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Metastatic Prostate CancerPhase 1/2NCT06782555

A Study of Evofosfamide in Combination With Zalifrelimab and Balstilimab

A Phase 1/2 study testing Evofosfamide, Zalifrelimab and Balstilimab in people with Metastatic Prostate Cancer and Metastatic Head and Neck Squamous Cell Carcinoma, run by ImmunoGenesis at 1 site in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The purpose of this Phase 1/2 study is to test the overall safety, tolerability, and effectiveness of the combination investigational drugs evofosfamide, zalifrelimab, and balstilimab in treating advanced or metastatic castration-resistant prostate cancer, pancreatic cancer, and human papilloma virus (HPV)-negative… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Evofosfamide, Zalifrelimab and Balstilimab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
71 participants
Where
1 siteUnited States
Study dates
8 Jan 2025to Jan 2028
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

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

  • Histologically confirmed locally advanced or metastatic castration-resistant prostate cancer, pancreatic cancer, or HPV-negative SCCHN for which no other lines of standard therapy with demonstrated clinical benefit are available or appropriate as treatment.
  • Appropriate to enter a clinical trial with a minimum estimated life expectancy of at least 3 months.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
  • Measurable disease as defined by RECIST 1.1. Patients with castration-resistant prostate cancer can have measurable or evaluable disease per PCWG3 criteria. Patients with evaluable disease must have documented evidence of PD as defined by any of the following:
  • PSA progression: minimum of 2 rising values (3 measurements) obtained a minimum of 7 days apart with the last result being at least ≥4.0 ng/mL.
  • New or increasing non-bone disease per RECIST 1.1 criteria.
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  • Positive bone scan with 2 or more new lesions (PCWG3).
  • Adequate bone marrow function as defined by the following laboratory test results obtained within 7 days of Cycle 1 Day 1:
  • White blood cell count ≥2500 cells/mm3.
  • Absolute neutrophil count ≥1500 cells/mm3.
  • Absolute lymphocyte count >500 cells/mm3.
  • Hemoglobin ≥9 g/dL.
  • Platelets ≥75,000 cells/mm3.
  • Adequate liver function as defined by the following laboratory test results obtained within 7 days of Cycle 1 Day 1:
  • Bilirubin ≤1.5 × institutional ULN; for patients with known Gilbert's syndrome, ≤3 × institutional ULN.
  • Aspartate aminotransferase (SGOT) and alanine aminotransferase (SGPT) ≤3 × institutional ULN; if liver metastases are present, then ≤5 × ULN is allowed.
  • At least 3 weeks from previous cytotoxic chemotherapy or radiation therapy and at least 5 half-lives or 6 weeks, whichever is shorter, from targeted or biologic therapy with the exception of CTLA-4, PD-1, or PD-L1 blocking antibodies for which only a 2 week interval is required. Patients with prostate cancer, unless they have undergone prior orchiectomy, may continue to receive androgen deprivation therapy, anti-androgen therapy, or therapy that interferes with androgenic stimulation.
  • All patients must be willing to undergo a biopsy to provide a new tumor sample within 14 days of Cycle 1 Day 1. Patients who are unable to undergo a biopsy at screening must submit archival tumor tissue retrieved within the last 6 calendar months. Patients must also consent to undergo a biopsy between Day 15 of Cycle 2 and Day 8 of Cycle 3 in those subjects which it is clinically safe and attainable. A biopsy is not required for participants with metastatic prostate cancer with bone-only disease or inaccessible soft tissue lesions.
  • Calculated creatinine clearance ≥ 60 mL/min (by the Cockcroft Gault formula) within 7 days of Cycle 1 Day 1

