Sponsor: GV20 Therapeutics (industry)
Phase: 1/2
Start date: March 23, 2023
Planned enrollment: 365
GV20-0251 (also known as XBH25) is a first‑in‑class, fully human, Fc‑attenuated IgG1 monoclonal antibody that targets the immune checkpoint IGSF8. It is being evaluated in an ongoing Phase 1/2A open‑label trial (NCT05669430) as monotherapy and in combination with pembrolizumab in patients with advanced solid tumors refractory to standard therapies. (oncologypro.esmo.org)
IGSF8 is an innate immune checkpoint overexpressed on many cancers, particularly those with impaired MHC‑I antigen presentation. Preclinical work showed that tumor IGSF8 interacts with the human NK inhibitory receptor KIR3DL2 (mouse Klra9), suppressing NK cytotoxicity; blockade with an anti‑IGSF8 antibody enhances NK‑cell killing, increases antigen presentation, and augments T‑cell signaling, with monotherapy activity and synergy with anti‑PD‑1 in multiple syngeneic models. (pubmed.ncbi.nlm.nih.gov)
Early clinical signals have been reported from the monotherapy dose‑escalation portion of the ongoing Phase 1/2A study:
Company press releases around ESMO 2024 reported two confirmed partial responses among 12 efficacy‑evaluable metastatic cutaneous melanoma patients, and additional stable disease across tumor types, consistent with the ESMO abstract summary. (Note: these are sponsor communications.) (prnewswire.com)
Updated monotherapy data were presented at ASCO 2025, with the sponsor highlighting “promising” efficacy; detailed numbers beyond the ESMO 2024 abstract have not been published in peer‑reviewed form as of October 7, 2025. (epicos.com)
Sponsor communications around ESMO 2024 and ASCO 2025 echo a favorable safety profile and the same pharmacokinetic observations. (Note: sponsor communications.) (prnewswire.com)
Last updated: Oct 2025
Goal: Evaluate the safety, tolerability, and preliminary antitumor activity of GV20-0251 as monotherapy and in combination with pembrolizumab, define the maximum tolerated dose and recommended Phase 2 dose, and characterize pharmacokinetics, pharmacodynamics, and clinical efficacy signals across selected solid tumor indications.
Patients: Adults (≥18 years) with histologically confirmed advanced and/or refractory solid tumors with measurable disease by RECIST v1.1, ECOG 0–1, and adequate organ function. All must be refractory, intolerant, ineligible for, or have declined standard therapy. Prior checkpoint inhibitor exposure requires documented progression. Fresh tumor biopsies are required pre-treatment (all parts) and on-treatment where feasible (Parts A and B). Expansion cohorts include endometrial carcinoma, squamous head and neck carcinoma, cutaneous melanoma, non-small cell lung cancer, and, for combination parts, pMMR/MSS colorectal adenocarcinoma. Key exclusions include active autoimmune disease requiring immunosuppression, uncontrolled infections, significant cardiac disease, symptomatic CNS disease, recent investigational therapy or major surgery, severe prior immune-related AEs, and pembrolizumab-specific risks in combination parts (e.g., pneumonitis).
Design: Multicenter, open-label, non-randomized Phase 1/2A study conducted in four parts. Part A: 3+3 dose escalation of GV20-0251 to determine MTD/RP2D. Part B: BOP2-driven monotherapy dose-expansion across tumor-specific cohorts. Part C: BOIN dose escalation of GV20-0251 plus pembrolizumab to determine combination MTD/RP2D. Part D: BOP2-guided combination dose-expansion across multiple cohorts. Planned enrollment is 365 participants.
Treatments: GV20-0251 monotherapy and GV20-0251 combined with pembrolizumab. GV20-0251 (also known as XBH25) is a first-in-class, fully human, Fc-attenuated IgG1 monoclonal antibody targeting IGSF8, a novel immune checkpoint. By blocking IGSF8 interactions, it enhances NK cell cytotoxicity, augments dendritic cell antigen presentation, and increases T-cell signaling, potentially benefiting tumors with impaired antigen presentation that are resistant to current checkpoint inhibitors. Early Phase 1 monotherapy data in heavily pretreated solid tumors demonstrated a generally favorable safety profile with predominantly grade 1–2 AEs and limited grade ≥3 events, dose-proportional PK with an approximate 26-day half-life, full target occupancy on circulating T cells at ≥3 mg/kg, and preliminary antitumor activity including confirmed partial responses in metastatic melanoma and disease stabilization in multiple patients. Pembrolizumab is an approved anti–PD-1 antibody used as standard immunotherapy across several solid tumors; here it is evaluated in combination to assess synergistic activity.
