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    Summary
    EudraCT Number:2021-001790-23
    Sponsor's Protocol Code Number:GCT1047-01
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-07-14
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2021-001790-23
    A.3Full title of the trial
    First-in-human, open-label, dose-escalation trial with expansion cohorts to evaluate safety of GEN1047 in subjects with malignant solid tumors
    Primer ensayo clínico en seres humanos, sin enmascaramiento, de aumento gradual de dosis, con cohortes de expansión para evaluar la seguridad de GEN1047 en participantes con tumores sólidos malignos
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Safety study of GEN1047 in patients with malignant solid tumors
    Ensayo para evaluar la seguridad de GEN1047 en participantes con tumores sólidos malignos
    A.3.2Name or abbreviated title of the trial where available
    GEN1047 for Solid Tumors – FIH trial
    A.4.1Sponsor's protocol code numberGCT1047-01
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorGenmab A/S
    B.1.3.4CountryDenmark
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportGenmab A/S
    B.4.2CountryDenmark
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGenmab A/S
    B.5.2Functional name of contact pointClinical Trial Information
    B.5.3 Address:
    B.5.3.1Street AddressKalvebod Brygge 43
    B.5.3.2Town/ cityCopenhagen V
    B.5.3.3Post code1560
    B.5.3.4CountryDenmark
    B.5.6E-mailclinicaltrials@genmab.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDuoBody®-CD3×B7H4
    D.3.2Product code GEN1047
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNGEN1047- DS
    D.3.9.1CAS number 2640279-10-1
    D.3.9.2Current sponsor codeGEN1047
    D.3.9.3Other descriptive nameDuobody(R)-CD3xB7H4
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Malignant Solid Tumors, per protocol GCT1047-01
    Tumores sólidos malignos, según el protocolo GCT1047-01
    E.1.1.1Medical condition in easily understood language
    Solid Tumor
    Tumor solido
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10065147
    E.1.2Term Malignant solid tumor
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Dose Escalation Part:
    • Determine the maximum tolerated dose (MTD) and/or recommended phase 2 dose (RP2D) and/or maximum administered dose (MAD)
    • Characterize the safety profile of GEN1047

    Dose Expansion Part:
    • Evaluate antitumor activity
    Parte de aumento de dosis:

    - Determinar la DMT o la DRF2 o la dosis máxima administrada (DMA)
    - Describir el perfil de seguridad de GEN1047

    Parte de expansión de dosis:
    -Evaluar la actividad antitumoral
    E.2.2Secondary objectives of the trial
    Dose Escalation Part:
    • Characterize pharmacokinetic (PK) profile
    • Evaluate immunogenicity of GEN1047
    • Evaluate preliminary antitumor activity based on response assessment criteria (Response Evaluation Criteria In Solid Tumors [RECIST] v1.1)

    Dose Expansion Part:
    • Evaluate preliminary antitumor activity based on response assessment criteria (RECIST v1.1)
    • Evaluate preliminary antitumor activity based on CA125 tumor marker in subjects with ovarian cancer
    • Evaluate preliminary efficacy
    • Further describe the safety profile of GEN1047
    • Further characterize PK profile
    • Further evaluate immunogenicity of GEN1047
    Parte de aumento de dosis:

    - Describir el perfil FC
    - Evaluar la inmunogenicidad de GEN1047
    -Evaluar la actividad antitumoral preliminar según los criterios de evaluación de la respuesta (Criterios de evaluación de la respuesta en tumores sólidos [RECIST] v1.1)

