On May 28, 2015 Celldex Therapeutics reported the initiation of an open-label, Phase 1/2 safety and tolerability study examining the investigational combination of varlilumab and sunitinib (SUTENT) in patients with metastatic clear cell renal cell carcinoma (CC-RCC) (Press release, Celldex Therapeutics, MAY 28, 2015, View Source [SID:1234504859]). Schedule your 30 min Free 1stOncology Demo! Varlilumab is Celldex’s fully human monoclonal agonist antibody that binds and activates CD27, a critical co-stimulatory molecule in the immune activation cascade. Sunitinib is approved by the FDA as monotherapy for the treatment of advanced renal cell carcinoma (RCC), as well as certain advanced gastrointestinal stromal tumors and pancreatic neuroendocrine tumors. Varlilumab is currently being studied in four Phase 1/2 combination studies, and additional combination studies will be initiated in 2015. Know more, wherever you are: Sunitinib blocks the function of receptor tyrosine kinases (RTKs), of which several are implicated in tumor growth, angiogenesis and metastasis. Sunitinib was selected for an investigational combination with varlilumab because it has demonstrated the potential to modulate anti-tumor immunity and reverse immune suppression in the tumor microenvironment. Varlilumab strengthens or creates an immune response against a new antigen, or target; therefore, a synergistic combination of sunitinib and varlilumab may elicit stronger responses in the immune system to fight CC-RCC and potentially other cancers. In Celldex’s Phase 1 study of varlilumab in multiple solid tumors, promising signs of clinical activity in patients with refractory CC-RCC were observed, including a durable partial response (13.0+ months) that has continued to decrease in tumor volume over time and prolonged stable disease (4 patients with a range of 5.3 to 33.0+ months).
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"A growing understanding of renal cell carcinoma tumor biology has suggested that sunitinib’s mechanism of action may result in immune system stimulation in this indication," said Thomas Davis, M.D., Executive Vice President and Chief Medical Officer of Celldex Therapeutics. "We think we may be able to build on this potential effect in clear cell renal cell carcinoma because varlilumab can both enhance immune responses and may have a therapeutic effect through T cell signaling mechanisms. This study furthers our commitment to expanding the applicability of varlilumab across several cancers and approaches with immunotherapy in novel combinations."
The Phase 1 portion of the study will assess the safety and tolerability of varlilumab at 0.3, 1.0 and 3.0 mg/kg combined with sunitinib at 50 mg in order to identify a recommended dose for the Phase 2 portion of the study. In both phases of the trial, varlilumab will be administered once every three weeks for up to eight six-week cycles (a total of up to 16 varlilumab doses). In each six-week cycle, sunitinib 50mg will be administered orally once daily for four weeks followed by two weeks without administration. The primary objective of the Phase 2 portion of the study is to assess the preliminary anti-tumor efficacy of the varlilumab/sunitinib combination measured by the overall response rate (ORR). Secondary objectives include safety and tolerability, pharmacokinetics, immunogenicity and further assessment of anti-tumor activity across a broad range of endpoints. The study is anticipated to include up to 10 sites in the United States and enroll approximately 60 patients.
About Varlilumab
Varlilumab is a fully human monoclonal agonist antibody that binds and activates CD27, a critical co-stimulatory molecule in the immune activation cascade. CD27 can be effectively manipulated with activating antibodies to induce potent anti-tumor responses and may result in fewer toxicities due to its restricted expression and regulation. Varlilumab is a potent anti-CD27 agonist that induces activation and proliferation of human T cells when combined with T cell receptor stimulation. In lymphoid malignancies that express CD27 at high levels, varlilumab may have an additional mechanism of action through a direct anti-tumor effect. Varlilumab has completed a Phase 1 dose-escalation study, demonstrating potent immunologic activity consistent with its mechanism of action and anti-tumor activity in patients with advanced, refractory disease. No maximum tolerated dose was reached and minimal toxicities were observed. Celldex has initiated a broad development program for varlilumab to explore its role as an immune activator in combination with a number of complementary investigational and approved oncology drugs.