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Clinical Trial Evaluating the Safety, Tolerability and Preliminary Efficacy of BNT116 Alone and in Combinations in Patients With Advanced Non-small Cell Lung Cancer (LuCa-MERIT-1)

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BioNTech

Status and phase

Enrolling
Phase 1

Conditions

Non-Small Cell Lung Cancer

Treatments

Biological: Bispecific antibody for PD-L1 and VEGF-A
Drug: Docetaxel
Biological: anti-HER3 antibody conjugated to topoisomerase I inhibitor
Drug: Carboplatin
Biological: BNT116
Biological: BNT316
Drug: Paclitaxel
Biological: anti-B7-H3 antibody conjugated to topoisomerase I inhibitor
Biological: Cemiplimab

Study type

Interventional

Funder types

Industry

Identifiers

NCT05142189
2023-509283-14-00 (EU Trial (CTIS) Number)
BNT116-01
2021-004739-94 (EudraCT Number)

Details and patient eligibility

About

This first-in-human (FIH) trial for BNT116 aims to establish the safety profile and a safe dose for BNT116 monotherapy as well as for BNT116 in combination with approved medicinal products and/or in combination with investigational medicinal products (IMPs) including, but not limited to, cemiplimab, docetaxel, carboplatin, paclitaxel, BNT316 (an anti-cytotoxic T-lymphocyte-associated protein 4 [CTLA-4] antibody), an anti-B7-H3 antibody conjugated to a topoisomerase I inhibitor, an anti-human epidermal growth factor receptor 3 (HER3) antibody conjugated to a topoisomerase I inhibitor or a bispecific antibody for programmed death ligand 1 (PD-L1) and vascular endothelial growth factor A (VEGF-A) in participants with non-small cell lung cancer (NSCLC).

The trial will comprise of several cohorts for dose confirmation in monotherapy as well as in combinations of BNT116 as mentioned above.

The trial will enroll participants with NSCLC in advanced or metastatic stage in Cohorts 1 to 4 and Cohorts 7 to 10, unresectable NSCLC Stage III in Cohorts 5 and 11, and resectable NSCLC of Stage II and III in Cohort 6.

Full description

The maximum duration of treatment for each individual participant in this trial is:

  • Cohorts 1 to 4, and Cohorts 7 to 10: 24 months
  • Cohorts 5 and 11: 18 cycles, i.e., 12 months
  • Cohort 6: 4 cycles of neo-adjuvant treatment and 18 cycles of adjuvant treatment, i.e., 12 months of adjuvant treatment

Enrollment

280 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Key Inclusion Criteria:

  • Participants must have histologically confirmed NSCLC and measurable disease by RECIST v1.1. Note: Participants in Cohorts 1, 5 and 11 do not have to present with measurable disease.

    1. Participants must present with unresectable Stage III or metastatic Stage IV NSCLC by American Joint Commission on Cancer (AJCC) Cancer Staging Manual, Eighth Edition.

      EXCEPT

    2. Participants in Cohorts 5 and 11 must present with unresectable Stage III NSCLC by AJCC Cancer Staging Manual, Eighth Edition before receiving pre-trial chemoradiotherapy.

    3. Participants in Cohort 6 with the initial diagnosis of resectable Stage II and Stage III NSCLC by AJCC Cancer Staging Manual, Eighth Edition.

  • Participants in Cohorts 2, 4, 5, 6, 10 and 11 must be able to tolerate (additional) anti-PD-1 therapy (i.e., did not permanently discontinue anti-programmed death protein 1 [PD-1] / programmed death ligand 1 [PD-L1] therapy due to toxicity).

  • Participants must have an Eastern Cooperative Oncology Group performance status (ECOG-PS) less than or equal to (<=) 1, except for participants in Cohorts 1, 4, 5, 10 and 11 who are eligible with an ECOG-PS of 0-2.

Cohort-specific inclusion criteria:

Cohort 1:

  • Participants prior therapy must have included at least a PD-1/PD-L1 inhibitor and a platinum-based chemotherapy regimen as well as one other line of systemic therapy (except if a participant is not candidate for a platinum-based chemotherapy and/or PD-1/PD-L1 inhibitor and/or another line of systemic therapy). Note: Participants newly enrolled in Cohort 1B under protocol v 5.0 and subsequent versions of the protocol must consent to mandatory blood sampling for peripheral blood mononuclear cells (PBMCs).
  • Participants who are to start cemiplimab at Cycle 3 must present with PD-L1 expression of tumor proportion score (TPS) greater than or equal to (>=) 1% in tumor cells (as determined locally).

