M1774 Combination Therapy for Solid Tumors

Recruiting in Palo Alto (17 mi)

+18 other locations

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 1

Recruiting

Sponsor: EMD Serono Research & Development Institute, Inc.

Disqualifiers: Uncontrolled disease, Additional malignancy, Carcinomatous meningitis, Serious gastrointestinal issues, Organ transplantation, others

No Placebo Group

Breakthrough Therapy

Trial Summary

What is the purpose of this trial?

This trial tests the safety and best dose of two drugs, tuvusertib and lartesertib, in patients with specific cancers. It also examines how food affects lartesertib and compares different forms of tuvusertib. The study includes patients with prostate and endometrial cancers with specific genetic mutations, as well as those with advanced solid tumors.

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial team or your doctor.

What data supports the effectiveness of the drug M1774 Combination Therapy for Solid Tumors?

Avelumab, a component of the combination therapy, is approved for treating certain cancers like Merkel cell carcinoma and urothelial carcinoma, and has shown effectiveness in combination with other drugs for renal cell carcinoma. Combining avelumab with other treatments has been shown to potentially enhance the immune response against tumors, suggesting that the combination therapy might be effective for solid tumors. ^{1 2 3 4 5}

Is the combination therapy M1774 generally safe for humans?

Avelumab, a component of the M1774 combination therapy, has been studied in various trials and is generally associated with a moderate rate of adverse events (side effects), with most being mild to moderate. In a large analysis, 73.78% of patients experienced treatment-related side effects, but only 14.44% were high-grade (more severe), and serious or fatal events were rare. ^{6 7 8 9 10}

What makes the drug M1774 Combination Therapy for Solid Tumors unique?

The M1774 Combination Therapy is unique because it includes avelumab, a monoclonal antibody that blocks PD-L1, helping the immune system attack cancer cells. This combination therapy is novel as it combines avelumab with other agents, potentially enhancing its effectiveness against solid tumors by targeting multiple pathways involved in cancer progression. ^{6 11 12 13 14}

Research Team

Medical Responsible

Principal Investigator

Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany

Eligibility Criteria

This trial is for adults with advanced solid tumors that standard treatments haven't helped or aren't suitable. They should be in fairly good physical shape (ECOG 0-1), expected to live at least 3 more months, and have their major organs working well. People can't join if they have other serious health issues, brain cancer spread, recent severe GI bleeding, trouble absorbing food, or had an organ transplant.

Inclusion Criteria

Participants with eastern Cooperative Oncology Group (ECOG) performance status 0 or 1, with estimated life expectancy of at least 3 months

Adequate hematological, hepatic, and renal function as defined in the protocol

There may be additional requirements that need to be met as stated in the study guidelines.

Exclusion Criteria

Participants with any condition, including any uncontrolled disease state other than with metastatic or locally advanced unresectable solid tumors, that in the Investigator's opinion constitutes an inappropriate risk or a contraindication for participation in the study or that could interfere with the study objectives, conduct, or evaluation

Participants with carcinomatous meningitis are excluded regardless of clinical stability

You have recently had severe bleeding in your stomach or intestines, persistent nausea and vomiting, uncontrollable diarrhea, or difficulties absorbing medications through your digestive system.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive tuvusertib in combination with lartesertib or avelumab to assess safety, tolerability, and pharmacokinetic/pharmacodynamic profile

4 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Open-label extension (optional)

Participants may opt into continuation of treatment long-term to further assess safety and efficacy

Treatment Details

Interventions

• Avelumab (Immune Checkpoint Inhibitor)
• Drug A (DNA Damage Response Inhibitor)
• Drug B (Immune Checkpoint Inhibitor)
• M1774 (Unknown)
• M4076 (Unknown)

Trial Overview The study tests M1774 combined with either M4076 or avelumab to find safe doses and see early effects on certain types of prostate and endometrial cancers with specific genetic changes. It's open-label so everyone knows what treatment they're getting; it includes dose finding and testing how the body absorbs the drug.

Participant Groups

Group I: Part B1: Tuvusertib and Avelumab Experimental Treatment 2 Interventions

Group II: Part A3: Tuvusertib and Lartesertib Experimental Treatment 2 Interventions

ARID1A in endometrial cancer

Group III: Part A2: Tuvusertib and Lartesertib Experimental Treatment 2 Interventions

ATM in prostate cancer (Part A2)

Group IV: Part A2/A3: Tuvusertib and Lartesertib Experimental Treatment 2 Interventions

Tablet formulation (TF1, test) compared to a capsule formulation (reference)

Group V: Part A1: Tuvusertib and Lartesertib Experimental Treatment 2 Interventions

Group VI: Part A1.2: Tuvusertib and Lartesertib Experimental Treatment 2 Interventions

Relative Bioavailability Assessment of Tuvusertib Tablet (TF1) vs Capsule Followed by Treatment with Tuvusertib in Combination with Lartesertib

Group VII: Part A1.1: Tuvusertib and Lartesertib Experimental Treatment 2 Interventions

Assessment of the Effect of Food (Low-fat Meal) on the PK of M4076 Monotherapy Followed by Treatment with M1774 in Combination with M4076

Avelumab is already approved in Japan for the following indications:

Approved in Japan as Bavencio for:

• Merkel cell carcinoma
• Renal cell carcinoma
• Urothelial carcinoma

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

University of Miami School of Medicine Miami, FL

Augusta University - formerly Georgia Regents University Augusta, GA

The University of Kansas Medical Center Research Institute, Inc. Kansas City, KS

NEXT Oncology San Antonio, TX

More Trial Locations

Who Is Running the Clinical Trial?

