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NCT02805660

Phase 1/2 Study of Mocetinostat and Durvalumab in Patients With Advanced Solid Tumors and NSCLC

Terminated Phase 1, PHASE2 Results posted Last updated 6 April 2021
What this trial tests

Phase 1, PHASE2 trial testing Mocetinostat - 50 mg in Advanced Cancer in 83 participants. Terminated before completion.

Timeline
1 June 2016
Primary endpoint
14 December 2019
20 December 2019

Quick facts

Lead sponsorMirati Therapeutics Inc.
PhasePhase 1, PHASE2
StatusTerminated
Study typeINTERVENTIONAL
Allocationnon randomized
Designsequential
Maskingnone
Primary purposetreatment
Enrollment83
Start date1 June 2016
Primary completion14 December 2019
Estimated completion20 December 2019
Sites15 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Mirati Therapeutics Inc. — full company profile →

Who can join

18 and older, any sex, with Advanced Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Participants Who Experience a Dose-Limiting Toxicity (DLT) During the First 28-day Cycle of Combination Treatment In Phase 1 Primary · 28 days

Toxicities were graded using the National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events (CTCAE) version 4.03. Any of the following events considered to be causally related to treatment with mocetinostat in combination with durvalumab that occurred during Phase 1 were considered a DLT: * Any Grade 4 immune-related adverse event (irAE) * Grade 3 or greater colitis * Grade 3 or greater noninfectious pneumonitis * Grade 2 pneumonitis that did not resolve to ≤ Grade 1 within 3 days of the initiation of maximal supportive care * Grade 3 irAE (excluding colitis or pneumonitis) t

GroupValue95% CI
Phase 1: Dose Escalation - 50 mg0
Phase 1: Dose Escalation - 70 mg0
Phase 1: Dose Escalation - 90 mg0
Objective Response Rate (ORR) Primary · Up to approximately 10 months

Objective Response Rate (ORR) was defined as the number of participants documented to have a confirmed Complete Response (CR) or Partial Response (PR). Complete Response was defined as the complete disappearance of all target lesions with the exception of nodal disease. Partial Response was defined at least a 30% decrease in the sum of diameters of target measurable lesions. Responses were determined by the investigator per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Participants without response data were counted as non-responders. Inferential statistical analyses were conduct

GroupValue95% CI
Phase 1: Dose Escalation - 50 mg00.0 – 52.2
Phase 1: Dose Escalation - 70 mg00.0 – 60.2
Phase 1: Dose Escalation - 90 mg00.0 – 33.6
Phase 2: Combination Regimen - Cohort 16.70.2 – 31.9
Phase 2: Combination Regimen - Cohort 200.0 – 70.8
Phase 2: Combination Regimen - Cohort 39.51.2 – 30.4
Phase 2: Combination Regimen - Cohort 423.15.0 – 53.8
Number of Participants Experiencing Treatment-Emergent Adverse Events Secondary · Day 1 to 28 days after last dose of study treatment (up to a maximum of 125 weeks in phase 1 and a maximum of 92 weeks in phase 2)
GroupValue95% CI
Phase 1: Dose Escalation - 50 mg5
Phase 1: Dose Escalation - 70 mg4
Phase 1: Dose Escalation - 90 mg10
Phase 2: Combination Regimen - Cohort 118
Phase 2: Combination Regimen - Cohort 23
Phase 2: Combination Regimen - Cohort 323
Phase 2: Combination Regimen - Cohort 418
Duration of Response (DR) Secondary · Up to approximately 10 months

DR was defined as the time in days from date of the first documentation of objective response (Complete Response \[CR\] or Partial Response \[PR\]) to the first documentation of objective Progressive Disease (PD) or to death due to any cause in the absence of documented PD. DR was only calculated for the subgroup of participants who achieved a Best Overall Response of CR or PR and was presented for responses assessed by Investigator's assessment. Data is displayed for Phase 2 only, as no participants experienced an objective response (CR or PR) during Phase 1.

