanced) breast cancer.
  • Erbb2 amplification by ISH and/or HER2 IHC of 3+, or 2+. If Herceptest score is 2+, ISH results should demonstrate erbb2 amplification.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1.
  • Documented history of erbb2 amplification.
  • Patients must have received at least one line of an approved or established therapy.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1.
  • Advanced (unresectable/recurrent/metastatic) gastric cancer or cancer of the gastro-esophageal junction.
  • Tumor must have been declared HER2 positive.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1.
  • Advanced (unresectable/recurrent/metastatic) gastric cancer or cancer of the gastro-esophageal junction.
  • Tumor must have been declared HER2 low; ISH non-amplified and/or HER2 IHC of 0, 1+ or 2+. If Herceptest score is 0, HER2 must be detected by IHC on at least 1+ of the tumor cells.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1.
  • Advanced (unresectable/recurrent/metastatic) esophageal cancer.
  • Tumor must have been declared HER2 positive.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1.
  • Advanced (unresectable/recurrent/metastatic) esophageal cancer.
  • Tumor must have been declared HER2 low; ISH non-amplified and/or HER2 IHC of 0, 1+ or 2+. If Herceptest score is 0, HER2 must be detected by IHC on at least 1+ of the tumor cells.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1.
  • Histologically confirmed NSCLC meeting stage criteria for stage IIIB, stage IV, or recurrent disease that has been confirmed to have HER2 expression (at least 1+, however, patients must not carry an erbb2 amplification) via archival or fresh biopsy tissue prior to study enrollment.
  • Patients must have recurrent or progressive disease during or after platinum doublet-based chemotherapy.
  • Disease must be measurable with at least 1 unidimensional measurable lesion by RECIST 1.1.
  • Histologically confirmed NSCLC meeting stage criteria for stage IIIB, stage IV, or recurrent disease that has been confirmed to have amplification of erbb2 via archival or fresh biopsy tissue prior to study enrollment.
  • Patients must have recurrent or progressive disease during or after platinum doublet-based chemotherapy.

Exclusion Criteria25

  • Concurrent anticancer treatment (eg, cytoreductive therapy, radiotherapy \[with the exception of palliative bone directed radiotherapy\], immune therapy, or cytokine therapy except for erythropoietin), major surgery (excluding prior diagnostic biopsy), concurrent systemic therapy with steroids or other immunosuppressive agents, or use of any investigational drug within 28 days or 5 half-lives before the start of study treatment. Note: Patients receiving bisphosphonates are eligible provided treatment was initiated at least 14 days before the first dose of DF1001.
  • Previous malignant disease other than the target malignancy to be investigated in this study within the last 3 years, with the exception of basal or squamous cell carcinoma of the skin or cervical carcinoma in situ.
  • Rapidly progressive disease.
  • Active or history of central nervous system (CNS) metastases.
  • Receipt of any organ transplantation including autologous or allogeneic stem-cell transplantation.
  • Significant acute or chronic infections (including historic positive test for human immunodeficiency virus \[HIV\], or active or latent hepatitis B or active hepatitis C tested during the screening window).
  • Preexisting autoimmune disease (except for patients with vitiligo) needing treatment with systemic immunosuppressive agents for more than 28 days within the last 3 years or clinically relevant immunodeficiencies (eg, dys-gammaglobulinemia or congenital immunodeficiencies), or fever within 7 days of Day 1.
  • Known severe hypersensitivity reactions to mAbs (≥ Grade 3 NCI-CTCAE v5.0), any history of anaphylaxis, or uncontrolled asthma (ie, 3 or more features of partly controlled asthma).
  • Persisting toxicity related to prior therapy \> Grade 1 NCI-CTCAE v5.0, however alopecia and sensory neuropathy ≤ Grade 2 is acceptable.
  • Pregnancy or lactation in females during the study.
  • Known alcohol or drug abuse.
  • Serious cardiac illness
  • NYHA III of IV heart failure or systolic dysfunction (LVEF \< 55%)
  • High-risk uncontrolled arrhythmias ie, tachycardia with a heart rate \> 100/min at rest
  • Significant ventricular arrhythmia (ventricular tachycardia) or higher-grade Atrioventricular block (AV-block; second-degree AV-block Type 2 \[Mobitz 2\] or third-degree AV-block)
  • Angina pectoris requiring anti-anginal medication
  • Clinically significant valvular heart disease
  • Evidence of transmural infarction on ECG
  • Poorly controlled hypertension (defined by: systolic \> 180 mm Hg or diastolic \> 100 mm Hg)
  • Clinically relevant uncontrolled cardiac risk factors, clinically relevant pulmonary disease or any clinically relevant medical condition in the opinion of the Investigator that may limit participation in this study.
  • Severe dyspnea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy.
  • All other significant diseases (e.g., inflammatory bowel disease), which, in the opinion of the Investigator, might impair the patient's ability to participate
  • Any psychiatric condition that would prohibit the understanding or rendering of informed consent.
  • Legal incapacity or limited legal capacity.
  • Incapable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol .

