Chimeric Antigen Receptor T Cells Targeting claudin18.2 in Solid Tumors.

Peking University

Status and phase: Completed; Phase 1

Conditions: Advanced Solid Tumor

Treatments: Drug: PD-1 Monoclonal Antibody; Drug: CAR-CLDN18.2 T-Cells; Drug: Chemotherapy

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT03874897

CT041-CG4006

Details and patient eligibility

About

An open label, single/multiple dose exploratory clinical study to evaluate the safety, efficacy, and pharmacokinetics of autologous humanized anti-claudin18.2 chimeric antigen receptor T cell in advanced solid tumor.

Full description

This study is an open, single/multiple infusion, dose escalation/dose regimen finding study to assess the safety and pharmacokinetics of CAR-CLDN18.2 T cell therapy, and to obtain the preliminary efficacy results in subjects who have been diagnosed with advanced solid tumor with positive claudin 18.2 expression and failed to standard systemic treatment.

Enrollment: 134 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Aged 18 to 75 years, male or female;
2. Subjects with pathologically confirmed solid tumors (ie, advanced gastric cancer, esophagogastricgastroesophageal junction cancer, and pancreatic cancer) and have been failed to at least first-one prior line of systemic treatment;
3. Tumor tissue samplessample was positive for claudin 18.2 positive through for claudin18.2 IHC staining;assay(≥2+, and ≥40%);
4. Estimated life expectancy > 12 weeks;
5. According to the RECIST 1.1, there is at least one measurable or unmeasurable tumor lesionslesion；
6. ECOG physical status score 0 ~ 1, within 24 hours prior to apheresis, and at baseline (prior to pre-treatment);
7. Sufficient venous access for mononuclear cell collection (abbreviation: apheresis)
8. Subjects should have adequate organ functions before screening and pre-treatment (at baseline).
9. Female subjects of childbearing age must undergo a serum pregnancy test at screening and prior to preconditioning and the results must be negative, and are willing to use a very effective and reliable method of contraception within 1 year after the last study treatment. The methods that can be used are: bilateral tubal ligation / bilateral salpingectomy or bilateral tubal occlusion; or approved oral, injection or hormone-imparting contraceptive methods; or barrier contraceptive method: containing spermicidal foam / Gel/film/cream/suppository condom or occlusive cap (diaphragm or cervix/cap);
10. Men who have actively sexual intercourse with women with child-bearing potential, must agree to use barrier-based contraception if they have no vasectomy, for example, a condom containing a spermicidal foam/gel/film/paste/suppository, or use a contraceptive method for their spouse (see article 9 of the inclusion criteria). Moreover, all men are absolutely forbidden to donate sperm within 1 year after receiving the last study treatment infusion；
11. Subject participates in this clinical trial and sign Informed Consent Form voluntarily.

Exclusion criteria

1. Pregnant or lactating women;
2. HIV, Treponema pallidum or HCV serologically positive;
3. Any uncontrollable active infection, including but not limited to active tuberculosis, HBV infection (HBsAg positive, or HBcAb positive and HBV DNA positive);
4. Subjects have clinically significant thyroid dysfunction determined by investigator (serum thyroid hormone assays TT4, TT3, FT3, FT4, and serum thyroid stimulating hormone TSH) which is not suitable for entering into the study;
5. The side effects caused by the previous treatment of the subjects did not return to CTCAE ≤1; except hair loss and, hyperpigmentation or other tolerable events determined by investigator or laboratory abnormalities allowed by the protocol;
6. Subjects who are using steroidshave recieved ≥15 mg/day glucocorticoid systemically currently within 7 days prior to apheresis; those using inhaled steroids recently or currently are not excluded;
7. Previously allergic to immunotherapy and related drugs, history of severe allergiespreconditioning drug such as cyclophosphamide, fludarabine, or allergiestocilizumab or allergic to components of CT041CAR-CLDN18.2T injection, allergic to β-lactam antibiotics;the CT041 infusion;
8. Previously received any chimeric antigen receptor-modified T-cells(including CAR-T、TCR-T) .
9. Subjects have untreated or symptomatic brain metastases;
10. Subjects have central or extensivelywith centralcor diffused metastases in lung and .extensiveor diffused metastases in liver;liveror with rapid tumor progression since screening period evaluated by the investigator preconditioning (at baseline)；
11. The largest target tumor lesion>4cm
12. Subjects with unstable or active ulcers and gastrointestinal bleeding currently;
13. Subjects with a history of organ transplantation or awaiting organ transplantation;
14. Subjects requiring anticoagulant therapy;
15. Subjects requiring continuous anti-platelet therapy;
16. Subjects who have undergone major surgery or significant trauma within 4 weeks prior to apheresis, or who are expected to undergo major surgery during the study;
17. There are no other serious diseases that may limit subjects' participation in this trial;
18. The investigator assessed that the subject was unable or unwilling to comply with the requirements of the study protocol;
19. Blood oxygen saturation ≤ 95% before pre-treatmentapheresis or preconditioning (accept finger oxygen detection method);
20. Prior to pretreatmentpreconditioning, subjects developed, including but not limited to, new arrhythmias that could not be controlled with drugs, hypotension requiring pressor agent, bacterial, fungal or viral infections that required intravenous antibiotics. Creatinine clearance rate <40mL / min; The investigator judges that the subject is not suitable for continuing the trial. Subjects who use antibiotics to prevent infection can continue the trials if judged by the investigator;
21. The subject has a central nervous system disease sign or an abnormal neurological test result with clinical significance;
22. The subject is currently suffered from or have suffered from other incurable malignant tumors within previous 3 years, except in situ cervical cancer or skin basal cell cancer.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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134 participants in 5 patient groups

CAR-CLDN18.2 T-Cells

Experimental group

Description:

The subjects enrolled will be sequentially assigned to the corresponding dose level.

Treatment:

Drug: CAR-CLDN18.2 T-Cells

Cohort 1

Experimental group

Description:

CT041 monotherapy in patients with GI cancers who failed standard chemotherapy

Treatment:

Drug: CAR-CLDN18.2 T-Cells

Cohort 2

Experimental group

Description:

CT041 plus anti-PD1 therapy in patients with GI cancers who failed standard chemotherapy

Treatment:

Drug: PD-1 Monoclonal Antibody

Drug: CAR-CLDN18.2 T-Cells

Cohort 3

Experimental group

Description:

CT041 sequential treatment after first-line therapy in GC/GEJ

Treatment:

Drug: Chemotherapy

Drug: CAR-CLDN18.2 T-Cells

Cohort 4

Experimental group

Description:

prior treatment failure to anti-CLDN18.2 monoclonal antibody

Treatment:

Drug: CAR-CLDN18.2 T-Cells