A Study of Anti-PD-L1 Checkpoint Antibody (LY3300054) Alone and in Combination in Participants With Advanced Refractory Solid Tumors (PACT)

Lilly

Status and phase: Completed; Phase 1

Conditions: Solid Tumor; Microsatellite Instability-High (MSI-H) Solid Tumors; Breast Cancer (HR+HER2-); Pancreatic Cancer; Cutaneous Melanoma

Treatments: Drug: Merestinib; Drug: Ramucirumab; Drug: LY3300054; Drug: LY3321367; Drug: Abemaciclib

Study type: Interventional

Funder types: Industry

Identifiers

NCT02791334

I8J-MC-JYCA (Other Identifier)

16088

2016-000440-33 (EudraCT Number)

Details and patient eligibility

About

The main purpose of this study is to evaluate the safety and tolerability of anti-programmed cell death ligand 1 (PD-L1) checkpoint antibody LY3300054 in participants with advanced refractory solid tumors.

Enrollment: 164 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Histologic or cytologic confirmation of advanced solid tumor.

• For LY3300054 + abemaciclib only: No participants with liver metastases. Participants must have normal aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, direct bilirubin.

• For LY3300054 + abemaciclib in HR+, HER- breast cancer:

  • Express at least 1 of the hormone receptors [HR; estrogen receptor (ER) or progesterone receptor (PR)] by immunohistochemistry (IHC) to fulfill the requirement for HR+ disease on the primary tumor or metastatic lesion of the breast cancer. ER and PR assays are considered positive if there is at least 1% positive tumor nuclei in their sample as defined in the relevant American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) or local guidelines.
  • To fulfill the requirement of HER2- disease, a breast cancer must not demonstrate, at initial diagnosis or upon subsequent biopsy, overexpression of HER2 by either IHC or in-situ hybridization (ISH) as defined in the relevant ASCO/CAP or local guidelines.
  • Most recent HR and HER2 receptor testing should be used to determine eligibility.
  • Have previously received prior treatment with at least 1 but no more than 3 chemotherapy regimens in the metastatic setting.
  • Have AST, ALT, GGT, and AP that are ≤2.5x upper limit of normal (ULN) and normal bilirubin (total and direct) regardless of liver involvement.

• For LY3300054 + merestinib in pancreatic cancer:

  • Histologically or cytological confirmed diagnosis of metastatic or locally advanced, unresectable pancreatic adenocarcinoma (excluding other pancreatic malignancies for example, acinar cell carcinomas, adenosquamous carcinomas, and neuroendocrine islet cell neoplasms).
  • Have had disease progression, be refractory or intolerant to no more than 2 prior systemic regimens.

• For LY3300054 + LY3321367 in PD-1/PD-L1-naive, MSI-H/MMR-deficient advanced solid tumors:

  • Have histologically or cytologically confirmed diagnosis of advanced solid tumor AND shown to be MSI-H or MMR-deficient.

• For LY3300054 + LY3321367 in PD-1/PD-L1- resistant/refractory, MSI-H/MMR-deficient advanced solid tumors:

  • Have histologically or cytologically confirmed diagnosis of advanced solid tumor AND shown to be MSI-H or MMR-deficient.
  • Prior exposure to PD-1/PD-L1 agent regardless of response.

• For Phase 1b LY3300054 monotherapy or combination therapy, no prior treatment with a PD-1 or PD-L1 agent is allowed.

  • Exception: the LY3321367 combination in participants with PD-1/PD-L1- resistant/refractory, MSI-H, where prior exposure to PD-1/PD-L1 agent required.

• For Phase 1a LY3300054 monotherapy or combination therapy, previous immunotherapy is acceptable if the following criteria are met:

  • Must not have experienced a toxicity that led to permanent discontinuation of prior immunotherapy.
  • Must have completely recovered or recovered to baseline prior to screening from any prior adverse events (AEs) occurring while receiving prior immunotherapy.
  • Must not have experienced a Grade ≥3 immune-related AE or an immune-related neurologic or ocular AE of any grade while receiving prior immunotherapy.
  • Must not have required the use of additional immunosuppressive agents other than corticosteroids for the management of an AE, not have experienced recurrence of an AE if re-challenged, and not currently require maintenance doses of >10 milligrams prednisone or equivalent per day.

• Have at least 1 measurable lesion assessable using standard techniques by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.

• Have adequate organ function.

• Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) scale.

• Have an estimated life expectancy of ≥12 weeks, in the judgment of the investigator.

