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Safety of SNK01 in Subjects With Pathologically Confirmed Metastatic and/or Unresectable Cancer Refractory to Conventional Therapy

Primary Purpose

Refractory Cancer, Metastatic Cancer, Recurrent Cancer

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
SNK01
Avelumab
Pembrolizumab
Sponsored by
NKGen Biotech, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Refractory Cancer focused on measuring Natural killer cell, NK cell, Expanded natural killer cell, Immunotherapy, Cancer, Metastatic cancer, Advanced solid tumor, Refractory cancer, Recurrent cancer, Unresectable carcinoma, Solid tumor, Neoplasms

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Voluntary written informed consent signed by patient, obtained prior to study enrollment.
  • Males and females ages 18 to 75 years, inclusive.
  • Pathologically confirmed diagnosis of refractory cancer that has failed three or more prior lines of conventional standard of care therapy.
  • Diagnosed with any histologically confirmed malignancy whose disease is confirmed to be metastatic and/or unresectable for which standard curative or beneficial treatments are no longer effective.
  • Eastern Cooperative Oncology Group (ECOG) performance status <2.
  • At least 4 weeks since any prior systemic therapy (excluding corticosteroid therapy) to treat the underlying malignancy (standard or investigational).
  • At least 2 weeks since prior palliative radiotherapy.
  • Adequate bone marrow function:

    • Neutrophils: 2.0-8.0 K/uL
    • Platelet Count: 140-440 K/uL
    • Hemoglobin: 10.0-18.0 g/dL
    • No ongoing transfusion requirements
  • Adequate hepatic function:

    • Serum total bilirubin < 1.5 x upper limit of normal (ULN)
    • Serum albumin ≥ 3.0 g/dL
    • Alanine transaminase (ALT) and aspartate transaminase (AST) ≤ 2.5 x ULN
    • International normalized ratio (INR) ≤ 1.5 x ULN
  • Adequate renal function with creatinine ≤ 2.0 mg/dL.
  • Negative pregnancy test for women of childbearing potential and use of effective contraception (hormonal or barrier method of birth control) during study.

Exclusion Criteria:

  • Pregnant and/or lactating females.
  • Life expectancy of less than three months.
  • Currently being treated by "biological therapy" as defined by the National Cancer Institute (example: checkpoint inhibitors, adoptive cell transfer, monoclonal antibodies, treatment vaccines, cytokines, Bacillus Calmette-Guerin (BCG), chimeric antigen receptor T cell therapy (CAR-T), and natural killer cell therapy).
  • Patients tested positive for hepatitis B and/or C surface antigen.
  • High fever or any active or unresolved infection, including human immunodeficiency virus (HIV) positive.
  • Autoimmune disease requiring therapy; immunodeficiency, or any disease process requiring immunosuppressive therapy.
  • Prior clinical trial requiring patient to receive an investigational drug within two weeks of enrollment.
  • Congestive heart failure, unstable angina or other underlying cardiac disease; history of thrombosis currently requiring anticoagulation.
  • Mental or psychological illness preventing cooperation with treatment, efficacy evaluations, or unable to understand the informed consent process.
  • Subjects who have undergone prior organ transplantation, including allogeneic stem-cell transplantation.
  • Adult subjects who lack capacity to consent for themselves and for whom consent must be provided by a legally authorized representative.
  • For SNK01+avelumab arm only: Subjects with prior hypersensitivity to avelumab or its excipients, including known severe hypersensitivity reactions to monoclonal antibodies (NCI CTCAE v4.03 Grade ≥ 3).
  • For SNK01+avelumab arm only: Subjects with a significant immune-mediated adverse event due to a prior checkpoint inhibitor immunotherapy that led to permanent discontinuation of the therapy.

Sites / Locations

  • Sarcoma Oncology Research Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Cohort 1 - Low dose SNK01

Cohort 2 - Medium dose SNK01

Cohort 3 - High dose SNK01

Cohort 4 - SNK01 with avelumab

Cohort 4 - SNK01 with pembrolizumab

Arm Description

SNK01 (low dose) administered once a week for five weeks.

SNK01 (medium dose) administered once a week for five weeks.

SNK01 (high dose) administered once a week for five weeks.

