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Also known as etirinotecan pegol, Pegylated Irinotecan, PEG-irinotecan
NKTR-102 · 10 trials · 19 indications
To compare Overall Survival (OS) of patients who receive 145 mg/m2 NKTR-102 given once every 21 days (q21d) with OS of patients who receive Treatment of Physician's Choice (TPC). Overall survival is defined as the time from the date of randomization to the date of death from any cause. Patients will be followed until their date of death or until final database closure. Patients who are lost-to-follow-up or are alive at the time of analysis will be censored at the time they were last known to be alive or at the date of event cut-off for OS analysis.
Duration of OS was defined as the time from the date of randomisation to the date of death due to any cause. Subjects were followed until their date of death, loss to follow-up, withdrawal of consent for further follow-up for survival, or final database closure. OS was determined using the ITT population which included all subjects randomized into 1 of the 2 treatment arms. Subjects who were lost-to-follow-up or were not known to have died were censored at last date they were shown to be alive. Subjects who did not have any follow-up since the date of randomization were censored at the date of randomization.
The distribution of time to disease progression will be estimated in each group using the method of Kaplan-Meier at 18 weeks.
Will be described using Kaplan-Meier estimates. The PFS probability at 6 weeks (PFS-6week) will be estimated with an 80% power and 95% confidence intervals (80% in accord with the planned alpha level, 95% for comparability with other studies, confidence intervals based on the Greenwood formula for the variance of a survival probability).
Central nervous system (CNS) disease control (DC) is defined as a complete response (CR); partial response (PR); or stable disease (SD). The outcome is reported as the number and percentage of participants who achieve DC, a number without dispersion. Response criteria are as follows. Note that any lesion less than 10 mm in longest diameter (LD) is considered unchanged unless there is a ≥ 3 mm change in the sum of the LDs. * CR = Disappearance of all target lesions, sustained for ≥ 4 weeks with no new lesions; clinical condition stable or improved * PR = ≥ 30% decrease in target lesion LD and no new lesions, sustained for ≥ 4 weeks; clinical condition stable or improved * PD (progressive disease) = Any of 20% increase in target lesion LD; increase in T2/FLAIR non-enhancing lesions; any new lesions; non-target progression; or clinical deterioration * SD = Neither PR or PD
To provide access to NKTR-102 to subjects who previously received NKTR-102 in a clinical trial and were without signs of disease progression since receiving NKTR-102.
PFS was defined as the time from the date of randomisation to the date of disease progression (assessed by central radiological review according to Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1) or death due to any cause, whichever comes first. PFS was determined using the intention-to-treat (ITT) population which included all randomized patients who underwent baseline evaluation, with treatment assigned according to randomized arm. For patients whose disease did not progress or who did not die, the PFS time was censored at the time of the last tumor assessment that demonstrated lack of disease progression. For patients who received new anti-cancer therapy, the PFS time was censored at the time of last tumor assessment prior to the new anti-cancer therapy starts.
Per Response Evaluation Criteria In Solid Tumors (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), at least a 30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
Number of patients with Dose Limiting Toxicities
10 pre-dose and 18 post-dose ECG measurements to evaluate the effect of NKTR-102
| Arm | Type | Description |
|---|---|---|
| NKTR-102 | EXPERIMENTAL | In Group A, NKTR-102 will be administered at a dose level of 145 mg/m2 on a q21d schedule as a 90-minute intravenous (IV) infusion on Day 1 of each treatment cycle. |
| Treatment of Physician's Choice (TPC) | ACTIVE_COMPARATOR | In Group B, TPC will be administered per standard of care. Patients randomized to TPC will receive single-agent IV chemotherapy, limited to choice of one of the following 7 agents: eribulin, ixabepilone, vinorelbine, gemcitabine, paclitaxel, docetaxel, or nab-paclitaxel. |
| Physician's Treatment of Choice | ACTIVE_COMPARATOR | - |
| Treatment (pegylated irinotecan NKTR 102) | EXPERIMENTAL | Patients receive pegylated irinotecan NKTR 102 IV over 90 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity |
| Drug: Etirinotecan pegol | EXPERIMENTAL | 145 mg/m2 dose |
| Cohort A - Pegylated Irinotecan to treat NSCLC | EXPERIMENTAL | Patients with non-small cell lung carinoma (NSCLC) will receive pegylated irinotecan intravenously (IV) over 90 minutes every 21 days in the absence of disease progression or unacceptable toxicity. |
| Cohort B - Pegylated Irinotecan to treat SCLC | EXPERIMENTAL | Patients with small cell lung carinoma (SCLC) will receive pegylated irinotecan intravenously (IV) over 90 minutes every 21 days in the absence of disease progression or unacceptable toxicity. |
