A Dose Escalation and Cohort Expansion Study of NKTR-214 in Combination With Nivolumab and Other Anti-Cancer Therapies in Patients With Select Advanced Solid Tumors

NCT ID: NCT02983045

Last Updated: 2023-03-13

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

557 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-19

Study Completion Date

2022-04-28

Brief Summary

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In this four-part study, NKTR-214 was administered in combination with nivolumab and with/without other anticancer therapies. Part 1 considered escalating doublet (NKTR 214 + nivolumab) doses to determine the RP2D. Part 2 considered dose expansion cohorts for the doublet (NKTR 214 + nivolumab ± chemotherapy). Part 3 was schedule-finding for a triplet therapy (NKTR 214 + nivolumab + ipilimumab). Part 4 dose expansion for the triplet (NKTR 214 + nivolumab + ipilimumab) was planned to further assess the efficacy of the RP2D triplet combination at dosing schedules from Part 3.

Detailed Description

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Part 1 enrolled patients with advanced or metastatic melanoma, renal cell carcinoma (RCC), non-small cell lung cancer (NSCLC), urothelial carcinoma, or triple negative breast cancer (TNBC) to determine the recommended Phase 2 dose (RP2D) or maximum tolerated dose (MTD) of NKTR 214 + nivolumab doublet therapy.

Part 2 enrolled patients with advanced or metastatic solid tumor malignancies (including 9 tumor types consisting of the same 5 tumor types as in Part 1, plus hormone receptor positive human epidermal growth factor receptor 2 \[HER 2\] negative breast cancer \[HR+ HER2- BC\], gastric cancer, colorectal carcinoma, and small cell lung cancer \[SCLC\]) to assess the efficacy of the RP2D.

Part 3 enrolled patients with advanced or metastatic melanoma, RCC, NSCLC, or urothelial carcinoma (UCC) in a first-line setting (1L) to assess the safety and tolerability of NKTR 214 + nivolumab + ipilimumab triplet therapy Three dosing schedules were evaluated to establish RP2D dosing schedules for Part 4 of the study.

Part 4 planned to enroll patients with advanced or metastatic melanoma, RCC, NSCLC, or UCC to further assess the efficacy of the RP2D triplet combination at the 3 dosing schedules from Part 3. Patients were enrolled simultaneously to each tumor cohort.

All patients enrolled in the study were closely monitored for safety, tolerability and response per RECIST criteria. The primary efficacy endpoint was objective response rate (ORR) using RECIST 1.1 at the RP2D doublet.

Conditions

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Melanoma Renal Cell Carcinoma Non Small Cell Lung Cancer Urothelial Carcinoma Triple Negative Breast Cancer HR+/HER2- Breast Cancer Gastric Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dose Escalation: Combination of NKTR-214 + nivolumab

NKTR 214 + nivolumab at 5 dosage levels to determine the RP2D Part 1 of RP2D in patients with advanced or metastatic melanoma, RCC, NSCLC, urothelial carcinoma, or TNBC.

Group Type EXPERIMENTAL

Dose Escalation Doublet: Combination of NKTR-214 + nivolumab

Intervention Type DRUG

NKTR 214 + nivolumab at 5 dosage levels.

Dose Expansion: Combination of NKTR-214 + nivolumab

NKTR-214+nivolumab in patients with advanced or metastatic solid tumor malignancies to assess the efficacy of the RP2D.

Group Type EXPERIMENTAL

Dose Expansion Doublet: Combination of NKTR-214 + nivolumab

Intervention Type DRUG

Select patient cohorts with select tumor types will be dosed with NKTR-214 + nivolumab at the RP2D + other anti-cancer therapies per institution standard.

Experimental: Combination of NKTR-214 + nivolumab + ipilimumab

To assess the safety and tolerability of NKTR 214 + nivolumab + ipilimumab triplet therapy and establish RP2D dosing schedules for Part 4 in patients with advanced or metastatic melanoma, RCC, NSCLC, or UCC in a first-line setting (1L).

Group Type EXPERIMENTAL

Schedule Finding Triplet: Combination of NKTR-214+ nivolumab+ ipilimumab

Intervention Type DRUG

1L patients with RCC, NSCLC, UCC, and melanoma received NKTR-214 0.006 mg/kg q3w in combination with nivolumab and ipilimumab according to 3 dosing schedules.

Experimental: Dose Expansion of Part 3

To further assess the RP2D triplet combination dosing schedules from Part 3 in 1L NSCLC and 1L RCC patients.