SNK01 (high dose) administered in combination with avelumab once every two weeks (14-day cycle) for five cycles.

SNK01 (high dose) administered in combination with pembrolizumab once every three weeks (21-day cycle) for five cycles.

Outcomes

Primary Outcome Measures

To assess the safety profile
Assessed by the incidence and severity of dose limiting toxicity (DLT) and other adverse events graded according to the National Cancer Institute's Common Toxicity Criteria for Adverse Events (NCI-CTCAE), Version 5.0, or the cytokine release syndrome revised grading system.

Secondary Outcome Measures

To assess clinical objective response rate (ORR) of SNK01 in patients with refractory cancer
Objective response rate (ORR) is defined by the percentage of subjects who achieve a confirmed complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1.
To assess clinical objective response rate (ORR) of SNK01 in combination with avelumab in patients with refractory cancer
Objective response rate (ORR) is defined by the percentage of subjects who achieve a confirmed complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1.
To assess clinical objective response rate (ORR) of SNK01 in combination with pembrolizumab in patients with refractory cancer
Objective response rate (ORR) is defined by the percentage of subjects who achieve a confirmed complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1.

Full Information

First Posted
May 3, 2019
Last Updated
July 12, 2023
Sponsor
NKGen Biotech, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03941262
Brief Title
Safety of SNK01 in Subjects With Pathologically Confirmed Metastatic and/or Unresectable Cancer Refractory to Conventional Therapy
Official Title
Phase 1, Open-Label, Safety Study of Escalating Doses of Ex Vivo Expanded, Autologous Natural Killer Cells in Patients With Pathologically Confirmed Cancer Refractory to Conventional Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 15, 2019 (Actual)
Primary Completion Date
February 17, 2023 (Actual)
Study Completion Date
September 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NKGen Biotech, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to evaluate the safety and preliminary efficacy of SNK01 (autologous natural killer cell), as a single agent and in combination with avelumab or pembrolizumab, for the treatment of subjects with advanced and/or metastatic refractory cancer that has failed three or more prior lines of conventional standard of care therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Refractory Cancer, Metastatic Cancer, Recurrent Cancer, Unresectable Carcinoma, Solid Tumor, Adult, Advanced Cancer, Advanced Solid Tumor
Keywords
Natural killer cell, NK cell, Expanded natural killer cell, Immunotherapy, Cancer, Metastatic cancer, Advanced solid tumor, Refractory cancer, Recurrent cancer, Unresectable carcinoma, Solid tumor, Neoplasms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
27 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1 - Low dose SNK01
Arm Type
Experimental
Arm Description
SNK01 (low dose) administered once a week for five weeks.
Arm Title
Cohort 2 - Medium dose SNK01
Arm Type
Experimental
Arm Description
SNK01 (medium dose) administered once a week for five weeks.
Arm Title
Cohort 3 - High dose SNK01
Arm Type
Experimental
Arm Description
SNK01 (high dose) administered once a week for five weeks.
Arm Title
Cohort 4 - SNK01 with avelumab
Arm Type
Experimental
Arm Description
SNK01 (high dose) administered in combination with avelumab once every two weeks (14-day cycle) for five cycles.
Arm Title
Cohort 4 - SNK01 with pembrolizumab
Arm Type
Experimental
Arm Description
SNK01 (high dose) administered in combination with pembrolizumab once every three weeks (21-day cycle) for five cycles.
Intervention Type
Biological
Intervention Name(s)
SNK01
Intervention Description
Patient-specific ex vivo expanded autologous natural killer cells
Intervention Type
Drug
Intervention Name(s)
Avelumab
Other Intervention Name(s)
Bavencio
Intervention Description
Avelumab is a humanized monoclonal antibody immune checkpoint blockade immunotherapy that targets the programmed cell death-ligand 1 (PD-L1).
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
Keytruda
Intervention Description
Pembrolizumab is a humanized monoclonal antibody immune checkpoint blockade immunotherapy that targets the programmed cell death receptor-1 (PD-1).
Primary Outcome Measure Information:
Title
To assess the safety profile
Description
Assessed by the incidence and severity of dose limiting toxicity (DLT) and other adverse events graded according to the National Cancer Institute's Common Toxicity Criteria for Adverse Events (NCI-CTCAE), Version 5.0, or the cytokine release syndrome revised grading system.