Who cannot join

  • A history of currently active/uncontrolled autoimmune diseases or disorders, including inflammatory bowel disease (including Crohn's disease and ulcerative colitis), rheumatoid arthritis, systemic sclerosis (scleroderma), systemic lupus erythematosus, or autoimmune vasculitis (eg, Wegener's granulomatosis).
  • Patients with prior history of any Grade 3 or Grade 4 AEs from anti-CTLA-4, anti-PD-1/PD-L1, or anti-CTLA-4 and anti-PD-1/PD-L-1 combination therapy.
  • History of acute diverticulitis, intra-abdominal abscess, gastrointestinal obstruction, abdominal carcinomatosis, or other known risk factors for bowel perforation.
  • Patients on long-term systemic steroids (>10 mg daily prednisone equivalent initiated >2 weeks prior to study enrollment). Inhaled or topical steroids are permitted in the absence of active autoimmune disease.
  • Any underlying medical or psychiatric condition, which in the opinion of the investigator, will make the administration of study treatment hazardous or obscure the interpretation of AEs, e.g., a condition associated with frequent diarrhea or chronic skin conditions, recent surgery (within 30 days) or colonic biopsy from which the patient has not recovered, partial endocrine organ deficiencies, or substance abuse.
  • Concomitant use of QT-prolonging drugs with a risk of causing Torsades de Pointes (TdP).
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  • History of risk factors for TdP, including family history of long QT syndrome.
  • Corrected QT (QTc) interval of ≥470 msec calculated according to Fridericia's formula (QTc=QT/RR [0.33]).
  • Sustained systolic blood pressure (BP) >140 mmHg or <90 mmHg and sustained diastolic BP >100 mmHg or <60 mmHg.
  • Patients with newly diagnosed, uncontrolled and/or untreated cancer-related central nervous system disease. Patients with treated brain metastases that are radiographically or clinically stable for at least 2 weeks after therapy and have no evidence of cavitation or hemorrhage in the brain lesion(s) are eligible if they are asymptomatic and do not require corticosteroids (must have discontinued steroids at least 1 week prior to study enrollment).
  • Uncontrolled intercurrent illness including, but not limited to, myocardial infarction within 6 months, unstable symptomatic ischemic heart disease, significant cardiac arrythmias, active uncontrolled infection requiring systemic therapy, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Major surgical procedure, open biopsy, or significant traumatic injury within 4 weeks prior to study enrollment.
  • Current evidence of active and uncontrolled infection, New York Heart Association Class III-IV chronic heart failure, documented Child's class B and C cirrhosis, active symptomatic pancreatitis, or uncontrolled medical disease which, in the opinion of the investigator, could compromise assessment of study treatment efficacy.
  • Active human immunodeficiency virus infection (Exception: patients with well-controlled HIV [e.g., CD4 ≥ 350 cells/uL and undetectable viral load] who have been on an effective (drug, dosage, and schedule associated with reduction and control of the viral load) antiretroviral therapy (ART) for ≥ 4 weeks are eligible). Patients with a history of acquired immunodeficiency syndrome (AIDS)-defining opportunistic infections in the last 12 months are not eligible. Note: Drug-drug interactions with ART occur via many mechanisms, with cytochrome P450 CYP3A4-mediated interactions being the most common. Patients who are using concurrent strong or moderate CYP3A4 inhibitors (e.g., ritonavir, cobicistat) or strong or moderate CYP3A4 inducers must be switched to an alternate effective ART regimen ≥ 4 weeks before study enrollment or should be excluded from the study if their regimen cannot be altered.
  • Active or chronic hepatitis B or C virus infection. Patients with a history of HCV infection must have completed curative antiviral treatment and must have a viral load below the limit of quantification. A patient who is HCV Ab positive but HCV RNA negative due to prior treatment or natural resolution is eligible.
  • Known hypersensitivity to any components of the study treatment or any of their excipients or analogs or drugs of similar chemical or biologic composition.
  • Live vaccine within 4 weeks prior to study enrollment.
  • Concomitant therapy with interleukin-2, interferon, or other non-study immunotherapy agents, or immunosuppressive agents.
  • Concomitant use of strong or moderate inhibitors or strong or moderate inducers of CYP3A4 within 14 days or 5 half-lives (whichever is longer) prior to study enrollment and for the duration of study treatment.
  • Concomitant use of anti-cancer chemotherapy, radiotherapy, hormone therapy, or targeted therapy. Patients with prostate cancer may continue treatment with anti-androgen and bone targeted therapies (e.g., zoledronic acid and denosumab). Palliative radiotherapy to nontarget lesions is permitted.

Trial locations and contacts

1 site in 1 country.

United States1 site

  • MD Anderson Cancer Center

    Houston, Texas, 77030

Other trials in United States

About this study

Official title: A Phase 1/2 Immunotherapy Study of Evofosfamide in Combination With Zalifrelimab and Balstilimab in Patients With Advanced Solid Malignancies

The purpose of this Phase 1/2 study is to test the overall safety, tolerability, and effectiveness of the combination investigational drugs evofosfamide, zalifrelimab, and balstilimab in treating advanced or metastatic castration-resistant prostate cancer, pancreatic cancer, and human papilloma virus (HPV)-negative squamous cell carcinoma of the head and neck (SCCHN).

Read the detailed description

Tumor hypoxia can lead to poor effector T-cell penetration and immunosuppressive signaling via myeloid-derived suppressor cells, myofibroblasts, and regulatory T-cells. Disruption of these hypoxic regions within the tumor microenvironment by the hypoxia-directed cytotoxic agent evofosfamide may enhance the ability of immune checkpoint inhibitors to reject otherwise resistant solid tumors. The hypothesis tested in this study is that evofosfamide, by specifically targeting the hypoxic tumor microenvironment, may enhance the anti-tumor effects of the immune checkpoint inhibitors zalifrelimab (anti-CTLA-4) and balstilimab (anti-PD-1) in select tumors that are generally resistant to therapy.

