IMPACT study: A phase II-III clinical study with the immunomodulator MGN1703 in patients with advanced colorectal carcincoma.

Abstract

633 Background: The synthetic DNA-based immunomodulator MGN1703 acts as an agonist of toll-like receptor 9. Based on promising data from a phase I study in patients with metastatic solid tumors including those with CRC, a phase II-III study was initiated in patients with advanced CRC having disease control after first-line therapy. The objective of the study is to assess efficacy and safety of the MGN1703 treatment in comparison to placebo. Methods: The IMPACT study is designed as a randomized double-blind placebo-controlled phase II-III study, which is conducted in patients with advanced CRC showing disease control after first-line therapy with standard chemotherapy regimen. The treatment is administered subcutaneously twice weekly in a ratio 2:1 (60 mg MGN1703 or placebo). The study is conducted in Germany, Austria, France, UK, Czech Republic and Russia, and 129 patients will be recruited into the study. The efficacy and safety of the study treatment will be evaluated based on extensive immunological tests, radiological assessment, safety laboratory results and assessments of the quality of life. The study treatment will be continued until tumor progression, intolerable toxicity, exclusion criteria or withdrawal of consent. Results: The majority of adverse events were assessed as not drug-related by the investigator. The remaining AEs include mild night sweat (not assessable), mild fever (at three occasions, possible related), and mild arthralgia (certain related) in one patient each. Three SAE have been reported so far of which one was assessed as probably drug-related – atypical pneumonia. Only in single patients local reactions such as mild redness and swelling at injection site were reported. No laboratory or clinical signs of autoimmunity or dose-limiting toxicities were reported, so far. Conclusions: With these preliminary safety results of the ongoing clinical study in patients with advanced CRC it could be shown that ttreatment with MGN1703 at the dosage of 60 mg is well tolerated and safe. Reported adverse events assessed as possibly drug-related belong to expected study drug reactions known for immune modulating drugs. These events were not accompanied by any signs of autoimmunity.

Genuine Immunomodulation With dSLIM

“…dSLIM molecules (MGN1703) are under investigation in a phase 2 clinical trial metastatic colorectal carcinoma (IMPACT, registered #NCT01208194). 42 In this study where bi-weekly 60 mg of MGN1703 was subcutaneously applied, dSLIM was well tolerated with some patients have been receiving treatment in excess of 2 years without major adverse effects. 43 One important reason for such a smooth transition from basic research into clinical efficacy may be the sustained concentration–efficacy relation illustrated on model ELAM41 cells as well as isolated PBMCs and cellular subpopulations thereof.…”

Trial Watch: Immunostimulation with Toll-like receptor agonists in cancer therapy

“…Schmoll and colleagues (University Clinic Halle, Halle, Germany) investigated the clinical profile of MGN1703 (a TLR9 agonist) [47][48][49] in patients with metastatic CRC achieving disease control upon standard, first-line chemotherapy. 50 Fifty-nine patients were enrolled in this Phase II, randomized, placebocontrolled study (NCT01208194), and were randomized 2:1 to receive 60 mg MGN1703 or placebo s.c., twice weekly until disease progression, withdrawal, or death.…”