A Clinical Study of TAB006 in Patients With Previously Treated, Advanced Malignancies

Inclusion Criteria:

* 1\. Able to understand and willing to sign the Informed Consent Form;
* 2\. Male or female ≥ 18 years;
* 3\. Histopathologically or cytologically confirmed advanced solid tumors and advanced lymphoma. In the Dose Escalation and Dose Expansion Phases, both Parts A and B, patients must have disease progression on standard therapy, or be ineligible for or intolerant of available approved standard therapies known to confer clinical benefit (including immunotherapy) or for whom no effective standard therapy exists. In the Indication-specific Expansion Phase, patients must have disease progressed after at least one prior line of standard therapy;
* 4\. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1and expected survival ≥12 weeks;
* 5\. At least one measurable lesion per RECISTv1.1 or 2014 Lugano Classification;
* 6\. Ability to provide an archived tumor sample obtained within the past 2 years or agreement to undergo a pre-treatment biopsy from safely accessible lesions to provide a tumor sample if such an archived specimens cannot be provided. For patients who cannot provide a fresh pre-treatment biopsy, and a recent sample from the past 2 years is not available, the most recent accessible archival specimen will be required;
* 7\. Adequate organ and marrow function, as defined below:

  1. Absolute neutrophil count (ANC) ≥ 1.5×109/L (1,500/mm3) with no administration of hematopoietic growth factors for at least 14 days prior to the planned first dose of TAB006;
  2. Lymphocyte count ≥ 600/mm3;
  3. Platelet (PLT) ≥ 100×109/L (100,000/mm3) with no administration of hematopoietic growth factors or platelet transfusions at least 14 days prior to the planned first dose of TAB006;
  4. Hemoglobin (Hb) ≥9 g/dL with no administration of hematopoietic growth factors or red blood cell transfusions for at least 14 days prior to the planned first dose of TAB006;
  5. Total bilirubin (TBIL) ≤ 1.5 times (x) the ULN; for patients with liver metastasis or Gilbert syndrome, TBIL ≤ 3 x ULN;
  6. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 x ULN in patients without liver metastases and ALT and AST ≤ 5 × ULN for patients with liver metastases at baseline;
  7. Blood creatinine (Cr) ≤ 1.5 x ULN, calculated creatinine clearance (Cockcroft-Gault formula) ≥ 40 mL/min, or 24-h urine creatinine clearance ≥ 40 mL/min;
  8. Left ventricular ejection fraction ≥ 50%;
  9. International normalized ratio (INR), prothrombin time (PT), and activated partial thromboplastin time (aPTT) ≤ 1.5 x ULN except for patients receiving anticoagulation.

     Patients taking anticoagulants must be on a stable dose and INR or aPTT within the therapeutic goal for warfarin or low molecular weight heparins, respectively for at least 28 days prior to the first dose of TAB006;
  10. The thyroid function test free triiodothyronine (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH) are within the normal range or no more than Grade 1 abnormalities in patients requiring hormone replacement for those with pre-existing hypothyroidism;
  11. Fridericia-corrected QTc interval, ≤ 450 ms for men and ≤ 470 ms for women;
* 8\. Females of childbearing potential who are sexually active with a non-sterilized male partner must agree to use effective contraception starting 72 hours before the first dose until 4 months after the final dose of TAB006 or toripalimab, whichever is later. Females of childbearing potential are defined as those who are not surgically sterile (i.e., bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy) or postmenopausal (defined as at least 12 months with no menses confirmed by follicle stimulating hormone (FSH) levels performed during the screening period);
* 9\. Non-sterilized males who are sexually active with a female partner of childbearing potential must agree to use effective contraception from Day 1 through 90 days after receipt of the final dose of TAB006 or TAB006 combined with toripalimab.