    Parte de expansión de dosis:
    -Evaluar la actividad antitumoral preliminar según los criterios de evaluación de la respuesta (Criterios de evaluación de la respuesta en tumores sólidos [RECIST] v1.1)
    - Evaluar la actividad antitumoral preliminar basada en el marcador tumoral CA125 en sujetos con cáncer de ovario
    - Evaluar la eficacia preliminar
    - Describrir con más detalle el perfil de seguridad de GEN1047
    - Caracterizar aún más el perfil PK
    - Evaluar más a fondo la inmunogenicidad de GEN1047
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Criteria Applicable only to Dose Escalation Part
    • Subject must have histologically or cytologically confirmed solid tumor(s) in any of the following selected indications for which there is no further available standard therapy likely to confer clinical benefit (or subject is not a candidate or refuses such available therapy), and for whom, in the opinion of the investigator, experimental therapy with GEN1047 may be beneficial (breast cancer, uterine cancer, ovarian cancer, non-small-cell lung cancer [NSCLC], cervical cancer, head and neck squamous cell carcinoma [HNSCC], urothelial cancer; cholangiocarcinoma [CCA]).

    Criteria Applicable only to Expansion Part
    • Subject must have an advanced or metastatic, pathologically confirmed diagnosis of one of the following tumors for which there is no further available standard therapy likely to confer clinical benefit (or subject is not a candidate or refuses such available therapy), and for whom, in the opinion of the investigator, experimental therapy with GEN1047 may be beneficial (breast cancer, uterine cancer, ovarian cancer, NSCLC, cervical cancer, HNSCC, urothelial cancer; CCA). For all indications: Subjects may have received up to 4 prior systemic treatment regimens for advanced/metastatic disease (maintenance treatment is considered being part of 1 treatment line).

    Criteria Applicable to Dose Escalation and Expansion Parts
    • Subjects with ovarian cancer:
    - Must have documented progressive disease (PD) on or after last prior treatment and within 60 days of Screening.
    - CA-125 positivity according to the Gynecologic Cancer Intergroup Guideline (GCIG) with a pretreatment sample that is at least twice the upper limit of the reference range and within 2 weeks before starting the treatment. Note: Subjects are not evaluable by CA-125 if they have received mouse antibodies (unless the assay used has been shown not to be influenced by human anti-mouse antibody) or if there has been medical and/or surgical interference with their peritoneum or pleura during the previous 28 days (eg, paracentesis).
    - Isolated GCIG CA-125 progression does NOT qualify for trial entry.
    • Must be at least 18 years of age.
    • Must have either recurrence after, or progression on or lack of response to established standard of care (SOC) anticancer therapies; or are deemed intolerant to or ineligible for, standard curative therapy in the recurrent setting.
    • Must have at least 1 measurable lesion per RECIST v1.1. The measurable lesion(s) must be outside the field of radiation therapy (RT) if there was prior treatment with RT.
    • Must have an Eastern Cooperative Oncology Group performance status (ECOG- PS) score of 0 to 1 at Screening and on Cycle 1 Day 1 (C1D1) pretreatment. Note: Do not perform C1D1 ECOG-PS if within 5 days of Screening ECOG-PS.
    • Must provide a tumor tissue sample during the Screening period and prior to C1D1. A fresh biopsy obtained during Screening may be provided; if a fresh biopsy cannot be obtained, the most recent archival tissue can be submitted if acquired ≤6 months prior to C1D1. Note: Tumor tissue sample acquired >6 months prior to C1D1 requires sponsor approval on a case-by-case basis.
    • Must have acceptable laboratory parameters according to the list below:
    - Glomerular Filtration Rate: ≥30 mL/min (estimated using Cockcroft-Gault formula)
    - Total Bilirubin: ≤1.5× institutional ULN (except Gilbert syndrome, then direct bilirubin ≤2× institutional ULN)
    - Aspartate Aminotransferase (AST): ≤2.5× institutional ULN
    - Alanine Aminotransferase (ALT): ≤2.5× institutional ULN
    - Hemoglobin: ≥5.6 mmol/L (9.0 g/dL). Note: Must be met without erythropoietin dependency and without transfusion within 2 weeks prior to C1D1.
    - Absolute Neutrophil Count: ≥1.5×109/L (1,500/µL). Note: Must be met without administration of growth factors within 2 weeks prior to C1D1.
    - Platelet count: ≥100×109/L (100,000/µL). Note: Must be met without administration of platelet transfusion within 2 weeks prior to C1D1.
    ULN=upper limit of normal (institutional).
    Criterios de inclusión principales Aumento de la dosis

    -El participante debe tener tumor o tumores sólidos confirmados histológica o citológicamente en cualquiera de las siguientes indicaciones seleccionadas para las cuales no existe ningún tratamiento de referencia disponible que pueda conferir un beneficio clínico (o el participante no es candidato o rechaza dicho tratamiento disponible) y para el que, en opinión del investigador, el tratamiento experimental con GEN1047 podría ser beneficioso (cáncer de mama, cáncer uterino, cáncer de pulmón no microcítico [CPNM], cáncer cervicouterino, carcinoma escamoso de cabeza y cuello [CECC], cáncer urotelial; colangiocarcinoma [CCC]).

    Criterios de inclusión principales Expansión

    - El participante debe tener un diagnóstico avanzado o metastásico confirmado patológicamente de uno de los siguientes tumores para los cuales no existe ningún tratamiento de referencia disponible que pueda conferir un beneficio clínico (o el participante no es candidato o rechaza dicho tratamiento disponible) y para el que, en opinión del investigador, el tratamiento experimental con GEN1047 podría ser beneficioso (cáncer de mama, cáncer cervicouterino, CPNM, cáncer cervicouterino, CECC, cáncer urotelial y CCC). Para todas las indicaciones: Los participantes pueden haber recibido hasta 4 pautas previas de tratamiento sistémico para la enfermedad avanzada/metastásica (el tratamiento de mantenimiento se considera parte de 1 línea de tratamiento).

    Criterios de inclusión principales Aumento de la dosis y Expansión
    Participantes con cáncer de ovario:
    • Debe tener progresión de la enfermedad (PE) documentada durante o después del último tratamiento previo y en los 60 días de la Selección.
    • Resultado positivo para CA-125 según la guía del Intergrupo de cáncer ginecológico (Gynecologic Cancer Intergroup Guideline, GCIG) (Rustin et al., 2004; Rustin et al., 2011) con una muestra previa al tratamiento que es al menos dos veces el límite superior del intervalo de referencia y en las 2 semanas antes de iniciar el tratamiento. Nota: Los participantes no se pueden evaluar con CA-125 si han recibido anticuerpos antimurinos (a menos que se haya demostrado que el análisis utilizado no está influido por anticuerpos humanos antimurinos) o si se han producido interferencias médicas o quirúrgicas con el peritoneo o la pleura durante los 28 días previos (p. ej.: paracentesis).
    •La progresión CA-125 aislada del GCIG NO es apta para la entrada en el ensayo.
    - Tener al menos 18 años de edad.
    -Deben tener recurrencia o progresión o falta de respuesta después o durante los tratamientos antineoplásicos establecidos en la práctica clínica habitual (PCH), o bien que se consideren intolerantes o no aptos para el tratamiento curativo estándar en el contexto recurrente.
    - Deben tener al menos 1 lesión medible según los criterios RECIST v1.1. La lesión o lesiones medibles deben estar fuera del campo de radioterapia (RT) si hubo tratamiento previo con RT.
    -Presentar una puntuación del estado general del Grupo Oncológico Cooperativo del Este (Eastern Cooperative Oncology Group, ECOG) de 0 a 1 en la Selección y en el pretratamiento del D1C1. Nota: No lleve a cabo D1C1 EG ECOG si está dentro de los cinco días previos a la Selección.
    -Debe proporcionar una muestra de tejido tumoral durante el periodo de Selección y antes del D1C1. Se proporcionará una biopsia reciente obtenida durante la Selección; si no se puede realizar la biopsia, podrá enviarse el tejido de archivo más reciente si se obtuvo ≤6 meses antes del D1C1. Nota: La muestra de tejido tumoral adquirida >6 meses antes del D1C1 requiere la aprobación del promotor caso por caso.
    - Debe tener parámetros analíticos aceptables según la siguiente lista:
    • VFG: ≥30 ml/min (calculado mediante la fórmula de Cockcroft-Gault)
    • Bilirrubina total: ≤1,5 × LSN institucional (excepto síndrome de Gilbert y luego bilirrubina directa ≤2 × LSN institucional)
    • AST: ≤2,5 × LSN institucional
    • ALT: ≤2,5 × LSN institucional
    • Hemoglobina: ≥5,6 mmol/l (9,0 g/dl) Nota: Debe cumplirse sin dependencia de la eritropoyetina y sin transfusión en las 2 semanas previas al D1C1.
    • RAN: ≥1,5 × 109/l (1500/μl) Nota: Debe cumplirse sin administración de factores de crecimiento en las 2 semanas previas al D1C1.
    • Numero de trombocitos: ≥100 × 109/l (100 000/μl)Nota: Debe cumplirse sin administración de transfusión de plaquetas en un plazo de 2 semanas antes del D1C1.
    E.4Principal exclusion criteria
    • Cardiovascular Disease
    - Symptomatic congestive heart failure (NYHA grade III or IV), unstable angina pectoris or cardiac arrhythmia.
    - Myocardial infarction within 6 months of start of GEN1047.
    - Uncontrolled hypertension (systolic ≥160 mmHg and/or diastolic ≥100 mmHg), despite optimal management. QTc interval >480 msec using Fridericia's QT correction formula.
    - Other cardiac disease not listed that, in the opinion of the investigator, is/are clinically significant and/or unacceptable.
    • Central Nervous System
    - History of intracerebral arteriovenous malformation, cerebral aneurysm, new (within 6 months) or symptomatic brain metastases, spinal cord compression (from disease), or stroke. Transient ischemic attack >1 month before Screening is allowed.
    - Subjects with unstable CNS metastases and active or history of carcinomatous meningitis are excluded. Subjects with prior treated brain metastases are permitted if they are radiologically stable (no evidence of progression) for at least 28 days by repeat imaging before C1D1. Subjects should be clinically stable and not undergoing steroid taper or have received stereotactic radiation or whole-brain radiation within 14 days before C1D1. Chronic steroid therapy is acceptable provided the dose is stable in the 14 days prior to C1D1 (≤10 mg prednisone daily or equivalent, corresponding to a maximum exposure of ≤140 mg within 14 days).
    - Subject with new or progressive brain metastases. Spinal cord metastasis is acceptable. Subjects with spinal cord compression are excluded.
    • Subject has received any of the following in the stated timeframes:
    - Radiotherapy within 14 days of first GEN1047 dose. Palliative radiotherapy is allowed.
    - RANK-L inhibitors and bisphosphonates (if on stable dose for ≥4 weeks) are permitted in this trial. Initiation of growth factors and bisphosphonates is not allowed during the first 4 weeks of GEN1047 administration, unless agreed by the investigator and sponsor medical monitor.
    - Treatment with investigational or non-investigational anticancer agents (including investigational vaccines) or used an invasive investigational medical device within 28 days or 5 half-lives, whichever is shorter, before the first GEN1047 dose or is currently enrolled in an interventional trial. Subjects in the follow-up phase of an interventional trial may participate if they have not received an investigational agent within 28 days of the first GEN1047 dose.
    - Prophylaxis with live, attenuated vaccines within 28 days of the first dose of GEN1047; or prophylaxis with the first and/or subsequent injection(s) of SARS-CoV-2 nucleic acid vaccine within 28 days prior to first dose of GEN1047.
    - Chronic systemic immunosuppressive corticosteroids, ie, prednisone >10 mg daily (or equivalent) or a cumulative dose >140 mg prednisone within 14 days (or equivalent) before the first GEN1047 dose. Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is permitted.
    - Has received granulocyte colony-stimulating factor (G-CSF) or granulocyte/macrophage colony stimulating factor support within 2 weeks prior to the first dose of GEN1047 or being chronically transfusion dependent.
    - Any prior therapy with an antibody targeting CD3 or other T cell activating surface marker.
    • Toxicities from previous anticancer therapies that have not resolved to baseline levels or to ≤ grade 1, except for alopecia, anorexia, vitiligo, fatigue, hyperthyroidism, hypothyroidism, and peripheral neuropathy. Anorexia, hyperthyroidism, hypothyroidism, and peripheral neuropathy must have recovered to ≤ grade 2.
    • Ongoing or active infection requiring IV treatment with anti-infective therapy administered <2 weeks prior to first GEN1047 dose.
    • History of non-infectious pneumonitis that required steroids, or currently has any grade of pneumonitis.
    • A serious, non-healing wound, or skin ulcer (of any grade).
    • Has had an organ allograft (except for corneal transplant).
    • Autologous or allogeneic bone marrow transplant, or stem cell rescue within 3 months before the first GEN1047 dose.
    • Chimeric antigen receptor -T cell therapy within 30 days prior to first GEN1047 dose.
    • Known past or current malignancy other than inclusion diagnosis, except for:
    - Cervical carcinoma of Stage 1B or less
    - Non-invasive basal cell or squamous cell skin carcinoma
    - Non-invasive, superficial bladder cancer
    - Prostate cancer with a current PSA level <0.1 ng/mL
    - Any curable cancer with a complete response of >2 years duration
    • History of ≥ grade 3 allergic reactions to antibody therapy or known allergies, hypersensitivity, or intolerance to GEN1047 or its excipients.
    • History of ≥ grade 3 cytokine release syndrome or ≥ grade 3 immune effector cell-associated neurotoxicity syndrome to antibody therapy, CAR-T cell therapy, or other immune effector cell therapy.
    - Exclusiones relacionadas con la enfermedad cardiovascular o Insuficiencia cardíaca congestiva sintomática (de grado III o IV según la clasificación de la New York Heart Association), angina de pecho inestable o arritmia cardíaca.
    o Antecedentes de infarto de miocardio en los 6 meses previos al inicio previsto de GEN1047.
    o Hipertensión no controlada definida como presión arterial sistólica ≥160 mmHg o presión arterial diastólica ≥100 mmHg, a pesar de un tratamiento médico óptimo. Prolongación del intervalo QTc >480 milisegundos utilizando la fórmula de corrección del intervalo QT de Fridericia.
    o Cualquier otra enfermedad cardíaca no enumerada que, en opinión del investigador, es clínicamente significativa o inaceptable.