| Cohort C - Pegylated Irinotecan to treat mBC | EXPERIMENTAL | Patients with metastatic breast cancer (MBC) to brain will receive pegylated irinotecan intravenously (IV) over 90 minutes every 21 days in the absence of disease progression or unacceptable toxicity. |
| irinotecan | ACTIVE_COMPARATOR | irinotecan IV every 3 weeks |
| NKTR-102 q14d | EXPERIMENTAL | NKTR-102 |
| NKTR-102 q21d | EXPERIMENTAL | NKTR-102 |
| NKTR-102 100 mg/m2 + Cetuximab | ACTIVE_COMPARATOR | NKTR-102 100 mg/m2 + Cetuximab Arm All patients received NKTR-102 in combination with cetuximab. NKTR-102 was administered intravenously (IV) once every 3 weeks (q3w) over 90 minutes on Day 1. Patients were to be enrolled in one of the following sequential dosing cohorts of NKTR-102: 100, 125, 150, or 175 mg/m2. Only the 100 and 125 mg/m2 were enrolled. |
| NKTR-102 125 mg/m2 + Cetuximab | ACTIVE_COMPARATOR | NKTR-102 125 mg/m2 + Cetuximab Arm All patients received NKTR-102 in combination with cetuximab. NKTR-102 was administered intravenously (IV) once every 3 weeks (q3w) over 90 minutes on Day 1. Patients were to be enrolled in one of the following sequential dosing cohorts of NKTR-102: 100, 125, 150, or 175 mg/m2. Only the 100 and 125 mg/m2 were enrolled. |
| Name | Type | Description |
|---|---|---|
| NKTR-102 | DRUG | - |
| Eribulin | DRUG | - |
| Ixabepilone | DRUG | - |
| Vinorelbine | DRUG | - |
| Gemcitabine | DRUG | - |
| Paclitaxel | DRUG | - |
| Docetaxel | DRUG | - |
| Nab-paclitaxel | DRUG | - |
| Treatment of Physician's Choice (TPC) | DRUG | One of the following Treatment of Physician Choice will be administered per standard of care: eribulin, ixabepilone, vinorelbine, gemcitabine, paclitaxel, docetaxel, or nab-paclitaxel |
| Laboratory Biomarker Analysis | OTHER | Correlative studies |
| Pegylated Irinotecan | DRUG | Given IV |
| Pharmacological Study | OTHER | Correlative studies |
| Etirinotecan pegol | DRUG | - |
| NKTR-102 145 mg/m2 | DRUG | A 90 minute IV infusion of 145 mg/m2 or less of NKTR-102 on Day 1 of each 21-day treatment cycle. |
| NKTR-102 120 mg/m2 | DRUG | A 90 minute IV infusion of 120 mg/m2 or less of NKTR-102 on Day 1 of each 21-day treatment cycle. |
| NKTR-102 95 mg/m2 | DRUG | A 90 minute IV infusion of 95 mg/m2 or less of NKTR-102 on Day 1 of each 21-day treatment cycle. |
| NKTR-102 50 mg/m2 | DRUG | A 90 minute IV infusion of 50 mg/m2 or less of NKTR-102 on Day 1 of each 21-day treatment cycle. |
| irinotecan | DRUG | IV every 3 weeks |
| NKTR-102 100 mg/m2 | DRUG | NKTR-102 100 mg/m2 + Cetuximab Arm: All patients received NKTR-102 in combination with cetuximab. NKTR-102 was administered intravenously (IV) once every 3 weeks (q3w) over 90 minutes on Day 1. Patients were to be enrolled in one of the following sequential dosing cohorts of NKTR-102: 100, 125, 150, or 175 mg/m2. Only the 100 and 125 mg/m2 were enrolled. |
| NKTR-102 125 mg/m2 | DRUG | NKTR-102 125 mg/m2 + Cetuximab Arm: All patients received NKTR-102 in combination with cetuximab. NKTR-102 was administered intravenously (IV) once every 3 weeks (q3w) over 90 minutes on Day 1. Patients were to be enrolled in one of the following sequential dosing cohorts of NKTR-102: 100, 125, 150, or 175 mg/m2. Only the 100 and 125 mg/m2 were enrolled. |
| Cetuximab | DRUG | Cetuximab was administered once weekly via a 2-hour IV infusion at a starting dose of 400 mg/m2 on Day 1 and subsequently administered weekly at 250 mg/m2 via a 1-hour infusion thereafter. |
Inclusion Criteria: * Female or male, age ≥ 18 years. * Histologically-confirmed carcinoma of the breast (either the primary or metastatic lesions) for whom single-agent cytotoxic chemotherapy is indicated. Patients may have either measurable or non-measurable disease according to RECIST version 1....
NKTR-102 is an investigational small molecule oncology drug developed by Nektar Therapeutics for advanced cancer. It has been studied in metastatic and locally recurrent breast cancer, colorectal cancer, and malignant solid tumors. NKTR-102 is also known as etirinotecan pegol.
NKTR-102 has been studied in metastatic breast cancer, locally recurrent breast cancer, advanced cancer, colorectal cancer, and malignant solid tumors. Trials have enrolled patients with metastatic disease and stable brain metastases, as well as those with metastatic solid tumors. It remains investigational and is not an approved therapy.
NKTR-102 is developed by Nektar Therapeutics, which trades on the Nasdaq under the ticker NKTR. Nektar sponsored the clinical studies of the drug, including the BEACON Phase 3 study and the Phase 3 study in patients with stable brain metastases.
NKTR-102 is investigational and has been tested in Phase 1, Phase 2, and Phase 3 clinical trials. The Phase 3 BEACON study and a Phase 3 study in metastatic breast cancer with stable brain metastases have both completed. No Phase 1 trials are currently active.
NKTR-102 has been evaluated in completed studies including NCT01492101, the Phase 3 BEACON study in locally recurrent and metastatic breast cancer with 852 patients, NCT02915744, a Phase 3 study in metastatic breast cancer with stable brain metastases, NCT01976143, a Phase 1 QTc and pharmacokinetics study, and NCT01457118, a Phase 2 extension study.
Yes, NKTR-102 is the same drug as etirinotecan pegol. The names NKTR-102 145 mg/m2, NKTR-102/m2, and NKTR-102 100 mg/m2 refer to dose levels of the same agent used in clinical studies. Searches for any of these names refer to the Nektar Therapeutics compound.