A Study in Patients With Different Types of Advanced Cancer (Solid Tumors) to Test Different Doses of BI 907828 (Brigimadlin) in Combination With BI 754091 (Ezabenlimab) and BI 754111 or BI 907828 (Brigimadlin) in Combination With BI 754091 (Ezabenlimab)

Last updated: April 29, 2025
Sponsor: Boehringer Ingelheim
Overall Status: Active - Not Recruiting

Phase

1

Condition

Neoplasms

Treatment

ezabenlimab

BI 907828

BI 754111

Clinical Study ID

NCT03964233
1403-0002
2019-001173-84
  • Ages > 18
  • All Genders

Study Summary

This study has 2 parts. The first part of the study is done. The first part was open to adults with different types of advanced cancer (solid tumors). The second part is open to people with specific types of soft tissue sarcoma, advanced lung cancer, and cancer in the stomach, bladder or bile ducts.

The participants get a combination of 2 medicines called brigimadlin (also called BI 907828) and ezabenlimab (also called BI 754091). Brigimadlin is a so-called MDM2 inhibitor that is being developed to treat cancer. Ezabenlimab is an antibody that may help the immune system fight cancer (immune checkpoint inhibitor). When the study started, some participants got a third medicine called BI 754111 in addition. Treatment with BI 754111 was stopped because data from another study showed no additional effect of BI 754111.

The purpose of the first part of the study was to find out the highest dose of brigimadlin that the participants could tolerate in combination with ezabenlimab. This dose is used in the second part of the study.

The purpose of the second part is to see whether the combination of brigimadlin with ezabenlimab is able to make tumors shrink.

The participants are in the study as long as they benefit from treatment and can tolerate it.

Ezabenlimab treatment is limited to 2 years. During this time, they get infusions of ezabenlimab, and take tablets with brigimadlin every 3 weeks. The doctors check how many participants have health problems during the study. The doctors also monitor the size of the tumor.

Eligibility Criteria

Inclusion

Inclusion Criteria:

All cohorts:

  • Provision of signed and dated, written informed consent form ICF in accordance withInternational Council on Harmonization-Good Clinical Practice (ICH-GCP)and locallegislation prior to any trial-specific procedures, sampling, or analyses.

  • Male or female ≥18 years old at the time of signature of the ICF.

  • ECOG performance status of 0 or 1.

  • Life expectancy of at least 12 weeks after the start of the treatment according tothe Investigator's judgement.

  • Patients with radiologically documented disease progression or relapse during orafter all standard of care treatments. Patients who are not eligible to receivestandard of care treatments, and for whom no proven treatments exist, are eligible.

  • Previous treatment with an anti-PD-1/PD-L1 mAb is allowed as long as the lastadministration of the anti-PD-1/PD-L1 mAb on the previous treatment occurred aminimum of 28 days prior to the first administration of study treatment.

  • Patient must be willing to participate in the blood sampling for thePharmacokinetics (PK), Pharmacodynamics (PD), biomarker, and PGx analyses.

  • Adequate organ function defined as all of the following (all screening labs shouldbe performed locally within 10 days of treatment initiation):

  • Hematological

  • Absolute neutrophil count - ≥1.5 x 10^9/L

  • Platelets - ≥100 x 10^9/L

  • Hemoglobin 0 ≥8.5 g/dL or ≥5.3 mmol/L or ≥ 85 g/L

  • Hepatic

  • Total bilirubin ≤ 1,5 times the upper limit of normal (ULN), (patientswith Gilbert's syndrome, total bilirubin must be < 3 x ULN)

  • Aspartate Transaminase (AST) and Alanine Aminotransferase (ALT) ≤2.5 x ULNOR ≤5 x ULN for patients with liver metastases

  • Renal --- Creatinine - ≤1.5 x ULN - Patients may enter if creatinine is >1.5 x ULNand estimated glomerular filtration rate (eGFR) >50 mL/min (assessed by ChronicKidney Disease Epidemiology [CKDEPI] Collaboration equation); confirmation ofeGFR is only required when creatinine is >1.5 X ULN

  • Coagulation --- International Normalised Ratio (INR) or Prothrombin Time (PT).Activated Partial Thromboplastin Time (aPTT) - ≤1.5 x institutional ULN.Patients taking low dose warfarin must have their INR followed closely andaccording to institutional guidelines

  • Women of childbearing potential (WOCBP, defined as female patients who arepremenopausal or who had no cessation of menses within 12 months without analternative medical cause, but not including female patients who are permanentlysterilized) and men able to father a child must be ready and able to use twomedically acceptable methods of birth control per ICH M3 (R2) that result in a lowfailure rate of less than 1% per year when used consistently and correctly beginningat screening, during trial participation. A list of contraception methods meetingthese criteria is provided in the patient information.

Phase Ia (dose escalation part):

  • Patients with a confirmed diagnosis of unresectable, advanced and/or metastaticsolid tumors (any type) irrespective of the TP53 mutation status,

  • Patient with either evaluable or non-evaluable disease.

