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Completed

NCT Number: NCT04659629

NL-201 Monotherapy and in Combination With Pembrolizumab in Patients With Relapsed or Refractory Cancer

Parts 1 and 2 The primary purpose of this study is to understand the safety of NL-201 when given intravenously as monotherapy in patients with advanced cancer to evaluate tolerability and to identify a recommended dose and schedule for further testing. In Part 1, there will be backfill cohorts at certain Data Monitoring Committee (DMC)-cleared dose levels and schedules to collect pharmacokinetic (PK), pharmacodynamic (PD) and response data in certain tumor types or to explore additional pre-medication regimens.

Parts 3 and 4 The primary purpose of this study is to understand the safety of NL-201 in combination with pembrolizumab when both drugs are given intravenously in patients with advanced cancer, to evaluate tolerability, and to identify a recommended dose and schedule for further testing.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Melanoma Institute Australia, Sydney, New South Wales, Australia

Loading trial locations.

About this study

Patients will have tests and exams to see if they are eligible for the clinical trial.

Parts 1 and 2 If eligible, the patient will receive NL-201 treatment by vein. Tumor response to treatment will be assessed every 6 weeks for 12 weeks, and every 12 weeks thereafter until disease progression.

Patients will be able to receive study treatment as long as it is tolerated and there is evidence of clinical benefit. Safety follow-up will occur within 7 days after the last dose of NL-201. Patients will then enter long-term follow-up until starting a subsequent therapy.

In Part 1, there will be backfill cohorts at certain DMC-cleared dose levels and schedules to collect PK, PD and response data in certain tumor types or to explore additional pre-medication regimens.

Parts 3 and 4 If eligible, the patient will receive NL-201 and pembrolizumab treatment by vein. Tumor response to treatment will be assessed every 6 weeks for 12 weeks, and every 12 weeks thereafter until disease progression.

Patients will be able to receive study treatments as long as they are tolerated and there is evidence of clinical benefit. Safety follow-up will occur within 7 days after the last dose of investigational product. Patients will then enter long-term follow-up until starting a subsequent therapy.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients with measurable disease
  • Patients with Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • At least 6 weeks from any prior nitrosurea or mitomycin C therapy; at least 4 weeks from any other prior chemotherapy or checkpoint inhibitor; at least 2 weeks from any kinase inhibitor
  • Part 1 Only: Patients with relapsed or refractory advanced solid tumor, other than prostate cancer, who have progressed, not tolerated or are ineligible for all approved lines of therapy
  • Part 2 Only: Patients with kidney and skin cancer who have failed at least 1 line of systemic therapy
  • Part 3 Only: Patients with solid tumors who have received ≥ 1 prior line of therapy for advanced or metastatic disease
  • Part 4 Only: Patients with diagnosed target disease OR previously received pembrolizumab

Exclusion criteria

  • Prostate Cancer
  • Any serious medical condition or laboratory abnormality or psychiatric condition or any other significant or unstable concurrent medical illness (in the opinion of the Investigator) would preclude protocol adherence or would make the safety of the study drug difficult to assess
  • Known or suspected SARS-CoV-2 infection, unless patient tests negative for SARS-CoV-2 within the Screening period
  • History of solid organ transplant or bone marrow transplant
  • Prior chimeric antigen receptor T-cell (CAR-T) or allogeneic cellular therapy
  • Prior IL-2-based cancer therapy
  • Ongoing systemic immunosuppressive therapy
  • Concurrent therapy with any other investigational agent, vaccine, or device.
  • Part 3 and 4 Only: History of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease
  • Part 3 and 4 Only: Known additional cancer that is progressing or has required active treatment within the past 2 years. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (eg, breast carcinoma, cervical cancer in situ) that have undergone curative resection are eligible.

Treatment and study plan

NL-201

Drug

NL-201 is a de novo protein therapeutic.

