Phase Ib Study of TNO155 in Combination With Spartalizumab or Ribociclib in Selected Malignancies

A Phase Ib, Open-label, Multi-center Study to Characterize the Safety, Tolerability, and Preliminary Efficacy of TNO155 in Combination With Spartalizumab or Ribociclib in Selected Malignancies

ClinicalTrials.gov Identifier: NCT04000529

Novartis Reference Number: CTNO155B12101

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All compounds are either investigational or being studied for (a) new use(s). Efficacy and safety have not been established. There is no guarantee that they will become commercially available for the use(s) under investigation. 

Study Description

This study is a Phase Ib, multi-center, open-label study of TNO155 in combination with spartalizumab or ribociclib with a dose escalation part followed by a dose expansion part in adult subjects with advanced solid tumors.

These two treatment arms will enroll subjects in parallel to characterize the safety, tolerability, PK, PD and preliminary antitumor activity.

The study treatment will be administered until the subject experiences unacceptable toxicity, progressive disease, and/or has treatment discontinued at the discretion of the Investigator or the subject, or due to withdrawal of consent.

Condition 
Non-small Cell Lung Carcinoma
Head and Neck Squamous Cell Carcinoma
Esophageal SCC
Gastrointestinal Stromal Tumors
Colorectal Cancer
Phase 
Phase 1
Overall status 
Recruiting
Enrollment count 
126 participants
Start date 
Jul 30, 2019
Completion date 
Sep 13, 2022
Gender 
All
Age(s)
18 Years and older (Adult, Older Adult)

Interventions

Drug
TNO155
Capsule
Drug
Spartalizumab
Concentrate for solution for infusion
Drug
Ribociclib
Capsule and tablet

Eligibility Criteria

Key Inclusion Criteria:

Signed informed consent must be obtained prior to participation in the study.
Age ≥ 18 years. For Japan only: written consent is necessary both from the patient and his/her legal representative if he/she is under the age of 20 years.
ECOG (Eastern Cooperative Oncology Group) performance status ≤ 1.

Dose escalation part: Patients with advanced solid tumors, with evaluable disease as determined by RECIST version 1.1, and fit into one of the following groups:

a. For TNO155 plus spartalizumab combination: i. Advanced EGFR WT, ALK WT NSCLC, after progression on or intolerance to platinum-containing combination chemotherapy and after progression on anti-PD-1 or anti-PD-L1 therapy.

ii. Advanced HNSCC or esophageal SCC, after progression on or intolerance to platinum-containing combination chemotherapy.

iii. Advanced CRC, after progression on or intolerance to all standard-of-care (SOC) therapy per local guidelines.

b. For TNO155 plus ribociclib combination: i. Advanced NSCLC, after progression on or intolerance to platinum-containing combination chemotherapy and anti-PD-1 or anti-PD-L1 therapy.

ii. Advanced HNSCC or esophageal SCC after progression on or intolerance to, platinum-containing combination chemotherapy and anti-PD-1 or anti-PD-L1 therapy, where such therapy is available and considered standard of care.

iii. Advanced CRC or GIST, after progression on or intolerance to all SOC therapy per local guidelines.

Dose expansion part: Patients with advanced solid tumors, with at least one measurable lesion as determined by RECIST version 1.1, who fit into one of the following groups:

a. For TNO155 plus spartalizumab combination: i. Advanced EGFR WT, ALK WT, KRAS G12C NSCLC after progression on or intolerance to platinum-containing combination chemotherapy and after progression on anti-PD-1 or anti-PD-L1 therapy.

ii. Advanced EGFR WT, ALK WT, KRAS WT NSCLC, after progression on or intolerance to platinum-containing combination chemotherapy and after progression on anti-PD-1 or anti-PD-L1 therapy.

iii. Advanced HNSCC, after progression on or intolerance to, platinum-containing combination chemotherapy.

b. For TNO155 plus ribociclib combination: i. Advanced EGFR WT, ALK WT, KRAS WT NSCLC, after progression on or intolerance to platinum-containing chemotherapy and anti-PD-1 or anti-PD-L1 therapy ii. Advanced CRC harboring a KRAS codon 12, 13, or 61 mutation, after progression on or intolerance to all SOC per local guidelines

