A multicentre, open-label, phase Ia/Ib study investigating the safety, tolerability and efficacy of 177Lu-SSO110 with companion imaging 68Ga-SSO120 in participants with extensive stage Small Cell Lung Cancer who are on maintenance treatment with Atezolizumab
Key Inclusion Criteria:
- Aged at least 18 years (inclusive at the time of informed consent).
- Must be able and willing to provide written informed consent prior to start of any study procedures and assessments and must be willing to comply with all study procedures.
- Histologically or cytologically confirmed ES-SCLC.
- Adequate organ and marrow function within 7 days of first dose of 177Lu-SSO110 as defined below:
- absolute neutrophil count greater than or equal to 1,000/µL;
- platelets of greater than or equal to 100,000/µL;
- total bilirubin less than or equal to 1.5 × upper limit of normal (ULN) or less than or equal to 3.0 × ULN for participants with hereditary benign hyperbilirubinaemia;
- AST (aspartate aminotransferase or serum glutamic oxaloacetic transaminase, SGOT) and ALT (alanine aminotransferase or serum glutamic pyruvic transaminase, SGPT) less than or equal to 3 × ULN (or less than or equal to 5 × ULN if liver metastases are present);
- serum creatinine less than or equal to 1.5 × ULN;
- estimated glomerular filtration rate greater than or equal to 45 mL/min/1.73 m2;
- serum albumin greater than or equal to 30 g/L.
- Life expectancy of >18 weeks at confirmation of eligibility, in the opinion of the Investigator.
- Women of childbearing potential (WOCBP) must have a negative beta-human chorionic gonadotropin test within 72 hours before the first dose of study drug and must not be breastfeeding. WOCBP are defined as those who are not surgically sterile or post-menopausal. Female participants will be considered post-menopausal if they have been amenorrhoeic for 12 months without an alternative medical cause. Female participants <50 years old who meet the criteria for post-menopausal status without previous surgical sterilization should be considered for further investigation with luteinising hormone and follicle stimulating hormone levels to confirm serological post-menopausal status.
- WOCBP must agree to use a highly effective method of contraception during the study and for 90 days after the last dose of study drug.
- Male participants who are able to father a child must agree to avoid impregnating a partner and to adhere to a highly effective method of contraception during the study and for 90 days after the last dose of study drug. All male participants must agree to not donate sperm during the study and for 90 days after the last dose of study drug.
- Either positive 68Ga-SSO120 scan at screening (positive being a lesion concordant with a known lesion based on CT or FDG-PET/CT with uptake visually assessed as greater than the liver on 68Ga-SSO120 scan) or at the Investigator’s discretion, in the case of no/insufficient visible lesions at screening, a positive test for SST2 from archival tissue or histology report (positive being a H-score >50).
- To receive the first dose of 177Lu-SSO110, participants must have received at least 1 and no more than 2 doses of maintenance atezolizumab after induction therapy consisting of a platinum-based agent (e.g., cisplatin/carboplatin), etoposide and atezolizumab.
- Participants with previously treated brain metastases are eligible to participate if:
- they are clinically and radiologically stable disease (no evidence of progression by imaging; same imaging modality [magnetic resonance imaging or CT scan]) must be used for each assessment) for at least 28 days prior to the first dose of study drug;
- any neurologic symptoms returned to baseline;
- no longer on steroids.
Note: Participants with a history of leptomeningeal disease may not participate even if stable clinically.
This study aims to assess the safety and tolerability of two new drugs in patients with extensive stage small cell lung cancer (ES SCLC). The first drug (68Ga-SSO120/68Ga-Satoreotide Trizoxetan) is used as a tumour imaging agent for patients who have tumours with specific receptors, while the second drug (177Lu-SSO110) targets and damages cancer cells with these specific receptors.
Who is it for?
You may be eligible for this study if you are an adult aged 18 years or older, you have been diagnosed with extensive stage small cell lung cancer and if you are going to be receiving atezolizumab maintenance therapy. All potential participants will be reviewed by the study investigators to ensure that they meet additional health criteria before enrolment.
All participants who choose to enrol in this study will undergo two screening scans using the new 68Ga-SSO120 imaging drug. The first scan will be to confirm eligibility to receive the 177Lu-SSO110 drug. If eligible, the first treatment dose with 177Lu-SSO110 will be scheduled at least 18 days after the 68Ga-SSO120 scan. The second scan with 68Ga-SSO120 will be taken at the end of treatment visit, which will be 6 weeks following the last dose of 177Lu-SSO110. For each scan, the 68Ga-SSO120 drug will be administered via an intravenous infusion 1 hour (40-90 minutes) before the PET/CT scan. The scans are anticipated to take 1-2 hours in total to complete. Participants who are confirmed to have somatostatin receptor 2 tumour cells based on the first screening scan will then be offered the opportunity to undergo treatment with the 177Lu-SSO110 drug. Participants who choose to enrol in the 177Lu-SSO110 arm of this study will have 177Lu-SSO110 administered via an intravenous infusion 7 days after their first or second atezolizumab maintenance therapy. Up to 3 additional 177Lu-SSO110 administration cycles will be given 6 to 9 weeks after the previous 177Lu-SSO110 administration (each within 7 days following an atezolizumab therapy). For participants with clinical benefit at the end of the 4 cycles the Investigator may request that the patient is provided with up to three additional treatments, which will be approved at the Sponsor’s discretion
It is hoped this research will demonstrate that each of the study drugs, 68Ga-SSO120 and 177Lu-SSO110 are safe and well tolerated by patients with extensive stage small cell lung cancer. If the results of this initial study are positive, a larger trial involving a greater number of patients with extensive stage small cell lung cancer may be undertaken to further determine the potential benefits of the new drugs.
For more information regarding this clinical trial click here.