Breast CancerPhase 2MARIO-3NCT03961698
Evaluation of IPI-549 Combined With Front-line Treatments in Pts. With Triple-Negative Breast Cancer or Renal Cell Carcinoma
A Phase 2 study testing IPI-549 (eganelisib), Atezolizumab and nab-paclitaxel in people with Breast Cancer and Renal Cell Carcinoma, run by Infinity Pharmaceuticals, Inc. at 24 sites in United States.
Trial summary
MARIO-3 is a Phase 2 multi-arm combination cohort study designed to evaluate IPI-549, Infinity Pharmaceutical's first-in-class, oral immuno-oncology product candidate targeting immune-suppressive tumor-associated myeloid cells through selective inhibition of phosphoinositide-3-kinase (PI3K)-gamma, in combinations with… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Breast Cancer, Renal Cell Carcinoma
- What is being tested?
- IPI-549 (eganelisib), Atezolizumab and nab-paclitaxel
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 91 participants
- Where
- 24 sitesUnited States
- Study dates
- 17 Dec 2019to 31 Aug 2023
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- ≥18 years of age.
- Have signed and dated an independent review board (IRB)/independent ethics committee (IEC) approved informed consent form (ICF) in accordance with regulatory and institutional guidelines. This must be obtained before the performance of any protocol-related procedures that are not part of normal patient care.
- Willing and able to comply with scheduled visits, treatment schedule, laboratory tests, fresh tumor biopsies, and all other protocol requirements.
- At least 1 measurable disease lesion by computed tomography (CT) or magnetic resonance imaging (MRI) as defined by RECIST v1.1 performed within 1 week prior to first dose.
- Willing to undergo one pre-treatment core biopsy (unless archival tumor tissue is available within 3 months of first dose) and one on-treatment tumor biopsy, unless not safe or medically feasible. If the patient is unwilling to undergo biopsy, they may be eligible with approval of the medical monitor.
- Evaluable tumor tissue (archived [without time constraints] or new biopsy) must be provided for biomarker analysis, which will include PD-L1 expression level using immunohistochemistry (IHC) to measure specific PD-L1 signals in tumor-infiltrating immune cells (ICs). Results are not required prior to start of study treatment.
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- Eastern Cooperative Oncology Group (ECOG) performance status ≤1.
- Life expectancy ≥12 weeks.
- Baseline laboratory values must meet the following criteria within 14 days of the first dose:
- Adequate hematologic function, defined as white blood cell (WBC) count ≥2.0 × 109/L, absolute neutrophil count ≥1.5 × 109/L (without granulocyte colony-stimulating factor [GCSF] support within 2 weeks prior to Cycle 1, Day 1), lymphocyte count ≥0.5 × 109/L, hemoglobin ≥9.0 g/dL (patients may be transfused or receive erythropoietic treatment to meet this criterion), and platelet count ≥100 × 109/L (without transfusion within 2 weeks prior to Cycle 1, Day 1).
- Calculated creatinine clearance ≥30 mL/min.
- Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) <2.5 × upper limit of normal (ULN). ALT and AST ≤5 × ULN if documented liver metastasis. ALP ≤5 × ULN if documented bone or liver metastasis.
- Total bilirubin ≤1.25 × ULN (unless elevated due to Gilbert's syndrome who can have total bilirubin <3.0 mg/dL).
- International normalized ratio (INR) and activated partial thromboplastin time (aPTT) ≤1.5 × ULN. This applies to patients who are not receiving therapeutic anticoagulation; patients receiving therapeutic anticoagulation should be on a stable dose.
- Serum albumin >2.5 g/dL
- Women of childbearing potential (WOCBP) must have a negative serum or urine β human chorionic gonadotropin (βhCG) pregnancy test within 1 week before administration of study drug WOCBP is defined as any female who has ≥12 months of non-therapy induced amenorrhea or is surgically sterile.
- Women must not be breastfeeding.
- Willingness of male and female patients who are not surgically sterile or postmenopausal to use medically acceptable methods of birth control for the duration of study treatment, including 30 days after the last dose of IPI-549 and of nab-paclitaxel, or 6 months after the last dose of atezolizumab or bevacizumab, whichever is later. Male patients must refrain from donating sperm for these same periods. Male patients with a pregnant female partner must agree to remain abstinent or use a condom during the treatment period and for the duration of the pregnancy.
