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Study to Evaluate the Efficacy, Safety and Pharmacokinetics of CT041 Autologous CAR T-cell Injection

Primary Purpose

Gastric Adenocarcinoma, Pancreatic Cancer, Gastroesophageal Junction Adenocarcinoma

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CT041 autologous CAR T-cell injection
Physician's Choice(Paclitaxel or Irinotecan or Apatinib or Anti-PD-1 antibody)
Sponsored by
CARsgen Therapeutics Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastric Adenocarcinoma focused on measuring advanced solid tumors, Gastric Cancer, Pancreatic Cancer, Esophagogastric Junction Cancer, Claudin18.2, CLDN18.2, CAR T cell

Eligibility Criteria

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

Inclusion Criteria:

  1. Be willing to participate in a clinical trial, be informed and sign inform consent; and be willing to follow and be able to complete all trial procedures;
  2. Aged 18 to 75 years;
  3. Phase Ib:Patients with pathologically diagnosed advanced gastric/ gastroesophageal junction adenocarcinoma who have failed at least 2 prior lines treatment; or patients with pathologically diagnosed advanced pancreatic cancer who have failed at least 1 prior line treatment ; Phase II:Patients with pathologically diagnosed advanced gastric/ gastroesophageal junction adenocarcinoma who have failed at least 2 prior lines treatment;
  4. Phase Ib:Tumor tissue samples were positive for CLDN18.2 IHC staining; Phase II:Tumor tissue samples were positive for CLDN18.2 IHC staining and HER2 expression was negative;
  5. Estimated life expectancy >12 weeks;
  6. According to the RECIST 1.1, there is measurable tumor lesions;
  7. ECOG physical status score 0 ~ 1 at screening, within 24 hours prior to apheresis, and at baseline;
  8. Sufficient venous access for mononuclear cell collection;
  9. Unless otherwise specified, patients should meet the certain conditions prior to screening and pre-treatment and be allowed one week to retest if an abnormal laboratory test does not meet the criteria, and if the criteria are still not met, the screening is considered to have failed;
  10. Female patients of childbearing age must undergo a serum pregnancy test at screening and prior to pretreatment 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;
  11. Men who have actively sexual intercourse with women with child-bearing potential, must agree to use barrier-based contraception if they have no vasectomy.

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;
  4. The side effects caused by the previous treatment of the subjects did not return to CTCAE ≤1; except hair loss and other tolerable events determined by investigator;
  5. Patients known to have active autoimmune diseases, including but not limited to psoriasis or rheumatoid arthritis, or other diseases requiring long-term immunosuppressive therapy;
  6. Previously allergic to immunotherapy and related drugs,history of severe allergies, or allergic to components of CT041.
  7. Previously received any gene-modified cell therapies(including CAR-T, TCR-T);
  8. Patients have brain metastasis or symptoms of brain metastasis;
  9. Patients at high risk of hemorrhage or perforation;
  10. Patients requiring anticoagulant therapy;
  11. Patients requiring continuous anti-platelet therapy;
  12. Patients with a history of organ transplantation or awaiting organ transplantation;
  13. Patients 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;
  14. Presence of other serious pre-existing medical conditions that may limit patient participation in the study;
  15. The investigator assessed that the patient was unable or unwilling to comply with the requirements of the study protocol;
  16. Prior to pretreatment, patients 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. The investigator judges that the patient is not suitable for continuing the trial. Patients who use antibiotics to prevent infection can continue the trials if judged by the investigator;
  17. The patient has a central nervous system disease sign or an abnormal neurological test result with clinical significance;
  18. The patient 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.