    -Exclusiones relacionadas con el sistema nervioso central o El participante tiene antecedentes de malformación arteriovenosa intracerebral, aneurisma cerebral, metástasis cerebrales nuevas (en los últimos seis meses) o sintomáticas cerebrales, compresión de la médula espinal (derivada de la enfermedad) o accidente cerebrovascular. (Accidente isquémico transitorio
    >1 mes antes de la Selección está permitido) o Los pacientes con metástasis inestables en el SNC conocidas y con antecedentes de meningitis carcinomatosa quedarán excluidos. Los pacientes con metástasis cerebrales tratadas anteriormente podrán participar siempre que estén radiológicamente estables (es decir, sin signos de progresión) durante al menos 28 días por imágenes repetidas antes del D1C1. Los participantes deben estar clínicamente estables y no deben someterse a una reducción gradual de corticoesteroides ni haber recibido radioterapia estereotáctica o radiación a todo el cerebro en los 14 días previos al D1C1. Se acepta el tratamiento crónico con esteroides siempre que la dosis se mantenga estable durante los últimos 14 días previos al D1C1 (≤10 mg de prednisona o equivalente al día, correspondiente a una exposición máxima a la administración de ≤140 mg en los 14 días).
    o Participante con metástasis cerebral nueva o progresiva. Se aceptan las metástasis en la médula espinal. Sin embargo, deberá excluirse a los pacientes con compresión de la médula espinal.