GroupValue95% CI
Phase 2: Combination Regimen - Cohort 1115NA – NA
Phase 2: Combination Regimen - Cohort 3329NA – NA
Phase 2: Combination Regimen - Cohort 4NA230 – NA
Clinical Benefit Rate (CBR) Secondary · Up to approximately 10 months

Clinical benefit rate (CBR) was defined as the number of participants documented to have a confirmed Complete Response (CR), Partial Response (PR), or Stable Disease (SD) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Participants who were not be able to be assessed for response were counted as non-responders.

GroupValue95% CI
Phase 1: Dose Escalation - 50 mg1
Phase 1: Dose Escalation - 70 mg2
Phase 1: Dose Escalation - 90 mg2
Phase 2: Combination Regimen - Cohort 14
Phase 2: Combination Regimen - Cohort 20
Phase 2: Combination Regimen - Cohort 33
Phase 2: Combination Regimen - Cohort 45
Progression-Free Survival (PFS) Secondary · Randomization until progressive disease or death due to any cause (up to 42 months)

Progression-free survival (PFS) was defined as the time from date of first study treatment to first Progressive Disease (PD) or death due to any cause in the absence of documented PD per RECIST v1.1

GroupValue95% CI
Phase 1: Dose Escalation - 50 mg31.88 – NA
Phase 1: Dose Escalation - 70 mgNANA – NA
Phase 1: Dose Escalation - 90 mg21.51 – 27.57
Phase 2: Combination Regimen - Cohort 132.01 – 5.86
Phase 2: Combination Regimen - Cohort 24NA – NA
Phase 2: Combination Regimen - Cohort 321.94 – 14.57
Phase 2: Combination Regimen - Cohort 432.04 – 9.57
1-Year Survival Rate Secondary · 1 year
GroupValue95% CI
Phase 1: Dose Escalation - 50 mg0.400.05 – 0.75
Phase 1: Dose Escalation - 70 mg0.380.01 – 0.81
Phase 1: Dose Escalation - 90 mg0.530.18 – 0.80
Phase 2: Combination Regimen - Cohort 10.720.41 – 0.89
Phase 2: Combination Regimen - Cohort 21.001.00 – 1.00
Phase 2: Combination Regimen - Cohort 30.520.31 – 0.70
Phase 2: Combination Regimen - Cohort 40.500.23 – 0.72
Overall Survival (OS) Secondary · From date of first study treatment until death due to any cause (up to 42 months)

OS was defined as the time from first dose of study treatment to the date of death due to any cause.

