A Study of Botensilimab (AGEN1181) for the Treatment of Advanced Melanoma

NCT ID: NCT05529316

Last Updated: 2026-01-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-12-12

Study Completion Date

2028-02-29

Brief Summary

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This study is an open-label, 2-part, Phase 2, multicenter study to evaluate the efficacy, safety, tolerability, and pharmacokinetic profiles of botensilimab as monotherapy and in combination with balstilimab in participants with advanced cutaneous melanoma refractory to checkpoint inhibitor therapy.

Detailed Description

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This Phase 2 study will enroll up to approximately 220 evaluable adult participants with a histologically confirmed diagnosis of either Stage III (unresectable) or Stage IV cutaneous melanoma and who have had prior treatments with anti-programmed death (ligand) 1 \[PD-(L)1\].

This study will consist of 2 parts. Part 1 consists of 2 cohorts (Cohorts A and B) that will receive botensilimab monotherapy. In Cohort A, participants refractory to PD-(L)1 will receive botensilimab. In Cohort B, participants refractory to PD-(L)1 and cytotoxic T-lymphocyte antigen 4 (CTLA-4) will receive botensilimab. Part 2 consists of Cohorts A and B that will receive botensilimab combination therapy. In Cohort A, participants refractory to PD-(L)1 will receive botensilimab in combination with balstilimab. In Cohort B, participants refractory to PD-(L)1 and CTLA-4 will receive botensilimab in combination with balstilimab.

Conditions

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Advanced Melanoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Part 1 Cohort A: Botensilimab

Participants refractory to PD-(L)1 therapy will receive botensilimab intravenously (IV).

Group Type EXPERIMENTAL

Botensilimab

Intervention Type DRUG

An anti-CTLA-4 monoclonal antibody

Part 1 Cohort B: Botensilimab

Participants refractory to PD-(L)1 and anti-CTLA-4 therapies will receive botensilimab IV.

Group Type EXPERIMENTAL

Botensilimab

Intervention Type DRUG

An anti-CTLA-4 monoclonal antibody

Part 2 Cohort A: Botensilimab + Balstilimab

Participants refractory to PD-(L)1 will receive botensilimab IV in combination with balstilimab IV.

Group Type EXPERIMENTAL

Botensilimab

Intervention Type DRUG

An anti-CTLA-4 monoclonal antibody

Balstilimab

Intervention Type DRUG

An anti-PD-1 monoclonal antibody

Part 2 Cohort B: Botensilimab + Balstilimab

Participants refractory to PD-(L)1 and CTLA-4 will receive botensilimab IV in combination with balstilimab IV.

Group Type EXPERIMENTAL

Botensilimab

Intervention Type DRUG

An anti-CTLA-4 monoclonal antibody

Balstilimab

Intervention Type DRUG

An anti-PD-1 monoclonal antibody

Interventions

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Botensilimab

An anti-CTLA-4 monoclonal antibody

Intervention Type DRUG

Balstilimab

An anti-PD-1 monoclonal antibody

Intervention Type DRUG

Other Intervention Names

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AGEN1181 AGEN2034

Eligibility Criteria

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Inclusion Criteria

Cohort A only:

1. Prior treatment with anti-PD-(L)1 therapy (for example, pembrolizumab or nivolumab) for at least 6 weeks and radiologic progression confirmed by 2 scans at least 4 weeks apart, or if symptomatic due to progressive malignancy, then 1 scan showing progression is sufficient.
2. Progression must be either on treatment with anti-PD-(L)1 regimen or ≤ 12 weeks from last anti-PD-(L)1 dose in metastatic setting or ≤ 24 weeks from completion of therapy in adjuvant/ neoadjuvant setting.
3. For Part 2 only, no intervening anti-cancer therapy between the last course of anti-PD-(L)1 treatment and the first dose of study treatment except for local measures (for example, surgical excision, biopsy, focal radiation therapy), or BRAF ± MEK inhibition when applicable in BRAF mutant participants.

Cohort B only:

1. Prior treatment with first-generation anti-CTLA-4 therapy (for example, ipilimumab or tremelimumab) and prior treatment with anti-PD-(L)1 for at least 6 weeks.
2. Progression on most recent anti-cancer therapy.
3. For Part 2 only, no more than 3 prior lines of therapy in the advanced setting for BRAF mutant and no more than 2 prior lines of therapy in the advanced setting in the BRAF wild type.

Cohorts A and B:

1. Voluntarily agree to participate by giving signed, dated, and written informed consent prior to any study-specific procedures.
2. Histologically confirmed Stage III (unresectable) or Stage IV histologically confirmed cutaneous melanoma as per the American Joint Committee on Cancer 8th edition staging system.
3. Measurable disease on baseline imaging per RECIST 1.1 criteria.
4. BRAF V600 mutation status or consent to BRAF V600 mutation testing per local institutional standards during the screening period.
5. Life expectancy ≥ 3 months.
6. Eastern Cooperative Oncology Group performance status of 0 or 1.
7. Adequate organ function is defined as the following laboratory values within 14 days of Cycle 1 Day 1 (C1D1):

1. Neutrophils \> 1500/microliter (μL) (stable off any growth factor within 4 weeks of first study treatment administration).
2. Platelets \> 100 × 10\^3/μL (transfusion to achieve this level is not permitted within 2 weeks of first study treatment administration).
3. Hemoglobin \> 8.0 grams/deciliter (g/dL) (transfusion to achieve this level is not permitted within 2 weeks of first study treatment administration).
4. Creatinine clearance ≥ 45 milliliters/minute (measured or calculated using modification of diet in renal disease).
5. Aspartate aminotransferase/alanine aminotransferase \< 3.0 × upper limit of normal (ULN).
6. Total bilirubin \< 1.5 × ULN, or \< 3.0 × ULN for participants with Gilbert syndrome.
7. Albumin ≥ 3.0 g/dL.
8. International normalized ratio or prothrombin time ≤ 1.5 × ULN and activated partial thromboplastin time ≤ 1.5 × ULN (unless participant is receiving anticoagulant therapy).
8. Participant must provide a formalin-fixed paraffin-embedded tumor tissue sample from the most recent biopsy of a tumor lesion, obtained within 90 days from signing informed consent form. If recent tumor tissue is unavailable or inadequate, a fresh biopsy will be required, unless the Sponsor agrees that it is not safe/feasible.
9. Women of childbearing potential (WOCBP) must have a negative urine or serum pregnancy test at screening (within 72 hours of first dose of study medication) and prior to study drug administration. In part 1, WOCBP must agree to use highly effective contraceptive measures starting with the screening visit through 3 months after the last dose of study treatment. In Part 2, WOCBP must agree to use highly effective contraceptive measures starting with the screening visit through 5 months after the last dose of study treatment. Note: Abstinence is acceptable if this is the established and preferred contraception for the participant.
10. In Part 1, male participants with a female partner(s) of childbearing potential must agree to use highly effective contraceptive measures throughout the study, starting with the screening visit through 3 months after the last dose of study treatment is received. In Part 2, male participants with a female partner(s) of childbearing potential must agree to use highly effective contraceptive measures throughout the study starting with the screening visit through 5 months after the last dose of study treatment is received. Males with pregnant partners must agree to use a condom; no additional method of contraception is required for the pregnant partner.

Exclusion Criteria

Cohort A:

1\. Received prior anti-CTLA-4 therapy.

Cohort B:

1\. Received prior Fc-engineered or Fc-enhanced anti-CTLA-4 therapy (for example, BMS-96218, BMS-986288, HBM4003, XTX101, CTLA-4 targeting bispecific or other approaches such as ONC-392).

Cohorts A and B:

1. Ocular, uveal, or mucosal melanoma.
2. Any persistent toxicities (Common Terminology Criteria for Adverse Events \[CTCAE\] Grade ≥ 2) from prior cancer therapy, excluding endocrinopathies stable on medication, stable neuropathy, and alopecia.
3. Any history of CTCAE Grade ≥ 3 immune-mediated toxicity (excluding endocrinopathies and non-necrotizing/bullous rash) from prior checkpoint inhibitor therapy that required treatment with systemic corticosteroids (\> 10 mg/day prednisone or equivalent) or other immunosuppressive medications for more than 4 weeks.
4. Refractory ascites require 2 or more therapeutic paracentesis in the last 4 weeks or ≥ 4 within the last 90 days prior to study entry.
5. Bowel obstruction within the past 3 months or an impending bowel obstruction.
6. Clinically significant (that is, active) cardiovascular disease: cerebral vascular accident/stroke or myocardial infarction within 6 months of enrollment, unstable angina, congestive heart failure (New York Heart Association class ≥ III), or serious uncontrolled cardiac arrhythmia requiring medication.
7. Active brain metastases or leptomeningeal metastases with the following exceptions:

1. Treated brain metastases require a) surgical resection, or b) stereotactic radiosurgery. These participants must be off steroids ≥ 10 days prior to randomization for the purpose of managing their brain metastases. Repeat brain imaging following surgical resection or stereotactic radiosurgery is not required if their last brain magnetic resonance imaging is within screening window. Whole-brain radiation is not allowed.
2. Untreated isolated brain metastases that are too small for treatment by surgical resection or stereotactic radiosurgery (for example, 1-2 millimeters) and/or of uncertain etiology are potentially eligible but need to be discussed with and approved by the study Medical Monitor.
8. Concurrent malignancy (present during screening) requiring treatment or history of prior malignancy active within 2 years prior to the first dose of study treatment (that is, participants with a history of prior malignancy are eligible if treatment was completed at least 2 years before the first dose of study treatment and the participant has no evidence of disease). Participants with history of prior early-stage basal/squamous cell skin cancer, low-risk prostate cancer eligible for active surveillance or noninvasive or in situ cancers who have undergone definitive treatment at any time are also eligible.
9. Incomplete resolution of clinically significant adverse events related to most recent therapy/intervention prior to enrollment.
10. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine or booster \< 7 days before C1D1. For vaccines requiring more than 1 dose, the full series should be completed prior to C1D1, when feasible. A booster shot is not required but if given, must be administered \> 7 days from C1D1 or \> 7 days from future cycle on study.
11. Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.
12. Any evidence of current interstitial lung disease (ILD) or pneumonitis or a prior history of ILD or non-infectious pneumonitis requiring high-dose glucocorticoids.
13. History of allogeneic organ transplant, stem cell transplant or bone marrow transplant (autologous stem cell transplant \> 5 years prior to study enrollment with no evidence of disease are eligible unless lymphopenia Grade \> 1 is present).
14. Psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study.
15. Participants with a condition requiring systemic treatment with either corticosteroids (\> 10 milligrams \[mg\] daily prednisone equivalent) within 14 days or another immunosuppressive medication within 30 days of the first dose of study treatment. Inhaled or topical steroids, and adrenal replacement steroid doses \> 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease.
16. Active autoimmune disease or history of autoimmune disease that required systemic treatment within 2 years before starting study treatment (that is, with use of disease-modifying agents or immunosuppressive drugs).
17. History or current evidence of any condition, co-morbidity, therapy, any active infections, or laboratory abnormality that might confound the results of the study, interfere with the participants participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating Investigator.
18. A WOCBP who is pregnant or breastfeeding or WOCBP who are not willing to employ effective birth control from screening to 90 days after the last dose of botensilimab (whichever is later).
19. Previous SARS-CoV-2 infection within 10 days for mild or asymptomatic infections or 20 days for severe/critical illness prior to C1D1.
20. Uncontrolled infection with human immunodeficiency virus (HIV). Participants on stable highly active antiretroviral therapy with undetectable viral load and normal cluster of differentiation 4 counts for at least 6 months prior to study entry are eligible. Serological testing for HIV at screening is not required.
21. Known to be positive for hepatitis B virus (HBV) surface antigen, or any other positive test for HBV indicating acute or chronic infection. Participants who are receiving or who have received anti-HBV therapy and have undetectable HBV DNA for at least 6 months prior to study entry are eligible. Serological testing for HBV at screening is not required.
22. Known active hepatitis C virus (HCV) as determined by positive serology and confirmed by polymerase chain reaction (PCR). Participants on or who have received antiretroviral therapy are eligible, provided they are virus-free by PCR for at least 6 months prior to study entry. Serological testing for HCV at screening is not required.
23. Dependence on total parenteral nutrition.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Agenus Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Agenus Inc.