Outcomes: Primary endpoints: safety and tolerability in dose-escalation parts (A and C; incidence of adverse events) and objective response rate per RECIST v1.1 in expansion parts (B and D). Key secondary endpoints include additional safety (TEAEs per CTCAE v5.0), pharmacokinetics of GV20-0251 (Cmax, Tmax, half-life, AUC), immunogenicity (anti-drug and neutralizing antibodies), disease control rate, duration of response, progression-free survival, and overall survival.
Burden on patient: High. As a Phase 1/2A trial with both monotherapy and combination dose-escalation and expansion, participants should expect frequent on-site visits, intensive safety monitoring, serial pharmacokinetic and immunogenicity blood draws, and mandatory fresh tumor biopsies pre-treatment with additional on-treatment biopsies in certain parts. Imaging for response assessments will occur at regular intervals consistent with RECIST-based evaluations. Combination cohorts may entail added immune-related toxicity monitoring. Travel demands and visit frequency, particularly early in treatment and around PK/biopsy time points, will exceed standard-of-care follow-up for refractory solid tumors.
Last updated: Oct 2025
Inclusion Criteria:
* Participants ≥18 years of age
* Previously treated, histologically-confirmed advanced solid malignancy with progressive disease requiring therapy
* Refractory or intolerant to standard therapy(ies)
* Must have received, be not eligible or decline standard of care therapy
* Participants must have measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST version 1.1)
* For participants who have received prior treatment with a checkpoint inhibitor there must be documented disease progression
* ECOG performance status of 0 or 1
* Life expectancy of ≥ 12 weeks in Parts A and C and ≥ 24 weeks in Parts B and D
* Participants must be willing to provide fresh tumor biopsy (core biopsy) both pre-treatment (Parts A, B, C and D) and on-treatment (Parts A and B), if clinically feasible
* Disease-free of active second/secondary or prior malignancies for ≥ 2 years
* Laboratory test results within the required parameters
* Women of child bearing potential (WOCBP) and men must agree to use adequate contraception
* Parts B, C and D may include the following tumor types:
* Endometrial carcinoma
* Squamous head and neck carcinoma
* Cutaneous melanoma
* Non-small cell lung cancer
* Proficient MMR (pMMR)/MSS adenocarcinoma of the colon or rectum (Parts C and D only)
Parts A, B, C and D Exclusion Criteria:
* Participant with acute leukemia or CLL (Parts A and B only)
* Participant with heart disease or unstable arrhythmia
* Active, uncontrolled bacterial, viral, or fungal infections requiring systemic therapy
* Participant has active autoimmune disease or other medical conditions requiring chronic systemic steroid or immunosuppressive therapy
* History of major organ transplant
* History of a bone marrow transplant
* Symptomatic central nervous system (CNS) malignancy or metastasis
* Serious nonmalignant disease
* Pregnant or nursing women
* Treatment with PD-1 and equivalent immune modulators or major surgery prior to the first dose of study medication
* Participants who are currently receiving any other investigational agent or have received an investigational agent within 4 weeks prior to the first dose of study medication
* Treatment with any anticancer treatments with 2-weeks prior to the first dose of study medication
* Radiation for symptomatic lesions must have been completed prior to the first dose of study medication
* Participants with liver metastases unless approved by the Sponsor
* Any history of an immune related ≥ Grade 3 AE attributed to prior cancer immunotherapy
* Has a known additional malignancy that is progressing or has required active treatment within the past 2 years from C1D1
* Has received radiation therapy to the lung that is higher than 30 Gy within 6 months prior to C1D1 for NSCLC (Parts C and D only)
* Has a known additional malignancy that is progressing or has required active treatment within the past 2 years from C1D1 (Parts C and D only)
* Has severe hypersensitivity ( ≥ Grade 3) to Pembrolizumab and/or any of its excipients (Parts C and D only)
* Has a history of (non-infectious) pneumonitis / interstitial lung disease that required steroids or has current pneumonitis / interstitial lung disease (Parts C and D only)
* Has a condition, therapy, laboratory abnormality, or circumstance that could confound study results or interfere with full participation, making it unsuitable for the participant, as determined by the treating Investigator (Parts C and D only)
* Active substance abuse
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