A Phase 1/2, First-in-Human, Open-Label, Dose Escalation and Expansion Study of STAR0602, a Selective T Cell Receptor (TCR)-targeting, Bifunctional Antibody-fusion Molecule, in Subjects with Unresectable, Locally Advanced, or Metastatic Solid Tumors that are Antigen-rich (START-001)
Lay Description
START-001 is a two-part, open label, FIH Phase 1/2 study to determine the safety, tolerability, PK, pharmacodynamics, and preliminary anti-tumor activity of STAR0602 as a monotherapy in subjects with advanced solid tumors.
Category
- Cancers and Other Neoplasms
- Nervous System
- IRB Number
- STUDY00001009
- NCT Number
- NCT # not yet entered
Eligibility
- Eligible Ages
- 18 and over
- Eligible Genders
- all
- Accepts Healthy Volunteers
- No
Inclusion Criteria
. Age ≥ 18 years old. 2. Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1. 3. Ability to provide written informed consent prior to initiation of any study-related tests or procedures that are not part of standard of care for the subject’s disease. Subjects must also be willing and able to comply with study procedures, including the acquisition of specified research specimens. 4. Life expectancy ≥ 12 weeks. 5. Measurable disease as per RECIST v1.1 criteria and documented by CT and/or MRI. Cutaneous or subcutaneous lesions must be measurable by calipers. Lesions to be used as measurable disease for the purpose of response assessment must either: a) not reside in a field that has been subjected to prior radiotherapy; or b) have demonstrated clear evidence of radiographic progression since the completion of prior radiotherapy and prior to study enrollment.
Exclusion Criteria
1. Subjects with a history of known autoimmune disease with exceptions of: • Vitiligo; • Psoriasis, atopic dermatitis, or other autoimmune skin condition not requiring systemic treatment; • History of Graves’ disease, now euthyroid for > 4 weeks; • Hypothyroidism managed by thyroid replacement; • Alopecia; • Arthritis managed without systemic therapy beyond oral nonsteroidal antiinflammatory drugs. • Adrenal insufficiency- well controlled on replacement therapy. 2. Major surgery or traumatic injury within 8 weeks before first dose of study drug. 3. Unhealed wounds from surgery or injury. 4. Treatment with >10 mg per day of prednisone (or equivalent) or other immune-suppressive drugs within 7 days prior to the initiation of study drug. Exceptions may be made for patients who have had allergic reaction to iodinated contrast media. Steroids for topical, ophthalmic, inhaled, or nasal administration are allowed. 5. Prior therapy within the following timeframe before the planned infusion of STAR0602 as follows: • Cytotoxic chemotherapy, small molecule inhibitors, radiation, interventional radiology procedure, or similar investigational therapies within ≤ 2 weeks or subjects who have not recovered (i.e., ≤ Grade 1 or to baseline) from AEs due to a previously administered agent; • Monoclonal antibodies, antibody-drug conjugates, radioimmunoconjugates, or similar investigational therapies within 6 weeks prior to the initiation of study drug or subjects who have not recovered (i.e., ≤ Grade 1 or to baseline) from AEs due to agents administered more than 6 weeks earlier. Note: Subjects with ≤ Grade 2 neuropathy or ≤ Grade 2 alopecia are an exception to this criterion and may qualify for the study. Note: Concurrent use of hormones either to maintain castrate levels of testosterone in subjects with castration-sensitive prostate cancer or for STAR0602 Marengo Therapeutics, Inc. Protocol Number: CP-START-001 08 August 2024 Confidential Page 90 of 191 non-cancer-related conditions (e.g., insulin for diabetes, hormone replacement therapy) is acceptable. Bisphosphonates are permitted for supportive care of bone metastases (e.g., breast or prostate cancer). 