- Patients in Cohort A must meet the following additional criteria for inclusion:
- Women with metastatic or locally advanced (not amenable to resection with curative intent), histologically documented TNBC, i.e., absence of human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER) and progesterone receptor (PR) expression:
- HER2 negativity defined as either of the following by local laboratory assessment
- ER and PR negativity defined as <1% of cells expressing hormonal receptors via IHC analysis
- No prior chemotherapy or targeted systemic therapy for inoperable locally advanced or metastatic TNBC. Radiation therapy for metastatic disease is permitted. There is no required minimum washout period for radiation therapy. Patients should be recovered from the effects of radiation. Prior chemotherapy (including taxanes) in the neoadjuvant or adjuvant setting is allowable if treatment was completed ≥12 months prior to randomization.
- Patients in Cohort B must meet the following additional criteria for inclusion:
- Men or women with histologically documented unresectable advanced or metastatic RCC with clear-cell histology.
- No prior treatment with active or experimental systemic agents, including treatment in the neoadjuvant or adjuvant setting. Prior radiotherapy is permitted but must not have been administered within 14 days of Cycle 1, Day 1.
Who cannot join
- WOCBP who are pregnant or breastfeeding.
- Women with a positive pregnancy test at enrollment or prior to administration of study medication.
- Any serious or uncontrolled medical disorder that, in the opinion of the Investigator, may increase the risk associated with study participation or study drug administration, impair the ability of the patient to receive protocol therapy, or interfere with the interpretation of study results, including significant liver disease (such as cirrhosis, uncontrolled major seizure disorder, or superior vena cava syndrome).
- Any history of, or currently active, brain or leptomeningeal metastases.
- Significant cardiovascular disease, such as New York Heart Association (NYHA) cardiac disease (Class II or greater), myocardial infarction within 3 months prior to randomization, unstable arrhythmias, or unstable angina. Patients with a known left ventricular ejection fraction (LVEF) <40% will be excluded. Patients with known coronary artery disease, congestive heart failure not meeting the above criteria, or LVEF <50% must be on a stable medical regimen that is optimized in the opinion of the treating physician, in consultation with a cardiologist if appropriate.
- Baseline QT interval corrected with Fridericia's method (QTcF) >480 ms.
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- Major surgical procedure within 4 weeks prior to enrollment or anticipation of the need for a major surgical procedure during the course of the study other than for diagnosis. Placement of central venous access catheter(s) (e.g., port or similar) is not considered a major surgical procedure and is therefore permitted.
- Active tuberculosis.
- Ongoing systemic bacterial, fungal, or viral infections at Screening.
- Positive test for human immunodeficiency virus (HIV).
- Active hepatitis B (defined as having a positive hepatitis B surface antigen [HBsAg] test at screening) or hepatitis C. Patients with past hepatitis B virus (HBV) infection or resolved HBV infection (defined as having a negative HBsAg test and a positive antibody to hepatitis B core antigen [anti-HBc] antibody test) are eligible. Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV RNA.
- Dependence on continuous supplemental oxygen use.
- Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures (once monthly or more frequently). Patients with indwelling catheters (e.g., PleurX®) are allowed.
- Uncontrolled hypercalcemia (>1.5 mmol/L ionized calcium or calcium >12 mg/dL or corrected serum calcium >ULN) or symptomatic hypercalcemia requiring continued use of bisphosphonate therapy. Patients who are receiving denosumab must discontinue denosumab use and replace it with a bisphosphonate instead while on study. There is no required minimum washout period for denosumab. Patients who are receiving bisphosphonate therapy specifically to prevent skeletal events and who do not have a history of clinically significant hypercalcemia are eligible.
- Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells, or any of the study drug components.
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins.
- History of stroke, transient ischemic attack, or ventricular arrhythmia requiring medication or mechanical control within the last 6 months prior to Screening.
- Other prior malignancy active within the previous 5 years except for local or organ confined early stage cancer that has been definitively treated with curative intent, does not require ongoing treatment, has no evidence of residual active disease, and has a negligible risk of recurrence and is therefore unlikely to interfere with the primary and secondary endpoints of the study, including response rate and safety.
- History of autoimmune disease, including but not limited to myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener's granulomatosis, Sjögren's syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis.