Sites / Locations

  • Anhui Provincial Cancer Hospital
  • Beijing Cancer HospitalRecruiting
  • Harbin medical university Affiliated Cancer Hospital
  • Henan Tumor HospitalRecruiting
  • Nanjing Drum Tower Hospital
  • Ruijin Hospital, affiliated to Shanghai Jiaotong University, school of medicineRecruiting
  • Fudan University Shanghai Cancer Center
  • Shanghai Zhongshan Hospital
  • West China Hospital, Sichuan University
  • Tianjin Medical University Cancer Institute and Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

CT041 autologous CAR T-cell injection

Physician's Choice

Arm Description

Two stages: Phase 1b: dose escalation and dose expansion; Phase 2: verify CT041 efficacy and safety

Participants will receive physician's choice of treatment in Phase II

Outcomes

Primary Outcome Measures

Phase Ib: Incidence of Treatment Related adverse events (AEs)
Incidence of treatment related AEs, AEs of special interest and serious adverse events(SAEs).
Phase Ib: Identification of Maximum Tolerated Dose (MTD)
Incidence of dose-limiting toxicities (DLTs)
Phase II: Progression-free survival (PFS), as assessed by IRC, of CT041 autologous CAR T-cell injection versus Physician's Choice
Progression-free survival (PFS) was defined as the time from the date of randomization to the earliest date of the first objective documentation of progressive disease (PD) or death due to any cause.

Secondary Outcome Measures

Phase Ib: Objective Response Rate (ORR), as assessed by Investigators
The Objective Response Rate (ORR) is the percentage of participants who achieved a best overall response of Complete Response (CR) or Partial Response (PR) based on RECIST version 1.1.
Phase Ib: Progression-free survival (PFS), as assessed by Investigators
Progression-free survival (PFS) was defined as the time from the date of first infusion of CT041 to the earliest date of the first objective documentation of progressive disease (PD) or death due to any cause.
Phase Ib:Overall survival (OS)
Overall Survival (OS) was defined as the time from the date of first infusion of CT041 to the date of death due to any cause.
Phase Ib:Duration of response (DOR), as assessed by Investigators
Duration of response (DOR) is defined as the time from the first documented objective response (CR or PR) to the first documented disease progression or death.
Phase Ib:Disease control rate (DCR), as assessed by Investigators
Disease control rate (DCR) is the percentage of participants who achieved a best overall response of Complete Response (CR) or Partial Response (PR) or Stable disease (SD) based on RECIST version 1.1.
Phase II: Overall survival (OS) of CT041 autologous CAR T-cell injection versus Physician's Choice
Overall Survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.
Progression-free survival (PFS), as assessed by Investigators, of CT041 autologous CAR T-cell injection versus Physician's Choice
Progression-free survival (PFS) was defined as the time from the date of randomization to the earliest date of the first objective documentation of progressive disease (PD) or death due to any cause.infusion
Phase II:Objective Response Rate (ORR), as assessed by IRC and by Investigators
The Objective Response Rate (ORR) is the percentage of participants who achieved a best overall response of Complete Response (CR) or Partial Response (PR) based on RECIST version 1.1.
Phase II: Duration of response (DOR), as assessed by IRC and by Investigators
Duration of response (DOR) is defined as the time from the first documented objective response (CR or PR) to the first documented disease progression or death.
Phase II: Disease control rate (DCR), as assessed by IRC and by Investigators
Disease control rate (DCR) is the percentage of participants who achieved a best overall response of Complete Response (CR) or Partial Response (PR) or Stable disease (SD) based on RECIST version 1.1.

Full Information

First Posted
September 24, 2020
Last Updated
February 13, 2022
Sponsor
CARsgen Therapeutics Co., Ltd.
Collaborators
Peking University Cancer Hospital & Institute, Fudan University
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1. Study Identification

Unique Protocol Identification Number
NCT04581473
Brief Title
Study to Evaluate the Efficacy, Safety and Pharmacokinetics of CT041 Autologous CAR T-cell Injection
Official Title
An Open, Multicenter, Phase Ib/II Study to Evaluate the Efficacy, Safety and Pharmacokinetics of CT041 Autologous CAR T-cell Injection in Patients With Advanced Gastric/ Gastroesophageal Junction Adenocarcinoma and Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
October 23, 2020 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
June 30, 2038 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CARsgen Therapeutics Co., Ltd.
Collaborators
Peking University Cancer Hospital & Institute, Fudan University