Locations

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Scottsdale Healthcare Hospitals DBA HonorHealth

Scottsdale, Arizona, United States

Site Status

Virginia K. Crosson Cancer Center at St. Jude Medical Center

Fullerton, California, United States

Site Status

Providence Saint John's Health Center

Santa Monica, California, United States

Site Status

Yale University School of Medicine - Yale Cancer Center

New Haven, Connecticut, United States

Site Status

Georgetown University Medical Center

Washington D.C., District of Columbia, United States

Site Status

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Site Status

John Theurer Cancer Center at Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status

Universitair Ziekenhuis Brussel

Jette, , Belgium

Site Status

Oncosite - Centro de Pesquisa Clinica Em Oncologia

Ijuí, , Brazil

Site Status

Centro de Pesquisas Clinicas da Fundação Doutor Amaral Carvalho

Jaú, , Brazil

Site Status

Centro Gaucho Integrado de Oncologia, Hematologia, Ensino e Pesquisa

Porto Alegre, , Brazil

Site Status

INCA II - Instituto Nacional de Cancer Jose Alencar Gomes da Silva

Rio de Janeiro, , Brazil

Site Status

Hospital Sirio Libanes

São Paulo, , Brazil

Site Status

Real e Benemerita Associaçao Portuguesa de Beneficencia - A Beneficencia Portuguesa de Sao Paulo

São Paulo, , Brazil

Site Status

Hospital A.C. Camargo Cancer Center

São Paulo, , Brazil

Site Status

CHU Amiens Picardie - Hopital Sud

Amiens, , France

Site Status

CHU Grenoble-Alpes - Hopital Michallon

La Tronche, , France

Site Status

Centre Leon Berard

Lyon, , France

Site Status

CHU de Nantes

Nantes, , France

Site Status

AP-HP Hopital Saint-Louis

Paris, , France

Site Status

Centre Eugene Marquis

Rennes, , France

Site Status

Gustave Roussy

Villejuif, , France

Site Status

Universitaetsklinikum Essen

Essen, , Germany

Site Status

Universitaetsklinikum Hamburg-Eppendorf

Hamburg, , Germany

Site Status

Universitaetsklinikum Heidelberg

Heidelberg, , Germany

Site Status

University Hospital Schleswig-Holstein

Kiel, , Germany

Site Status

Universitaetsmedizin der Johannes Gutenberg - Universitaet Mainz

Mainz, , Germany

Site Status

Klinikum der Universitaet München

München, , Germany

Site Status

Universitaetsklinikum Tuebingen

Tübingen, , Germany

Site Status

Universitaetsklinikum Würzburg

Würzburg, , Germany

Site Status

IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori - IRST S.r.l.

Meldola, , Italy

Site Status

Istituto Nazionale Tumori IRCCS Fondazione G. Pascale

Napoli, , Italy

Site Status

Azienda Ospedaliero Universitaria Senese

Siena, , Italy

Site Status

Blokhin National Medical Research Oncology Centre

Moscow, , Russia

Site Status

Branch Office of "Hadassah Medical Ltd"

Moscow, , Russia

Site Status

Moscow City Oncology Hospital #62

Moscow, , Russia

Site Status

LLC Medical Services

Saint Petersburg, , Russia

Site Status

Clinical Hospital Russian Railways - Medicine

Saint Petersburg, , Russia

Site Status

Petrov National Medical Research Center of Oncology

Saint Petersburg, , Russia

Site Status

Hospital Universitario Vall d'Hebron

Barcelona, , Spain

Site Status

Hospital Clinic Barcelona

Barcelona, , Spain

Site Status

Onkologikoa

Donostia / San Sebastian, , Spain

Site Status

Hospital General Universitario Gregorio Maranon

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status

Hospital Universitario Virgen Macarena

Seville, , Spain

Site Status

Consorcio Hospital General Universitario de Valencia

Valencia, , Spain

Site Status

CHUV - Centre hospitalier universitaire vaudois

Lausanne, , Switzerland

Site Status

Universitaetsspital Zuerich

Zurich, , Switzerland

Site Status

Royal Marsden Foundation Trust

London, , United Kingdom

Site Status

The Christie NHS Foundation Trust

Manchester, , United Kingdom

Site Status

Mount Vernon Cancer Centre

Middlesex, , United Kingdom

Site Status

Countries

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United States Belgium Brazil France Germany Italy Russia Spain Switzerland United Kingdom

Other Identifiers

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2022-500652-37

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

C-800-23

Identifier Type: -

Identifier Source: org_study_id

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