- History of idiopathic pulmonary fibrosis (including pneumonitis), drug-induced pneumonitis, organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), or evidence of active pneumonitis on screening chest CT scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted.
- Past medical history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis which required steroid treatment, or any evidence of clinically active interstitial lung disease.
- Prior allogeneic stem cell or solid organ transplantation.
- Administration of a live or attenuated vaccine within 4 weeks of first dose of study drug or anticipation that such a live or attenuated vaccine will be required during the study or within 5 months following the last dose of atezolizumab.
- Prior therapy with experimental anti-tumor vaccines; any T cell co-stimulation or checkpoint pathways, such as anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-CTLA-4 antibody, including ipilimumab, or other medicines specifically targeting the T cell; or IPI-549.
- Treatment with systemic immunostimulatory agents (including but not limited to interferons or IL-2) within 4 weeks or 5 half-lives of the drug (whichever is shorter) prior to enrollment.
- Treatment with systemic corticosteroids or other systemic immunosuppressive medications (including but not limited to prednisone, dexamethasone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor [TNF] agents) within 2 weeks prior to randomization, or anticipated requirement for systemic immunosuppressive medications during the trial.
- Treatment with botanical preparations (e.g., herbal supplements or traditional Chinese medicines) intended for general health support or to treat the disease under study within 2 weeks prior to randomization.
- Administration of any of the following within 1 week prior to the administration of study drug:
- Strong inhibitors or inducers of cytochrome P450 (CYP) 3A4, including grapefruit, grapefruit juice and herbal supplements.
- Warfarin, phenytoin, or other substrates of CYP2C8 or CYP2C9 with a narrow therapeutic range.
- P-glycoprotein (P-gp) inhibitors.
- Prior surgery or gastrointestinal dysfunction that may affect drug absorption (e.g., gastric bypass surgery, gastrectomy).
- Patients in Cohort A are to be excluded from the study if they meet any of the following criteria:
- Spinal cord compression not definitively treated with surgery and/or radiation, or previously diagnosed and treated spinal cord compression without evidence that disease has been clinically stable for >2 weeks prior to first dose of study treatment.
- Uncontrolled tumor-related pain.
- Known hypersensitivity to nab-paclitaxel or to any of the excipients.
- Patients in Cohort B are to be excluded from the study if they meet any of the following criteria:
- Inadequately controlled hypertension (systolic blood pressure >150 mmHg and/or diastolic blood pressure >100 mmHg or prior history of hypertensive crisis or hypertensive encephalopathy.
- Significant vascular disease (e.g., aortic aneurysm requiring surgical repair or recent peripheral arterial thrombosis) within 6 months prior to Cycle 1, Day 1.
- Evidence of bleeding diathesis or clinically significant coagulopathy (in the absence of therapeutic anticoagulation).
- Current or recent (within 10 calendar days prior to Cycle 1, Day 1) use of dipyridamole, clopidogrel, or cilostazol.
- History of abdominal or tracheoesophageal fistula or gastrointestinal perforation within 5 months prior to Cycle 1, Day 1.
- Clinical signs or symptoms of gastrointestinal obstruction or requirement for routine parenteral hydration, parenteral nutrition, or tube feeding.
- Evidence of abdominal free air not explained by paracentesis or recent surgical procedure.
- Serious, non-healing or dehiscing wound, active ulcer, or untreated bone fracture.
- Proteinuria, as demonstrated by urine dipstick or >1.0 g of protein in a 24-hour urine collection. All patients with ≥2+ protein on dipstick urinalysis at baseline must undergo a 24-hour urine collection for protein.
Trial locations and contacts
24 sites in 1 country.
