AB154 Combined With AB122 for Recurrent Glioblastoma

  • STATUS
    Recruiting
  • End date
    Jul 23, 2023
  • participants needed
    46
  • sponsor
    Yale University
Updated on 23 July 2021
karnofsky performance status
MRI
neutrophil count
aptt
recurrent glioblastoma
recurrent tumor

Summary

This is a phase 0/I exploratory study. Patients at first or second recurrence of glioblastoma will be enrolled. The study will be divided into two cohorts: Cohort A (safety cohort) and Cohort B (surgical patient cohort).

Cohort A: Eligible patients will be sequentially enrolled to receive intravenous AB154 combined with AB122 (N=6). AB154 will be given at a dose of 10 mg/kg and AB122 will be given at a dose of 240 mg (flat).

Cohort B: Expansion surgical cohort. The purpose of cohort B is to provide an additional safety evaluation of AB154 + AB122 as well as tissue and blood for exploratory ancillary studies investigating the effects of AB154 + AB122 in the tumor and tumor microenvironment. A total of 40 patients will be enrolled in this cohort.

Description

This is a phase 0/I exploratory study. Patients at first or second recurrence of glioblastoma will be enrolled. The study will be divided into two cohorts: Cohort A (safety cohort) and Cohort B (surgical patient cohort).

Cohort A: Eligible patients will be sequentially enrolled to receive intravenous AB154 combined with AB122 (N=6). AB154 will be given at a dose of 10 mg/kg and AB122 will be given at a dose of 240 mg (flat).

Cohort B: Expansion surgical cohort. The purpose of cohort B is to provide an additional safety evaluation of AB154 + AB122 as well as tissue and blood for exploratory ancillary studies investigating the effects of AB154 + AB122 in the tumor and tumor microenvironment. A total of 40 patients will be enrolled in this cohort.

Following completion of cohort A, patients who are candidates for surgical resection for management of tumor progression (i.e. need for diagnostic confirmation or tumor debulking) will be enrolled prior to surgical resection, and initiate study treatment approximately two weeks prior to the resection.

Patients will be randomized to one of the four treatment arms and initiate treatment prior to surgery, according to treatment assignment.

The pre-surgical dose (neoadjuvant treatment) will be double-blinded. A total of 10 patients will be allocated to each one of the following groups in a blinded fashion, approximately two weeks before surgery:

  • B1 (N=10): AB154 single agent (10 mg/kg) + placebo
  • B2 (N=10): AB122 single agent (240 mg) + placebo
  • B3 (N=10): AB154 (10 mg/kg) +AB122 (240 mg)
  • B4 (N=10): Two placebo infusions

Following surgery, all patients (N=40) will initiate treatment with the combination of AB154 and AB122.

Details
Condition Glioblastoma Multiforme, glioblastoma
Treatment Placebo, AB122, AB154
Clinical Study IdentifierNCT04656535
SponsorYale University
Last Modified on23 July 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Grade IV glioma (glioblastoma and its variants according to the World Health Organization 2016), confirmed in tissue at time of initial diagnosis
First or second recurrence after treatment. Prior treatment must include at least radiation therapy
Measurable contrast enhancing tumor by Response Assessment in Neuro-Oncology (RANO) criteria
Age 18 years
Karnofsky performance status 80
Patients must have adequate organ and marrow function as defined below within 14 days of treatment
Absolute neutrophil count (ANC) 1,500 /mcL
Platelets 100,000 / mcL
Hemoglobin 9 g/dL or 5.6 mmol/L without transfusion or Erythropoietin (EPO) dependency (within 7 days of assessment)
Serum creatinine 1.5 X upper limit of normal (ULN) OR measured or calculated creatinine clearance (GFR can also be used in place of creatinine or CrCl) 60 mL/min for subject with creatinine levels > 1.5 X institutional ULN
Serum total bilirubin 1.5 X ULN OR direct bilirubin ULN for subjects with total bilirubin levels > 1.5 ULN
aspartate aminotransferase and alanine transaminase (SGPT) 2.5 X ULN
Albumin >2.5 mg/dL
International Normalized Ratio (INR) or Prothrombin Time (PT) 1.5 X ULN unless subject is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants
Activated Partial Thromboplastin Time (aPTT) 1.5 X ULN unless subject is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants
An interval of >=12 weeks from the end of prior radiation therapy is required unless there is either: i) histopathologic confirmation of recurrent tumor, or ii) new enhancement on MRI outside of the radiation treatment field
An interval of >=3 weeks or 5 half-lives (whichever is longer) after the last administration of any investigational agent or any other treatment prior to first study dose
Female subjects of childbearing potential should have a negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. Female subjects of childbearing potential must be willing to use 2 methods of birth control or be surgically sterile or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study medication. Subjects of childbearing potential are those who have not been surgically sterilized or have not been free from menses for > 1 year. Male subjects should agree to use an adequate method of contraception starting with the first dose of study therapy through 120 days after the last dose of study therapy
Ability to understand and the willingness to sign a written informed consent document
ADDITIONAL CRITERIA FOR COHORT B
\. Deemed a candidate for tumor debulking, as determined by the
neurosurgeon

Exclusion Criteria

Patients who have been treated with bevacizumab. Note: Previous use of intra-arterial bevacizumab may be allowed, contingent upon review and approval by study principal investigator and sponsor
Patients who have not recovered from adverse events due to prior therapy (i.e. >Grade
with the exception of alopecia and fatigue
Patients with multifocal disease. (Cohort B only)
Subjects requiring escalating or chronic supraphysiologic doses of corticosteroids (> 10 mg/d of prednisone equivalent or > 2 mg dexamethasone) for control of disease at the time of registration
Patients receiving previous or current treatment with an immune checkpoint inhibitor
Patients with a known diagnosis of immunodeficiency, including Human Immunodeficiency Virus (HIV) or acquired immunodeficiency syndrome (AIDS)
Has known active Hepatitis B (e.g., Hepatitis B surface antigen reactive) or Hepatitis C (e.g., Hepatitis C Virus RNA [qualitative] is detected)
Has a known history of active tuberculosis (Bacillus Tuberculosis)
Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer
Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment
Has known history of, or any evidence of active, non-infectious pneumonitis
Has an active infection requiring systemic therapy
Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator
Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial
Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of trial treatment
Unable to undergo MRI of the brain with and without contrast enhancement (i.e. pacemaker, allergy to MRI contrast agent or any other contraindication for MRIs)
Has received a live vaccine within 30 days of planned start of study therapy. Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist) are live attenuated vaccines, and are not allowed
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