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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04140526
Registration number
NCT04140526
Ethics application status
Date submitted
24/10/2019
Date registered
28/10/2019
Titles & IDs
Public title
Safety, PK and Efficacy of ONC-392 in Monotherapy and in Combination of Anti-PD-1 in Advanced Solid Tumors and NSCLC
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Scientific title
Safety, Pharmacokinetics (PK), and Efficacy of ONC-392 as a Single Agent and in Combination With Pembrolizumab in Advanced Solid Tumors and NSCLC: An Open Label Phase IA/IB Study. Preserve CTLA4 Checkpoint Function (PRESERVE-001)
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Secondary ID [1]
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4R44CA250824-02
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Secondary ID [2]
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ONC-392-001
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Universal Trial Number (UTN)
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Trial acronym
PRESERVE-001
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Non Small Cell Lung Cancer
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Advanced Solid Tumor
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Metastatic Melanoma
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Metastatic Head and Neck Carcinoma
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Metastatic Renal Cell Carcinoma
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Metastatic Colorectal Cancer
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Sarcomas
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Metastatic Prostate Cancer
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Ovarian Cancer
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Small Cell Lung Cancer
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Metastatic Breast Cancer
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Pancreas Cancer
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Gastric Cancer
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Esophageal Cancer
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Gastroesophageal Junction Adenocarcinoma
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Cervical Cancer
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Adenoid Cystic Carcinoma
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Salivary Gland Cancer
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Urothelial Carcinoma
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Condition category
Condition code
Cancer
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Non melanoma skin cancer
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Cancer
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Kidney
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Cancer
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Lung - Mesothelioma
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Cancer
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Lung - Non small cell
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Cancer
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Lung - Small cell
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Cancer
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Head and neck
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Oral and Gastrointestinal
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Cancer
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Pancreatic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - ONC-392
Treatment: Drugs - Pembrolizumab
Treatment: Drugs - Docetaxel
Experimental: ONC-392 Treatment as single agent - The Part A study will test ONC-392 intravenous (IV) infusion up to five predefined dose levels from 0.1 mg/kg to 10 mg/kg ONC-392 as monotherapy every 21 days (Q3W). The Part A study will determine the maximal tolerable dose (MTD) and the recommended Phase 2 dose in monotherapy (RP2D-M).
In Part C, Arms A-C, I-N monotherapy expansion cohorts will further assess the safety and efficacy of ONC-392 in different dose levels as monotherapy in pancreatic cancer, triple negative breast cancer, non small cell lung cancer with driver mutations, PD-1 resistant non small cell lung cancer, PD-1 resistant melanoma, head and neck cancer, ovarian cancer, renal cell carcinoma and other solid tumors.
Part D is a Phase II study on recurrent and/or metastatic adenoid cystic carcinoma.
Experimental: ONC-392 in combination with pembrolizumab - The Part B1 study will test ONC-392 intravenous (IV) infusion, Q3W, in combination with fixed dose of pembrolizumab. The dose for pembrolizumab will be fixed at 200mg/cycle dosed every 21 days (Q3W).
The Part B1 will start at one level below RP2D-M dose for ONC-392 and 200mg of pembrolizumab. When 2 DLTs occur before 6 patients are enrolled, the ONC-392 dose will be decreased to the next dose level until = 1/6 patients treated at that dose develops a DLT. This dose level will be designated RP2D-C.
In Part C, the expansion cohorts Arm D to G will assess the safety and efficacy of ONC-392 in different dose levels and Pembrolizumab combination therapy in non small cell lung cancer, and metastatic melanoma.
Experimental: ONC-392 and docetaxel - Part E Arm O will test ONC-392 in combination with docetaxel, IV infusion, Q3W, in PD-1 resistant NSCLC patients.
Treatment: Drugs: ONC-392
ONC-392 will be given by intravenous infusion, once every 21 days (Q3W). In Part C Arm M and in Part D, ONC-392 will be given Q4W.
Treatment: Drugs: Pembrolizumab
Pembrolizumab will be given intravenous (IV) infusion at 200 mg/cycle, once every 21 days (Q3W).
Treatment: Drugs: Docetaxel
Docetaxel will be given intravenous (IV) infusion at 75 mg/m2, once every 21 days (Q3W).
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Dose limiting toxicity (DLT) in monotherapy
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Assessment method [1]
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The number of subjects who have dose limiting toxicity during the first cycle of study drug, ONC-392, administration.
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Timepoint [1]
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21 days
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Primary outcome [2]
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Maximal tolerable dose (MTD) in monotherapy
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Assessment method [2]
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The study drug, ONC-392, dose level that has two out of six subjects who have dose limiting toxicity.