GroupValue95% CI
Phase 1: Dose Escalation - 50 mg72.40 – 32.99
Phase 1: Dose Escalation - 70 mg117.17 – NA
Phase 1: Dose Escalation - 90 mg163.49 – 26.05
Phase 2: Combination Regimen - Cohort 1NA7.37 – NA
Phase 2: Combination Regimen - Cohort 2NANA – NA
Phase 2: Combination Regimen - Cohort 3157.73 – NA
Phase 2: Combination Regimen - Cohort 4145.07 – 20.86
Concentration of Mocetinistat in Blood Plasma Secondary · Cycle 1 Day 1 pre-dose, 1, 3, and 7 hours post-dose, Cycle 1 Day 15 pre-dose and 1 hour post-dose, Cycle 2 Day 1 pre-dose and 1 hour post-dose, Cycle 3 Day 1 pre-dose and 1 hour post-dose and Cycle 7 Day 1 pre-dose (each cycle is 28 days)
Cycle 1: Day 1 - pre-dose
GroupValue95% CI
Phase 1: Mocetinostat 50 mgNA± NA
Phase 1: Mocetinostat 70 mg0.91± 83.20
Phase 1: Mocetinostat 90 mg1.02± 114.68
Phase 2: Mocetinostat 70 mg39.65± 175.97
Cycle 1: Day 1 - 1 hour post-dose
GroupValue95% CI
Phase 1: Mocetinostat 50 mg19.85± 441.16
Phase 1: Mocetinostat 70 mg106.61± 43.77
Phase 1: Mocetinostat 90 mg92.56± 143.96
Phase 2: Mocetinostat 70 mg12.19± 289.89
Cycle 1: Day 1 - 3 hours post-dose
GroupValue95% CI
Phase 1: Mocetinostat 50 mg33.53± 111.21
Phase 1: Mocetinostat 70 mg61.63± 24.78
Phase 1: Mocetinostat 90 mg55.27± 53.19
Cycle 1: Day 1 - 7 hours post-dose
GroupValue95% CI
Phase 1: Mocetinostat 50 mg15.75± 58.30
Phase 1: Mocetinostat 70 mg20.92± 27.20
Phase 1: Mocetinostat 90 mg33.89± 45.21
Cycle 1: Day 15 - pre-dose
GroupValue95% CI
Phase 1: Mocetinostat 50 mg5.36± NA
Phase 1: Mocetinostat 70 mg0.98± 95.06
Phase 1: Mocetinostat 90 mg3.84± 202.26
Phase 2: Mocetinostat 70 mg1.92± 127.96
Cycle 1: Day 15 - 1 hour post-dose
GroupValue95% CI
Phase 1: Mocetinostat 50 mg102.67± 7.17
Phase 1: Mocetinostat 70 mg22.30± 14646.88
Phase 1: Mocetinostat 90 mg18.32± 1297.79
Phase 2: Mocetinostat 70 mg10.86± 330.59
Cycle 2: Day 1 - pre-dose
GroupValue95% CI
Phase 1: Mocetinostat 50 mg0.72± NA
Phase 1: Mocetinostat 70 mg0.85± NA
Phase 1: Mocetinostat 90 mg1.22± 83.65
Phase 1: Mocetinostat 40 mgNA± NA
Phase 2: Mocetinostat 70 mg1.16± 91.63
Phase 2: Mocetinostat 50 mg0.68± NA
Cycle 2: Day 1 - 1 hour post-dose
GroupValue95% CI
Phase 1: Mocetinostat 50 mg75.11± 25.53
Phase 1: Mocetinostat 70 mg49.30± 86.19
Phase 1: Mocetinostat 90 mg2.45± 83.60
Phase 1: Mocetinostat 40 mg0.72± NA
Phase 2: Mocetinostat 70 mg14.65± 396.22
Phase 2: Mocetinostat 50 mg105.00± NA
Concentration of Durvalumab in Blood Plasma Secondary · Cycle 1 Day 1 pre-dose + end of infusion, Cycle 1 Day 15 pre-mocetinostat dose, Cycle 2 Day 1 pre-dose, Cycle 3 Day 1 pre-dose, Cycle 4 Day 1 pre-dose + end of infusion, Cycle 7 Day 1 pre-dose + 90 days after participant's last dose (Up to max 133 weeks)

Plasma concentration of Durvalumab was evaluated. All participants received the same Durvalumab dose regardless of Mocetinistat dose group.

Cycle 1: Day 1 - pre-dose
GroupValue95% CI
Durvalumab259.18± 334.86
Cycle 1: Day 1 - end of infusion
GroupValue95% CI
Durvalumab385779.56± 36.49
Cycle 1: Day 15 - pre-Mocetinostat
GroupValue95% CI
Durvalumab102925.55± 40.05
Cycle 2: Day 1 - pre-dose
GroupValue95% CI
Durvalumab44140.86± 130.83
Cycle 3: Day 1 - pre-dose
GroupValue95% CI
Durvalumab72049.14± 91.22
Cycle 4: Day 1 - pre-dose
GroupValue95% CI
Durvalumab101852.34± 89.01
Cycle 4: Day 1 - end of infusion
GroupValue95% CI
Durvalumab365307.01± 81.59
Cycle 7: Day 1 - pre-dose
GroupValue95% CI
Durvalumab130335.14± 70.34
Number of Participants With the Presence of Anti-Drug Antibody (ADA) in the Blood Secondary · Up to approximately 10 months
GroupValue95% CI
Phase 1: Dose Escalation - 50 mg0
Phase 1: Dose Escalation - 70 mg0
Phase 1: Dose Escalation - 90 mg1
Phase 2: Combination Regimen - Cohort 11
Phase 2: Combination Regimen - Cohort 21
Phase 2: Combination Regimen - Cohort 31
Phase 2: Combination Regimen - Cohort 40
Number of Participants With Tumor Expression of Programmed Cell Death Ligand 1 (PD-L1) at Baseline Secondary · Baseline
No/Low PD-L1 Expression
GroupValue95% CI
Phase 1: Dose Escalation - 50 mg0
Phase 1: Dose Escalation - 70 mg0
Phase 1: Dose Escalation - 90 mg0
Phase 2: Combination Regimen - Cohort 117
Phase 2: Combination Regimen - Cohort 20
Phase 2: Combination Regimen - Cohort 36
Phase 2: Combination Regimen - Cohort 49
High PD-L1 Expression
GroupValue95% CI
Phase 1: Dose Escalation - 50 mg0
Phase 1: Dose Escalation - 70 mg0
Phase 1: Dose Escalation - 90 mg1
Phase 2: Combination Regimen - Cohort 10
Phase 2: Combination Regimen - Cohort 23
Phase 2: Combination Regimen - Cohort 38
Phase 2: Combination Regimen - Cohort 41
Missing
GroupValue95% CI
Phase 1: Dose Escalation - 50 mg5
Phase 1: Dose Escalation - 70 mg4
Phase 1: Dose Escalation - 90 mg8
Phase 2: Combination Regimen - Cohort 11
Phase 2: Combination Regimen - Cohort 20
Phase 2: Combination Regimen - Cohort 39
Phase 2: Combination Regimen - Cohort 44