Cohort 2:

  • Participants must present with PD-L1 expression of tumor proportion score (TPS) >= 50% in tumor cells (as determined locally prior to inclusion in this trial).

  • Participants must present with progressive disease either

    1. in the advanced or metastasized stage of NSCLC: while on a PD-1/PD-L1 inhibitor therapy or within 6 months of termination of this treatment as first-line treatment. Or
    2. be refractory to ongoing adjuvant therapy/maintenance treatment after CRT with a PD-1/PD-L1 inhibitor that has been given for at least 3 months in monotherapy (i.e., after an initial combination therapy) before being enrolled into this trial.

Cohort 3:

  • Participants prior therapy must have included at least a PD-1/PD-L1 inhibitor and a platinum-based chemotherapy regimen (except if a participant is not candidate for a platinum-based chemotherapy and/or PD-1/PD-L1 inhibitor).
  • Participants must present with progressive disease.

Cohort 4:

  • Participants who are not candidates for chemotherapy as first-line treatment for the advanced or metastasized stage of NSCLC may be enrolled if presenting with PD-L1 expression: TPS >= 1% in tumor cells (as determined locally).

Cohort 5:

  • Participants NSCLC must have been considered unresectable due to participant's condition and/or tumor-related factors and the participants must have undergone chemoradiotherapy before entering the trial.

Cohort 6:

  • Participants NSCLC must be considered technically and medically resectable.
  • Participants must be considered eligible for neo-adjuvant treatment.

Cohort 7:

  • Participants prior therapy must have included at least a PD-1/PD-L1 inhibitor and a platinum-based chemotherapy regimen (except if a participant is not a candidate for a platinum-based chemotherapy and/or PD-1/PD-L1 inhibitor). Note 1: Participants may have received prior therapy targeting CTLA-4, lymphocyte-activation gene 3 (LAG-3), T cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif [ITIM] domain (TIGIT), VEGF or VEGF receptor (VEGFR) inhibitor as monotherapy or part of a combination therapy. Note 2: If the participants' prior therapies included a CTLA-4 inhibitor, the participant must be able to tolerate (additional) treatment with the CTLA-4 inhibitor.
  • Participants must present with progressive disease at trial enrollment.
  • Participants must consent to mandatory blood sampling for PBMCs.

Cohorts 8 & 9:

  • Participants prior therapy must have included at least a PD-1/PD-L1 inhibitor and a platinum-based chemotherapy regimen (except if a participant is not a candidate for a platinum-based chemotherapy and/or PD-1/PD-L1 inhibitor).
  • Participants must present with progressive disease at trial enrollment.

Cohort 10:

  • Participants who are not candidates for chemotherapy as first-line treatment for the advanced or metastasized stage of NSCLC may be enrolled.

Cohort 11:

  • Participant's NSCLC must have been considered unresectable due to participants condition and/or tumor related factors and the participants must have undergone chemoradiotherapy before entering the trial.

Key Exclusion Criteria:

  • Ongoing active systemic treatment against NSCLC.
  • Presence of a driver mutation for which approved target therapies are available except if the participant is not a candidate for the respective targeted therapy.
  • Ongoing or recent evidence (within the last 5 years) of significant autoimmune disease that required treatment with systemic immunosuppressive treatments which may suggest risk for immune-related adverse events. Note: Participants with autoimmune-related hyperthyroidism, autoimmune-related hypothyroidism who are in remission, or on a stable dose of thyroid-replacement hormone, vitiligo, or psoriasis may be included.
  • Current evidence of new or growing brain or spinal metastases during screening. Participants with leptomeningeal disease are excluded. Participants with known brain or spinal metastases may be eligible for all Cohorts, except for Cohorts 5, 6 and 11, if they:
  • had radiotherapy or another appropriate therapy for the brain or spinal metastases, AND
  • have no neurological symptoms that can be attributed to the current brain lesions, AND
  • have stable brain or spinal disease on the computed tomography (CT) or magnetic resonance imaging (MRI) scan within 4 weeks before signing the informed consent (confirmed by stable lesions on two scans at least 4 weeks apart), AND
  • do not require steroid therapy for the treatment of brain or spinal metastases within 14 d before the first dose of trial treatment. Note: Spinal bone metastases (that is, of the vertebrae) are allowed, unless imminent fracture or cord compression is anticipated.
  • Systemic immune suppression:
  • Current use of chronic systemic steroid medication (<= 5 mg/day prednisolone equivalent is allowed); participants using physiological replacement doses of prednisone for adrenal or pituitary insufficiency are eligible. Note: Steroid medication given for supportive or prophylactic reasons during CRT for participants in Cohorts 5 and 11 needs to be tapered to <= 5 mg/day prednisolone equivalent at latest on the day before the trial treatment starts.
  • Other clinically relevant systemic immune suppression within the last 3 months before trial enrollment.
  • Known history of seropositivity for human immunodeficiency virus (HIV) with CD4+ T-cell (CD4+) counts less than (<) 350 cells/microlitre (mcL) and with a history of acquired immunodeficiency syndrome (AIDS)-defining opportunistic infections.
  • Prior splenectomy.
  • History/risk of interstitial lung disease or low baseline lung function (baseline pulse oximetry of less than 92% oxygen saturation [SpO2] without additional oxygen).