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Timepoint [2]
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21 days
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Primary outcome [3]
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Recommended Phase II Dose (RP2D)
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Assessment method [3]
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The study drug, ONC-392, dose level that is one level below MTD, or an intermediate dose level that below MTD and pre-specified in protocol. This dose level will be the RP2D for monotherapy.
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Timepoint [3]
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21 days
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Primary outcome [4]
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Rate of treatment related adverse events (TRAE) according to CTCAE v5.0
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Assessment method [4]
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The safety profile will be presented as tabulated TRAE.
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Timepoint [4]
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One year
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Secondary outcome [1]
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The serum half life of the study drug, ONC-392, in monotherapy.
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Assessment method [1]
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To determine the drug concentration in serum samples that are taken in various timepoints during the treatment in order to calculate drug half life.
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Timepoint [1]
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12 weeks
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Secondary outcome [2]
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The serum half life of the study drug, ONC-392, in combination therapy with Pembrolizumab.
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Assessment method [2]
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To determine the drug concentration in serum samples that are taken in various timepoints during the treatment in order to calculate drug half life.
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Timepoint [2]
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12 weeks
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Secondary outcome [3]
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Objective Response Rate (ORR)
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Assessment method [3]
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To determine the objective response rate based on RECIST v1.1.
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Timepoint [3]
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1 year
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Secondary outcome [4]
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Progression Free Survival (PFS)
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Assessment method [4]
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To determine the progression free survival based on RECIST 1.1 and iRECIST.
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Timepoint [4]
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1 year
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Secondary outcome [5]
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Overall Survival (OS)
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Assessment method [5]
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To determine the overall survival.
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Timepoint [5]
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1 year
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Eligibility
Key inclusion criteria
1. . Patients must have a histological or cytological diagnosis of NSCLC or any other type of carcinoma or sarcomas, progressive metastatic disease, or progressive locally advanced disease not amenable to local therapy.
1. In the Part A Phase I dose escalation study of ONC-392 monotherapy, patients with advanced/metastatic solid tumors of any histology are eligible for participation.
Please note: tumor types of primary interest in this study are malignant melanoma, renal cell carcinoma, hepatocellular carcinoma, non-small cell lung cancer, head and neck carcinoma, gastric carcinoma, ovarian carcinoma, colorectal cancer, any type of sarcoma.
2. In Part B dose finding of the ONC-392 plus pembrolizumab combination, patients with advanced/metastatic solid tumors of any histology that Pembrolizumab has been approval as standard of care are eligible for participation.
3. In Part C, patients with pancreatic cancer, triple negative breast cancer, non small cell lung cancer, melanoma, Head and Neck cancer, ovarian cancer, and other solid tumors are eligible.
4. In Part D, patients with recurrent and/or metastatic adenoid cystic carcinoma with disease progression within 12 months are eligible.
5. Patients must have RECIST V1.1 Measurable disease:
2. Patient is male or female and >18 years of age on day of signing informed consent.
3. Patient must have a performance status of 0 or 1 on the ECOG Performance Scale
4. Patient must have adequate organ function as indicated by the following laboratory values:
Hematological: Absolute neutrophil count (ANC) =1,500 /mcL; Plateletsa =100,000 / mcL; Hemoglobin =9 g/dL or =5.6 mmol/L- without qualifications; Renal: Serum creatinine =1.5 X upper limit of normal (ULN); Hepatic: Serum total bilirubin =1.5 X ULN; OR Direct bilirubin = ULN for patients with total bilirubin levels >1.5 ULN; AST (SGOT) and ALT (SGPT) =2.5 X ULN, OR =5 X ULN for patients with active liver metastases Coagulation: International Normalized Ratio (INR) or Prothrombin Time (PT) =1.5 X ULN Activated Partial Thromboplastin Time (aPTT) =1.5 X ULN
5. Patient has voluntarily agreed to participate by giving written informed consent.
6. Female patient of childbearing potential has a negative urine or serum pregnancy test.
7. Female and Male patients must agree to use adequate methods of contraception starting with the first dose of study drug through 90 days after the last dose of study therapy.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
A patient meeting any of the following criteria is not eligible to participate in this study:
1. Patients who have not recovered to CTCAE = 1 from the AE due to cancer therapeutics. The washout period for cancer therapeutic drugs (such as chemotherapy, radioactive, or targeted therapy) is 21 days, and for antibody drug 28 days.
2. Patients who are currently enrolled in a clinical trial of an investigational agent or device.
3. Patients who are on chronic systemic steroid therapy at doses >10 mg/day
4. Patients who have active symptomatic brain metastasis or leptomeningeal metastasis.
5. Patients who have an active infection requiring systemic IV therapy within 14 days of prior to administration of ONC-392 or combined ONC-392 and Pembrolizumab.
6. Patients who have a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the patient's participation for the full duration of the study, or is not in the best interest of the patient to participate, in the opinion of the treating Investigator.