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse events (AEs) are reported from the first day of study treatment until at least 28 days after last dose of study drug, and until resolution or stabilization of acute AEs (up to 125 weeks in Phase 1 and 92 weeks in Phase 2.) Serious adverse events (SAEs) are reported from the time of informed consent until 90 days after the last administration of mocetinostat or durvalumab (up to 133 weeks in Phase 1 and 101 weeks in Phase 2.). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Phase 1: Dose Escalation - 50 mg
Serious: 4/5 (80%)
Deaths: 5/5
Phase 1: Dose Escalation - 70 mg
Serious: 1/4 (25%)
Deaths: 2/4
Phase 1: Dose Escalation - 90 mg
Serious: 4/11 (36%)
Deaths: 9/11
Phase 2: Combination Regimen - Cohort 1
Serious: 6/18 (33%)
Deaths: 5/18
Phase 2: Combination Regimen - Cohort 2
Serious: 2/3 (67%)
Deaths: 0/3
Phase 2: Combination Regimen - Cohort 3
Serious: 5/23 (22%)
Deaths: 14/23
Phase 2: Combination Regimen - Cohort 4
Serious: 11/19 (58%)
Deaths: 12/19

Serious adverse events (40 terms)

ReactionSystemPhase 1: Dose Escalation -…Phase 1: Dose Escalation -…Phase 1: Dose Escalation -…Phase 2: Combination Regim…Phase 2: Combination Regim…Phase 2: Combination Regim…Phase 2: Combination Regim…
PneumoniaInfections and infestations
Pericardial effusionCardiac disorders
Atrial fibrillationCardiac disorders
Septic shockInfections and infestations
Malignant neoplasm progressionNeoplasms benign, malignant and unspecified (incl cysts and polyps)
PericarditisCardiac disorders
Cardiac tamponadeCardiac disorders
ColitisGastrointestinal disorders
NauseaGastrointestinal disorders
OesophagitisGastrointestinal disorders
VomitingGastrointestinal disorders
Axillary painGeneral disorders
Mucosal inflammationGeneral disorders
Non-cardiac chest painGeneral disorders
PyrexiaGeneral disorders
SepsisInfections and infestations
Bacterial infectionInfections and infestations
Clostridium difficile colitisInfections and infestations
Gastroenteritis adenovirusInfections and infestations
Herpes zosterInfections and infestations
PyelonephritisInfections and infestations
Urinary tract infectionInfections and infestations
ContusionInjury, poisoning and procedural complications
Femur fractureInjury, poisoning and procedural complications
Ejection fraction decreasedInvestigations
Other adverse events (231 terms — click to expand)

