Testing a new antibody for advanced solid tumors

FIH Phase 1A /1B Study of AG01 Antibody Against Progranulin/GP88 in Advanced Solid Tumor Malignancies With Expansion Cohorts in Advanced Triple Negative Breast Ca, Hormone Resistant Breast Ca, Non Small Cell Lung Cancer and Mesothelioma

This study is testing a new antibody treatment for people with advanced solid tumors that haven't responded to other therapies to see how safe it is and how well it works.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 77 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: A&G Pharmaceutical Inc. (Industry-sponsored)
• Drugs / interventions: Atezolizumab, Pembrolizumab, Sacituzumab, chemotherapy, radiation
• Locations: 1 site (Baltimore, Maryland)
• Trial ID: NCT05627960 on ClinicalTrials.gov

What this trial studies

This is a first in human phase 1 study evaluating AG01, an anti-Progranulin/GP88 antibody, in patients with advanced solid tumors. The study consists of a dose escalation phase to determine the maximum tolerated dose and safety of AG01, followed by a cohort expansion phase focusing on specific cancer types such as triple negative breast cancer and non-small cell lung cancer. Patients enrolled will have relapsed or refractory malignancies that have not responded to standard therapies. The treatment involves administering the AG01 antibody every 14 days over 28-day cycles.

Who should consider this trial

Good fit: Ideal candidates include adults with advanced solid tumors who have failed previous standard therapies and have specific GP88 expression levels for the expansion cohort.

Not a fit: Patients with early-stage cancers or those who have not yet undergone standard treatment options may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new therapeutic option for patients with advanced solid tumors that currently have limited treatment options.

How similar studies have performed: While this approach is novel in its specific targeting of GP88, similar studies targeting other tumor markers have shown promise in treating advanced cancers.

Eligibility criteria

Inclusion Criteria:

1. Signed informed consent/authorization is obtained prior to conducting any study-specific screening procedures.
2. 18 years of age or older.
3. Histologic or cytologic diagnosis of advanced cancer.
4. Radiographic evidence of at least 1 measurable metastatic lesion per RECIST 1.1 criteria.
5. Patients with relapsed/refractory solid tumor malignancies who failed one or more standard chemotherapy or targeted therapy regimens per SOC guidelines such as NCCN guidelines and for whom no standard therapy exists (Phase 1A). No GP88 expression pre-required for phase 1A.
6. For phase 1B, patients must have GP88 tissue tumor tissue expression of 1+, 2+ or 3+ by IHC, archival tumor tissue will be used whenever possible. If no archival tissue is available, subject will be asked to consent to a study specific tumor biopsy for GP88 testing (phase1B). Patients who do not have archival tissue available for the dose expansion cohort (1B) will not be exposed to significant risk procedure to obtain tissue and may still be eligible for the study, after discussion with the Sponsor and Medical Monitor.
7. At least 4 weeks after the last dose of chemotherapy or radiation therapy; 6 weeks for mitoxantrone or mitomycin therapy.
8. ECOG performance status must be ≤2 (Appendix A).
9. Adequate hepatic, renal, and bone marrow function:

   Absolute neutrophil count ≥ 1,000/uL Platelets ≥ 100,000/µL Total bilirubin WNL per Institution ULN AST (SGOT)/ALT (SGPT) ≤ 2.5 X institutional ULN Creatinine ≤1.2 mg/dL Clearance ≥50ml/min (Cockcroft-Gault)
10. All study participants (male and female) with reproductive potential must practice highly effective methods of contraception (failure rate \<1% annually) while on this study and for 90 days after completion of study therapy.
11. Men and women of all ethnic groups are eligible for this trial.
12. Females at reproductive age must have a negative urine pregnancy test prior to entry to this study.
13. Males with partners at reproductive age must use highly effective birth control methods to prevent partners' pregnancy while on study and for 90 days after completion of study treatments.
14. Life expectancy is greater than 12 weeks.
15. Subjects with triple negative breast cancer (TNBC) cohort must have received 1 or more standard of care (SOC) or targeted therapies for metastatic TNBC. If PD(L)1-positive, must have received a combination of chemotherapy and a PD (L)-1 agent (Atezolizumab or Pembrolizumab), unless not a candidate for these therapies. If gBRCA 1 or 2 mutation is present, must have received SOC therapies including a PARPi, unless not a candidate for these therapies. is FDA approved for treatment of advanced TNBC. Prior exposure to Sacituzumab Govitecan ADC therapy does not preclude eligibility in the current study.
16. Subjects with Cohort 2-Breast Cancer ER and/or PR positive, hormone-resistant breast cancer who received 1 or more hormonal (HT) therapies or HT/CD4/6 kinase inhibitor or HT/MTOR inhibitor for treatment of metastatic breast cancer are eligible. If the tumor has known PIK3CA mutation, HT/Alpelisib combination should be considered unless not a candidate for this therapy.
17. Subjects with metastatic/recurrent NSCLCA who failed 2 or more SOC therapies, including platinum-based chemotherapy and an anti-PD (L) -1 agent (sequentially or consecutively). Patients with sensitizing mutations/alterations/rearrangements are eligible if received 1 or more SOC agent/s targeting these mutations unless not a candidate for these therapies.
18. Mesothelioma patients who have received at least 1 SOC therapy for metastatic/recurrent mesothelioma per NCCN recommendations or not a candidate for SOC therapy.

Exclusion Criteria:

1. Uncontrolled inter-current illness including, but not limited to, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmias not well controlled with medication, myocardial infarction within the previous 6 months, or psychiatric illness/social situations that would limit compliance with study requirements.
2. Uncontrolled or untreated CNS metastases and treated CNS metastases are allowed, as long as the patient is clinically stable.
3. Presence carcinomatous meningeal involvement.
4. Patients may not be receiving any other investigational agents, or have participated in any investigational drug study \< 28 days prior to starting on the current study.
5. Since the teratogenic potential of AG01 is currently unknown, females who are pregnant or lactating are excluded.
6. Males and females unable to adhere to abstinence or use highly effective methods of contraception (annual failure rate \< 1%) to prevent study subjects' pregnancy or study subjects' partner pregnancy.
7. History of any other malignancies in the last 2 years except for in-situ cancer, basal or squamous cell skin cancer treated with curative intent.

Where this trial is running

Baltimore, Maryland

• University of Maryland Greenebaum Comprehensive Cancer Center — Baltimore, Maryland, United States (Recruiting)

Study contacts

• Principal investigator: Katherine Tkaczuk, MD — University of Maryland, Baltimore
• Study coordinator: Ginette Serrero, PhD/DSC.

Conditions Triple Negative Breast Cancer; Hormone-Resistant Breast Cancer; Non Small Cell Lung Cancer; Mesothelioma; Progranulin; Advanced solid malignancies; Phase 1; Anti-Progranulin antibody