Spevatamig (PT886) as Monotherapy or in Combination With Chemo and/or ICI, for the Treatment of Patients With Advanced Gastric, Gastroesophageal Junction, Pancreatic Ductal or Biliary Tract Carcinomas (the TWINPEAK Study)

Purpose

This is a first-in-human, Phase 1/2, open-label, dose escalation and dose expansion and combination study designed to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary efficacy of Spevatamig (PT886). Patients with the following tumor types will be eligible for screening: unresectable or metastatic gastric adenocarcinoma, gastroesophageal junction (GEJ) adenocarcinoma, biliary tract carcinoma (BTC) and pancreatic ductal adenocarcinoma (PDAC).

Conditions

  • Gastric or Gastroesophageal Junction Adenocarcinoma
  • Pancreatic Ductal Adenocarcinoma
  • Biliary Tract Cancer (BTC)

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  1. 18 years or older and able to sign informed consent and comply with the protocol. 2. Measurable disease as defined by RECIST V1.1 criteria for solid tumors. 3. 3. Part A and Part B: Histologically or cytologically confirmed unresectable advanced or metastatic solid gastric, gastroesophageal junction (GEJ), biliary tract or pancreatic carcinomas previously treated for advanced (metastatic or unresectable) disease or for which treatment is not available or not tolerated. Part C, substudy C1: 2L m/a GC/GEJ-C patients will receive Spevatamig (PT886) in combination with Paclitaxel. Patients who are HER2 positive are eligible. Part C, substudy C2: 1L m/a PDAC patients will receive Spevatamig (PT886) in combination with Gemcitabine plus nab-Paclitaxel (Abraxane). Part C, substudy C3: 1L m/a PDAC patients will receive Spevatamig (PT886) in combination with Gemcitabine plus FOLFIRINOX/mFFX. Part C, substudy C4: Patients with m/a BTC who have progressed on 1L SOC chemotherapy (GemCis) ± ICI and are eligible for 2L SOC FOLFOX treatment. Part D, substudy D3: 2L or 3L m/a GC/GEJ-C patients will receive Spevatamig (PT886) in combination with KEYTRUDA® (pembrolizumab). Part D, substudy D4: 1L HER2 negative m/a GC/GEJ-C patients will receive Spevatamig (PT886) in combination with SOC chemotherapy and KEYTRUDA® (pembrolizumab). 4. Able to provide a formalin fixed, paraffin embedded (FFPE) tumor tissue sample (preferably fresh biopsy or if not possible, archival tissue) to be assessed for CLDN18.2 expression and other biomarkers. 5. ECOG performance status of 0 or 1. 6. Adequate organ function confirmed at screening and within 72 hours of initiating treatment.

Exclusion Criteria

Patients are excluded from the study if any of the following criteria apply: 1. Women who are pregnant or lactating. 2. Women of child-bearing potential (WOCBP) who do not use adequate birth control. 3. Has an active autoimmune disease that has required systemic treatment in the past 2 years. 4. Prior CLDN18.2 or CD47 targeting therapies, or SIRPα (signal regulatory protein alpha) targeting agents. Additional inclusion and exclusion criteria will apply.

Study Design

Phase
Phase 1/Phase 2
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Sequential Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Dose Escalation
An accelerated titration design will be employed for early dose levels, followed by the standard 3+3 design at higher dose levels.
  • Drug: Spevatamig (PT886)
    Spevatamig (PT886) monotherapy, a novel bispecific antibody that targets Claudin 18.2 and CD47.
Experimental
Dose Expansion
Two dose levels will be explored; the recommended dose for expansion (RDE) from Part A, and another dose level.
  • Drug: Spevatamig (PT886)
    Spevatamig (PT886) monotherapy, a novel bispecific antibody that targets Claudin 18.2 and CD47.
Experimental
Combination Expansion with Chemotherapy
Part C, substudy C1: 2L m/a GC/GEJ-C patients will receive Spevatamig (PT886) in combination with Paclitaxel. Part C, substudy C2: 1L m/a PDAC patients will receive Spevatamig (PT886) in combination with Gemcitabine plus nab-Paclitaxel (Abraxane). Part C, substudy C3: 1L m/a PDAC patients will receive Spevatamig (PT886) in combination with Gemcitabine plus FOLFIRINOX/mFFX. Part C, substudy C4: 2L BTC patients will receive PT886 in combination with SOC chemotherapy mFOLFOX6.
  • Drug: Spevatamig (PT886)
    Spevatamig (PT886) monotherapy, a novel bispecific antibody that targets Claudin 18.2 and CD47.
  • Drug: Paclitaxel
    Chemotherapy as a combination partner to Spevatamig (PT886) in Part C: substudy C1
  • Drug: Gemcitabine
    Chemotherapy as a combination partner to Abraxane and Spevatamig (PT886) in Part C: substudy C2
  • Drug: Abraxane
    Chemotherapy as a combination partner to Gemcitabine and Spevatamig (PT886) in Part C: substudy C2
  • Drug: FOLFOX
    Chemotherapy as a combination partner to Spevatamig (PT886) and KEYTRUDA® (pembrolizumab, Part D only)
  • Drug: FOLFIRINOX
    Chemotherapy as a combination partner to Spevatamig (PT886) in Part C: substudy C3
Experimental
Combination Expansion with KEYTRUDA® (pembrolizumab)
Part D, substudy D3: 2L or 3L m/a GC/GEJ-C patients will receive Spevatamig (PT886) in combination with KEYTRUDA® (pembrolizumab). Part D, substudy D4: 1L HER2 negative m/a GC/GEJ-C patients will receive Spevatamig (PT886) in combination with SOC chemotherapy and KEYTRUDA® (pembrolizumab).
  • Drug: Spevatamig (PT886)
    Spevatamig (PT886) monotherapy, a novel bispecific antibody that targets Claudin 18.2 and CD47.
  • Drug: KEYTRUDA® (pembrolizumab)
    Immune checkpoint inhibitor as a combination partner to Spevatamig (PT886) in Part D.
  • Drug: FOLFOX
    Chemotherapy as a combination partner to Spevatamig (PT886) and KEYTRUDA® (pembrolizumab, Part D only)
  • Drug: CAPOX
    Chemotherapy as a combination partner to KEYTRUDA® (pembrolizumab) and Spevatamig (PT886)

Recruiting Locations

City of Hope (City of Hope National Medical Center, City of Hope Medical Center)
Duarte, California 91010

USC Norris Comprehensive Cancer Center
Los Angeles, California 90033

Sarah Cannon Research Institute (SCRI)
Denver, Colorado 80218

University of Iowa
Iowa City, Iowa 52242

Norton Cancer Institute
Louisville, Kentucky 40202

Duke Cancer Center
Durham, North Carolina 27710

University of Pittsburgh Medical Center (UPMC)
Pittsburgh, Pennsylvania 15232

MD Anderson Cancer Center, GI Medical Oncology Dept
Houston, Texas 77030

NEXT Oncology
Fairfax, Virginia 22031

University of Wisconsin Carbone Cancer Center - University Hospital
Madison, Wisconsin 53792

More Details

Status
Recruiting
Sponsor
Phanes Therapeutics

Study Contact

Phanes Therapeutics
858-766-0852
clinical-trials@phanestx.com