Study of mRNA-4359 Administered Alone and in Combination With Immune Checkpoint Blockade in Participants With Advanced Solid Tumors

Trial statusRecruiting
Trial phasePhase 1, Phase 2
Trial typeInterventional
Biological sexAll
Age12+
SponsorModernaTX, Inc.

About this trial

The primary goal of this study is to assess the safety and tolerability of mRNA-4359 administered alone and in combination with pembrolizumab or ipilimumab and nivolumab.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Males or females ≥18 years of age who have provided written informed consent prior to completing any study-specific procedure. For Arm 2d, participants ≥12 years are eligible with informed consent/assent.

Dose Escalation (Arm 1a): Participant has histologically confirmed locally advanced or metastatic cancer (cutaneous melanoma, NSCLC, non-muscle invasive bladder cancer, head and neck squamous cell carcinoma, microsatellite stable colorectal cancer [MSS CRC], basal cell carcinoma, or triple negative breast cancer) with measurable disease as determined by RECIST v1.1. Arm 1a participants must have received, and then progressed, relapsed, or been intolerant to, or ineligible for, at least 1 standard treatment regimen in the advanced or metastatic setting. Participants with a known driver mutation must have also received or been offered a mutation-directed therapy, where indicated. Participants must have a tumor lesion amenable to biopsy and must have another lesion that can be followed for response.

Dose Confirmation (Arm 1b): Participant has histologically confirmed locally advanced or metastatic, and CPI refractory melanoma or locally advanced or metastatic, and CPI refractory NSCLC with measurable disease as determined by RECIST v1.1 who has disease progression after, at least 1 line of standard therapy (no limit to prior lines of therapy), and has been treated with or refused standard of care treatment. Participants in PD arm Group 2 must also have PD-L1 TPS ≥1%. Participants must have primary refractory or acquired secondary resistance to prior immune checkpoint treatments. Primary refractory is defined as prior exposure to anti-programmed death-1 (PD-1)/PD-L1 antibody for at least 6 weeks but no more than 6 months with demonstration of progression on 2 separate scans at least 4 weeks apart but no more than 12 weeks apart and progression occurring within 6 months after first dose of anti-PD-1 antibody. Acquired secondary resistance must have confirmed objective response or prolonged stable disease (SD) (>6 months), followed by disease progression in the setting of ongoing treatment and confirmed progression on scans at least 4 weeks apart. Participants must have a tumor lesion amenable to biopsy and must have another lesion that can be followed for response.

For NSCLC participants with known EGFR, ALK, proto-oncogene tyrosine-protein kinase reactive oxygen species (ROS1), or other actionable mutations for which there are approved targeted therapies, participants must have received prior approved targeted therapy or have been offered and declined approved targeted therapy.

Disqualifiers

Participant has active central nervous system tumors or metastases.

Participant has received treatment with prohibited medications (that is, concurrent anticancer therapy including other chemotherapy, radiation [local radiation for palliative care is permitted with approval from the Sponsor], hormonal anticancer treatment, biologic therapy, or immunotherapy) or investigational agents within 5 half-lives or 14 days prior to the first day of study treatment, whichever is shorter. Prior exposure to any investigational or approved agent designed to simultaneously target both indoleamine 2,3-dioxygenase (IDO1) and PD-L1 is also exclusionary.

Participant has required the use of additional immunosuppression (for example, infliximab) other than corticosteroids for the management of an AE, has experienced recurrence of an AE if rechallenged, and currently requires maintenance doses of >10 milligrams (mg) prednisone or equivalent per day.

Participant has any plan to receive a live attenuated vaccine during study treatment or has received a live vaccine within 30 days before the first dose of study treatment. Examples of live vaccines include, but are not limited to measles, mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus Calmette-Guérin, and typhoid vaccine. Seasonal influenza vaccines and non-live coronavirus disease 2019 (COVID-19) for injection are generally allowed.

Trial design

Design model

Parallel

Treatments tested in this trial

  • mRNA-4359

    Biological/Vaccine

    Intramuscular Injection

  • Pembrolizumab

    Biological/Vaccine

    Intravenous infusion

  • Ipilimumab

    Biological/Vaccine

    Intravenous infusion

  • Nivolumab

    Biological/Vaccine

    Intravenous infusion

Treatment groups

361 Participants
are divided into 9 treatment groups

9

Treatment groups

See each treatment group below.

Group A: Arm 1a (Dose Escalation): mRNA-4359 AloneExperimental treatment 1 intervention
Group B: Arm 1b (Dose Confirmation): mRNA-4359 in Combination with PembrolizumabExperimental treatment 2 interventions
Group C: Arm 1b (Melanoma Expansion Cohort): mRNA-4359 in Combination With PembrolizumabExperimental treatment 2 interventions
Group D: Arm 2a (Dose Expansion): mRNA-4359 in Combination with PembrolizumabExperimental treatment 2 interventions
Group E: Arm 2b (Dose Expansion): mRNA-4359 in Combination with PembrolizumabExperimental treatment 3 interventions
Group F: Arm 2c (Dose Expansion): mRNA-4359 in Combination with Ipilimumab and NivolumabExperimental treatment 2 interventions
Group G: Arm 2d (Dose Expansion): mRNA-4359 in Combination with PembrolizumabExperimental treatment 2 interventions
Group H: Pharmacodynamic (PD) Arm (Group 1): mRNA-4359 in Combination with PembrolizumabExperimental treatment 2 interventions
Group I: PD Arm (Group 2): mRNA-4359 in Combination with PembrolizumabExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Arms 1a and 1b: Maximum Tolerated Dose (MTD) or Recommended Dose for Expansion (RDE) of mRNA-4359

Time frame
Days 1-21 (Cycle 1)
2

Arms 1, 2a, 2b, and 2c: Number of Participants with Dose Limiting Toxicities (DLTs)

Time frame
Days 1-21 (Cycle 1)
3

Arms 1, 2a, 2b, and 2c: Number of Participants with Adverse Events (AEs), AE of Special Interest (AESIs), and Serious AEs (SAEs)

Time frame
Up to 27 months
4

Arm 2d: Objective Response Rate (ORR) Based on Blinded Independent Central Review (BICR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)

Time frame
Day 1 up to 60 months

Secondary outcomes

1

Arms 1, 2a, 2b, and 2c: ORR Based on Investigator Assessment Per RECIST v1.1

Time frame
Day 1 up to 27 months
2

Arms 1, 2a, 2b, and 2c: Disease Control Rate (DCR) Based on Investigator Assessment Per RECIST v1.1

Time frame
Day 1 up to 27 months
3

Arms 1, 2a, 2b, and 2c: Duration of Response (DOR) Based on Investigator Assessment Per RECIST v1.1

Time frame
Day 1 up to 27 months
4

Arms 1, 2a, 2b, and 2c: Progression Free Survival (PFS) Based on Investigator Assessment Per RECIST v1.1

Time frame
Day 1 up to 27 months

Other outcomes

Sponsors and contacts

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