In the Phase 1 dose escalation part of the study, the maximum tolerated dose (or maximum allowable dose) of evofosfamide in combination with zalifrelimab and balstilimab will be determined. A recommended Phase 2 dose (RP2D) will be determined based on safety and the totality of data.

The Phase 2 dose expansion part of the study will evaluate the Phase 2 dose of the triplet combination in 3 cohorts: 1) patients with locally advanced or metastatic castration-resistant prostate cancer; 2) patients with locally advanced or metastatic pancreatic cancer; and 3) patients with locally advanced or metastatic HPV-negative SCCHN. Each cohort expansion will be carried out independently.

Being tested
Evofosfamide, Zalifrelimab, Balstilimab
Medical subject headings
Prostatic Neoplasms, Squamous Cell Carcinoma of Head and Neck, Pancreatic Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • EvofosfamideDrug

    Evofosfamide administered on Days 1 and 8 of Cycles 1, 2, and 3.

  • ZalifrelimabDrug

    Zalifrelimab administered on Day 8 of Cycles 1, 3, and 5.

  • BalstilimabDrug

    Balstilimab administered every 2 weeks beginning on Day 8 of Cycle 1.

Study groups in NCT06782555
Study groupRoleWhat they receive
Castration-resistant prostate cancerExperimentalEvofosfamide + zalifrelimab + balstilimab
Receives: Drug: Evofosfamide; Drug: Zalifrelimab; Drug: Balstilimab
Pancreatic cancerExperimentalEvofosfamide + zalifrelimab + balstilimab
Receives: Drug: Evofosfamide; Drug: Zalifrelimab; Drug: Balstilimab
Human papilloma virus-negative squamous cell carcinoma of the head and neckExperimentalEvofosfamide + zalifrelimab + balstilimab
Receives: Drug: Evofosfamide; Drug: Zalifrelimab; Drug: Balstilimab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence and severity of adverse events including dose-limiting toxicities

    Measured: 12 months

Secondary outcomes (9)

  1. Serious adverse events, discontinuations, and deaths

    Measured: 12 months

  2. Progression-free survival per RECIST 1.1 and iRECIST

    Measured: 12 months

  3. Objective response rate per RECIST 1.1 and iRECIST criteria (or PCWG3/RECIST for prostate cancer)

    Measured: 12 months

  4. Duration of response per RECIST 1.1 and iRECIST

    Measured: 12 months

  5. Overall survival

    Measured: 12 months

  6. Pharmacokinetic parameters including area under the concentration-time curve (AUC) for evofosfamide, Br-IPM, balstilimab, and zalifrelimab

    Measured: 12 months

  7. Pharmacokinetic parameters including Cmax for evofosfamide, Br-IPM, balstilimab, and zalifrelimab

    Measured: 12 months

  8. Pharmacokinetic parameters including t1/2 for evofosfamide, Br-IPM, balstilimab, and zalifrelimab

    Measured: 12 months

  9. Detection of anti-drug antibodies of zalifrelimab and balstilimab

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Jan 2025
  2. Study start8 Jan 2025
  3. Primary completionOct 2027 (estimated)
  4. Study completionJan 2028 (estimated)

Resources

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 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
71 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06782555
Sponsor's protocol ID
EVO-011
Status last verified
Nov 2026
First submitted
9 Jan 2025
Last updated
4 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided: Availability of this study's data will later be determined according to ImmunoGenesis commitment to the EFPIA/PhRMA "Principles for responsible clinical trial data sharing". This pertains to scope, timepoint and process of data access. As such, ImmunoGenesis commits to sharing upon request from qualified researchers patient-level clinical trial data, study-level clinical trial data, and protocols from clinical trials in patients for medicines and indications approved in the US and EU as necessary for conducting legitimate research. Interested researchers should contact ImmunoGenesis patient-level data and supporting documents from clinical studies to conduct research.

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Evofosfamide, Zalifrelimab and Balstilimab in people with Metastatic Prostate Cancer and Metastatic Head and Neck Squamous Cell Carcinoma, run by ImmunoGenesis at 1 site 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 19 inclusion and 20 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: under way, not looking for participants, as of the sponsor's last update on 4 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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 combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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?

This study is still under way. Results are not available in the source record yet.

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?

Incidence and severity of adverse events including dose-limiting toxicities (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06782555.

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 4 Nov 2026.

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