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Pegylated Irinotecan

Phase 3

Recurrent Small Cell Lung Carcinoma | Small molecule | Oncology |Nektar Therapeutics|Trials Updated: Dec 12, 2023

Pegylated Irinotecan development status

Highest phase Phase 3 (NCT01492101)
Phase scored for NKTRPhase 2
Registered trials 8 across 4 sponsors since Dec 2008

Pegylated Irinotecan target and mechanism

Molecular targetF8
Target classExogenous Protein
ModalitySmall molecule

Also known as NKTR-102, PEG-irinotecan, etirinotecan pegol

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLEDDMC
Total Trials10
Total Enrollment1,346

FDA Designations

No designations recorded

Pegylated Irinotecan clinical trials

Pegylated Irinotecan · 10 trials · 19 indications

Phase 3 2Phase 2 7Phase 1 1
NCT02915744A Study of Etirinotecan Pegol (NKTR-102) Versus Treatment of Physician's Choice (TPC) in Patients With Metastatic Breast Cancer Who Have Stable Brain Metastases and Have Been Previously Treated With an Anthracycline, a Taxane, and CapecitabineMetastasis
COMPLETED178 Analytics
NCT01492101The BEACON Study (Breast Cancer Outcomes With NKTR-102)Locally Recurrent Breast Cancer
COMPLETED852 Analytics
PHASE3COMPLETED
A Study of Etirinotecan Pegol (NKTR-102) Versus Treatment of Physician's Choice (TPC) in Patients With Metastatic Breast Cancer Who Have Stable Brain Metastases and Have Been Previously Treated With an Anthracycline, a Taxane, and Capecitabine
MetastasisUnlock trial analytics
PHASE3COMPLETED
The BEACON Study (Breast Cancer Outcomes With NKTR-102)
Locally Recurrent Breast CancerUnlock trial analytics

Study Endpoints

Primary Endpoints

Overall Survival (OS) of Patients
Within 3 years from study start

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.

Kaplan-Meier Estimate of Overall Survival: Intention to Treat (ITT) Population
36 Months

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.

18 Week Progression-free Survival Rate
Time from registration to the date of first documented disease progression or death, assessed at 18 weeks

The distribution of time to disease progression will be estimated in each group using the method of Kaplan-Meier at 18 weeks.

Progression Free Survival, Assessed by Revised Assessment in Neuro-oncology (RANO) Criteria
6 weeks from first administration of NKTR-102

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 Rate (Cohort A and C)
At 12 weeks

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

Length of Exposure to NKTR-102
Screening, Every 21 day cycle of treatment and Quarterly Follow-up

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.

Kaplan-Meier Estimate of PFS by Central Radiological Review: ITT Population
Every 6 weeks (± 5 days) from Cycle 1, Day 1 until documented disease progression, start of new therapy for cancer, death, or end of study, approximately 42 months.

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.

Objective Response Rate (ORR)
Up to 2 years.

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
12 months

Number of patients with Dose Limiting Toxicities

QTcF interval values
Day -1 through Day 42

10 pre-dose and 18 post-dose ECG measurements to evaluate the effect of NKTR-102

Secondary Endpoints

Progression-Free Survival (Outside the Central Nervous System)
Through study completion, an expected average of 1 year
Progression-Free Survival in Brain Metastasis (PFS-BM)
Through study completion, an expected average of 1 year
Progression-Free Survival (Overall)
Through study completion, an expected average of 1 year
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
NKTR-102EXPERIMENTALIn 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_COMPARATORIn 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 ChoiceACTIVE_COMPARATOR -
Treatment (pegylated irinotecan NKTR 102)EXPERIMENTALPatients 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 pegolEXPERIMENTAL145 mg/m2 dose
Cohort A - Pegylated Irinotecan to treat NSCLCEXPERIMENTALPatients 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 SCLCEXPERIMENTALPatients 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 mBCEXPERIMENTALPatients 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.
irinotecanACTIVE_COMPARATORirinotecan IV every 3 weeks
NKTR-102 q14dEXPERIMENTALNKTR-102
NKTR-102 q21dEXPERIMENTALNKTR-102
NKTR-102 100 mg/m2 + CetuximabACTIVE_COMPARATORNKTR-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 + CetuximabACTIVE_COMPARATORNKTR-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.

Interventions

NameTypeDescription
NKTR-102DRUG -
EribulinDRUG -
IxabepiloneDRUG -
VinorelbineDRUG -
GemcitabineDRUG -
PaclitaxelDRUG -
DocetaxelDRUG -
Nab-paclitaxelDRUG -
Treatment of Physician's Choice (TPC)DRUGOne 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 AnalysisOTHERCorrelative studies
Pegylated IrinotecanDRUGGiven IV
Pharmacological StudyOTHERCorrelative studies
Etirinotecan pegolDRUG -
NKTR-102 145 mg/m2DRUGA 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/m2DRUGA 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/m2DRUGA 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/m2DRUGA 90 minute IV infusion of 50 mg/m2 or less of NKTR-102 on Day 1 of each 21-day treatment cycle.
irinotecanDRUGIV every 3 weeks
NKTR-102 100 mg/m2DRUGNKTR-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/m2DRUGNKTR-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.
CetuximabDRUGCetuximab 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.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites56

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....

Countries:United StatesAustraliaBelgiumCanadaFranceIsraelItalyPortugalSpainUnited KingdomGermanyNetherlandsRussiaSouth KoreaIndia
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Frequently asked questions about Pegylated Irinotecan

What is Pegylated Irinotecan used for?

Pegylated Irinotecan is being studied for recurrent small cell lung carcinoma and Stage IV non-small cell lung cancer. It has also been evaluated in trials that included extensive-stage small cell lung cancer, tumors metastatic to the brain, and metastatic breast cancer. It is an investigational therapy and is not approved for commercial use.

What does Pegylated Irinotecan target?

Pegylated Irinotecan targets F8, an exogenous protein. It is a small molecule therapeutic. By attaching polyethylene glycol to irinotecan, the drug is designed to extend circulation time in the body compared with unconjugated irinotecan.

Who is developing Pegylated Irinotecan?

Nektar Therapeutics, which trades under the ticker NKTR, is the developer of Pegylated Irinotecan. The company has advanced the asset through Phase 2 clinical testing in lung cancer and other solid tumor settings.

What phase is Pegylated Irinotecan in?

Pegylated Irinotecan is in Phase 2 development. It is an investigational agent and has not received FDA approval. The clinical program includes completed Phase 2 studies in recurrent small cell lung cancer and in refractory brain metastases and advanced lung cancer.

What clinical trials is Pegylated Irinotecan in?

Pegylated Irinotecan has been studied in two completed Phase 2 trials. NCT01876446 evaluated it in relapsed small cell lung cancer with 38 patients. NCT02312622 tested it in refractory brain metastases and advanced lung cancer or metastatic breast cancer with 27 patients. Both were conducted in the United States.

Is Pegylated Irinotecan the same as etirinotecan pegol?

Yes. Pegylated Irinotecan is also known as etirinotecan pegol and NKTR 102. These names refer to the same Nektar Therapeutics compound. The NCT02312622 trial title uses the etirinotecan pegol name, while NCT01876446 uses the NKTR 102 designation.