Time Frame
Up to 6 months
Secondary Outcome Measure Information:
Title
To assess clinical objective response rate (ORR) of SNK01 in patients with refractory cancer
Description
Objective response rate (ORR) is defined by the percentage of subjects who achieve a confirmed complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1.
Time Frame
Up to 12 months
Title
To assess clinical objective response rate (ORR) of SNK01 in combination with avelumab in patients with refractory cancer
Description
Objective response rate (ORR) is defined by the percentage of subjects who achieve a confirmed complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1.
Time Frame
Up to 12 months
Title
To assess clinical objective response rate (ORR) of SNK01 in combination with pembrolizumab in patients with refractory cancer
Description
Objective response rate (ORR) is defined by the percentage of subjects who achieve a confirmed complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1.
Time Frame
Up to 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Voluntary written informed consent signed by patient, obtained prior to study enrollment. Males and females ages 18 to 75 years, inclusive. Pathologically confirmed diagnosis of refractory cancer that has failed three or more prior lines of conventional standard of care therapy. Diagnosed with any histologically confirmed malignancy whose disease is confirmed to be metastatic and/or unresectable for which standard curative or beneficial treatments are no longer effective. Eastern Cooperative Oncology Group (ECOG) performance status <2. At least 4 weeks since any prior systemic therapy (excluding corticosteroid therapy) to treat the underlying malignancy (standard or investigational). At least 2 weeks since prior palliative radiotherapy. Adequate bone marrow function: Neutrophils: 2.0-8.0 K/uL Platelet Count: 140-440 K/uL Hemoglobin: 10.0-18.0 g/dL No ongoing transfusion requirements Adequate hepatic function: Serum total bilirubin < 1.5 x upper limit of normal (ULN) Serum albumin ≥ 3.0 g/dL Alanine transaminase (ALT) and aspartate transaminase (AST) ≤ 2.5 x ULN International normalized ratio (INR) ≤ 1.5 x ULN Adequate renal function with creatinine ≤ 2.0 mg/dL. Negative pregnancy test for women of childbearing potential and use of effective contraception (hormonal or barrier method of birth control) during study. Exclusion Criteria: Pregnant and/or lactating females. Life expectancy of less than three months. Currently being treated by "biological therapy" as defined by the National Cancer Institute (example: checkpoint inhibitors, adoptive cell transfer, monoclonal antibodies, treatment vaccines, cytokines, Bacillus Calmette-Guerin (BCG), chimeric antigen receptor T cell therapy (CAR-T), and natural killer cell therapy). Patients tested positive for hepatitis B and/or C surface antigen. High fever or any active or unresolved infection, including human immunodeficiency virus (HIV) positive. Autoimmune disease requiring therapy; immunodeficiency, or any disease process requiring immunosuppressive therapy. Prior clinical trial requiring patient to receive an investigational drug within two weeks of enrollment. Congestive heart failure, unstable angina or other underlying cardiac disease; history of thrombosis currently requiring anticoagulation. Mental or psychological illness preventing cooperation with treatment, efficacy evaluations, or unable to understand the informed consent process. Subjects who have undergone prior organ transplantation, including allogeneic stem-cell transplantation. Adult subjects who lack capacity to consent for themselves and for whom consent must be provided by a legally authorized representative. For SNK01+avelumab arm only: Subjects with prior hypersensitivity to avelumab or its excipients, including known severe hypersensitivity reactions to monoclonal antibodies (NCI CTCAE v4.03 Grade ≥ 3). For SNK01+avelumab arm only: Subjects with a significant immune-mediated adverse event due to a prior checkpoint inhibitor immunotherapy that led to permanent discontinuation of the therapy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Chang, MPH
Organizational Affiliation
NKGen Biotech, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Sarcoma Oncology Research Center
City
Santa Monica
State/Province
California
ZIP/Postal Code
90403
Country
United States

12. IPD Sharing Statement

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Safety of SNK01 in Subjects With Pathologically Confirmed Metastatic and/or Unresectable Cancer Refractory to Conventional Therapy

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