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NCT04167137

Safety and Tolerability of SYNB1891 Injection Alone or in Combination With Atezolizumab in Adult Participants

Terminated Phase 1 Results posted Last updated 3 May 2024
What this trial tests

Phase 1 trial testing SYNB1891 in Metastatic Solid Neoplasm in 32 participants. Terminated before completion.

Timeline
12 December 2019
Primary endpoint
9 December 2021
9 December 2021

Quick facts

Lead sponsorSynlogic
PhasePhase 1
StatusTerminated
Study typeINTERVENTIONAL
Allocationnon randomized
Designsequential
Maskingnone
Primary purposetreatment
Enrollment32
Start date12 December 2019
Primary completion9 December 2021
Estimated completion9 December 2021
Sites6 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Synlogic — full company profile →

Who can join

18 and older, any sex, with Metastatic Solid Neoplasm or Lymphoma. 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 With Dose-limiting Toxicity Primary · 21 days (1 cycle)

The following adverse events (AEs) were DLTs if they occurred in Cycle 1 and were assessed by the Investigator as related to treatment: 1. Grade (Gr) 4 nonhematologic toxicity (not laboratory) 2. Gr 4 hematologic toxicity ≥ 7 days, any Gr 4 thrombocytopenia, or Gr 3 thrombocytopenia with significant bleeding 3. Gr ≥ 3 nonhematologic toxicity (exceptions: Gr 3 fatigue ≤ 3 days; Gr 3 diarrhea, nausea, or vomiting without treatment; Gr 3 rash without treatment) 4. Gr 3/4 nonhematologic laboratory value for \> 1 week or resulting in significant medical intervention, hospitalization, or drug-induc

GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)0
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)0
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)0
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)0
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)0
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)1
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab0
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab0
Number of Participants With Treatment-Emergent Adverse Events Secondary · Up to 13 months

Toxicity was graded in accordance with the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 5.0, as follows: Grade 1 (mild/asymptomatic; no intervention); Grade 2 (moderate; minimal intervention); Grade 3 (severe/medically significant; hospitalization indicated; disabling); Grade 4 (life-threatening; urgent intervention required); or Grade 5 (fatal). Adverse events (AEs) were reported from clinical laboratory tests, vital sign and weight measurements, physical examinations, and any other medically indicated assessments, including participant inter

Any TEAE
GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)3
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)3
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)4
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)5
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)3
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)6
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab4
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab4
Maximum TEAE severity Grade 1
GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)0
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)1
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)2
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)1
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)1
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)0
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab1
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab1
Maximum TEAE severity Grade 2
GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)1
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)1
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)1
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)1
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)1
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)3
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab3
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab1
Maximum TEAE severity Grade 3
GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)1
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)0
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)1
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)3
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)1
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)3
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab0
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab1
Maximum TEAE severity Grade 4
GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)0
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)0
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)0
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)0
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)0
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)0
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab0
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab0
Maximum TEAE severity Grade 5
GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)1
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)1
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)0
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)0
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)0
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)0
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab0
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab1
TEAE related to SYNB1891
GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)3
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)1
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)2
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)3
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)3
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)6
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab2
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab2
TEAE related to atezolizumab
GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)0
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)0
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)0
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)0
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)0
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)0
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab0
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab2
Number of Participants With Best Tumor Response as Measured by the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) Secondary · Up to 13 months

Appropriate imaging of the SYNB1891-injected tumor(s) and up to 5 target (noninjected) lesions was performed at baseline and every 2 cycles during the treatment period. Tumor response was assessed by the local investigator using RECIST 1.1 (Eisenhauer et al 2009). Per RECIST 1.1, target lesions are categorized as follows: complete response (CR): disappearance of all target lesions (no evaluable disease); partial response (PR): ≥ 30% decrease in the sum of the longest diameter of target lesions; progressive disease (PD): ≥ 20% increase in the sum of the longest diameter of target lesions; stabl

GroupValue95% CI
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)1
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)1
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)1
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)1
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)1
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)1
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab1
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab2
Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)1
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)1
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)3
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)3
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)2
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)2
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab3
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab1

Adverse events — posted to ClinicalTrials.gov

Time frame: All AEs occurring from the time a participant signed informed consent through the safety follow-up period were documented, regardless of the causal relationship to study drug. AEs that occurred or worsened in severity after the first dose of study treatment were considered treatment emergent (i.e., TEAEs). The longest duration of study participation for any participant was 13 months.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Arm 1 Cohort 1: SYNB1891 Monotherapy (1 × 10^6 Live Cells)
Serious: 1/3 (33%)
Deaths: 2/3
Arm 1 Cohort 2: SYNB1891 Monotherapy (3 × 10^6 Live Cells)
Serious: 1/3 (33%)
Deaths: 2/3
Arm 1 Cohort 3: SYNB1891 Monotherapy (1 × 10^7 Live Cells)
Serious: 1/4 (25%)
Deaths: 0/4
Arm 1 Cohort 4: SYNB1891 Monotherapy (3 × 10^7 Live Cells)
Serious: 3/5 (60%)
Deaths: 1/5
Arm 1 Cohort 5: SYNB1891 Monotherapy (1 × 10^8 Live Cells)
Serious: 0/3 (0%)
Deaths: 0/3
Arm 1 Cohort 6: SYNB1891 Monotherapy (3 × 10^8 Live Cells)
Serious: 3/6 (50%)
Deaths: 0/6
Arm 2 Cohort 1: SYNB1891 (1 × 10^7 Live Cells) + Atezolizumab
Serious: 0/4 (0%)
Deaths: 0/4
Arm 2 Cohort 2: SYNB1891 (3 × 10^7 Live Cells) + Atezolizumab
Serious: 2/4 (50%)
Deaths: 1/4

Serious adverse events (14 terms)

ReactionSystemArm 1 Cohort 1: SYNB1891 M…Arm 1 Cohort 2: SYNB1891 M…Arm 1 Cohort 3: SYNB1891 M…Arm 1 Cohort 4: SYNB1891 M…Arm 1 Cohort 5: SYNB1891 M…Arm 1 Cohort 6: SYNB1891 M…Arm 2 Cohort 1: SYNB1891 (…Arm 2 Cohort 2: SYNB1891 (…
Cytokine release syndromeImmune system disorders
AspirationRespiratory, thoracic and mediastinal disorders
Back painMusculoskeletal and connective tissue disorders
ConstipationGastrointestinal disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
HypoxiaRespiratory, thoracic and mediastinal disorders
Pulmonary embolismRespiratory, thoracic and mediastinal disorders
SepsisInfections and infestations
SyncopeNervous system disorders
Synovial sarcoma metastaticNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Tracheal haemorrhageInjury, poisoning and procedural complications
Transient ischaemic attackNervous system disorders
Tumour haemorrhageNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Vaginal haemorrhageReproductive system and breast disorders
Other adverse events (95 terms — click to expand)

ReactionSystemArm 1 Cohort 1: SYNB1891 M…Arm 1 Cohort 2: SYNB1891 M…Arm 1 Cohort 3: SYNB1891 M…Arm 1 Cohort 4: SYNB1891 M…Arm 1 Cohort 5: SYNB1891 M…Arm 1 Cohort 6: SYNB1891 M…Arm 2 Cohort 1: SYNB1891 (…Arm 2 Cohort 2: SYNB1891 (…
ChillsGeneral disorders
NauseaGastrointestinal disorders
HyponatraemiaMetabolism and nutrition disorders
Tumour PainNeoplasms benign, malignant and unspecified (incl cysts and polyps)
PyrexiaGeneral disorders
FatigueGeneral disorders
Decreased appetiteMetabolism and nutrition disorders
Injection site painGeneral disorders
VomitingGastrointestinal disorders
AnxietyPsychiatric disorders
Back painMusculoskeletal and connective tissue disorders
HeadacheNervous system disorders
AnaemiaBlood and lymphatic system disorders
ConstipationGastrointestinal disorders
Injection site reactionGeneral disorders
DiarrhoeaGastrointestinal disorders
HyperglycaemiaMetabolism and nutrition disorders
HypokalaemiaMetabolism and nutrition disorders
Activated Partial Thromboplastin Time ProlongedInvestigations
Aspartate Aminotransferase IncreasedInvestigations
Blood Lactate Dehydrogenase IncreasedInvestigations
International Normalised Ratio IncreasedInvestigations
Corona Virus InfectionInfections and infestations
Urinary Tract InfectionInfections and infestations
HypertensionVascular disorders
HypotensionVascular disorders
Peripheral SwellingGeneral disorders
Abdominal PainGastrointestinal disorders
DysphagiaGastrointestinal disorders
Blood Uric Acid IncreasedInvestigations
Lymphocyte Count DecreasedInvestigations
ArthralgiaMusculoskeletal and connective tissue disorders
BursitisMusculoskeletal and connective tissue disorders
Groin painMusculoskeletal and connective tissue disorders
Musculoskeletal painMusculoskeletal and connective tissue disorders
LeukocytosisBlood and lymphatic system disorders
ConjunctivitisInfections and infestations
PneumoniaInfections and infestations
EpistaxisRespiratory, thoracic and mediastinal disorders
Productive CoughRespiratory, thoracic and mediastinal disorders

Most-reported serious reactions: Cytokine release syndrome, Aspiration, Back pain, Constipation, Dyspnoea, Hypoxia, Pulmonary embolism, Sepsis.

Data from ClinicalTrials.gov NCT04167137 adverse events section.

Sponsor's own description

This Phase 1, open-label, multicenter, 2-arm study was designed to evaluate SYNB1891 when administered either as monotherapy (Arm 1) or in combination with atezolizumab (Arm 2) in participants with advanced/metastatic solid tumors or lymphoma. The primary objective was to evaluate the safety and tolerability of study treatment, with a secondary objective of assessing preliminary tumor response to treatment and exploratory objectives of evaluating the pharmacokinetics/pharmacodynamics (PK/PD) of study treatment.

Publications & conference data

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

  1. The microbiome and human cancer.
    Sepich-Poore GD, Zitvogel L, Straussman R, Hasty J, et al · · 2021 · cited 945× · PMID 33766858 · DOI 10.1126/science.abc4552
  2. Gut microbiota influence immunotherapy responses: mechanisms and therapeutic strategies.
    Lu Y, Yuan X, Wang M, He Z, et al · · 2022 · cited 360× · PMID 35488243 · DOI 10.1186/s13045-022-01273-9
  3. Immunotherapy with engineered bacteria by targeting the STING pathway for anti-tumor immunity.
    Leventhal DS, Sokolovska A, Li N, Plescia C, et al · · 2020 · cited 326× · PMID 32483165 · DOI 10.1038/s41467-020-16602-0
  4. STING Agonists as Cancer Therapeutics.
    Amouzegar A, Chelvanambi M, Filderman JN, Storkus WJ, et al · · 2021 · cited 311× · PMID 34070756 · DOI 10.3390/cancers13112695
  5. Engineering bacteria as interactive cancer therapies.
    Gurbatri CR, Arpaia N, Danino T. · · 2022 · cited 288× · PMID 36423303 · DOI 10.1126/science.add9667
  6. Targeting cytokine and chemokine signaling pathways for cancer therapy.
    Yi M, Li T, Niu M, Zhang H, et al · · 2024 · cited 264× · PMID 39034318 · DOI 10.1038/s41392-024-01868-3
  7. Chemical and Biomolecular Strategies for STING Pathway Activation in Cancer Immunotherapy.
    Garland KM, Sheehy TL, Wilson JT. · · 2022 · cited 250× · PMID 35107989 · DOI 10.1021/acs.chemrev.1c00750
  8. Type I interferon-mediated tumor immunity and its role in immunotherapy.
    Yu R, Zhu B, Chen D. · · 2022 · cited 229× · PMID 35292881 · DOI 10.1007/s00018-022-04219-z

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