24 sites in 1 country
United States24 sites
University Cancer & Blood Center
Athens, Georgia, 30607
University of Colorado
Aurora, Colorado, 80045
University of Maryland
Baltimore, Maryland, 21201
Massachusetts General Hospital
Boston, Massachusetts, 02114
Ironwood Cancer and Research Center
Chandler, Arizona, 85224
Rush University Medical Center
Chicago, Illinois, 60612
Fort Wayne Medical Oncology and Hematology
Fort Wayne, Indiana, 46804
St. Joseph Heritage Healthcare
Fullerton, California, 92835
MD Anderson Cancer Center
Houston, Texas, 77030
Cancer & Blood Specialty Clinic
Los Alamitos, California, 90720
Norton Cancer Institute
Louisville, Kentucky, 40207
Tennessee Oncology
Nashville, Tennessee, 37203
Orlando Health
Orlando, Florida, 32806
Utah Cancer Specialists
Salt Lake City, Utah, 84106
Sharp Memorial Hospital
San Diego, California, 92123
Samsum Clinic
Santa Barbara, California, 93105
UCLA
Santa Monica, California, 90404
Olive View - UCLA Medical Center
Sylmar, California, 91342
Moffitt Cancer Center
Tampa, Florida, 33612
Arizona Oncology Associates
Tucson, Arizona, 85704
Arizona Clinical Research Center
Tucson, Arizona, 85715
UT Health East Texas HOPE Cancer Center
Tyler, Texas, 75701
Valley Breast Cancer Care and Women's Health Center
Van Nuys, California, 15211
Cancer Center of Kansas
Wichita, Kansas, 67214
About this study
Official title: Ph 2, Multi-arm, Multicenter, Open-label Study to Evaluate Efficacy and Safety of IPI-549 Administered in Combo With Front-line Treatment Regimens in Pts With Locally Advanced and/or Metastatic Triple-Negative Breast Cancer or Renal Cell Carcinoma
MARIO-3 is a Phase 2 multi-arm combination cohort study designed to evaluate IPI-549, Infinity Pharmaceutical's first-in-class, oral immuno-oncology product candidate targeting immune-suppressive tumor-associated myeloid cells through selective inhibition of phosphoinositide-3-kinase (PI3K)-gamma, in combinations with Tecentriq and Abraxane (nab-paclitaxel) in front-line triple negative breast cancer (TNBC) and in combination with Tecentriq and Avastin (bevacizumab) in front-line renal cell cancer (RCC).
Read the detailed description
MARIO-3 (Macrophage Reprogramming in Immuno-Oncology) is a prospective Phase 2 multi-arm, multicenter, open-label, combination cohort study designed to evaluate IPI-549, Infinity Pharmaceutical's first-in-class, oral immuno-oncology product candidate targeting immune-suppressive tumor-associated myeloid cells through selective inhibition of phosphoinositide-3-kinase (PI3K)-gamma. IPI-549 will be administered in combinations with Tecentriq and Abraxane (nab-paclitaxel) in front-line triple negative breast cancer (TNBC) and in combination with Tecentriq and Avastin (bevacizumab) in front-line renal cell cancer (RCC).
This study will enroll approximately 90 treatment-naïve patients across the following disease cohorts. Cohort A will be composed of patients with locally advanced and/or metastatic triple-negative breast cancer (TNBC). Cohort B will be composed of patients with locally advanced and/or metastatic renal cell carcinoma (RCC).
The primary objective of MARIO-3 is to evaluate the complete response (CR) rate per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 following combination treatment with IPI-549 and front-line treatment in patients with TNBC and RCC. Its secondary objectives include evaluation of the safety, objective response rate (ORR), time to CR (TTCR), time to response (TTR), duration of CR (DOCR), duration of response (DOR), and progression-free survival (PFS).
- Conditions
- Breast Cancer, Renal Cell Carcinoma
- Being tested
- IPI-549 (eganelisib), Atezolizumab, nab-paclitaxel, Bevacizumab
- Keywords
- Phase 2, PI3K, IPI-549, Advanced Solid Tumor, Triple Negative Breast Cancer (TNBC), Renal Cell Carcinoma (RCC), PD-L1, Myeloid-Derived Suppressor Cells (MDSCs), Front-Line Treatment, eganelisib
- Medical subject headings
- Breast Neoplasms, Carcinoma, Renal Cell, Triple Negative Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
IPI-549 (eganelisib)Drug
IPI-549 is an oral, selective inhibitor of phosphoinositide-3-kinase gamma (PI3K-gamma). It is an orally-administered capsule that will be dosed at either 20mg/day, 30mg/day, or 40mg/day to patients in both cohorts A and B depending on the results of the safety run-in phase for each cohort.