4. Oversight

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

5. Study Description

Brief Summary
An open, multicenter, phase Ib/II study to evaluate the efficacy, safety and pharmacokinetics of CT041 autologous CAR T-cell injection in patients with advanced gastric/ gastroesophageal junction adenocarcinoma and pancreatic cancer
Detailed Description
This study is an open, multicenter, Phase Ib/II clinical trial evaluating chimeric antigen receptor-modified autologous T cells targeting Claudin18.2 (CLDN18.2) (CT041 autologous CAR T) in subjects with CLDN18.2 expression-positive, advanced gastric/esophagogastric conjugate adenocarcinoma that has failed at least 2 prior lines therapy and advanced pancreatic cancer that has failed at least 1 prior line therapy. The purpose is to evaluate the efficacy, safety and pharmacokinetics There are two stages in the study. Phase Ib stage is dose escalation and dose expansion study, and Phase II stage is to verify the efficacy and safety of CT041 treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Adenocarcinoma, Pancreatic Cancer, Gastroesophageal Junction Adenocarcinoma
Keywords
advanced solid tumors, Gastric Cancer, Pancreatic Cancer, Esophagogastric Junction Cancer, Claudin18.2, CLDN18.2, CAR T cell

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
192 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
CT041 autologous CAR T-cell injection
Arm Type
Experimental
Arm Description
Two stages: Phase 1b: dose escalation and dose expansion; Phase 2: verify CT041 efficacy and safety
Arm Title
Physician's Choice
Arm Type
Active Comparator
Arm Description
Participants will receive physician's choice of treatment in Phase II
Intervention Type
Drug
Intervention Name(s)
CT041 autologous CAR T-cell injection
Other Intervention Name(s)
CAR T-cell injection
Intervention Description
Up to 3 times CT041 autologous CAR T-cell injection infusion
Intervention Type
Drug
Intervention Name(s)
Physician's Choice(Paclitaxel or Irinotecan or Apatinib or Anti-PD-1 antibody)
Other Intervention Name(s)
Best support care(BSC)
Intervention Description
Physician's choice of any BSC listed above
Primary Outcome Measure Information:
Title
Phase Ib: Incidence of Treatment Related adverse events (AEs)
Description
Incidence of treatment related AEs, AEs of special interest and serious adverse events(SAEs).
Time Frame
Up to 18 months
Title
Phase Ib: Identification of Maximum Tolerated Dose (MTD)
Description
Incidence of dose-limiting toxicities (DLTs)
Time Frame
day1-day28
Title
Phase II: Progression-free survival (PFS), as assessed by IRC, of CT041 autologous CAR T-cell injection versus Physician's Choice
Description
Progression-free survival (PFS) was defined as the time from the date of randomization to the earliest date of the first objective documentation of progressive disease (PD) or death due to any cause.
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
Phase Ib: Objective Response Rate (ORR), as assessed by Investigators
Description
The Objective Response Rate (ORR) is the percentage of participants who achieved a best overall response of Complete Response (CR) or Partial Response (PR) based on RECIST version 1.1.
Time Frame
Up to 18 months
Title
Phase Ib: Progression-free survival (PFS), as assessed by Investigators
Description
Progression-free survival (PFS) was defined as the time from the date of first infusion of CT041 to the earliest date of the first objective documentation of progressive disease (PD) or death due to any cause.
Time Frame
Up to 18 months
Title
Phase Ib:Overall survival (OS)
Description
Overall Survival (OS) was defined as the time from the date of first infusion of CT041 to the date of death due to any cause.
Time Frame
Up to 18 months
Title
Phase Ib:Duration of response (DOR), as assessed by Investigators
Description
Duration of response (DOR) is defined as the time from the first documented objective response (CR or PR) to the first documented disease progression or death.
Time Frame
Up to 18 months
Title
Phase Ib:Disease control rate (DCR), as assessed by Investigators
Description
Disease control rate (DCR) is the percentage of participants who achieved a best overall response of Complete Response (CR) or Partial Response (PR) or Stable disease (SD) based on RECIST version 1.1.
Time Frame
Up to 18 months
Title
Phase II: Overall survival (OS) of CT041 autologous CAR T-cell injection versus Physician's Choice
Description
Overall Survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.
Time Frame
Up to 24 months
Title
Progression-free survival (PFS), as assessed by Investigators, of CT041 autologous CAR T-cell injection versus Physician's Choice
Description
Progression-free survival (PFS) was defined as the time from the date of randomization to the earliest date of the first objective documentation of progressive disease (PD) or death due to any cause.infusion
Time Frame
Up to 24 months
Title
Phase II:Objective Response Rate (ORR), as assessed by IRC and by Investigators
