A Phase II, Multi-Center Study to Evaluate the Efficacy and Safety of Volrustomig as Monotherapy or in Combination With Anti-cancer Agents in Participants With Advanced/Metastatic Solid Tumors

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Investigational drug late phase More information Active drug More information Moderate burden on patient More information

Trial Details

Sponsor: AstraZeneca (industry)

Phase: 2

Start date: Aug. 22, 2024

Planned enrollment: 110

Trial ID: NCT06535607
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More trial details at ClinicalTrials.gov More info

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Investigational Drug AI Analysis

chevron Show for: Volrustomig (MEDI5752, PD-1/CTLA-4 DuetMab, MEDI-5752)

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Goal: Evaluate the antitumor activity and safety of the bispecific PD-1/CTLA-4 antibody volrustomig given alone or with chemotherapy across selected advanced/metastatic solid tumors, and characterize pharmacokinetics and immunogenicity.

Patients: Adults (≥18 years) with measurable, advanced or metastatic solid tumors in three cohorts: Sub-study 1 includes recurrent/metastatic cervical cancer (squamous, adeno, or adenosquamous) after 1–2 prior systemic regimens; Sub-study 2 includes recurrent/metastatic head and neck squamous cell carcinoma (oropharynx, oral cavity, hypopharynx, larynx), including PD-L1–positive, systemic-therapy–naive patients for the R/M setting and platinum-refractory patients; Sub-study 3 includes recurrent/metastatic HNSCC untreated in the R/M setting. ECOG 0–1, adequate organ function, life expectancy ≥12 weeks, PD-L1 testing required; key exclusions include active/unstable CNS disease, autoimmune disease, prior immune checkpoint therapy, uncontrolled infections (HBV/HCV/HIV), and contraindications to specified chemotherapies in the combination cohort.

Design: Phase 2, multi-center program with randomized allocation, organized as three parallel sub-studies. Approximately 110 evaluable patients in total. Efficacy assessed per RECIST 1.1 by investigator and/or independent central review, with longitudinal safety monitoring.

Treatments: Sub-study 1: Volrustomig monotherapy. Sub-study 2: Volrustomig monotherapy. Sub-study 3: Volrustomig combined with standard chemotherapy regimens (carboplatin plus paclitaxel, or fluorouracil plus a platinum). Volrustomig (MEDI5752) is a monovalent bispecific checkpoint antibody targeting PD-1 and CTLA-4, designed to fully inhibit PD-1 and preferentially inhibit CTLA-4 on activated PD-1–positive intratumoral T cells, potentially enhancing intratumoral activity and reducing peripheral toxicity versus separate antibodies. The bispecific format can drive PD-1 internalization/degradation, differentiating it from conventional PD-1 plus CTLA-4 combinations. Early-phase studies have shown encouraging responses across solid tumors, notably in first-line RCC with objective response rates around 45–48% at 500–750 mg every 3 weeks, with dose-dependent immune-related toxicity that increases at ≥1500 mg; development focuses on sub-1500 mg dosing and combinations.

Outcomes: Primary endpoints are confirmed objective response rate per RECIST 1.1 and safety/tolerability (AEs, SAEs, labs, vitals, ECGs). Key secondary endpoints include duration of response, progression-free survival, time to response, overall survival, disease control rate, PFS and OS landmark rates, pharmacokinetics of volrustomig, and anti-drug antibodies.

Burden on patient: Moderate. Patients will undergo screening tumor sampling for PD-L1 and require regular imaging for RECIST assessments approximately every 6–12 weeks, along with frequent clinic visits for infusion therapy. Safety monitoring includes serial labs, vitals, ECGs, and immune-related toxicity surveillance. The PK and immunogenicity objectives imply periodic additional blood draws beyond standard-of-care. Combination-therapy participants face higher visit frequency during chemotherapy cycles and potential need for premedications and management of cytotoxic toxicities. Travel demands are typical of multi-center phase 2 immunotherapy studies with combination cohorts, without mandated inpatient stays or intensive biopsy schedules beyond baseline sample submission.

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Londrina, 86015-520, Brazil

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Bengbu, 233004, China

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Jining, 272029, China

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Nanning, 530021, China

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Hanoi, 100000, Vietnam

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