  • Availability and willingness to provide a sample of archival Formalin-fixed paraffinembedded (FFPE) tumor tissue material

Phase Ia (Expansion Cohort):

  • Patients with MDM2 amplified tumors and TP53 wild type status confirmed on tumortissue

  • At least one target lesion that can be accurately measured per RECIST 1.1. Inpatients who only have one target lesion, the baseline imaging must be performed atleast two weeks after any biopsy of the target lesion.

Phase Ib (dose expansion part):

  • At least one target lesion that can be accurately measured per RECIST 1.1. Inpatients who only have one target lesion, the baseline imaging must be performed atleast two weeks after any biopsy of the target lesion.

  • Patients with TP53 wild-type status confirmed on tumor tissue. Provision of freshtissue biopsy at screening (may be omitted if patient has archival tissue within 12months prior to enrolment) and willingness to provide fresh tissue biopsy on study,if safe and feasible on either occasion

  • Expansion cohorts:

  • Cohort 1: Patients with unresectable, advanced and/or metastatic TP53 wt oneline of systemic medical treatment in the advanced and/or metastatic setting:Liposarcoma excluding dedifferentiated liposarcoma, Undifferentiatedpleomorphic sarcoma, Myxofibrosarcoma, Synovial sarcoma, Leiomyosarcoma

  • Cohort 2: Patients with unresectable, advanced and/or metastatic TP53 wtMDM2-amplified tumors as listed below, who received at least one line ofsystemic medical treatment in the advanced and/or metastatic setting: NSCLC (patients with NSCLC harboring genomic aberrations for which approved targetedtherapy is approved and available, must have received such prior treatment),Gastric adenocarcinoma, Urothelial carcinoma, Biliary tract carcinoma (including cholangiocarcinoma, intra-and extrahepatic biliary tree, gallbladder and ampulla of vater)

Exclusion

Exclusion criteria:

  • Previous administration of BI 907828 or any other MDM2-p53 or MDMX (MDM4)-p53antagonist

  • In Phase Ib (expansion phase) and Phase Ia expansion cohort only: a documentedamino-acid altering mutation in TP53 occurring in the patient's tumor.

  • Symptomatic brain metastases. Note: Patients with previously treated brainmetastases may participate but treated lesions should not be used as target lesions

  • Active bleeding, significant risk of haemorrhage (e.g. previous severegastrointestinal bleeding, previous haemorrhagic stroke at any time), or currentbleeding disorder (e.g. haemophilia, von Willebrand disease)

  • Major surgery (major according to the Investigator's assessment) performed within 12weeks prior to start of study treatment, or planned within 12 months after screening (e.g. hip replacement).

  • Any other documented active or suspected malignancy or history of malignancy within 3 years prior to screening, except appropriately treated basal cell carcinoma of theskin or in situ carcinoma of uterine cervix, or other local tumors considered curedby local treatment.

  • Patients who must or wish to continue the intake of restricted medications or anydrug considered likely to interfere with the safe conduct of the trial.

  • Currently enrolled in another investigational device or drug trial, or less than 4weeks since receiving other investigational treatments. Patients who are infollow-up/observation for another clinical trial are eligible.

  • Patients who have not recovered from all clinically significant adverse events fromtheir most recent therapy or intervention prior to study enrolment

  • Known history of human immunodeficiency virus (HIV) infection

  • Any of the following laboratory evidence of hepatitis virus infection:

  • Positive results of hepatitis B surface (HBs) antigen

  • Presence of HBc antibody together with HBV-DNA

  • Presence of hepatitis C RNA

  • Known hypersensitivity to the trial drugs or their excipients.

  • Serious concomitant disease or medical condition affecting compliance with trialrequirements or which are considered relevant for the evaluation of the efficacy orsafety of the trial drug, such as neurologic, psychiatric, infectious disease oractive ulcers (gastro-intestinal tract, skin) or laboratory abnormality that mayincrease the risk associated with trial participation or trial drug administration,and in the judgment of the Investigator, would make the patient inappropriate forentry into the trial.

  • Chronic alcohol or drug abuse or any condition that, in the Investigator's opinion,makes them an unreliable trial patient or unlikely to complete the trial.

  • Women who are pregnant, nursing, or who plan to become pregnant while in the trial;female patients who do not agree to the interruption of breast feeding from thestart of study treatment to within 30 days after the last study treatment.

  • History (including current) of interstitial lung disease or pneumonitis within thelast 5 years.

  • History of severe hypersensitivity reactions to other monoclonal antibodies

  • Immunosuppressive corticosteroid doses (>10 mg prednisone daily or equivalent)within 4 weeks prior to the first dose of study treatment.

