E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Phase 1: Any type of locally advanced or metastatic cancer who have no therapeutic alternatives;
Phase 2: Locally advanced or metastatic colorectal cancer (mCRC), NSCLC, or biliary tract cancer (BTC) |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10065252 |
E.1.2 | Term | Solid tumor |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10052362 |
E.1.2 | Term | Metastatic colorectal cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061873 |
E.1.2 | Term | Non-small cell lung cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10055111 |
E.1.2 | Term | Biliary cancer metastatic |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Phase 1: To assess the safety and tolerability of CAN04 in combination with selected standard chemotherapy regimens and to establish MTD and/or RP2D.
Phase 2: To assess the preliminary efficacy of CAN04 in combination with chemotherapy regimens measured as tumour response. |
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E.2.2 | Secondary objectives of the trial |
Phase 1
Efficacy: To assess preliminary anti-tumour activity of CAN04 in combination with selected standard chemotherapy regimens.
PK: To characterize the PK profiles of CAN04 after a single dose and at steady state after multiple doses in combination with chemotherapy using a population PK analysis approach.
Phase 2
Safety: To further characterise the safety and tolerability of CAN04 in combination with chemotherapy at the MTD/RP2D.
Efficacy: To assess the preliminary efficacy of CAN04 in combination with chemotherapy regimens measured as additional tumour response, time-to-event endpoints, and change in serum biomarkers.
PK: To characterise the PK profiles of CAN04 after a single dose and at steady state after multiple doses in combination with chemotherapy using a population PK analysis approach.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
General:
1. Subjects >= 18 years of age
2. ECOG 0-1
Phase I:
1. Subject has histologically or cytologically confirmed diagnosis of locally advanced cancer or metastatic cancer.
2. Subject has a condition where all standard therapeutic options with proven survival benefit have been exhausted, refused by the subject, or are contraindicated. OR Subject has a condition where 1 of the 3 study regimens (mFOLFOX, DTX, or G/C) is considered SoC for the next-line treatment.
Phase II:
1. Subject must have at least 1 measurable lesion as defined by RECIST v1.1.
2. Subjects with histologically or cytologically confirmed metastatic or locally advanced adenocarcinoma of rectum or colon, squamous or non-squamous unresectable stage IIIB or stage IV NSCLC, or non-resectable, recurrent, or metastatic biliay tract cancer amenable for G/C treatment
For a complete list of inclusion criteria, please refer to Protocol, section 4.1.1 Inclusion Criteria
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E.4 | Principal exclusion criteria |
General Study Exclusion Criteria:
1. Subject has a known or suspected allergy to study drugs (including chemotherapy regimens), any of its components.
2. Subject has another histologically confirmed cancer different from those described in inclusion criteria, except for cervical carcinoma in situ,
superficial non-invasive bladder tumour, curatively treated stage I non-melanoma skin cancer, or prostate cancer subjects curatively treated with surgery or radiation and not receiving systemic or androgen deprivation therapy.
3. Subject has uncontrolled or significant heart failure defined as New York Heart Association Classification III or IV.
4. Subjects to receive mFOLFOX or DTX: having peripheral sensory neuropathy Grade ≥2.
5. Subject has QT interval corrected using Fridericia’s formula (QTcF) >480 msec at screening.
6. Subjects to receive DTX and CAN04: if they have liver metastases and aspartate aminotransferase (AST) and/or ALT >1.5 × upper limit of normal (ULN) concomitant with alkaline phosphatase >2.5 × ULN.
7. Subject has uncontrolled brain metastases. Subjects are allowed to be enrolled if brain metastasis has been previously treated with surgery, and/or stereotactic radiosurgery and are considered controlled (controlled by the dose ≤10 mg/day of prednisone or equivalent) at the time of the first dose of CAN04. For asymptomatic subjects, brain imaging during screening is not required.
8. Subject has an active severe infection requiring parenteral antibiotics at the time of enrolment or subjects currently receiving oral antibiotics as a continuation of a previous course of parenteral antibiotics. Subjects can be enrolled when antibiotic treatment is complete and if there are no signs of residual infection.
9. Subject has a history of autoimmune disease requiring systemic immunosuppressive therapy (daily prednisone equivalent doses >10 mg/day).
10. Subject is expected to require any other form of systemic or localised anti-neoplastic therapy while on study (including maintenance therapy with another agent, radiation therapy, and/or surgical resection).
11. Subject has had an allogeneic tissue/solid organ transplant.
For a complete list of exclusion criteria, including Dose Escalation Phase (Phase 1) and Phase 2 please refer to Protocol, section 4.1.2 Study Exclusion Criteria |
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E.5 End points |
E.5.1 | Primary end point(s) |
Phase 1
• Nature, grade, and frequency of DLTs
• Frequency, duration, and severity (according to CTCAE v5.0) of AEs
• Changes in vital signs, serum chemistry, and haematology
• Treatment modifications measured as a percentage of relative dose intensity
• Percentage of subjects discontinued from all or part of study treatment and reasons for discontinuations
Phase 2
ORR defined as the percentage of subjects with PR or CR based on RECIST v1.1 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Phase 1
Efficacy:
• ORR defined as the percentage of subjects with PR or CR based on RECIST v1.1
• iORR defined as the percentage of subjects with iPR or iCR based on iRECIST
• PFS per RECIST v1.1, measured from the start of study treatment until disease progression or death from any cause
• iPFS by iRECIST
• DCR measured as a percentage of subjects with CR + PR + SD ≥16 weeks
• iDCR measured as a percentage of subjects with iCR + iPR + iUPD/iSD ≥16 weeks
• DOR defined as the time from response to progression/death
• Change from baseline upon treatment in serum biomarkers: CEA and CA19-9 (CEA for subjects with CRC; CEA and CA19-9 for subjects with BTC)
• Changes from baseline upon treatment in ECOG PS and body weight
PK:
• Serum PK parameters of CAN04 and potential covariates that impact the PK parameters
Phase 2
Safety:
• Frequency, duration, and severity (according to CTCAE v5.0) of AEs
• Changes in vital signs, serum chemistry, and haematology
• Treatment modifications measured as a percentage of relative dose intensity
• Percentage of subjects discontinued from all or part of study treatment and respective reason for discontinuation
Efficacy:
• iORR defined as the percentage of subjects with iPR or iCR based on iRECIST
• PFS per RECIST v1.1, measured from the start of study treatment until disease progression or death from any cause
• iPFS per iRECIST
• OS measured from the start of treatment until death from any cause
• DCR measured as a percentage of subjects with CR + PR + SD ≥16 weeks
• iDCR measured as a percentage of subjects with iCR + iPR + iUPD/iSD ≥16weeks
• DOR defined as the time from response to progression or death
• Change from baseline upon treatment in serum biomarkers: CEA and CA19-9 (CEA for subjects with CRC. CEA and CA19-9 for subjects with BTC)
• Changes from baseline upon treatment in ECOG PS and body weight
PK:
• Serum PK parameters of CAN04 and potential covariates that impact the PK parameters |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Biomarkers: To assess disease-related, genetic, inflammatory, immune, or microenvironment-related parameters related to CAN04, in the circulation and in tumour tissue.
Immunogenicity: To assess ADA formation against CAN04. |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
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E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 15 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Israel |
Belgium |
France |
Latvia |
Lithuania |
Poland |
Spain |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The end of the study is defined as the date on which the last subject completes the last visit of Phase 2 of the study. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |