Title
A Phase 1/2 Study of ASP1570 as Monotherapy and in Combination with Pembrolizumab or Standard Therapies Including Chemotherapy and/or Immunotherapy in Participants with Locally Advanced or Metastatic Solid Tumors

Description
Immune therapies work with the body's immune system to treat a number of cancers. They work with T-cells, a type of white blood cell, to target and attack specific tumors. However, some tumors can become resistant to attack by T-cells over time. They do this by sending "off" signals to T-cells. The researchers are finding ways to switch the T-cells back on.

Early studies have shown that ASP1570 can switch T-cells back on to attack tumors.

This study will provide more information on this potential new treatment in adults with advanced solid tumors. Their tumor has either grown outside of the area where it started (locally advanced and unresectable) or it has spread to other parts of the body (metastatic). Their cancer gets worse after standard therapy or they are unable to have standard therapy.

People will either be treated with ASP1570 by itself, or together with another medicine called pembrolizumab.

This study will be in 2 parts.

In Part 1, the best dose of ASP1570 to give to people with advanced solid tumors will be worked out. Different small groups of people with advanced solid tumors will take lower to higher doses of ASP1570 by itself or with pembrolizumab. There are different doses of ASP1570, with each group staying on the same dose. There is just 1 dose of pembrolizumab. After taking the lowest dose of ASP1570, the first group will be checked for medical problems. The next group can only take the higher dose of ASP1570 if the first group on the lowest dose had no major medical problems. This will continue in the same way for each group. This means each group will take the next highest dose of ASP1570 as long as the previous group did not have any major medical problems.

Each group will take tablets of ASP1570 either once or twice every day in a 21-day cycle. People taking part in Japan will stay in hospital for up to 21 days during the first treatment cycle only. People will continue with more treatment cycles on the same dose unless they have major medical problems, their cancer gets worse or the study doctor decides that person should stop treatment. People who are also receiving treatment with pembrolizumab will be infused with pembrolizumab on the first day of every other cycle of ASP1570 (once every 6 weeks).

In Part 2, different small groups of people with advanced solid tumors will take the best dose of ASP1570 worked out from Part 1. The dose will not go above the highest dose that people took in Part 1 without getting major medical problems. Some groups of people will have specific advanced tumors. These include tumors from metastatic melanoma or non-small cell lung cancer (NSCLC for short). Other groups will have solid tumors that showed a response in Part 1. Again, each group will take tablets of ASP1570 once or twice every day in a 21-day cycle. Only people with NSCLC will also be infused with pembrolizumab on the first day of every other cycle of ASP1570 (once every 6 weeks). All groups will continue with more treatment cycles with ASP1570 by itself or with pembrolizumab, unless they have major medical problems, their cancer gets worse or the study doctor decides that person should stop treatment.

After treatment with ASP1570, people in the study will visit their clinic 45 days after their last dose of ASP1570. People who were treated with ASP1570 and pembrolizumab will visit their clinic either 45 days after their last dose of ASP1570 or 30 days after their last dose of pembrolizumab. It will depend on which treatment was the last one they had. Then, the study clinic will contact each person in the study at least every 12 weeks until the end of the study or if they decide to leave the study.

Objective
Primary:
-To determine the safety and tolerability of ASP1570 as monotherapy and in combination with pembrolizumab
-To determine the RP2D and/or MTD as monotherapy and in combination with pembrolizumab
Secondary:
-To evaluate the anti-tumor effects of ASP1570 as monotherapy and in combination with pembrolizumab
-To evaluate pharmacokinetics of ASP1570 as monotherapy and in combination with pembrolizumab
-To evaluate the effect of ASP1570 as monotherapy and in combination with pembrolizumab on level and proliferative index of TILs in tumor microenvironment

Treatment A Phase 1/2 Study of ASP1570 as Monotherapy and in Combination With Pembrolizumab in Participants With Locally Advanced or Metastatic Solid Tumors

Key Eligibility For full study eligibility, see this study's ClinicalTrials.gov record.

Applicable Disease Sites
Anal; Any Site; Bladder; Brain/Central Nervous System; Breast; Cervix; Colon and Rectum; Endocrine cancers; Esophagus; Gastrointestinal cancers, other; Genitourinary cancers, other; Head and Neck; Ill-Defined Sites; Kidney; Liver; Lung; Melanoma/Skin cancer; Ovary; Pancreas; Prostate; Sarcoma; Stomach; Thyroid; Unknown Sites; Uterus

Participating Institutions
UW Health Eastpark Medical Center; UW Health University Hospital