AtezolizumabDrug
Also called Tecentriq
Atezolizumab is a fully humanized, engineered monoclonal antibody of IgG1 isotype against the protein programmed cell death-ligand 1 (PD-L1). 840 mg of the drug will be administered intravenously (IV) on days 1 and 15 in combination of each 28-day cycle for patients with TNBC. 1200mg will be administered IV on day 1 of each 21-day cycle to patients with RCC.
nab-paclitaxelDrug
Also called Abraxane
Nab-paclitaxel is a nanoparticle albumin-bound formulation of paclitaxel (Taxol), a mitotic inhibitor chemotherapy, with less toxicity than solvent-based (sb) paclitaxel and achieves a 33% higher tumor uptake in preclinical models. Nab-paclitaxel will be administered intravenously (IV) at 100 mg/m2 on days 1, 8 and 15 of each 28-day cycle for patients with TNBC.
BevacizumabDrug
Also called Avastin
Bevacizumab is an anti-vascular endothelial growth factor (anti-VEGF) recombinant monoclonal antibody that is approved by the FDA for the treatment of multiple solid tumors in combination with chemotherapy. It will be administered at 15 mg/kg IV on day 1 of each 21-day cycle to patients with RCC.
| Study group | Role | What they receive |
|---|---|---|
| Cohort A (TNBC) | Experimental | IPI-549 in combination with front-line treatment. Cohort A will include two sub-cohorts: Cohorts A1 and A2.
Cohort A1: Approximately 30 patients with locally advanced and/or metastatic TNBC with programmed death-ligand 1 (PDL1) positive disease based on immunohistochemistry (IHC) defined as IC1/2/3.
Cohort A2: Approximately 30 patients with locally advanced and/or metastatic TNBC with PDL1 negative disease based on IHC defined as IC0. Receives: Drug: IPI-549 (eganelisib); Drug: Atezolizumab; Drug: nab-paclitaxel |
| Cohort B (RCC) | Experimental | IPI-549 in combination with front-line treatment. Cohort B will include two sub-cohorts: Cohorts B1 and B2.
Cohort B1: Approximately 15 patients with locally advanced and/or metastatic RCC, with PDL1 positive disease based on IHC defined as IC1/2/3.
Cohort B2: Approximately 15 patients with locally advanced and/or metastatic RCC, with PDL1 negative disease based on IHC defined as IC0. Receives: Drug: IPI-549 (eganelisib); Drug: Atezolizumab; Drug: Bevacizumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Complete Response (CR) rate (change in target lesion size).
Complete Response (CR) rate is defined per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 as disappearance of all target and non-target lesions.
Measured: CR rate assessments will be conducted through month 12 for Cohort A (TNBC) and through month 18 for Cohort B (RCC) until unacceptable toxicity, confirmed progression of disease, withdrawal of consent, or other treatment discontinuation criteria are met.
Secondary outcomes (16)
Incidence of treatment-emergent adverse events (TEAEs)
Treatment emergent adverse events (TEAE) are undesirable events not present prior to medical treatment, or an already present event that worsens either in intensity or frequency following the treatment.
Measured: TEAE assessments will be conducted from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC). Additional assessments will be conducted 30 days and 90 days from last dose.
Incidence of serious adverse events (SAEs), including deaths
Serious adverse events include death, life-threatening events, initial or prolonged hospitalization, disability or permanent damage, or require an intervention to prevent impairment.
Measured: SAE assessments will be conducted from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC). Additional assessments will be conducted 30 days and 90 days from last dose.
Incidence of adverse events (AEs) leading to treatment discontinuation
An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An adverse event (AE) can therefore be any unfavourable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.
Measured: AE assessments will be conducted from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC). Additional assessments will be conducted 30 days and 90 days from last dose.
Changes from baseline in electrocardiograms (ECGs)
ECGs assess heart problems by measuring the electrical activity generated by the heart as it contracts. The components that will be assessed during the ECG are P wave, QRS complex, ST segment, and T wave.
Measured: ECG assessments will be performed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Objective response rate (ORR)
ORR is defined as best response of CR or partial response (PR), as determined by RECIST v1.1.
Measured: ORR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Time to Complete Remission (TTCR)
TTCR is defined as the time from the first dose of study treatment to CR.
Measured: TTCR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Time to response (TTR)
TTR is defined as the time from the first dose of study treatment to first objective response (CR or PR) in patients with CR or PR.
Measured: TTR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Duration of Complete Remission (DOCR)
DOCR is defined as the time from the first CR to documented disease progression in patients with CR.
Measured: DOCR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Duration of response (DOR)
DOR is defined as the time from the first objective response (CR or PR) to documented disease progression in patients with CR or PR.
