Rovalpituzumab Tesirine (SC16LD6.5) in Recurrent Small Cell Lung Cancer

Stemcentrx

Status and phase: Completed; Phase 2; Phase 1

Conditions: Recurrent Small Cell Lung Cancer

Treatments: Drug: Rovalpituzumab tesirine (SC16LD6.5)

Study type: Interventional

Funder types: Industry

Identifiers

NCT01901653

SCRX16-001

Details and patient eligibility

About

The purpose of this study is to assess the safety and tolerability of rovalpituzumab tesirine (SC16LD6.5) at different dose levels in patients with small cell lung cancer whose cancer has progressed or recurred following standard chemotherapy. Once a safe and tolerable dose is determined, the anti-cancer activity of SC16LD6.5 will be assessed by measuring the extent of tumor shrinkage. SC16LD6.5 is an antibody-drug conjugate (ADC). The antibody (SC16) targets a protein that appears to be expressed on the surface of most small cell lung cancers that have been assessed using an immunohistochemical assay. The drug, D6.5, is a very potent form of chemotherapy, specifically a DNA-damaging agent, that is cell cycle independent. ADC's theoretically provide more precise delivery of chemotherapy to cancer cells, possibly improving effectiveness relative to toxicities.

Enrollment: 82 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

1. Provision of informed consent

2. Male or female ≥18 years of age

3. Histologic or cytologic confirmed diagnosis of small cell lung cancer, either limited or extensive disease at initial presentation is allowed

4. Evidence of progressive disease during or following 1 or 2 prior chemotherapy regimens

   • At least 1 prior regimen must have contained a platinum salt
   • 'Adjuvant therapy' will constitute a prior treatment regimen
   • No more than 2 prior regimens are allowed

5. Measurable disease (only for the phase II portion)

6. Eastern Cooperative Oncology Group (ECOG) Performance status 0-1

7. A minimum life expectancy of 12 weeks

8. Adequate bone marrow, hepatic and renal function as evidenced by:

   • Absolute neutrophil count (ANC) ≥ 1.5 x 109/L
   • Platelet count ≥ 100 x 109/L
   • Hemoglobin ≥ 9.0 g/dL
   • Serum bilirubin < 1.5 x ULN
   • Aspartate aminotransferase (AST)/Alanine transferase (ALT) (SGOT/SGPT) < 2.5 x ULN for the reference laboratory or < 5 x ULN in the presence of liver metastases
   • Serum creatinine < 1.5 x ULN

9. No 'active' CNS metastases. Prior CNS metastases are allowed, provided adequate palliative therapy has been administered and CNS disease control has been established prior to study entry.

   • A brain MRI scan, ≤ 28 days from day 1, is required

10. Female patients who are not of child-bearing potential, and female patients of child-bearing potential who agree to use adequate contraceptive measures and who have a negative serum pregnancy test within 1 week prior to initial study treatment. (See Appendix B)

11. Male patients willing to use adequate contraceptive. (See Appendix B)

12. At least 21 days must have elapsed prior to day 1 cycle 1, from chemotherapy, radiotherapy, immunotherapy or following major surgery and any surgical incision should be completely healed. At least 14 days must have elapsed prior to Day 1 Cycle 1 for "limited palliative radiotherapy", defined as a course of therapy encompassing < 25% total bone marrow volume and not exceeding 30 Gy.

13. At least 14 days must have elapsed for chemotherapy regimens, biologic, and targeted therapy given continuously or on a weekly basis with limited potential for delayed toxicity.

Exclusion Criteria:

1. Patients who are pregnant or breastfeeding.
2. Active involvement of the Central Nervous System (CNS).
3. Uncontrolled infection or systemic disease.
4. Clinically significant cardiac disease not well controlled with medication (e.g., congestive heart failure, symptomatic coronary artery disease e.g. angina, and cardiac arrhythmias) or myocardial infarction within the last 12 months.
5. Chemotherapy regimens within the last 21 days (or within 6 weeks for prior nitrosourea or mitomycin C). Chemotherapy regimens, biologic, and targeted therapy given continuously or on a weekly basis with limited potential for delayed toxicity within the last 14 days.
6. No concurrent systemic chemotherapy or anticancer biologic therapy is allowed. Note: Patients on hormonal treatment for breast cancer or prostate cancer may continue on treatment and enter into study.
7. Known hypersensitivity to any components of SC16LD6.5 study drug product.
8. Patients with known human immunodeficiency virus (HIV) or Hepatitis B or C (active, previously treated or both), a history of solid organ or bone marrow transplantation would generally be considered to have met exclusion criteria, however exceptions may be considered on a case-by-case basis by the medical monitor.
9. Psychiatric disorder or social or geographic situation that would preclude study participation.
10. QT interval measurement corrected by Fridericia's formula (QTcF) interval of >450 msec (males) or >470 msec (females)

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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82 participants in 1 patient group

Rovalpituzumab tesirine

Experimental group

Description:

Rovalpituzumab tesirine will be administered as a single agent, at increasing dose levels as permitted based on real-time assessment of safety and tolerability, intravenously over 30 minutes. Doses will be repeated on Day 1 of each 21-day or 42-day cycle until either unacceptable toxicity or evidence of disease progression occurs.

Treatment:

Drug: Rovalpituzumab tesirine (SC16LD6.5)