REVEAL Study of NKTR-262 in Combination With NKTR-214 and Nivolumab in Patients With Locally Advanced / Metastatic Solid Tumor Malignancies

Last updated: February 8, 2023
Sponsor: Nektar Therapeutics
Overall Status: Terminated

Phase

1/2

Condition

Carcinoma

Head And Neck Cancer

Neuroendocrine Carcinoma

Treatment

N/A

Clinical Study ID

NCT03435640
17-262-01
2018-004625-84
  • Ages > 18
  • All Genders

Study Summary

Patients received intratumoral (IT) injections of NKTR-262 in 3-week cycles for up to 3 cycles; bempegaldesleukin with or without nivolumab was administered every 3 weeks (q3w), and treatment continued until unacceptable toxicity, death, or disease progression per RECIST 1.1. Based on Phase 1 results of the study, the decision was made not to start the Phase 2 part of the study and the study was terminated.

Eligibility Criteria

Inclusion

Key Inclusion Criteria:

  • Histologically confirmed diagnosis of a locally advanced (not amenable to curativetherapy such as surgical resection) metastatic cancer of the following histologies:melanoma (MEL), Merkel cell carcinoma (MCC), triple-negative breast cancer (TNBC),renal cell carcinoma (RCC), colorectal cancer, head and neck squamous cell carcinoma (HNSCC), or sarcoma.
  • Life expectancy > 12 weeks as determined by the Investigator.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
  • Measurable disease per RECIST 1.1.
  • Patients enrolled in Cohorts 1-10, Cohort A, Cohort B and Phase 2 Doublet must berefractory to all therapies known to confer clinical benefit to their disease.
  • Fresh tumor tissue available for cellular characterization and programmed cell deathprotein 1 (PD-L1) status.
  • Injected lesions (up to two) must be between 20 mm and 90 mm in diameter for ITinjection; lesions must be accessible for baseline and on-treatment biopsies. Anyliver lesion targeted for injection must not exceed 50 mm at the time of injection.
  • Demonstrated adequate organ function within 14 days of Cycle 1 Day 1 (C1D1).

Exclusion

Key Exclusion Criteria:

  • Use of an investigational agent or an investigational device within 21 days beforeadministration of first dose of study drug(s).
  • Patients treated with prior interleukin-2 (IL-2).
  • Patients who have been previously treated with a toll-like receptor (TLR) agonist (excluding topical agents) and patients who have received experimental cancervaccines.
  • Patients who have received systemic interferon (IFN)α within the previous 6 monthsprior to enrollment to the study.
  • Other active malignancy, except non-melanomic skin cancer
  • Evidence of clinically significant interstitial lung disease or active, noninfectiouspneumonitis.
  • Prior surgery or radiotherapy within 14 days of initiating study drug(s). Patientsmust have recovered from all radiation-related toxicities, not requiredcorticosteroids and have not had radiation pneumonitis.
  • Prolonged Fridericia's corrected QT interval (QTcF) > 450 ms for men and > 470 ms forwomen at Screening. History of unstable or deteriorating cardiac disease within the previous 6 months prior toscreening including but not limited to the following:
  • Unstable angina or myocardial infarction.
  • Congestive heart failure (NYHA Class III or IV).
  • Uncontrolled clinically significant arrhythmias.
  • Patients with a history of any retinal disorders (e.g., retinal detachment, diabeticretinopathy, retinal hemorrhage, macular degeneration).
  • Uveal melanoma will be excluded
  • Patients with tumor that invade the superior vena cava or other major blood vessels. Additional general and tumor specific inclusion and exclusion criteria will apply.

Study Design

Total Participants: 64
Study Start date:
March 15, 2018
Estimated Completion Date:
May 09, 2022

Study Description

Cancer treatments that couple pharmacological activation of tumor antigen presentation with activation and expansion of CD8+ T and natural killer (NK) cells in the tumor environment have the potential to induce an effective anti-tumor immune response in patients. NKTR-262 is a small molecule agonist of toll-like receptors (TLRs) 7/8 designed to be retained in the tumor micro-environment in order to activate antigen-presenting cells (APC), such as dendritic cells, to create new antigen-specific cytotoxic T cells. As a CD122-biased agonist, bempegaldesleukin monotherapy increases newly proliferative CD8+ T cells in tumors. NKTR-262 plus bempegaldesleukin is expected to increase expansion of antigen-specific CD8+ T cells. In preclinical studies, a single IT injection of NKTR-262 plus IV bempegaldesleukin resulted in complete abscopal effects in tumor models. Preliminary clinical data show bempegaldesleukin plus nivolumab enhances immune-stimulatory responses. The REVEAL trial will assess safety and anti-tumor activity of NKTR-262 with bempegaldesleukin +/- nivolumab for the treatment of selected cancers.

  • Melanoma (1st-line and relapsed/refractory)

  • Merkel Cell Carcinoma (2nd-line and relapsed/refractory)

  • Triple Negative Breast Cancer (1st- and 2nd-line and relapsed/refractory)

  • Renal Cell Carcinoma (1st-line and relapsed/refractory)

  • Colorectal Cancer (2nd-line and relapsed/refractory; MSI non-high)

  • Colorectal Cancer (2nd 3rd-line+, I-O therapy naive; relapsed/refractory; MSI high)

  • Head and Neck Squamous Cell Carcinoma (2nd-line and relapsed/refractory)

  • Sarcoma (2nd-line and relapsed/refractory)

Connect with a study center

  • HonorHealth

    Scottsdale, Arizona 85258
    United States

    Site Not Available

  • UC San Diego Moores Cancer Center

    La Jolla, California 92093
    United States

    Site Not Available

  • University of California, San Francisco

    San Francisco, California 94143
    United States

    Site Not Available

  • Yale Cancer Center - New Haven

    New Haven, Connecticut 06520
    United States

    Site Not Available

  • Moffitt Cancer Center

    Tampa, Florida 33612
    United States

    Site Not Available

  • Winship Cancer Center, Emory University Hospital

    Atlanta, Georgia 30322
    United States

    Site Not Available

  • University of Iowa

    Iowa City, Iowa 52242
    United States

    Site Not Available

  • University of Kansas Research Center

    Fairway, Kansas 66205
    United States

    Site Not Available

  • University of Kansas Hospital

    Kansas City, Kansas 66160
    United States

    Site Not Available

  • Henry Ford Health System

    Detroit, Michigan 48202
    United States

    Site Not Available

  • Masonic Cancer Center, University of Minnesota

    Minneapolis, Minnesota 55455
    United States

    Site Not Available

  • Investigator Site - Buffalo

    Buffalo, New York 14203
    United States

    Site Not Available

  • Memorial Sloan Kettering Cancer Center

    New York, New York 10065
    United States

    Site Not Available

  • Duke University Medical Center

    Durham, North Carolina 27710
    United States

    Site Not Available

  • Cleveland Clinic

    Cleveland, Ohio 44195
    United States

    Site Not Available

  • Providence Portland Medical Center

    Portland, Oregon 97213
    United States

    Site Not Available

  • Vanderbilt University Medical Center

    Nashville, Tennessee 37232
    United States

    Site Not Available

  • University of Texas Southwestern Medical Center

    Dallas, Texas 75390
    United States

    Site Not Available

  • MD Anderson Cancer Center

    Houston, Texas 77030
    United States

    Site Not Available

  • Seattle Cancer Care Alliance

    Seattle, Washington 98109
    United States

    Site Not Available

  • Medical College of Wisconsin

    Milwaukee, Wisconsin 53226
    United States

    Site Not Available

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