EMD Serono Research & Development Institute, Inc.

Lead Sponsor

Trials

86

Recruited

22,700+

Miguel Fernández Alcalde

EMD Serono Research & Development Institute, Inc.

Chief Executive Officer

Bachelor’s Degree in Pharmacy from the University Complutense in Madrid, MBA from the University of Alcalá de Henares, Master’s Degree in Management from IESE Business School

Danny Bar-Zohar

EMD Serono Research & Development Institute, Inc.

Chief Medical Officer since 2022

MD

Merck KGaA, Darmstadt, Germany

Industry Sponsor

Trials

449

Recruited

122,000+

Belén Garijo

Merck KGaA, Darmstadt, Germany

Chief Executive Officer since 2021

MD

Danny Bar-Zohar

Merck KGaA, Darmstadt, Germany

Chief Medical Officer since 2022

MD

Findings from Research

In a phase 2a trial involving 43 patients with advanced squamous non-small cell lung cancer (NSCLC), the combination of avelumab and cetuximab with chemotherapy resulted in a 34.9% objective response rate, indicating notable antitumor activity.

While the treatment showed tolerable safety, with 88.4% of patients experiencing treatment-related adverse events, the overall response rate was not significantly better than existing standard treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Avelumab in Combination With Cetuximab and Chemotherapy as First-Line Treatment for Patients With Advanced Squamous NSCLC. Andric, Z., Gálffy, G., Cobo Dols, M., et al.[2023]

Avelumab, an anti-PD-L1 monoclonal antibody, and cetuximab, an anti-EGFR monoclonal antibody, have complementary mechanisms of action that may enhance treatment efficacy when used together, particularly in cancer therapies.

Both drugs not only target tumor growth but also activate the immune system, potentially leading to improved patient outcomes through increased immune response, as seen in ongoing clinical trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Avelumab and cetuximab as a therapeutic combination: An overview of scientific rationale and current clinical trials in cancer. Bourhis, J., Stein, A., Paul de Boer, J., et al.[2021]

In a long-term study of 123 patients with advanced nonsquamous NSCLC, the combination of pembrolizumab with pemetrexed-carboplatin significantly improved the objective response rate (58% vs. 33%) and progression-free survival (24.5 months vs. 9.9 months) compared to chemotherapy alone.

Patients who completed 2 years of pembrolizumab treatment had a remarkable 92% survival rate at the data cutoff, indicating a durable clinical benefit, while the safety profile remained manageable with no new safety concerns identified.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Long-Term Overall Survival From KEYNOTE-021 Cohort G: Pemetrexed and Carboplatin With or Without Pembrolizumab as First-Line Therapy for Advanced Nonsquamous NSCLC. Awad, MM., Gadgeel, SM., Borghaei, H., et al.[2021]

The combination of vibostolimab and pembrolizumab is well tolerated by patients, indicating a favorable safety profile for this treatment regimen.

This combination therapy demonstrates antitumor activity, suggesting it may be an effective option for cancer treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Anti-TIGIT Antibody with a PD-1 Inhibitor Shows Promise in Solid Tumors. [2022]

Avelumab, a monoclonal antibody targeting PD-L1, demonstrated an acceptable safety profile in a phase 1a trial with 53 patients, with only one dose-limiting toxicity observed at the highest dose of 20 mg/kg, indicating that the maximum tolerated dose was not reached.

The pharmacokinetic analysis showed a dose-proportional exposure and a half-life of approximately 4 days at higher doses, leading to the selection of 10 mg/kg every 2 weeks for further development, as it achieved over 90% target occupancy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Avelumab for metastatic or locally advanced previously treated solid tumours (JAVELIN Solid Tumor): a phase 1a, multicohort, dose-escalation trial. Heery, CR., O'Sullivan-Coyne, G., Madan, RA., et al.[2022]

Avelumab, an anti-PD-L1 antibody, was evaluated for safety and antitumor activity in pediatric patients with refractory/relapsed solid tumors, with dosing determined through pharmacokinetic modeling in a study involving 21 patients.