Patients with NSCLC whose tumors harbor genomic aberrations for which SOC targeted therapies exist and are locally approved and available must have had progression on or after, or intolerance to, the SOC targeted therapy/therapies as indicated
Patients must have a site of disease amenable to biopsy

Key Exclusion Criteria:

Prior treatment with a MAPK pathway inhibitor
Clinically significant cardiac disease or risk factors
Use of any agent known to prolong the QT interval unless it can be permanently discontinued for the duration of study (see list in Section 6.2.2).
History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO
Inflammatory bowel disease (e.g., ulcerative colitis, Crohn's disease) or impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drugs
Symptomatic CNS metastases which are neurologically unstable

Insufficient bone marrow function at screening:

Absolute Neutrophil Count (ANC) < 1.5 x 109/L.
Hemoglobin < 9.0 g/dL.
Platelets < 75 x 109/L for TNO155 plus spartalizumab combination; < 100 x 109/L for TNO155 plus ribociclib combination.

Insufficient hepatic or renal function at screening:

Serum total bilirubin > upper limit of normal (ULN) or, for TNO155 plus spartalizumab combination only, if liver metastases are present at baseline, serum total bilirubin > 1.5 x ULN. An exception for either combination is for patients with Gilbert's syndrome, who are excluded if total bilirubin > 3.0 x ULN or direct bilirubin > 1.5 x ULN
Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 3 x ULN for TNO155 plus spartalizumab combination or > 2.5 x ULN for TNO155 plus ribociclib combination, or > 5 x ULN for either combination if liver metastases are present.
Creatinine clearance < 60 mL/min (calculated using Cockcroft-Gault equation).

Pregnant or breast-feeding (lactating) women.

Additional exclusion criteria for the TNO155 plus spartalizumab combination

History of severe hypersensitivity reactions to other mAbs.
Active, known or suspected autoimmune disease.
History of or current interstitial lung disease or pneumonitis grade ≥ 2.
Human Immunodeficiency Virus (HIV) infection, unless the patient is on antiviral therapy and has undetectable viral load.
Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection.
Systemic chronic steroid therapy

Patients who discontinued prior anti-PD-1 therapy due to an anti-PD-1-related toxicity.

Additional exclusion criteria for the TNO155 plus ribociclib combination

Systolic Blood Pressure (SBP) < 90 mmHg.
International Normalized Ratio (INR) > 1.5 (unless the patient is receiving anticoagulants and the INR is within the therapeutic range of intended use for that anticoagulant within seven days prior to the first dose of study drug).
History of HIV infection (testing not mandatory)

Currently receiving any of the following substances and cannot be discontinued seven days prior to Cycle 1 Day 1:

Concomitant medications or herbal supplements, that are strong inducers or inhibitors of CYP3A4/5,
Medications that have a narrow therapeutic window and are predominantly metabolized through CYP3A4/5.
Previous treatment with a CDK4/6 inhibitor.
Patient is currently receiving or has received systemic corticosteroids ≤ 2 weeks prior to starting study drug, or who have not fully recovered from side effects of such treatment.

Note: The following uses of corticosteroids are permitted: single doses, topical applications (e.g., for rash), inhaled sprays (e.g., for obstructive airways diseases), eye drops or local injections (e.g., intra-articular).

Study Locations

Australia
Novartis Investigative Site
Recruiting
Westmead, 2145
New South Wales
Australia
Belgium
Novartis Investigative Site
Recruiting
Bruxelles, 1200
-
Belgium
China
Novartis Investigative Site
Recruiting
Chengdu, 610041
Sichuan
China
Germany
Novartis Investigative Site
Recruiting
Koeln, 50937
-
Germany
Hong Kong
Novartis Investigative Site
Recruiting
Hong Kong,
-
Hong Kong
Japan
Novartis Investigative Site
Recruiting
Chuo ku, 104 0045
Tokyo
Japan
Singapore
Novartis Investigative Site
Recruiting
Singapore, 119228
-
Singapore
Spain
Novartis Investigative Site
Recruiting
Barcelona, 08035
Catalunya
Spain

Contacts

Name: 
Novartis Pharmaceuticals
Phone: 
1-888-669-6682
Name: 
Novartis Pharmaceuticals
Phone: 
+41613241111
Email: 

Have a question?

Call 1-999-669-6682 or email [email protected]