Group Type EXPERIMENTAL

Dose Expansion Triplet: Combination of NKTR-214+ nivolumab+ ipilimumab

Intervention Type DRUG

Combination of NKTR-214 + nivolumab + ipilimumab was administered at RP2D dose/schedules in select tumor types

Interventions

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Dose Escalation Doublet: Combination of NKTR-214 + nivolumab

NKTR 214 + nivolumab at 5 dosage levels.

Intervention Type DRUG

Dose Expansion Doublet: Combination of NKTR-214 + nivolumab

Select patient cohorts with select tumor types will be dosed with NKTR-214 + nivolumab at the RP2D + other anti-cancer therapies per institution standard.

Intervention Type DRUG

Schedule Finding Triplet: Combination of NKTR-214+ nivolumab+ ipilimumab

1L patients with RCC, NSCLC, UCC, and melanoma received NKTR-214 0.006 mg/kg q3w in combination with nivolumab and ipilimumab according to 3 dosing schedules.

Intervention Type DRUG

Dose Expansion Triplet: Combination of NKTR-214+ nivolumab+ ipilimumab

Combination of NKTR-214 + nivolumab + ipilimumab was administered at RP2D dose/schedules in select tumor types

Intervention Type DRUG

Other Intervention Names

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Bempegaldesleukin + Opdivo® Bempegaldesleukin+ Opdivo® Carboplatin (Paraplatin®) Cisplatin (Platinol®) Pemetrexed (Alimta®) Paclitaxel (Taxol®) Bempegaldesleukin+ Opdivo®+ Yervoy® Bempegaldesleukin+ Opdivo®+ Yervoy®

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed diagnosis of a locally advanced (not amenable to curative therapy such as surgical resection) or metastatic solid tumors
* Life expectancy \> 12 weeks
* Patients must not have received prior interleukin-2 (IL-2) therapy
* Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
* Measurable disease per RECIST 1.1
* Patients with stable brain metastases under certain criteria

Exclusion Criteria

* Use of an investigational agent or an investigational device within 28 days before administration of first dose of NKTR--214
* Females who are pregnant or breastfeeding
* Participants who have an active autoimmune disease requiring systemic treatment within the past 3 months or have a documented history of clinically severe autoimmune disease that requires systemic steroids or immunosuppressive agents
* History of organ transplant that requires use of immune suppressive agents
* Active malignancy not related to the current diagnosed malignancy
* Evidence of clinically significant interstitial lung disease or active, noninfectious pneumonitis
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bristol-Myers Squibb

INDUSTRY

Sponsor Role collaborator

Nektar Therapeutics

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Study Director

Role: STUDY_DIRECTOR

Nektar Therapeutics

Locations

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UCSD, Moores Cancer Center

La Jolla, California, United States

Site Status

UCLA

Los Angeles, California, United States

Site Status

Stanford Cancer Institute

Stanford, California, United States

Site Status

University of Colorado, Denver

Denver, Colorado, United States

Site Status

Yale School of Medicine

New Haven, Connecticut, United States

Site Status

University of Florida

Gainesville, Florida, United States

Site Status

Orlando Health Inc.