Interventions

DRUGDF1001

Immunotherapy agent targeting NK cells.

DRUGNivolumab

Anti-PD-1 immunotherapy agent

DRUGNab paclitaxel

A chemotherapy treatment combining paclitaxel with albumin

DRUGSacituzumab Govitecan-hziy

A Trop-2 (Tumor-associated calcium signal transducer 2) directed antibody and topoisomerase inhibitor drug conjugate


Locations(52)

Severance Hospital

Seoul, South Korea

University of California Irvine Medical Center

Irvine, California, United States

University of Southern California

Los Angeles, California, United States

Sharp Healthcare

San Diego, California, United States

University of California San Francisco

San Francisco, California, United States

University of Kansas Medical Center Research Institute, Inc.

Westwood, Kansas, United States

Louisiana State University

New Orleans, Louisiana, United States

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Baltimore, Maryland, United States

University of Michigan

Ann Arbor, Michigan, United States

Henry Ford Health System

Detroit, Michigan, United States

Icahn School of Medicine: Tisch Cancer Institute at Mount Sinai Medical Center

New York, New York, United States

Montefiore Einstein Center for Cancer Care

The Bronx, New York, United States

University Hospitals Cleveland Medical Center

Cleveland, Ohio, United States

The Ohio State University

Columbus, Ohio, United States

University of Pennsylvania, Abramson Cancer Center

Philadelphia, Pennsylvania, United States

Rhode Island Hospital

Providence, Rhode Island, United States

Vanderbilt-Ingram Cancer Center

Nashville, Tennessee, United States

MD Anderson Cancer Center

Houston, Texas, United States

Multicare Health System Tacoma General Hospital

Tacoma, Washington, United States

University of Wisconsin

Madison, Wisconsin, United States

Centre Hospitalier de l'Ardenne

Arlon, Belgium

Grand Hopital de Charleroi

Charleroi, Belgium

Domaine Universitaire du Sart Tilman; CHU de Liege

Liège, Belgium

Rigshospitalet

Copenhagen, Capital Region, Denmark

Herlev og Gentofte Hospital

Herlev, Denmark

Institut Curie

Paris, Paris, France

Groupe Hospitalier Saint Andre

Bordeaux, France

Centre Georges-Francois Leclerc

Dijon, France

Centre Oscar Lambret

Lille, France

Centre Leon Berard

Lyon, France

Institut Paoli Calmettes

Marseille, France

Institut Regional du Cancer de Montepelier

Montpellier, France

Groupe Hospitalier Pitie Salpetriere

Paris, France

CHU de Rennes Hopital Pontechaillou

Rennes, France

ICO - Site Rene Gauducheau

Saint-Herblain, France

Institut Claudius Regaud

Toulouse, France

Amsterdam University Medical Center

Amsterdam, Netherlands

Universitair Medisch Centrum Groningen

Groningen, Netherlands

Maasticht University Medical Center

Maastricht, Netherlands

Radboud University Nijmegen

Nijmegen, Netherlands

Erasmus University Medical Center

Rotterdam, Netherlands

UMC Utrecht

Utrecht, Netherlands

Inje University Haeundae Paik Hospital

Busan, South Korea

Kosin University Gospel Hospital

Busan, South Korea

National Cancer Center

Goyang-si, South Korea

Ajou University Hospital

Gyeonggi-do, South Korea

CHA Bundang Medical Center, CHA University

Gyeonggi-do, South Korea

Seoul National University Bundang Hospital

Seongnam, South Korea

Asan Medical Center

Seoul, South Korea

Korea University Guro Hospital

Seoul, South Korea

Seoul National University Hospital

Seoul, South Korea

The Catholic University of Korea, Seoul St. Mary's Hospital

Seoul, South Korea

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