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RecruitingInterventionalPhase 1

NECTINIUM-2: A Phase 1b, 2 Part, Multicenter, Single Arm, Open Label Study to Evaluate the Safety and Efficacy of a Nectin-4 Radiopharmaceutical ([225Ac]Ac-AKY-1189) in Patients With Previously Treated Locally Advanced or Metastatic Solid Tumors

NCT ID: NCT07020117Sponsor: Aktis Oncology, Inc.Last updated: 2026-04-21

Summary

This is a first-in-human Phase 1b, 2-part, multicenter open-label clinical study to evaluate safety and efficacy of a Nectin-4 radiopharmaceutical (\[225Ac\]Ac-AKY-1189) in patients with locally advanced or metastatic solid tumors and to establish the maximum tolerated dose (MTD) or maximum administered dose (MAD) and the recommended Phase 2 dose.

Detailed description

This study consists of two parts (Part 1 and 2). Part 1 is the dose escalation portion of the study, which will investigate ascending doses of \[225Ac\]Ac-AKY-1189 (up to 6 cycles) in patients with locally advanced or metastatic solid tumors. The aim of Part 1 is to determine the maximum tolerated dose (MTD) or maximum administered dose (MAD) and the recommended Phase 2 dose. Part 2 will be the dose expansion portion of the study and will enroll locally advanced or metastatic solid tumor patients who are identified as Nectin-4 positive by \[64Cu\] Cu-AKY-1189. Part 2 aims to further assess the efficacy of \[225Ac\]Ac-AKY-1189 at the RP2D in 3 different cohorts of patients.

Arms & interventions

  • Drug[225Ac]Ac-AKY-1189 (therapeutic)

    \[225Ac\]Ac-AKY-1189 Injection

  • Drug[64Cu]Cu-AKY-1189 (imaging)

    \[64Cu\]Cu-AKY-1189 Injection

Outcome measures

Primary

  • Part 1: Number of Patients with Dose-Limiting Toxicities

    • Dose-limiting toxicities (DLTs) is defined as any predefined AE occurring during the DLT observation period, except those that are clearly and incontrovertibly due to extraneous circumstances. The number of patients who experience a DLT in Part 1, will be reported by dose level.

    Time frame: From enrollment to the end of Cycle 1 (each cycle is 28 days)

  • Part 1: Occurence of Adverse Events by Severity

    • An AE is defined as any untoward medical occurrence in a participant administered study drug, which does not necessarily have to have a causal relationship with the study drug. The number of patients experiencing an AE in Part 1 will be reported.

    Time frame: Up to the End of Treatment (30 days after the last dose)

  • Part 2: Objective Response Rate (ORR)

    • Objective response rate is defined as the percentage of patients who achieved a best overall response of confirmed Complete Response (CR) or Partial Response (PR), as determined by the investigator based on RECIST 1.1, by tumor types.

    Time frame: Up to 30 days following last administration

Secondary

  • Part 1: Objective Response Rate (ORR)

    Time frame: Up to 30 days following last adminstration

  • Part 2: Occurence of Adverse Events by Severity

    Time frame: Up to End of Treatment (30 days after the last dose)

  • Part 1 and 2: Duration of Response (DOR)

    Time frame: Up to 5 years after first administration

  • Part 1 and 2: Progression-Free Survival (PFS)

    Time frame: Up to 5 years after first administration

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Inclusion Criteria: * Histologic or cytologic confirmation of locally advance or metastatic disease * Radiologic confirmation on CT of at least one measurable tumor lesion per RECIST v1.1 * ECOG Performance Status of 0 or 1 * Adequate end-organ function * Ability to give informed consent and comply with study requirements * Patients with CNS metastases are eligible if they have received therapy and are neurologically stable, asymptomatic and not receiving corticosteroids * Documented disease progression on prior line of therapy for metastatic disease Exclusion Criteria: * Prior treatment with a therapeutic radiopharmaceutical * Prior treatment with a Nectin-4 targeted therapy, except enfortumab vedotin * Received an investigational agent within the previous 28days * Prior treatment with a cytotoxic chemotherapy, targeted therapy, biologic agent, immunotherapy or external-beam radiotherapy in the 3 weeks prior to study treatment * Concurrent serious medical condition that would impair study participation or impact the assessment of treatment related toxicity

Study locations (9)

City of Hope

Duarte, California, 91010

Recruiting
Abhishek Tripathi, MD · Contact

Hoag Memorial Hospital Presbyterian

Irvine, California, 92618

Recruiting
Ryan Reddy, MD · Contact

Biogenix Molecular, LLC

Miami, Florida, 33165

Recruiting

University of Iowa

Iowa City, Iowa, 52242

Recruiting
Kristin Plichta, MD, PhD · Contact

United Theranostics

Glen Burnie, Maryland, 21061

Recruiting

BAMF Health

Grand Rapids, Michigan, 49503

Recruiting

Icahn School of Medicine at Mt. Sinai

New York, New York, 10029

Recruiting
Sophia Rhoads · Contact
Patricia Acon · Contact

UPMC

Pittsburgh, Pennsylvania, 15232

Recruiting
Samantha Demko, RN, BSN · Contact

MD Anderson Cancer Center

Houston, Texas, 77030

Recruiting
Natalie Velez · Contact