Measured: DOR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Progression-free survival (PFS)
PFS is defined as the time from the first dose of study treatment to documented disease progression or death due to any cause.
Measured: PFS will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Population Pharmacokinetics (PK) of IPI-549
Population PK estimates (variability in drug concentrations within the study population measured in ng/mL) includes inter- and intra-subject variability and covariate effects.
Measured: PK assessments will be performed on day 1 of each 28-day cycle through cycle 2 for cohort A (TNBC) at and on day 1 of each 21-day cycle through cycle 2 for cohort B (RCC).
Pharmacokinetics (PK) of Atezolizumab
Concentration of Atezolizumab in the blood at predose measured in ug/mL.
Measured: PK assessments will be performed on day 1 of cycle 1, on day 1 of cycles 2 through 4, C8D1, C16D1 for both cohorts. Cohort A (TNBC) has a 28-day cycle and cohort B (RCC) has a 21-day cycle.
Changes from baseline in pulse rate
Pulse rate as measured in beats per minute (bpm).
Measured: Pulse rate will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Changes from baseline in temperature
Temperature as measured in celsius.
Measured: Temperature will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Changes from baseline in respiration rate
Respiration rate as measured in breaths per minute.
Measured: Respiration rate will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Changes from baseline in blood pressure
Systolic and diastolic blood pressure as measured in mmHg.
Measured: Blood pressure will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 May 2019
- Study start17 Dec 2019
- Primary completion31 Aug 2023 (estimated)
- Study completion31 Aug 2023 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Model description
- Participants are assigned to one of two or more groups in parallel for the duration of the study.
- Masking
- None (open label)
- Enrolment
- 91 participants (actual)
Sponsor and investigators
- Lead sponsor
- Infinity Pharmaceuticals, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Roche Pharma AG
- Responsible party
- Sponsor
- Investigators
- Feng Chi, PhD, RN, Study director, Medical Lead
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03961698
- Sponsor's protocol ID
- IPI-549-03
- Acronym
- MARIO-3
- Status last verified
- Aug 2023
- First submitted
- 8 Apr 2019
- Last updated
- 14 Aug 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 Aug 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ph 2, Multi-arm, Multicenter, Open-label Study to Evaluate Efficacy and Safety of IPI-549 Administered in Combo With Front-line Treatment Regimens in Pts With Locally Advanced and/or Metastatic Triple-Negative Breast Cancer or Renal Cell Carcinoma
- ClinicalTrials.gov ID
- NCT03961698
- Acronym / sponsor ID
- MARIO-3 / IPI-549-03
- Conditions
- Breast Cancer, Renal Cell Carcinoma
- Keywords
- Phase 2, PI3K, IPI-549, Advanced Solid Tumor, Triple Negative Breast Cancer (TNBC), Renal Cell Carcinoma (RCC), PD-L1, Myeloid-Derived Suppressor Cells (MDSCs)
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 91 participants (actual)
- Lead sponsor
- Infinity Pharmaceuticals, Inc.Industry (pharma, biotech, devices)
- Collaborators
- Roche Pharma AG
- Study start
- 17 Dec 2019 (actual)
- Primary completion
- 31 Aug 2023 (estimated)
- Study completion
- 31 Aug 2023 (estimated)
- First posted
- 23 May 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
MARIO-3 is a Phase 2 multi-arm combination cohort study designed to evaluate IPI-549, Infinity Pharmaceutical's first-in-class, oral immuno-oncology product candidate targeting immune-suppressive tumor-associated myeloid cells through selective inhibition of phosphoinositide-3-kinase (PI3K)-gamma, in combinations with Tecentriq and Abraxane (nab-paclitaxel) in front-line triple negative breast cancer (TNBC) and in combination with Tecentriq and Avastin (bevacizumab) in front-line renal cell cancer (RCC).
Detailed description
MARIO-3 (Macrophage Reprogramming in Immuno-Oncology) is a prospective Phase 2 multi-arm, multicenter, open-label, combination cohort study designed to evaluate IPI-549, Infinity Pharmaceutical's first-in-class, oral immuno-oncology product candidate targeting immune-suppressive tumor-associated myeloid cells through selective inhibition of phosphoinositide-3-kinase (PI3K)-gamma. IPI-549 will be administered in combinations with Tecentriq and Abraxane (nab-paclitaxel) in front-line triple negative breast cancer (TNBC) and in combination with Tecentriq and Avastin (bevacizumab) in front-line renal cell cancer (RCC).