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply to all or some participants depending on the cohort.

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Sequential Assignment

Masking

None (Open label)

280 participants in 12 patient groups

Cohort 1A - BNT116 Monotherapy
Experimental group
Treatment:
Biological: BNT116
Cohort 1B - BNT116 Monotherapy
Experimental group
Treatment:
Biological: BNT116
Cohort 2 - BNT116 + Cemiplimab (PD-1/PD-L1 Inhibitor Refractory/Relapsed Participants)
Experimental group
Treatment:
Biological: Cemiplimab
Biological: BNT116
Cohort 3 - BNT116 + Docetaxel
Experimental group
Treatment:
Biological: BNT116
Drug: Docetaxel
Cohort 4 - BNT116 + Cemiplimab (Frail Participants)
Experimental group
Treatment:
Biological: Cemiplimab
Biological: BNT116
Cohort 5 - BNT116 + Cemiplimab (After Concurrent Chemoradiotherapy [CRT])
Experimental group
Treatment:
Biological: Cemiplimab
Biological: BNT116
Cohort 6 - BNT116 + Cemiplimab + Carboplatin + Paclitaxel
Experimental group
Description:
BNT116 + cemiplimab + carboplatin + paclitaxel as neo-adjuvant treatment followed by surgery, thereafter adjuvant treatment with BNT116 + cemiplimab
Treatment:
Biological: Cemiplimab
Drug: Paclitaxel
Drug: Carboplatin
Biological: BNT116
Cohort 7 - BNT116 + BNT316
Experimental group
Description:
Dose finding for the combination of BNT116 with BNT316 (CTLA4 antibody) with dose escalation of BNT316
Treatment:
Biological: BNT316
Biological: BNT116
Cohort 8: BNT116 + Anti-B7-H3 Antibody Conjugated to Topoisomerase I Inhibitor
Experimental group
Description:
Dose finding for the combination of BNT116 with an anti-B7-H3 antibody conjugated to a topoisomerase I inhibitor with dose escalation of the anti-B7-H3 antibody conjugated to a topoisomerase I inhibitor
Treatment:
Biological: anti-B7-H3 antibody conjugated to topoisomerase I inhibitor
Biological: BNT116
Cohort 9: BNT116 + Anti-HER3 Antibody Conjugated to Topoisomerase I Inhibitor
Experimental group
Description:
Dose confirmation for the combination of BNT116 with an anti-HER3 antibody conjugated to a topoisomerase I inhibitor with dose escalation of the anti-HER3 antibody conjugated to a topoisomerase I inhibitor
Treatment:
Biological: BNT116
Biological: anti-HER3 antibody conjugated to topoisomerase I inhibitor
Cohort 10: BNT116 + Bispecific Antibody for PD-L1 and VEGF-A (Frail Participants)
Experimental group
Description:
Dose confirmation for BNT116 in combination with a bispecific antibody for programmed death ligand 1 (PD-L1) and vascular endothelial growth factor A (VEGF-A) will be established.
Treatment:
Biological: BNT116
Biological: Bispecific antibody for PD-L1 and VEGF-A
Cohort 11: BNT116 + Bispecific Antibody for PD-L1 and VEGF-A (After Concurrent CRT)
Experimental group
Description:
Dose confirmation for BNT116 in combination with a bispecific antibody for PD-L1 and VEGF-A will be established in participants after concurrent CRT.
Treatment:
Biological: BNT116
Biological: Bispecific antibody for PD-L1 and VEGF-A

Trial contacts and locations

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Central trial contact

BioNTech clinical trials patient information

Data sourced from clinicaltrials.gov

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