6. Clinically significant cardiovascular/vascular disease including: • Myocardial infarction or unstable angina < 6 months prior to the initiation of study drug; • Clinically significant cardiac arrhythmia (e.g., with potential for hemodynamic instability) not controlled or unresponsive to treatment; • Uncontrolled hypertension: systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg; Subjects with systolic blood pressure > 140 mmHg but < 180 mmHg and/or diastolic blood pressure > 90 mmHg but < 100 mmHg may be enrolled upon reviewing co-morbidities/risks and after the sponsor approval. These subjects need to be closely monitored with their blood pressure assessed and managed at each visit on treatment; • Pulmonary embolism, stroke, or transient ischemic attack < 6 months prior to initiation of STAR0602; • QTcF (Fridericia correction) prolongation > 480 msec; • Congestive heart failure (New York Heart Association Class III-IV); • Pericarditis/clinically significant pericardial effusion; • Myocarditis; • Vasculitis that has not resolved within 6 months prior to study drug. 7. Clinically significant gastrointestinal disorders including: • Gastrointestinal perforation < 6 months prior to study drug administration. Subjects must have documented evidence (e.g., upper endoscopy, colonoscopy) of completely healed area of prior perforation; • Gastrointestinal bleeding < 2 months prior to study drug administration. Subjects must have documented evidence (e.g., upper endoscopy, colonoscopy) of completely healed area of prior bleeding; • Pancreatitis 4 weeks prior to the initiation of study drug; • Diverticulitis flare < 2 months prior to study drug administration. Subjects must have a CT scan negative for evidence of remaining disease prior to the initiation of study drug; • History of Crohn’s disease or ulcerative colitis. 8. Inflammatory process that has not resolved for ≥ 4 weeks from the date of first study dose. Subjects with chronic low-grade inflammatory processes such as radiation-induced pneumonitis are excluded regardless of duration. STAR0602 Marengo Therapeutics, Inc. Protocol Number: CP-START-001 08 August 2024 Confidential Page 91 of 191 9. Clinically significant pulmonary compromise (e.g., requirement for supplemental oxygen on a continuous basis). 10. Active viral, bacterial, or systemic fungal infection requiring parenteral treatment within 7 days prior to the initiation of study drug. Systemic antiviral, antifungal, or antibacterial therapy must be completed > 1 week prior to the initiation of study drug. Antimicrobial prophylaxis (e.g., for pneumocystis carinii infection) may continue the antimicrobial for that purpose. 11. Vaccination with any live virus vaccine within 4 weeks prior to the initiation of study drug administration. Inactivated annual influenza vaccination is allowed. 12. Subjects who are known to be human immunodeficiency virus (HIV) positive or hepatitis B or C positive and have uncontrolled disease. Subjects treated for hepatitis C must have viral titers below the limit of quantification. to be eligible. Subjects with hepatitis B having undetectable or ≤ 500 IU/mL hepatitis B viral DNA are eligible for STAR0602. Subjects treated for HIV must have CD4+ T cell (CD4+) counts ≥ 350 cells/µL and HIV viral load less than 400 copies/mL to be eligible. 13. Second primary invasive malignancy not in remission for ≥ 1 year. Exceptions include non-melanoma locally advanced skin cancer, cervical carcinoma in situ, localized prostate cancer (Gleason score ≤ 7), resected melanoma in situ, or any malignancy considered to be indolent and never required systemic therapy, with the exception of indolent lymphomas. 14. Any serious underlying medical or psychiatric condition that would preclude understanding and rendering of informed consent or impair the ability of the subject to receive or tolerate the planned treatment. 15. Known hypersensitivity to STAR0602 or any excipient (histidine or polysorbate-80) contained in the drug or diluent formulation. 16. Any medical (e.g., requirement of an indwelling catheter such as PleurX or Tenckhoff catheter) or non-medical issue that would contraindicate the subject’s participation in the study or confound the results of the study. 17. Pregnant, likely to become pregnant, or lactating women (where pregnancy is defined as the state of a female after conception and until the termination of gestation). 18. Hepatic metastases unless adequately treated, either locally (e.g., by surgery, radiofrequency ablation, or chemoembolization) or systemically or both, and stable for 3 months.
Study Design
Arm Groups
Study Contact
Frances Crawford
210-450-5037
crawfordf1@uthscsa.edu
Myrna Montenegro
210-450-5954
montenegro@uthscsa.edu
Kathleen Rodriguez
210-450-1365
rodriguezk3@uthscsa.edu
Benjamin Schleif
210-450-1366
schleifb@uthscsa.edu
Morgan Seekatz
210-450-1133
seekatz@uthscsa.edu
Principal Investigator
Sukeshi Arora