This study will enroll approximately 90 treatment-naïve patients across the following disease cohorts. Cohort A will be composed of patients with locally advanced and/or metastatic triple-negative breast cancer (TNBC). Cohort B will be composed of patients with locally advanced and/or metastatic renal cell carcinoma (RCC).
The primary objective of MARIO-3 is to evaluate the complete response (CR) rate per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 following combination treatment with IPI-549 and front-line treatment in patients with TNBC and RCC. Its secondary objectives include evaluation of the safety, objective response rate (ORR), time to CR (TTCR), time to response (TTR), duration of CR (DOCR), duration of response (DOR), and progression-free survival (PFS).
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Participants are assigned to one of two or more groups in parallel for the duration of the study.
| Arm | Type | Receives |
|---|---|---|
| Cohort A (TNBC) | Experimental | Drug: IPI-549 (eganelisib), Drug: Atezolizumab, Drug: nab-paclitaxelIPI-549 in combination with front-line treatment. Cohort A will include two sub-cohorts: Cohorts A1 and A2. Cohort A1: Approximately 30 patients with locally advanced and/or metastatic TNBC with programmed death-ligand 1 (PDL1) positive disease based on immunohistochemistry (IHC) defined as IC1/2/3. Cohort A2: Approximately 30 patients with locally advanced and/or metastatic TNBC with PDL1 negative disease based on IHC defined as IC0. |
| Cohort B (RCC) | Experimental | Drug: IPI-549 (eganelisib), Drug: Atezolizumab, Drug: BevacizumabIPI-549 in combination with front-line treatment. Cohort B will include two sub-cohorts: Cohorts B1 and B2. Cohort B1: Approximately 15 patients with locally advanced and/or metastatic RCC, with PDL1 positive disease based on IHC defined as IC1/2/3. Cohort B2: Approximately 15 patients with locally advanced and/or metastatic RCC, with PDL1 negative disease based on IHC defined as IC0. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (26 listed)
- ≥18 years of age.
- Have signed and dated an independent review board (IRB)/independent ethics committee (IEC) approved informed consent form (ICF) in accordance with regulatory and institutional guidelines. This must be obtained before the performance of any protocol-related procedures that are not part of normal patient care.
- Willing and able to comply with scheduled visits, treatment schedule, laboratory tests, fresh tumor biopsies, and all other protocol requirements.
- At least 1 measurable disease lesion by computed tomography (CT) or magnetic resonance imaging (MRI) as defined by RECIST v1.1 performed within 1 week prior to first dose.
- Willing to undergo one pre-treatment core biopsy (unless archival tumor tissue is available within 3 months of first dose) and one on-treatment tumor biopsy, unless not safe or medically feasible. If the patient is unwilling to undergo biopsy, they may be eligible with approval of the medical monitor.
Key exclusion criteria (46 listed)
- WOCBP who are pregnant or breastfeeding.
- Women with a positive pregnancy test at enrollment or prior to administration of study medication.
- Any serious or uncontrolled medical disorder that, in the opinion of the Investigator, may increase the risk associated with study participation or study drug administration, impair the ability of the patient to receive protocol therapy, or interfere with the interpretation of study results, including significant liver disease (such as cirrhosis, uncontrolled major seizure disorder, or superior vena cava syndrome).
- Any history of, or currently active, brain or leptomeningeal metastases.