    - Participantes que hayan estado expuestos a cualquiera de los siguientes tratamientos previos en los plazos especificados:
    o Radioterapia. Radioterapia en los 14 días previos a la primera administración de GEN1047. Se permitirá la radioterapia paliativa.
    o El uso de inhibidores de RANK-L y bisfosfonatos (si está recibiendo una dosis estable durante al menos 4 semanas) está permitido mientras se participa en este ensayo. Sin embargo, el inicio de factores de crecimiento y bisfosfonatos durante las primeras 4 semanas de administración de GEN1047 no está permitido, a menos que el investigador y el supervisor médico del promotor lo acuerden.
    o Tratamiento con cualquier agente antineoplásico en investigación o no investigado (incluidas las vacunas en investigación) o usado en un dispositivo médico invasivo en investigación en los 28 días o 5 semividas, lo que sea más corto, anteriores a la primera dosis prevista de GEN1047 o que esté inscrito actualmente en un ensayo intervencionista. Nota: Los participantes que estén en la fase de seguimiento de un ensayo intervencionista pueden participar si el participante no ha recibido un fármaco en investigación en los 28 días previos a la primera administración de GEN1047.
    oProfilaxis con vacunas fabricadas con microbios vivos o atenuados en los 28 días previos a la primera dosis de GEN1047; o profilaxis con la primera o la(s) siguiente(s) inyección(es) de la vacuna de ácido nucleico contra el SARS-CoV-2 en los 28 días previos a la primera dosis de GEN1047.
    o Dosis crónicas de corticoesteroides inmunodepresores, es decir, 10 mg al día (o equivalente) de prednisona o una dosis acumulada de >140 mg de prednisona en los 14 días (o equivalente) antes de la primera administración de GEN1047. El tratamiento de restitución (por ejemplo, tratamiento de restitución con tiroxina, insulina o corticoesteroides con dosis fisiológicas para la insuficiencia suprarrenal o pituitaria) no se considera una forma de tratamiento sistémico y está permitido.
    o Ha recibido un factor estimulante de colonias de granulocitos (G-CSF) o apoyo de factor estimulante de colonias de granulocitos/macrófagos en las 2 semanas anteriores a la primera administración de GEN1047 o que dependa de una transfusión de forma crónica.
    o Cualquier tratamiento previo con un anticuerpo dirigido a CD3 u otro marcador de superficie activador de los linfocitos T.
    E.5 End points
    E.5.1Primary end point(s)
    Dose Escalation Part:
    • Dose-liming toxicities (DLT)
    • Adverse events (AE) and safety laboratory parameters

    Dose Expansion Part:
    • Objective response rate (ORR) based on RECIST v1.1
    Parte de aumento de dosis:
    • Toxicidades por encalado de la dosis (DLT)
    • Eventos adversos (EA) y parámetros de laboratorio de seguridad

    Parte de expansión de dosis:
    • Tasa de respuesta objetiva (ORR) basada en RECIST v1.1
    E.5.1.1Timepoint(s) of evaluation of this end point
    Assessments will be performed at regular intervals during the trial. Please see protocol for detailed schedule of events for Dose Escalation and Dose Expansion Parts. A final safety follow-up visit will be conducted 30 days (+14 days) after the subject receives the last dose of GEN1047. Thereafter, survival status will be assessed by contacting subjects every 3 months (±7 days), beginning from the day of the last dose of GEN1047 and continuing until the subject dies or withdraws from the trial.
    Las evaluaciones se realizarán a intervalos regulares durante el ensayo. Consulte el protocolo para obtener un cronograma detallado de eventos para las piezas de aumento de dosis y expansión de dosis. Se realizará una visita de seguimiento de seguridad final 30 días (+ 14 días) después de que el sujeto reciba la última dosis de GEN1047. A partir de entonces, el estado de supervivencia se evaluará contactando a los sujetos cada 3 meses (± 7 días), comenzando desde el día de la última dosis de GEN1047 y continuando hasta que el sujeto muera o se retire del ensayo.
    E.5.2Secondary end point(s)
    Dose Escalation Part:
    • PK parameters (clearance; volume of distribution; AUClast; AUCinf; Cmax; Tmax; Ctrough; and t1/2)
    • Anti-drug antibody (ADA) incidence
    • Antitumor activity, ie, reduction in tumor size according to response assessment (RECIST v1.1) per local review: ORR, disease control rate (DCR), duration of response (DOR), time to response (TTR)