Orlando, Florida, United States

Site Status

Emory University Hospital

Atlanta, Georgia, United States

Site Status

Loyola University Medical Center, Chicago

Maywood, Illinois, United States

Site Status

Indiana University Health Melvin & Bren Simon Cancer Center

Indianapolis, Indiana, United States

Site Status

University of Kansas Cancer Center

Kansas City, Kansas, United States

Site Status

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

Washington University School of Medicine in St. Louis

St Louis, Missouri, United States

Site Status

Roswell Park Cancer Institute

Buffalo, New York, United States

Site Status

New York University Langone Medical Center - NYU Cancer Institute

New York, New York, United States

Site Status

Memorial Sloan-Kettering Cancer Center

New York, New York, United States

Site Status

Providence Portland Medical Center

Portland, Oregon, United States

Site Status

The University of Texas MD Anderson Cancer Center

Houston, Texas, United States

Site Status

Inova Fairfax Hospital

Fairfax, Virginia, United States

Site Status

Virginia Cancer Specialists, PC

Fairfax, Virginia, United States

Site Status

Seattle Cancer Care Alliance

Seattle, Washington, United States

Site Status

Antwerp University Hospital

Edegem, , Belgium

Site Status

Vzw Az Groeninge

Kortrijk, , Belgium

Site Status

UZ Leuven

Leuven, , Belgium

Site Status

CHU de Liège

Liège, , Belgium

Site Status

GZA Ziekenhuizen Campus Sint-Augustinus

Wilrijk, , Belgium

Site Status

BC Cancer Agency Vancouver Centre

Vancouver, British Columbia, Canada

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

Princess Margaret Cancer Centre

Toronto, Ontario, Canada

Site Status

Jewish General Hospital

Montreal, Quebec, Canada

Site Status

L'Institut Paoli - Calmettes

Marseille, Brouches-duRhone, France

Site Status

Institut de Cancerologie de l'Ouest

Saint-Herblain, Loire-Atlantique, France

Site Status

Centre Léon Bérard

Lyon, , France

Site Status

Assistance Publique Hopitaux de Marseille - Hopital Nord

Marseille, , France

Site Status

Gustave Roussy

Villejuif, , France

Site Status

Fondazione IRCCS Istituto Nazionale dei Tumori

Milan, , Italy

Site Status

Istituto Europeo di Oncologia

Milan, , Italy

Site Status

Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"

Napoli, , Italy

Site Status

Azienda Ospedaliera San Camillo-Forlanini

Roma, , Italy

Site Status

Azienda Ospedaliera Universitaria Senese

Siena, , Italy

Site Status

Institute for Cancer Research and Treatment (IRCC)

Turin, , Italy

Site Status

Szpital Specjalistyczny w Brzozowie Podkarpacki Ośrodek Onkologiczny im. Ks. B. Markiewicza

Brzozów, , Poland

Site Status

Szpitale Pomorskie Sp. z o.o.

Gdynia, , Poland

Site Status

Instytut Medyczny Santa Familia Sp. z o. o. w Łodzi

Lodz, , Poland

Site Status

Mazowieckie Centrum Leczenia Chorób Płuc i Gruźlicy

Otwock, , Poland

Site Status

Wielkopolskie Centrum Pulmonologii i Torakochirurgii

Poznan, , Poland

Site Status

Med-Polonia Sp. z o.o.

Poznan, , Poland

Site Status

Hospital Quirón Barcelona

Barcelona, , Spain

Site Status

Hospital Clínic de Barcelona

Barcelona, , Spain

Site Status

Hospital Universitario Ramón y Cajal

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status

Centro Integral Oncológico Clara Campal (CIOCC)

Madrid, , Spain

Site Status

Clínica Universidad de Navarra

Pamplona, , Spain

Site Status

Campus Hospital Universitario Virgen del Rocío - Instituto de Biomedicina de Sevilla (IBIS)

Seville, , Spain

Site Status

The Royal Marsden NHS Trust

London, , United Kingdom

Site Status

Mount Vernon Cancer Centre

Northwood, , United Kingdom

Site Status

The Christie NHS Foundation Trust

Withington, , United Kingdom

Site Status

Countries

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United States Belgium Canada France Italy Poland Spain United Kingdom

References

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Siefker-Radtke AO, Cho DC, Diab A, Sznol M, Bilen MA, Balar AV, Grignani G, Puente E, Tang L, Chien D, Hoch U, Choudhury A, Yu D, Currie SL, Tagliaferri MA, Zalevsky J, Hurwitz ME, Tannir NM. Bempegaldesleukin plus Nivolumab in First-line Metastatic Urothelial Carcinoma: Results from PIVOT-02. Eur Urol. 2022 Oct;82(4):365-373. doi: 10.1016/j.eururo.2022.05.002. Epub 2022 May 25.

Reference Type DERIVED
PMID: 35643589 (View on PubMed)

Diab A, Tykodi SS, Daniels GA, Maio M, Curti BD, Lewis KD, Jang S, Kalinka E, Puzanov I, Spira AI, Cho DC, Guan S, Puente E, Nguyen T, Hoch U, Currie SL, Lin W, Tagliaferri MA, Zalevsky J, Sznol M, Hurwitz ME. Bempegaldesleukin Plus Nivolumab in First-Line Metastatic Melanoma. J Clin Oncol. 2021 Sep 10;39(26):2914-2925. doi: 10.1200/JCO.21.00675. Epub 2021 Jul 13.

Reference Type DERIVED
PMID: 34255535 (View on PubMed)

Veatch JR, Singhi N, Jesernig B, Paulson KG, Zalevsky J, Iaccucci E, Tykodi SS, Riddell SR. Mobilization of pre-existing polyclonal T cells specific to neoantigens but not self-antigens during treatment of a patient with melanoma with bempegaldesleukin and nivolumab. J Immunother Cancer. 2020 Dec;8(2):e001591. doi: 10.1136/jitc-2020-001591.

Reference Type DERIVED
PMID: 33298619 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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16-214-02

Identifier Type: -

Identifier Source: org_study_id

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