Purpose

This is a Phase 1b/2, open label, multicenter, safety and clinical activity study of avelumab in combination with chemotherapy as first-line treatment of adult patients with locally advanced or metastatic solid tumors. Initially, avelumab will be evaluated in combination with pemetrexed and carboplatin in patients with advanced non-squamous non-small cell lung cancer (NSCLC) (Cohort A1) and in combination with gemcitabine and cisplatin in patients with cisplatin-eligible urothelial (bladder) cancer (UC) (Cohort A2). As more information is learned about other anti-cancer immunotherapy agents, in future portions of the study, avelumab may be combined with chemotherapy and other anti-cancer immunotherapy agents in patients with these same or different tumor types.

Conditions

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  1. Histological diagnosis of locally advanced (primary or recurrent) or metastatic solid tumor that is not amenable for treatment with curative intent as follows:
  2. For all groups:
  3. Measurable disease by RECIST v1.1 with at least 1 measurable lesion;
  4. No prior systemic treatment for unresectable locally advanced or metastatic disease for the tumor type under study. If prior systemic chemotherapy treatment was given in the adjuvant or neo-adjuvant setting or as part of radiotherapy chemotherapy treatment, disease-free interval after stop of systemic treatment must be more than 6 months for non-squamous NSCLC and more than 12 months for UC;
  5. Cohort A1: Non-squamous NSCLC, with no activating EGFR mutations, ALK or ROS1 translocations/rearrangements. If monotherapy pembrolizumab is available as a standard of care treatment option, patients must have a tumor proportion score (TPS) <50% for PD L1 (via the 22C3 pharmDx or the Ventana (SP263) PD L1 IHC assay).
  6. Cohort A2: Transitional cell carcinoma of the urothelium including the bladder, urethra, renal pelvis, and ureter.
  7. ECOG performance status 0 or 1
  8. Estimated life expectancy of at least 90 days
  9. Adequate bone marrow, renal, and liver function
  10. Negative serum pregnancy test at screening
  11. Male and female patients able to have children must agree to use 2 highly effective methods of contraception throughout the study and for at least 90 days after last dose of chemotherapy or at least 30 days after last dose of avelumab, whichever is longer
  12. Signed and dated informed consent

Exclusion Criteria

  1. Prior immunotherapy with any antibody or drug specifically targeting T cell co-stimulation or immune checkpoint pathways.
  2. Patients with known symptomatic central nervous system metastases requiring steroids.
  3. Diagnosis of other malignancy within 2 years prior to enrollment except adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the bladder, breast, or cervix, or low grade (Gleason ≤6) prostate cancer
  4. Use of immunosuppressive medication at the time of enrollment
  5. Active or prior autoimmune disease that might deteriorate when receiving an immuno-stimulatory agent.
  6. Prior organ transplantation including allogenic stem cell transplantation
  7. Active infection requiring systemic therapy
  8. Known history of HIV or AIDS
  9. Hepatitis B virus (HBV) or hepatitis C virus (HCV) infection at screening
  10. Administration of live vaccine within 4 weeks prior to study entry
  11. Known prior severe hypersensitivity to the investigational products or any component in their formulations,
  12. Known prior severe hypersensitivity to platinum-related compounds for all cohorts, to pemetrexed for patients enrolled in Cohort A1, and to gemcitabine for patients enrolled in Cohort A2
  13. Persisting toxicity related to prior therapy (NCI CTCAE v4.03 Grade > 1)
  14. Known history of colitis, inflammatory bowel disease, pneumonitis, pulmonary fibrosis.
  15. Ongoing cardiac dysrhythmias of NCI CTCAE v4.03 Grade 2 or prolongation of the QTcF interval to >480 msec.
  16. Clinically significant (ie, active) cardiovascular disease: cerebral vascular accident/stroke (<6 months prior to enrollment), myocardial infarction (< 6 months prior to enrollment), unstable angina, congestive heart failure, or serious cardiac arrhythmia requiring medication.
  17. Major surgery ≤28 days or major radiation therapy ≤14 days prior to enrollment.
  18. Participation in other studies involving investigational drug(s) within 28 days prior to study entry.
  19. Concurrent treatment with a prohibited medication.
  20. Other acute or chronic medical or psychiatric condition
  21. Pregnant female patients; breastfeeding female patients; fertile male patients and female patients of childbearing potential who are unwilling or unable to use 2 highly effective methods of contraception as outlined in this protocol for the duration of the study and for at least 90 days after the last dose of chemotherapy or at least 30 days after the last dose of avelumab, whichever is longer.

Study Design

Phase
Phase 2
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Group A Cohort A1
Non-squamous non-small cell lung cancer (NSCLC) patients treated with avelumab plus pemetrexed/carboplatin
  • Drug: Avelumab in combination with pemetrexed / carboplatin
    Avelumab Pemetrexed Carboplatin
Experimental
Group A Cohort A2
Cisplatin-eligible urothelial cancer patients treated with avelumab plus gemcitabine/cisplatin
  • Drug: Avelumab in combination with gemcitabine / cisplatin.
    Avelumab Gemcitabine Cisplatin

Recruiting Locations

Montefiore Medical Center - Moses Division
Bronx, New York 10467

Montefiore Medical Center - Einstein Center for Cancer Care
Bronx, New York 10461

More Details

NCT ID
NCT03317496
Status
Recruiting
Sponsor
Pfizer

Study Contact

Pfizer CT.gov Call Center
1-800-718-1021
ClinicalTrials.gov_Inquiries@pfizer.com

Detailed Description

This is a Phase 1b/2, open label, multicenter, safety, clinical activity, pharmacokinetic (PK), and pharmacodynamics (PD) study of avelumab in combination with chemotherapy with or without other anti-cancer immunotherapies, as first-line treatment of adult patients with locally advanced or metastatic solid tumors. Initially, avelumab will be evaluated in combination with pemetrexed and carboplatin in patients with advanced non-squamous non-small cell lung cancer (NSCLC) (Cohort A1) and with gemcitabine and cisplatin in patients with cisplatin-eligible urothelial cancer (UC) (Cohort A2).

Given the growing preclinical and clinical indications that combinations of anti-cancer immunotherapies potentially improve patient outcomes compared to results seen with single agents, in portions of the study to be added in the future, avelumab will be evaluated in combination with both standard-of-care chemotherapy and other anti-cancer immunotherapies in patients with advanced malignancies. Each cohort in the study will consist of a Phase 1b lead-in portion to evaluate safety and a Phase 2 cohort expansion to evaluate safety and efficacy.

In the Phase 1b safety lead-in portion, up to 12 patients will be enrolled into each cohort and evaluated for dose-limiting toxicities (DLT) during the first 2 cycles of treatment. If investigational products administration in a cohort is deemed safe in the Phase 1b lead-in, enrollment will be expanded into the Phase 2 cohort expansion. Up to approximately 40 patients in each cohort (including those enrolled in the Phase 1b lead-in and those enrolled in the Phase 2 cohort expansion) will be enrolled and treated with avelumab plus chemotherapy in the initial portion of the study and, in future portions of the study, with avelumab plus chemotherapy with or without other anti-cancer immunotherapies.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.