Phase II Trial of Sacituzumab Govitecan in Recurrent and/or Metastatic Secretory Gland Cancers

M.D. Anderson Cancer Center

Status and phase

Enrolling

Phase 2

Conditions

Gland

Salivary Gland Cancers

Treatments

Drug: Sacituzumab Govitecan

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT05884320

NCI-2023-04260 (Other Identifier)

2022-0813

Details and patient eligibility

About

To learn if sacituzumab govitecan can help to control salivary gland cancer.

Full description

Primary Objectives:

To assess the efficacy of SG in patients with R/M secretory gland carcinomas, specifically ACC (cohort 1) and SDC, adeno-NOS, and MEC (cohort 2)

Secondary Objectives:

To estimate the median duration of response (DOR)
To estimate the median progression-free survival (PFS)
To estimate the median overall survival (OS)
To assess safety of SG

Tertiary / Exploratory Objectives:

To explore biomarkers that may predict response to therapy

Enrollment

30 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

All patients must meet all of the following inclusion criteria to be eligible for participation in this study:

Patients ≥18 years with histology-proven R/M salivary gland cancer.
Not amenable to curative intent surgery or radiotherapy
Measurable disease per RECIST 1.1
Performance status ECOG of 0 or 1
Patient has provided informed consent.
Laboratory measurements, blood counts:
1. Hemoglobin ≥ 9 g/dL. Red blood cell transfusions are permitted to meet the hemoglobin inclusion criteria
2. Absolute neutrophil count ≥ 1 x 10^9/mL without growth factor support for 28 days
3. Platelets ≥ 100 x 10^9/mL without platelet transfusion for 28 days
Laboratory measurements, renal function:

Creatinine clearance ≥ 30 mL/min as assessed by the Cockcroft-Gault equation
Laboratory measurements, hepatic function:
1. AST and ALT ≤ 2.5 x ULN or ≤ 5 x ULN in patients with liver metastases
2. Total bilirubin ≤ 1.5 x ULN or ≤ 3.0 x ULN and primarily unconjugated if patient has a documented history of Gilbert's syndrome or genetic equivalent
Female patients with reproductive potential must practice two effective contraceptive measures for the duration of study drug therapy and for at least 90 days after completion of study therapy. The two birth control methods can be either two barrier methods or a barrier method plus a hormonal method to prevent pregnancy. The following are considered adequate barrier methods of contraception: diaphragm, condom, copper intrauterine device, sponge, or spermicide. Appropriate hormonal contraceptives will include any registered and marketed contraceptive agent that contains an estrogen and/or a progesterone agent (including oral, subcutaneous, intrauterine, or intramuscular agents).
Male patients who are sexually active with women with reproductive potential must agree to use contraception for the duration of treatment and for at least 90 days after completion of study therapy.

Cohort 1:

In addition to meeting the inclusion criteria for all patients, patients who are enrolled into Cohort 1 must fulfill the following cohort-specific inclusion criteria:
Patients with histology-proven R/M ACC who are treatment-naïve or received any number of prior systemic therapy in the setting of R/M disease.
Disease progression per RECIST within 6 months or unequivocal clinical progression within 6 months per investigator's assessment.

Cohort 2:

In addition to meeting the inclusion criteria for all patients, patients who are enrolled into Cohort 2 must fulfill the following cohort-specific inclusion criterion:
13) Patients with histology-proven R/M SDC or intermediate or high-grade adenocarcinoma NOS, or intermediate or high grade MEC, who progressed on up to 3 lines of palliative chemotherapy in the R/M setting. Any number of prior targeted-therapy, hormonal therapy, and/or immunotherapy are allowed.
Patients with HER2 overexpressing (3+ by IHC) or amplified tumors, must have received at least one prior line with a HER2-targeting agent OR must have a contra-indication for HER-2 targeted therapy (Eg: reduced left ventricular ejection fraction).

Exclusion criteria

Patients who meet any of the following exclusion criteria are not eligible to be enrolled in this study:

Prior radiation therapy (or other non-systemic therapy) within 2 weeks prior to enrollment
Active CNS disease (patients with asymptomatic and stable, treated CNS lesions who have been off corticosteroids, radiation, or other CNS-directed therapy for at least 4 weeks are not considered active)
Red blood cell transfusion dependence, defined as requiring more than 2 units of packed RBC transfusions during the 4-week period prior to screening. Red blood cell transfusions are permitted during the screening period and prior to enrollment to meet the hemoglobin inclusion criterion.
Prior anticancer therapy including, but not limited to, chemotherapy, immunotherapy, or investigational agents within 4 weeks or 5 half-lives prior to SG treatment
Current participation in another interventional clinical study
History of previous malignancy other than malignancy treated with curative intent. Patients with the following diagnoses represents an exception and may enroll if ≥ 1 year with no evidence of active disease before the first dose of the study drug.:
1. Non-melanoma skin cancers with no current evidence of disease
2. Melanoma in situ with no current evidence of disease
3. Localized cancer of the prostate with prostate-specific antigen of <1 ng/mL
4. Treated or localized well-differentiated thyroid cancer
5. Treated cervical carcinoma in situ
6. Treated ductal/lobular carcinoma in situ of the breast
Evidence of uncontrolled, active infection, requiring systemic anti-bacterial, anti-viral or anti-fungal therapy ≤ 10 days prior to administration of investigational product. Patients with known hepatitis B, hepatitis C (HCV), or HIV infection could go on study provided the viral load is undetectable at screening.
Disease or medical conditions that would substantially increase the risk-benefit ratio of participating in the study that include: acute myocardial infarction within the last 6 months, unstable angina, uncontrolled diabetes mellitus, significant active infections, and congestive heart failure New York Heart Association Class III-IV
Female patients who are pregnant or breast-feeding
Known hypersensitivity to any of the study drugs, the metabolites, or formulation excipient
Received a live-virus vaccination within 30 days of planned treatment start. Seasonal flu vaccines that do not contain live virus are permitted.
High dose systemic corticosteroids (≥ 20 mg of prednisone or its equivalent) are not allowed within 2 weeks of study treatment (C1D1).
Cognitively impaired patients who are incompetent to consent.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Single Group Assignment

Masking

None (Open label)

30 participants in 2 patient groups

Cohort 1: ACC

Experimental group

Description:

Paritcipants will receive sacituzumab govitecan by vein on Days 1 and 8 of each cycle. The first dose will be given over about 3 hours. All other doses will be given over about 1-2 hours. Premedication for prevention of infusion reactions will be administered prior to each sacituzumab govitecan infusion.

Treatment:

Drug: Sacituzumab Govitecan

Cohort 2: Non-ACC

Experimental group

Description:

Treatment:

Drug: Sacituzumab Govitecan