Exclusion Criteria:

* 1\. Concurrent enrollment in another clinical study or participation in another clinical study within 28 days prior to the first dose of TAB006 except for observational (non- interventional) studies or the follow-up period of an interventional study;
* 2\. Current or prior use of systemic anticancer therapy, including but not limited to chemotherapy, immunotherapy, biologic therapy, hormone therapy, and targeted therapy within 28 days prior to the first dose of TAB006; except for nitrosoureas and mitomycin which may not have been administered within 6 weeks prior to the first dose of TAB006) unless toxicities from prior anticancer therapy (other than alopecia or autoimmune endocrinopathy that is clinically stable on hormone replacement therapy) have not improved to baseline or Grade 0 or 1 toxicity. Consult the Medical Monitor regarding enrollment of patients with toxicity that is irreversible (e.g., ototoxicity, visual loss) and unlikely to be exacerbated by TAB006 or toripalimab);
* 3\. Concurrent or prior radiotherapy within 28 days prior to the first dose of TAB006 or unresolved treatment-related radiation toxicity. Limited local radiotherapy for palliative intent (e.g., to a single site of metastatic disease) is permitted within 28 days prior to the first dose of TAB006 provided that the patient has no evidence of or had recovered from any treatment-related radiation toxicity;
* 4\. Prior exposure to monoclonal antibodies targeting TIGIT or any of its ligands, including CD155, CD112, or CD113;
* 5\. History of immune-related AE resulting in discontinuation of prior immunotherapy.
* 6\. Major surgery within 28 days prior to the first dose of TAB006 or still recovering from prior surgery;
* 7\. Symptomatic or untreated central nervous system metastases, including leptomeningeal metastases, requiring concurrent treatment, including but not limited to surgery, radiation, and/or corticosteroids. Patients with previously treated brain metastases may be eligible provided that they have been clinically stable for at least 28 days prior to the first dose of TAB006, without evidence of new or enlarging CNS metastases, and on less than 10 mg prednisone daily (or prednisone equivalent);
* 8\. Use of therapeutic immunosuppressive medication (e.g., prednisone dose of ≥10 mg/day or equivalent, TNF inhibitors) within 28 days prior to the first planned dose of TAB006. This does not include intranasal and inhaled corticosteroids or physiologic replacement doses of systemic corticosteroids;
* 9\. Moderate to severe hypersensitivity reaction to toripalimab or other PD-1 blocking antibodies;
* 10\. Prior allogeneic bone marrow transplantation or prior solid organ transplantation;
* 11\. Receipt of live attenuated vaccination within 30 days prior to the first dose of TAB006. For non-live vaccines, it is recommended that the vaccine not be administered within 48 hours prior to through 21 days after the first dose in Cycle 1;
* 12\. Patients with another malignancy that has not been curatively treated are not eligible. Patients with curatively treated malignancy within the past 3 years prior to the first dose of TAB006, with an expected three-year recurrence rate of ≥ 30% are not eligible;
* 13\. History of active autoimmune disease within the past 2 years, with the following exceptions: vitiligo, alopecia, endocrinopathies controlled by hormone replacement therapy, rheumatoid arthritis and other arthropathies that have not required immunosuppression other than non- steroidal anti-inflammatory agents, celiac disease controlled by diet, or psoriasis controlled with topical medication;
* 14\. History of primary immunodeficiency, other than selective IgA deficiency;
* 15\. Uncontrolled intercurrent diseases or conditions including, but not limited to:

  1. Ongoing or active infection, fever \> 38.5°C of unknown origin; history of tuberculosis; human immunodeficiency virus (HIV) seropositive; or evidence of hepatitis B or C virus infection, unless hepatitis has been curatively treated.

     Patients with a prior history or evidence of hepatitis B or C virus infection are eligible only if HBV viral load \[VL\] is \< 100 IU/mL during screening and the patient has completed or is undergoing appropriate antiviral therapy and agrees to complete such treatment during the conduct of the clinical trial. Patients with a history of hepatitis C virus (HCV) infection must have no detectable VL and the patient has completed or is- undergoing appropriate antiviral therapy and agrees to complete such treatment during the conduct of the clinical trial.
  2. Uncontrolled hypertension, unstable angina pectoris, poorly controlled cardiac arrhythmia;
  3. Active peptic ulcer disease or other sites of active gastrointestinal bleeding; or
  4. Psychiatric illness/social situations that would limit compliance with study requirements, substantially increase risk of incurring AEs from TAB006, or compromise the ability of the patient to give written informed consent.
* 16\. Active interstitial lung disease of any severity or history of Grade ≥ 2 interstitial lung disease;
* 17\. Pregnant women. Women who are lactating must agree to discontinue breast-feeding during treatment and for at least 4 months after the last dose of TAB006 or toripalimab, whichever is later;
* 18\. Any condition that, in the opinion of the investigator or sponsor, would interfere with the interpretation of study results.