AB821 for adults with advanced melanoma and other immune-responsive solid tumors

An Open-Label, Phase 1 Study to Investigate the Safety, Pharmacokinetics, Pharmacodynamics, and Antitumor Activity of AB821 in Adult Participants With Locally Advanced or Metastatic Melanoma and Other Solid Tumors

This will test whether AB821 given every two weeks is safe and shows early anti-tumor activity in adults with recurrent locally advanced or metastatic melanoma or other immune-responsive solid tumors.

Quick facts

• Phase: PHASE1
• Study type: Interventional
• Enrollment: 50 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Yale University (other)
• Drugs / interventions: immunotherapy, radiation, prednisone
• Locations: 1 site (New Haven, Connecticut)
• Trial ID: NCT07027488 on ClinicalTrials.gov

What this trial studies

This is a first-in-human, open-label, nonrandomized Phase 1 dose-escalation study of AB821 given as monotherapy every two weeks at a single center. Participants with melanoma must have prior PD-1/PD-L1 inhibitor therapy, while participants with other immune-responsive tumors must have received prior systemic treatment. Cohorts will enroll sequentially with 28-day DLT monitoring (two 14-day cycles) and predefined rules for cohort expansion; additional backfill cohorts (up to 20 participants) may be added to further characterize safety and pharmacodynamics. The study will measure safety, pharmacokinetics, pharmacodynamics, immunogenicity, and preliminary anti-tumor activity to determine an appropriate dose for later-phase testing.

Who should consider this trial

Good fit: Adults (≥18 years) with recurrent locally advanced or metastatic melanoma previously treated with a PD-1/PD-L1 inhibitor, or adults with other immune-responsive solid tumors who have had prior systemic therapy, with ECOG 0-1 and adequate organ function and life expectancy of at least 12 weeks.

Not a fit: Patients with non-immune-responsive tumor types, poor organ function, ECOG performance status >1, or who cannot travel to the study site are unlikely to benefit from participation.

Why it matters

Potential benefit: If successful, AB821 could offer a new treatment option that shrinks tumors or controls disease for patients who have progressed on available therapies.

How similar studies have performed: Other immune-targeting therapies, including PD-1/PD-L1 inhibitors and various immunomodulators, have demonstrated benefit in immune-responsive tumors, but AB821 is first-in-human and has not been tested in people before.

Eligibility criteria

Inclusion Criteria:

1. ≥18 years at the time consent is signed.
2. Ability to provide written informed consent for the study.
3. ECOG PS of 0 or 1.
4. Participants of childbearing potential must not be pregnant at enrollment and agree to comply with contraception requirements. Participants with partners of childbearing potential must also comply with contraception requirements.
5. Adequate organ function as defined below. Specimens must be collected within seven days prior to the start of the study treatment (i.e., Cycle 1 Day 1 \[C1D1\]) including:

   ANC\> 1500/ul Platelet count\>100,000 Hb\>9 g/dl Calculated creatinine clearance\> 50 mL/min Total bilirubin greater than or equal to 1.5 x ULN or direct bilirubin greater than or equal to ULN for participants with total bilirubin \> 1.5 x ULN PT INR \> 1.5 x ULN unless on anticoagulation Albumin \> 3g/dl
6. Life expectancy of ≥12 weeks, per treating investigator's judgment.
7. For Melanoma participants: Participants with unresectable or metastatic melanoma that have progressed on or after PD-1/PD-L1 checkpoint blockade (alone or with either CTLA-4 or LAG-3 checkpoint blockade).
8. For other tumor types: Must have a recurrent histologically or cytologically proven metastatic or locally advanced solid tumor (non-small cell lung cancer (NSCLC), renal cell carcinoma (RCC), Merkel-cell carcinoma, bladder cancer, or squamous cell carcinoma of the head and neck (SCCHN)), meeting each of the following:

   1. Tumor that is not amenable to curative treatment with surgery or radiation.
   2. Tumor for which immune checkpoint inhibitors form part of standard-of-care therapy.
   3. Participant has received at least one prior line of systemic anticancer therapy in the recurrent or metastatic setting.
9. Has measurable disease per RECIST v1.1 as assessed by the local site investigator/radiology.

Exclusion Criteria:

1. Has a diagnosis of immunodeficiency.
2. Prior stem cell, bone marrow, or organ transplant.
3. Known history of HIV infection. No HIV testing is required unless mandated by local health authority.
4. History of HBV (defined as HBV surface antigen reactive) or active HCV.
5. Active autoimmune disease (non-immunotherapy induced conditions) that has required systemic treatment in the past two 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) is not considered a form of systemic immune-suppressive treatment and is allowed.
6. Active Grade ≥2 diarrhea or enterocolitis.
7. Known active CNS metastases and/or carcinomatous meningitis. Individuals with previously treated brain metastases may participate provided they are radiologically stable (i.e., without evidence of progression for at least two weeks by repeat imaging, clinically stable, and without requirement of steroid treatment for at least 14 days prior to first dose of study treatment).
8. Any other current or previous malignancy within the previous three years except neoplasms that, in the opinion of the treating investigator and with the agreement of the sponsor-investigator, will not interfere with study-specific endpoints, e.g. basal cell carcinoma, localized tumors that have been fully excised with curative intent and no evidence of recurrence or metastasis, prostate cancer that is asymptomatic and does not require therapy other than anti-androgen therapy.
9. Participant is a regular user, as determined by treating investigator judgment (including recreational use), of any illicit drugs or has a recent history (within the last year) of substance abuse (including alcohol), at the time of signing the Informed Consent Form (ICF).
10. Has clinically significant heart disease that affects normal activities, including, unstable angina, or history of congestive heart failure (New York Heart Association Class II IV).
11. History of acute myocardial infarction within the last six months.
12. Has a history of new or worsening thrombosis (DVT/PE, other thrombo-embolic disease) within the last six months.
13. Has a mean QTcF value of \>470 ms.
14. Has a history or current evidence of any condition, therapy, or laboratory abnormality, or other circumstance that might confound the results of the study or interfere with the individuals' participation for the full duration of the study, such that it is not in the best interest of the individual to participate, in the opinion of the treating investigator.
15. Has an active infection, requiring systemic therapy.
16. Has had a severe hypersensitivity reaction to any components of the study treatment or any of their excipients.
17. Is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within seven days prior the first dose of study treatment.
18. Has received more than five prior lines of systemic treatment in the recurrent/metastatic setting.
19. Has received prior radiotherapy within two weeks of start of study treatment or has had a history of radiation pneumonitis.
20. Has a history of grade 3-4 autoimmune myocarditis or a history of Guillain Barre Syndrome.
21. History of congestive heart failure with an ejection fraction \< 40%.
22. Participant with NSCLC only: Has received radiation therapy to the lung that is \>30 Gy within six months of the first dose of study treatment.
23. Has received previous IL-21 based therapy or prior therapy with AB248
24. Prior systemic anticancer therapy including investigational agents within four weeks or, if shorter, within five half-lives prior to first dose of study treatment.
25. Major surgery from which the participant has not fully recovered
26. Has received a live or live attenuated vaccine within 30 days
27. Current use of any prohibited concomitant medications.
28. A participant of childbearing potential who has a positive serum pregnancy test within 14 days prior to treatment.

Where this trial is running

New Haven, Connecticut

• Yale University — New Haven, Connecticut, United States (RECRUITING)

Study contacts

• Principal investigator: Harriet Kluger, MD — Yale University
• Study coordinator: Stephanie Ladd

Conditions: Advanced Melanoma and Normal or Impaired, Advanced Melanoma, AB821, immune-responsive solid tumors