The study recommends avelumab dosing of 15 mg/kg every 2 weeks for children under 12 years or weighing less than 40 kg, and an adult flat dose of 800 mg every 2 weeks for those aged 12 years and older or weighing 40 kg or more, ensuring effective exposure similar to adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Avelumab Dose Selection for Clinical Studies in Pediatric Patients with Solid Tumors. Vugmeyster, Y., Grisic, AM., Brockhaus, B., et al.[2022]

Combining nivolumab and ipilimumab shows improved effectiveness in treating metastatic melanoma compared to using either drug alone, based on a retrospective analysis of approximately 7700 patients.

The combination therapy presents a safety profile that includes immune-related adverse events from both drugs, indicating that while the combination is effective, it also carries a heightened risk of toxicity that needs further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Retrospective Side Effect Profiling of the Metastatic Melanoma Combination Therapy Ipilimumab-Nivolumab Using Adverse Event Data. Soldatos, TG., Dimitrakopoulou-Strauss, A., Larribere, L., et al.[2022]

Avelumab, an immune checkpoint inhibitor, demonstrated a 14.18% objective response rate in 3935 cancer patients across 21 trials, showing more tumor responses compared to conventional treatments.

The treatment was associated with a lower incidence of adverse events, with only 14.44% experiencing high-grade treatment-related adverse events, indicating that avelumab has an active anti-tumor effect with manageable safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy and safety profile of avelumab monotherapy. Zhao, B., Gao, M., Zhao, H., et al.[2021]

M7824, a novel bifunctional fusion protein, effectively targets both PD-L1 and TGFβ in urothelial carcinoma, enhancing the immune response against tumor cells by increasing T-cell trafficking and susceptibility to immune-mediated lysis.

In comparison to traditional anti-PD-L1 treatments, M7824 shows improved immunogenic modulation of urothelial carcinoma cell lines, suggesting it may be a promising candidate for future clinical trials in treating urothelial cancer.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Anti-PD-L1/TGFβR2 (M7824) fusion protein induces immunogenic modulation of human urothelial carcinoma cell lines, rendering them more susceptible to immune-mediated recognition and lysis. Grenga, I., Donahue, RN., Gargulak, ML., et al.[2021]

The phase I trial of MEDI5752, a bispecific antibody that targets both PD-1 and CTLA4, shows that the drug is well tolerated by patients.

Preliminary results indicate that MEDI5752 is active in treating various tumor types, with durable responses observed, suggesting potential effectiveness in cancer therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

MEDI5752 Suppresses Two Immune Checkpoints. [2022]

Avelumab is an antibody that blocks programmed cell death ligand-1 (PD-L1) and has received accelerated approval in the USA for treating metastatic Merkel cell carcinoma (mMCC) in both adults and children aged 12 and older.

The drug is also undergoing regulatory reviews for other cancer treatments, including urothelial carcinoma, indicating its potential as a versatile cancer therapy in various stages of development worldwide.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Avelumab: First Global Approval. Kim, ES.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Avelumab in Combination With Cetuximab and Chemotherapy as First-Line Treatment for Patients With Advanced Squamous NSCLC. [2023]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Avelumab and cetuximab as a therapeutic combination: An overview of scientific rationale and current clinical trials in cancer. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Long-Term Overall Survival From KEYNOTE-021 Cohort G: Pemetrexed and Carboplatin With or Without Pembrolizumab as First-Line Therapy for Advanced Nonsquamous NSCLC. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Avelumab Versus Platinum-Based Doublet Chemotherapy as First-Line Treatment for Patients With High-Expression Programmed Death-Ligand 1-Positive Metastatic NSCLC: Primary Analysis From the Phase 3 JAVELIN Lung 100 Trial. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

An Anti-TIGIT Antibody with a PD-1 Inhibitor Shows Promise in Solid Tumors. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Avelumab for metastatic or locally advanced previously treated solid tumours (JAVELIN Solid Tumor): a phase 1a, multicohort, dose-escalation trial. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

CTLA-4 blockade with ipilimumab: biology, safety, efficacy, and future considerations. [2022]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Avelumab Dose Selection for Clinical Studies in Pediatric Patients with Solid Tumors. [2022]

9. Switzerland pubmed.ncbi.nlm.nih.gov

Retrospective Side Effect Profiling of the Metastatic Melanoma Combination Therapy Ipilimumab-Nivolumab Using Adverse Event Data. [2022]

10. Netherlands pubmed.ncbi.nlm.nih.gov

Efficacy and safety profile of avelumab monotherapy. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Anti-PD-L1/TGFβR2 (M7824) fusion protein induces immunogenic modulation of human urothelial carcinoma cell lines, rendering them more susceptible to immune-mediated recognition and lysis. [2021]

12. United States pubmed.ncbi.nlm.nih.gov

MEDI5752 Suppresses Two Immune Checkpoints. [2022]

13. United States pubmed.ncbi.nlm.nih.gov

Clinical Factors Associated With Long-Term Benefit in Patients With Metastatic Renal Cell Carcinoma Treated With Axitinib: Real-World AXILONG Study. [2022]

14. New Zealand pubmed.ncbi.nlm.nih.gov

Avelumab: First Global Approval. [2022]