    Dose Expansion Part:
    • Antitumor activity, ie, reduction in tumor size according to response assessment (RECIST v1.1) per local review with the option of a central independent imaging review: DCR, DOR, TTR
    • For ovarian cancer antitumor activity: cancer antigen 125 (CA-125) and modified ORR based on RECIST v1.1 and CA-125
    Evaluation of preliminary efficacy: progression free survival (PFS) and overall survival (OS)
    • AEs and safety laboratory parameters
    • PK parameters (clearance; volume of distribution; AUClast; AUCinf; Cmax; Tmax; Ctrough; t1/2)
    • ADA response
    Parte de aumento de dosis:
    • Parámetros PK (aclaramiento; volumen de distribución; AUClast; AUCinf; Cmax; Tmax; Ctrough; y t1 / 2)
    • Incidencia de anticuerpos antidrogas (ADA)
    • Actividad antitumoral, es decir, reducción del tamaño del tumor según la evaluación de la respuesta (RECIST v1.1) según la revisión local: ORR, tasa de control de la enfermedad (DCR), duración de la respuesta (DOR), tiempo de respuesta (TTR)

    Parte de expansión de dosis:
    • Actividad antitumoral, es decir, reducción del tamaño del tumor según la evaluación de la respuesta (RECIST v1.1) según la revisión local con la opción de una revisión de imágenes central e independiente: DCR, DOR, TTR
    • Para la actividad antitumoral del cáncer de ovario: antígeno del cáncer 125 (CA-125) y ORR modificado según RECIST v1.1 y CA-125
    Evaluación de la eficacia preliminar: supervivencia libre de progresión (SLP) y supervivencia global (SG)
    • EA y parámetros de laboratorio de seguridad
    • Parámetros PK (aclaramiento; volumen de distribución; AUClast; AUCinf; Cmax; Tmax; Ctrough; t1 / 2)
    • Respuesta de la ADA
    E.5.2.1Timepoint(s) of evaluation of this end point
    Assessments will be performed at regular intervals during the trial. Please see protocol for detailed schedule of events for Dose Escalation and Dose Expansion Parts. A final safety follow-up visit will be conducted 30 days (+14 days) after the subject receives the last dose of GEN1047. Thereafter, survival status will be assessed by contacting subjects every 3 months (±7 days), beginning from the day of the last dose of GEN1047 and continuing until the subject dies or withdraws from the trial.
    Las evaluaciones se realizarán a intervalos regulares durante el ensayo. Consulte el protocolo para obtener un cronograma detallado de eventos para las piezas de aumento de dosis y expansión de dosis. Se realizará una visita de seguimiento de seguridad final 30 días (+ 14 días) después de que el sujeto reciba la última dosis de GEN1047. A partir de entonces, el estado de supervivencia se evaluará contactando a los sujetos cada 3 meses (± 7 días), comenzando desde el día de la última dosis de GEN1047 y continuando hasta que el sujeto muera o se retire del ensayo.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans Yes
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    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.8.4.1Number of sites anticipated in Member State concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA24
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    United States
    Denmark
    France
    Spain
    E.8.7Trial 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
    The trial is considered completed when the last subject dies or withdraws from the trial. However, the maximum trial duration is 5 years after the last subject's first treatment in the trial.
    El ensayo se considera completado cuando el último sujeto muere o se retira del ensayo. Sin embargo, la duración máxima del ensayo es de 5 años después del primer tratamiento del último sujeto en el ensayo.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months6
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 190
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 190
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state30
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 260
    F.4.2.2In the whole clinical trial 380
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Post trial treatment is at the discretion of the patient's doctor per standard of care per country. The sponsor will make their best effort to provision post-trial access to GEN1047 for those ongoing subjects with a potential treatment benefit, in accordance with local laws and requirements.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2021-09-27
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-09-10
    P. End of Trial
    P.End of Trial StatusOngoing
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