ReactionSystemPhase 1: Dose Escalation -…Phase 1: Dose Escalation -…Phase 1: Dose Escalation -…Phase 2: Combination Regim…Phase 2: Combination Regim…Phase 2: Combination Regim…Phase 2: Combination Regim…
FatigueGeneral disorders
DiarrhoeaGastrointestinal disorders
NauseaGastrointestinal disorders
VomitingGastrointestinal disorders
Decreased appetiteMetabolism and nutrition disorders
ConstipationGastrointestinal disorders
HypokalaemiaMetabolism and nutrition disorders
CoughRespiratory, thoracic and mediastinal disorders
DehydrationMetabolism and nutrition disorders
Urinary tract infectionInfections and infestations
HyponatraemiaMetabolism and nutrition disorders
Back painMusculoskeletal and connective tissue disorders
Muscular weaknessMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
AnaemiaBlood and lymphatic system disorders
NeutropeniaBlood and lymphatic system disorders
Atrial fibrillationCardiac disorders
Abdominal painGastrointestinal disorders
Oedema peripheralGeneral disorders
Chest painGeneral disorders
PainGeneral disorders
Weight decreasedInvestigations
HypoalbuminaemiaMetabolism and nutrition disorders
HypocalcaemiaMetabolism and nutrition disorders
Flank painMusculoskeletal and connective tissue disorders
Musculoskeletal chest painMusculoskeletal and connective tissue disorders
DysuriaRenal and urinary disorders
HaemoptysisRespiratory, thoracic and mediastinal disorders
RashSkin and subcutaneous tissue disorders
HypotensionVascular disorders
Pericardial effusionCardiac disorders
PalpitationsCardiac disorders
PericarditisCardiac disorders
Dry eyeEye disorders
Gastrooesophageal reflux diseaseGastrointestinal disorders
Abdominal pain upperGastrointestinal disorders
Non-cardiac chest painGeneral disorders
AstheniaGeneral disorders
PyrexiaGeneral disorders

Most-reported serious reactions: Pneumonia, Pericardial effusion, Atrial fibrillation, Septic shock, Malignant neoplasm progression, Pericarditis, Cardiac tamponade, Colitis.

Data from ClinicalTrials.gov NCT02805660 adverse events section.

Sponsor's own description

Mocetinostat (MGCD0103) is an orally administered HDAC inhibitor. Durvalumab (MEDI4736) is a human monoclonal antibody that is an inhibitor of the Programmed Cell Death Ligand (or PD-L1). Durvalumab is also known as a checkpoint inhibitor. This study is evaluating the combination regimen of mocetinostat and durvalumab in participants with Advanced or Metastatic Solid Tumors and Non-Small Cell Lung Cancer.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Targeting epigenetic regulators for cancer therapy: mechanisms and advances in clinical trials.
    Cheng Y, He C, Wang M, Ma X, et al · · 2019 · cited 760× · PMID 31871779 · DOI 10.1038/s41392-019-0095-0
  2. Immune checkpoint therapy in liver cancer.
    Xu F, Jin T, Zhu Y, Dai C. · · 2018 · cited 299× · PMID 29843754 · DOI 10.1186/s13046-018-0777-4
  3. The timeline of epigenetic drug discovery: from reality to dreams.
    Ganesan A, Arimondo PB, Rots MG, Jeronimo C, et al · · 2019 · cited 234× · PMID 31791394 · DOI 10.1186/s13148-019-0776-0
  4. Study and analysis of antitumor resistance mechanism of PD1/PD-L1 immune checkpoint blocker.
    Wang Z, Wu X. · · 2020 · cited 147× · PMID 32875727 · DOI 10.1002/cam4.3410
  5. Epigenetics-targeted drugs: current paradigms and future challenges.
    Dai W, Qiao X, Fang Y, Guo R, et al · · 2024 · cited 131× · PMID 39592582 · DOI 10.1038/s41392-024-02039-0
  6. Combining epigenetic and immune therapy to overcome cancer resistance.
    Gomez S, Tabernacki T, Kobyra J, Roberts P, et al · · 2020 · cited 130× · PMID 31877341 · DOI 10.1016/j.semcancer.2019.12.019
  7. Recent developments in epigenetic cancer therapeutics: clinical advancement and emerging trends.
    Nepali K, Liou JP. · · 2021 · cited 122× · PMID 33840388 · DOI 10.1186/s12929-021-00721-x
  8. Epi-drugs in combination with immunotherapy: a new avenue to improve anticancer efficacy.
    Mazzone R, Zwergel C, Mai A, Valente S. · · 2017 · cited 113× · PMID 28572863 · DOI 10.1186/s13148-017-0358-y

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