• Have submitted a tumor tissue sample, as follows:

  • For participants entering the Phase 1a dose escalation: have submitted, if available, the most recent archival tumor tissue sample.
  • For those participating ONLY in Phase 1b expansions: Have submitted tumor tissue sample from a newly obtained core or excisional biopsy for a tumor lesion (preferred) or a recent biopsy taken with 3 months prior to study enrollment and following the participants most recent prior systemic treatment and be willing to undergo a biopsy procedure during the study treatment period for collection of additional tumor tissue sample.

Exclusion criteria

• Have a serious concomitant systemic disorder including human immunodeficiency virus (HIV), active hepatitis B virus (HBV), active hepatitis C virus (HCV), active autoimmune disorder or disease requiring high dose of steroids.
• Have a bowel obstruction, history or presence of inflammatory enteropathy or extensive intestinal resection or chronic diarrhea.
• Have evidence of interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected drug-related pulmonary toxicity or active, noninfectious pneumonitis.
• Have an active infection requiring systemic therapy.
• Have moderate or severe cardiovascular disease.
• Have symptomatic or uncontrolled brain metastases, spinal cord compression, or leptomeningeal disease requiring concurrent treatment.
• Have received a live vaccine within 30 days before the first dose of study treatment.
• Have a significant bleeding disorder or vasculitis or had a Grade ≥3 bleeding episode within 12 weeks prior to enrollment.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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164 participants in 12 patient groups

LY3300054

Experimental group

Description:

LY3300054 given intravenously (IV) on day 1 and day 15 of a 28 day cycle or LY3300054 given IV on day 1 of a 21 (or 28) day cycle.

Treatment:

Drug: LY3300054

LY3300054 + Ramucirumab

Experimental group

Description:

LY3300054 and ramucirumab given IV on day 1 and day 15 of a 28 day cycle or ramucirumab given IV on day 1 and day 8 and LY3300054 given IV on day 1 of a 21 day cycle.

Treatment:

Drug: LY3300054

Drug: Ramucirumab

Abemaciclib + LY3300054

Experimental group

Description:

LY3300054 given IV on day 1 and day 15 and abemaciclib given orally every 12 hours of a 28 day cycle.

Treatment:

Drug: Abemaciclib

Drug: LY3300054

LY3300054 + Abemaciclib (Concurrent Dosing)

Experimental group

Description:

LY3300054 given IV on day 1 and day 15 and abemaciclib given orally every 12 hours of a 28 day cycle.

Treatment:

Drug: Abemaciclib

Drug: LY3300054

LY3300054 + Abemaciclib

Experimental group

Description:

LY3300054 given IV on day 1 and day 15 and abemaciclib given orally every 12 hours of a 28 day cycle. This arm will only be initiated if required.

Treatment:

Drug: Abemaciclib

Drug: LY3300054

LY3300054 + Merestinib

Experimental group

Description:

LY3300054 given IV on day 1 and day 15 and merestinib given orally once daily of a 28 day cycle.

Treatment:

Drug: LY3300054

Drug: Merestinib

LY3300054 Expansion (Metastatic Cutaneous Melanoma)

Experimental group

Description:

LY3300054 given IV on day 1 and day 15 of a 28 day cycle.

Treatment:

Drug: LY3300054

LY3300054 Expansion (MSI-H Solid Tumors)

Experimental group

Description:

LY3300054 given IV on day 1 and day 15 of a 28 day cycle.

Treatment:

Drug: LY3300054

: LY3300054 + Abemaciclib (HR+, HER2- Breast Cancer) Expansion

Experimental group

Description:

LY3300054 given IV on day 1 and day 15 and abemaciclib given orally every 12 hours of a 28 day cycle.

Treatment:

Drug: Abemaciclib

Drug: LY3300054

LY3300054 + LY3321367 Expansion (PD-1/PD-L1 Naïve, MSI-H)

Experimental group

Description:

LY3300054 and LY3321367 given IV on day 1 and day 15 of a 28 day cycle.

Treatment:

Drug: LY3321367

Drug: LY3300054

LY3300054 + LY3321367 Expansion

Experimental group

Description:

LY3300054 and LY3321367 given IV on day 1 and day 15 of a 28 day cycle.

Treatment:

Drug: LY3321367

Drug: LY3300054

LY3300054 + Merestinib (Pancreatic Cancer) Expansion

Experimental group

Description:

LY3300054 given IV on day 1 and day 15 and merestinib given orally once daily of a 28 day cycle.

Treatment:

Drug: LY3300054

Drug: Merestinib