Pembrolizumab Injection [Keytruda]

Drug

A programmed death receptor-1 (PD-1)-blocking antibody

Other names: MK-3475, Pembrolizumab, Keytruda

Primary outcomes

  1. Recommended phase 2 dose (RP2D) for NL-201 (Parts 1 and 2)

    Time frame: Up to Day 33

    Evaluation of tolerability of NL-201 as measured by number of subjects with dose limiting toxicities (DLTs)

  2. Recommended dose schedule for NL-201 (Parts 1 and 2)

    Time frame: Up to Day 33

    Evaluation of tolerability of NL-201 as measured by number of subjects with dose limiting toxicities (DLTs)

  3. Recommended phase 2 dose (RP2D) for NL-201 in combination with Pembrolizumab (Parts 3 and 4)

    Time frame: Up to Day 33

    Evaluation of tolerability of NL-201 in combination with Pembrolizumab as measured by number of subjects with dose limiting toxicities (DLTs)

  4. Recommended dose schedule for NL-201 in combination with Pembrolizumab (Parts 3 and 4)

    Time frame: Up to Day 33

    Evaluation of tolerability of NL-201 in combination with Pembrolizumab as measured by number of subjects with dose limiting toxicities (DLTs)

  5. Incidence of treatment-emergent adverse events

    Time frame: Up to Day 33

    Rate of adverse events in patients with advanced solid tumors

  6. Severity of treatment-emergent adverse events

    Time frame: Up to Day 33

    Rate of adverse event grades in patients with advanced solid tumors

Secondary outcomes

  1. Best Objective Response according to RECIST version 1.1

    Time frame: Up to 36 months

    Based on Investigator assessment of radiographic imaging

  2. Objective Response Rate (ORR) according to RECIST version 1.1

    Time frame: Up to 36 months

    Based on Investigator assessment of radiographic imaging

  3. Progression-Free Survival (PFS) according to RECIST version 1.1

    Time frame: Up to 36 months

    Based on Investigator assessment of radiographic imaging

  4. Duration of Response (DOR) according to RECIST version 1.1

    Time frame: Upto 36 months

    Based on Investigator assessment of radiographic imaging

  5. Pharmacokinetic (PK) profile of NL-201 by half-life (t1/2)

    Time frame: Up to 24 Months

    Prespecified timepoints in serum before and after dosing with NL-201.

  6. Pharmacokinetic (PK) profile of NL-201 by area under the plasma concentration time curve (AUC)

    Time frame: Up to 24 months

    Prespecified timepoints in serum before and after dosing with NL-201.

  7. Pharmacokinetic (PK) profile of NL-201 by maximum observed plasma concentration (Cmax)

    Time frame: Up to 24 months

    Prespecified timepoints in serum before and after dosing with NL-201.

  8. Pharmacokinetic (PK) profile of NL-201 by volume of distribution (Vd)

    Time frame: Up to 24 Months

    Prespecified timepoints in serum before and after dosing with NL-201.

  9. Terminal-Phase Elimination Rate Constant (β) of NL-201

    Time frame: Up to 24 months

    Prespecified timepoints in serum before and after dosing with NL-201.

  10. Immunogenicity of NL-201

    Time frame: Up to 24 months

    Anti-drug antibodies in serum during and after treatment with NL-201

Other outcomes

  1. Flow cytometry analysis of immune cells in blood

    Time frame: Up to 36 months

    Based on appropriate assay

  2. Serum measurements of inflammatory cytokine levels

    Time frame: Up to 36 months

    Based on appropriate assay

  3. Analysis of immune characteristics of the tumor microenvironment

    Time frame: Up to 36 months

    Based on appropriate assay

  4. Estimate additional measures of anti-tumor activity of NL- 201 per iRECIST criteria

    Time frame: Up to 36 months

    Based on Investigator assessment of imaging

Sponsors and collaborators

Lead sponsor

Neurogene Inc.

Industry

Collaborators

  • Merck Sharp & Dohme LLC

Registry information

Official study title

A First-in-Human Phase 1 Study of NL-201 Monotherapy and in Combination With Pembrolizumab in Patients With Relapsed or Refractory Cancer

Important dates

Study start
2021
Primary completion
2022
Study completion
2024
First posted
Dec 9, 2020
Registry last updated
Oct 1, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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