  • Active autoimmune disease or a documented history of autoimmune disease, disease,that requires systemic treatment, i.e. corticosteroids or immunosuppressive drugs,except vitiligo or resolved childhood asthma/atopyatopy, alopecia, or any chronicskin condition that does not require systemic therapy; patients withautoimmune-related hypothyroidism on a stable dose of thyroid replacement hormoneand/or controlled Type 1 diabetes mellitus on a stable insulin regimen are eligible.

  • Active infection requiring systemic treatment (antibacterial, antiviral, orantifungal therapy) at start of treatment in this trial.

  • Any of the following cardiac criteria:

  • Mean resting corrected QT interval (QTc) >470 msec

  • Any clinically important abnormalities (as assessed by the Investigator) inrhythm, conduction, or morphology of resting ECGs, e.g., complete left bundlebranch block, third degree heart block

  • Any factor that increases the risk of QTc prolongation or risk of arrhythmicevents such as heart failure, hypokalaemia, congenital long QT syndrome, familyhistory of long QT syndrome or unexplained sudden death under 40 years-of-age,or any concomitant medication known to prolong the QT interval

  • Patients with an ejection fraction (EF) <50% or the lower limit of normal ofthe institutional standard will be excluded. Only in cases where theInvestigator (or the treating physician or both) suspects cardiac disease withnegative effect on the EF, will the EF be measured during screening using anappropriate method according to local standards to confirm eligibility (e.g.,echocardiogram, multi-gated acquisition scan). A historic measurement of EF noolder than 6 months prior to first administration of study drug can be acceptedprovided that there is clinical evidence that the EF value has not worsenedsince this measurement in the opinion of the Investigator or of the treatingphysician or both.

Study Design

Total Participants: 120
Treatment Group(s): 3
Primary Treatment: ezabenlimab
Phase: 1
Study Start date:
June 20, 2019
Estimated Completion Date:
May 30, 2026

Connect with a study center

  • Linear Clinical Research

    Nedlands, Western Australia 6009
    Australia

    Site Not Available

  • UZ Leuven

    Leuven, 3000
    Belgium

    Site Not Available

  • INS Bergonie

    Bordeaux, 33000
    France

    Site Not Available

  • CTR Leon Berard

    Lyon, 69373
    France

    Site Not Available

  • INS Gustave Roussy

    Villejuif, 94805
    France

    Site Not Available

  • Universitätsklinikum Frankfurt

    Frankfurt, 60590
    Germany

    Site Not Available

  • Universitätsklinikum Frankfurt

    Frankfurt am Main, 60590
    Germany

    Site Not Available

  • Universitätsklinikum Ulm

    Ulm, 89081
    Germany

    Site Not Available

  • Central Hospital of Northern Pest - Military Hospital

    Budapest, 1062
    Hungary

    Site Not Available

  • HUN Defence Forces HC Institute

    Budapest, 1062
    Hungary

    Active - Recruiting

  • National Cancer Center Hospital

    Tokyo, Chuo-ku, 104-0045
    Japan

    Site Not Available

  • Universitair Medisch Centrum Groningen

    Groningen, 9713 GZ
    Netherlands

    Site Not Available

  • National Cancer Centre Singapore

    Singapore, 168583
    Singapore

    Site Not Available

  • Hospital Vall d'Hebron

    Barcelona, 08035
    Spain

    Site Not Available

  • Hospital Vall d'Hebron-Barcelona-47683

    Barcelona, 08035
    Spain

    Site Not Available

  • Hospital Clínico San Carlos

    Madrid, 28040
    Spain

    Site Not Available

  • Velindre Cancer Centre

    Cardiff, CF14 2TL
    United Kingdom

    Site Not Available

  • The Royal Marsden Hospital

    London, SW3 6JJ
    United Kingdom

    Active - Recruiting

  • The Royal Marsden Hospital, Chelsea

    London, SW3 6JJ
    United Kingdom

    Site Not Available

  • Sarcoma Oncology Center

    Santa Monica, California 90403
    United States

    Site Not Available

  • Yale Cancer Center

    New Haven, Connecticut 06511
    United States

    Site Not Available

  • University Cancer and Blood Center

    Athens, Georgia 30607
    United States

    Site Not Available

  • Washington University School of Medicine

    Saint Louis, Missouri 63110
    United States

    Site Not Available

  • Memorial Sloan-Kettering Cancer Center

    New York, New York 10065
    United States

    Site Not Available

  • The University of Texas MD Anderson Cancer Center

    Houston, Texas 77030
    United States

    Site Not Available

  • NEXT Oncology

    Irving, Texas 75039
    United States

    Site Not Available

  • NEXT Oncology-Irving-69444

    Irving, Texas 75039
    United States

    Site Not Available

  • NEXT Oncology

    San Antonio, Texas 78229
    United States

    Site Not Available

  • NEXT Oncology-San Antonio-65273

    San Antonio, Texas 78229
    United States

    Site Not Available

  • NEXT Virginia

    Fairfax, Virginia 22031
    United States

    Site Not Available

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