7. Patients with known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
8. Patients who are pregnant or breastfeeding.
9. For the Part B and Part C Arm D to G, the patients that are deemed to be not suitable for Pembrolizumab.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/09/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
31/12/2027
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Actual
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Sample size
Target
733
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA
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Recruitment hospital [1]
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Newcastle Private Hospital - New Lambton Heights
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Recruitment hospital [2]
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Tasman Oncology Research - Southport
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Recruitment hospital [3]
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Cancer Research SA - Adelaide
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Recruitment hospital [4]
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Southern Oncology Clinical Research Unit - Bedford Park
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Recruitment postcode(s) [1]
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2305 - New Lambton Heights
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Recruitment postcode(s) [2]
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4120 - Southport
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Recruitment postcode(s) [3]
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5000 - Adelaide
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Recruitment postcode(s) [4]
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5042 - Bedford Park
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Recruitment outside Australia
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United States of America
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State/province [1]
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Arkansas
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United States of America
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California
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United States of America
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Colorado
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United States of America
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Connecticut
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United States of America
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District of Columbia
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United States of America
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Florida
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United States of America
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Georgia
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United States of America
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Kentucky
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United States of America
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Maryland
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Massachusetts
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Michigan
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New Jersey
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New York
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Ohio
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Pennsylvania
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South Carolina
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Tennessee
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United States of America
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Texas
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Utah
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Virginia
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United States of America
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Washington
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
OncoC4, Inc.
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Address
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Other collaborator category [1]
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Government body
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Name [1]
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National Cancer Institute (NCI)
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a First-in-Human Phase IA/IB/II open label dose escalation study of intravenous (IV) administration of ONC-392, a humanized anti-CTLA4 IgG1 monoclonal antibody, as single agent and in combination with pembrolizumab in participants with advanced or metastatic solid tumors and non-small cell lung cancers.
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Trial website
https://clinicaltrials.gov/study/NCT04140526
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Trial related presentations / publications
Zhang Y, Du X, Liu M, Tang F, Zhang P, Ai C, Fields JK, Sundberg EJ, Latinovic OS, Devenport M, Zheng P, Liu Y. Hijacking antibody-induced CTLA-4 lysosomal degradation for safer and more effective cancer immunotherapy. Cell Res. 2019 Aug;29(8):609-627. doi: 10.1038/s41422-019-0184-1. Epub 2019 Jul 2. Du X, Tang F, Liu M, Su J, Zhang Y, Wu W, Devenport M, Lazarski CA, Zhang P, Wang X, Ye P, Wang C, Hwang E, Zhu T, Xu T, Zheng P, Liu Y. A reappraisal of CTLA-4 checkpoint blockade in cancer immunotherapy. Cell Res. 2018 Apr;28(4):416-432. doi: 10.1038/s41422-018-0011-0. Epub 2018 Feb 22. Du X, Liu M, Su J, Zhang P, Tang F, Ye P, Devenport M, Wang X, Zhang Y, Liu Y, Zheng P. Uncoupling therapeutic from immunotherapy-related adverse effects for safer and effective anti-CTLA-4 antibodies in CTLA4 humanized mice. Cell Res. 2018 Apr;28(4):433-447. doi: 10.1038/s41422-018-0012-z. Epub 2018 Feb 20. May KF Jr, Roychowdhury S, Bhatt D, Kocak E, Bai XF, Liu JQ, Ferketich AK, Martin EW Jr, Caligiuri MA, Zheng P, Liu Y. Anti-human CTLA-4 monoclonal antibody promotes T-cell expansion and immunity in a hu-PBL-SCID model: a new method for preclinical screening of costimulatory monoclonal antibodies. Blood. 2005 Feb 1;105(3):1114-20. doi: 10.1182/blood-2004-07-2561. Epub 2004 Oct 14. Lute KD, May KF Jr, Lu P, Zhang H, Kocak E, Mosinger B, Wolford C, Phillips G, Caligiuri MA, Zheng P, Liu Y. Human CTLA4 knock-in mice unravel the quantitative link between tumor immunity and autoimmunity induced by anti-CTLA-4 antibodies. Blood. 2005 Nov 1;106(9):3127-33. doi: 10.1182/blood-2005-06-2298. Epub 2005 Jul 21. Liu Y, Zheng P. Preserving the CTLA-4 Checkpoint for Safer and More Effective Cancer Immunotherapy. Trends Pharmacol Sci. 2020 Jan;41(1):4-12. doi: 10.1016/j.tips.2019.11.003. Epub 2019 Dec 10.
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Public notes
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Contacts
Principal investigator
Name
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Tianhong Li, MD
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Address
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University of California, Davis
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Pan Zheng, MD, PhD
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Address
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Phone
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202 751 6823
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04140526