- Significant cardiovascular disease, such as New York Heart Association (NYHA) cardiac disease (Class II or greater), myocardial infarction within 3 months prior to randomization, unstable arrhythmias, or unstable angina. Patients with a known left ventricular ejection fraction (LVEF) <40% will be excluded. Patients with known coronary artery disease, congestive heart failure not meeting the above criteria, or LVEF <50% must be on a stable medical regimen that is optimized in the opinion of the treating physician, in consultation with a cardiologist if appropriate.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| IPI-549 (eganelisib)IPI-549 is an oral, selective inhibitor of phosphoinositide-3-kinase gamma (PI3K-gamma). It is an orally-administered capsule that will be dosed at either 20mg/day, 30mg/day, or 40mg/day to patients in both cohorts A and B depending on the results of the safety run-in phase for each cohort. | Drug | Cohort A (TNBC), Cohort B (RCC) |
| AtezolizumabAlso: TecentriqAtezolizumab is a fully humanized, engineered monoclonal antibody of IgG1 isotype against the protein programmed cell death-ligand 1 (PD-L1). 840 mg of the drug will be administered intravenously (IV) on days 1 and 15 in combination of each 28-day cycle for patients with TNBC. 1200mg will be administered IV on day 1 of each 21-day cycle to patients with RCC. | Drug | Cohort A (TNBC), Cohort B (RCC) |
| nab-paclitaxelAlso: AbraxaneNab-paclitaxel is a nanoparticle albumin-bound formulation of paclitaxel (Taxol), a mitotic inhibitor chemotherapy, with less toxicity than solvent-based (sb) paclitaxel and achieves a 33% higher tumor uptake in preclinical models. Nab-paclitaxel will be administered intravenously (IV) at 100 mg/m2 on days 1, 8 and 15 of each 28-day cycle for patients with TNBC. | Drug | Cohort A (TNBC) |
| BevacizumabAlso: AvastinBevacizumab is an anti-vascular endothelial growth factor (anti-VEGF) recombinant monoclonal antibody that is approved by the FDA for the treatment of multiple solid tumors in combination with chemotherapy. It will be administered at 15 mg/kg IV on day 1 of each 21-day cycle to patients with RCC. | Drug | Cohort B (RCC) |
Primary outcome
Complete Response (CR) rate (change in target lesion size).
Time frame: CR rate assessments will be conducted through month 12 for Cohort A (TNBC) and through month 18 for Cohort B (RCC) until unacceptable toxicity, confirmed progression of disease, withdrawal of consent, or other treatment discontinuation criteria are met.
Complete Response (CR) rate is defined per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 as disappearance of all target and non-target lesions.
16 secondary outcomes
Incidence of treatment-emergent adverse events (TEAEs)
Time frame: TEAE assessments will be conducted from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC). Additional assessments will be conducted 30 days and 90 days from last dose.
Incidence of serious adverse events (SAEs), including deaths
Time frame: SAE assessments will be conducted from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC). Additional assessments will be conducted 30 days and 90 days from last dose.
Incidence of adverse events (AEs) leading to treatment discontinuation
Time frame: AE assessments will be conducted from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC). Additional assessments will be conducted 30 days and 90 days from last dose.
Changes from baseline in electrocardiograms (ECGs)
Time frame: ECG assessments will be performed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Objective response rate (ORR)
Time frame: ORR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Time to Complete Remission (TTCR)
Time frame: TTCR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Time to response (TTR)
Time frame: TTR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Duration of Complete Remission (DOCR)
Time frame: DOCR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Duration of response (DOR)
Time frame: DOR will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Progression-free survival (PFS)
Time frame: PFS will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Population Pharmacokinetics (PK) of IPI-549
Time frame: PK assessments will be performed on day 1 of each 28-day cycle through cycle 2 for cohort A (TNBC) at and on day 1 of each 21-day cycle through cycle 2 for cohort B (RCC).
Pharmacokinetics (PK) of Atezolizumab
Time frame: PK assessments will be performed on day 1 of cycle 1, on day 1 of cycles 2 through 4, C8D1, C16D1 for both cohorts. Cohort A (TNBC) has a 28-day cycle and cohort B (RCC) has a 21-day cycle.
Changes from baseline in pulse rate
Time frame: Pulse rate will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Changes from baseline in temperature
Time frame: Temperature will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Changes from baseline in respiration rate
Time frame: Respiration rate will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Changes from baseline in blood pressure
Time frame: Blood pressure will be assessed from screening through month 12 for Cohort A (TNBC) and from screening through month 18 for Cohort B (RCC).
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Aug 2023.
- IPI-549Link provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Feng Chi, PhD, RN study director
Medical Lead
24 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing IPI-549 (eganelisib), Atezolizumab and nab-paclitaxel in people with Breast Cancer and Renal Cell Carcinoma, run by Infinity Pharmaceuticals, Inc. at 24 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 26 inclusion and 46 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 14 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 24 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Complete Response (CR) rate (change in target lesion size). (time frame: CR rate assessments will be conducted through month 12 for Cohort A (TNBC) and through month 18 for Cohort B (RCC) until unacceptable toxicity, confirmed progression of disease, withdrawal of consent, or other treatment discontinuation criteria are met.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Aug 2023.