Description
The Objective Response Rate (ORR) is the percentage of participants who achieved a best overall response of Complete Response (CR) or Partial Response (PR) based on RECIST version 1.1.
Time Frame
Up to 24 months
Title
Phase II: Duration of response (DOR), as assessed by IRC and by Investigators
Description
Duration of response (DOR) is defined as the time from the first documented objective response (CR or PR) to the first documented disease progression or death.
Time Frame
Up to 24 months
Title
Phase II: Disease control rate (DCR), as assessed by IRC and by Investigators
Description
Disease control rate (DCR) is the percentage of participants who achieved a best overall response of Complete Response (CR) or Partial Response (PR) or Stable disease (SD) based on RECIST version 1.1.
Time Frame
Up to 24 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: Be willing to participate in a clinical trial, be informed and sign inform consent; and be willing to follow and be able to complete all trial procedures; Aged 18 to 75 years; Phase Ib:Patients with pathologically diagnosed advanced gastric/ gastroesophageal junction adenocarcinoma who have failed at least 2 prior lines treatment; or patients with pathologically diagnosed advanced pancreatic cancer who have failed at least 1 prior line treatment ; Phase II:Patients with pathologically diagnosed advanced gastric/ gastroesophageal junction adenocarcinoma who have failed at least 2 prior lines treatment; Phase Ib:Tumor tissue samples were positive for CLDN18.2 IHC staining; Phase II:Tumor tissue samples were positive for CLDN18.2 IHC staining and HER2 expression was negative; Estimated life expectancy >12 weeks; According to the RECIST 1.1, there is measurable tumor lesions; ECOG physical status score 0 ~ 1 at screening, within 24 hours prior to apheresis, and at baseline; Sufficient venous access for mononuclear cell collection; Unless otherwise specified, patients should meet the certain conditions prior to screening and pre-treatment and be allowed one week to retest if an abnormal laboratory test does not meet the criteria, and if the criteria are still not met, the screening is considered to have failed; Female patients of childbearing age must undergo a serum pregnancy test at screening and prior to pretreatment 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; Men who have actively sexual intercourse with women with child-bearing potential, must agree to use barrier-based contraception if they have no vasectomy. Exclusion Criteria: Pregnant or lactating women; HIV, Treponema pallidum or HCV serologically positive; Any uncontrollable active infection, including but not limited to active tuberculosis, HBV infection; The side effects caused by the previous treatment of the subjects did not return to CTCAE ≤1; except hair loss and other tolerable events determined by investigator; Patients known to have active autoimmune diseases, including but not limited to psoriasis or rheumatoid arthritis, or other diseases requiring long-term immunosuppressive therapy; Previously allergic to immunotherapy and related drugs,history of severe allergies, or allergic to components of CT041. Previously received any gene-modified cell therapies(including CAR-T, TCR-T); Patients have brain metastasis or symptoms of brain metastasis; Patients at high risk of hemorrhage or perforation; Patients requiring anticoagulant therapy; Patients requiring continuous anti-platelet therapy; Patients with a history of organ transplantation or awaiting organ transplantation; Patients 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; Presence of other serious pre-existing medical conditions that may limit patient participation in the study; The investigator assessed that the patient was unable or unwilling to comply with the requirements of the study protocol; Prior to pretreatment, patients 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. The investigator judges that the patient is not suitable for continuing the trial. Patients who use antibiotics to prevent infection can continue the trials if judged by the investigator; The patient has a central nervous system disease sign or an abnormal neurological test result with clinical significance; The patient 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.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wei Wang, MD, Ph.D
Phone
86-21-54489926
Email
weiwang@carsgen.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yilin Wang
Phone
86-21-64501828
Email
yilinwang@carsgen.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lin Shen, Professor
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Xianjun Yu, Professor
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Anhui Provincial Cancer Hospital
City
Hefei
State/Province
Anhui
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Changlu Hu, Professor
Facility Name
Beijing Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shen Lin, PhD
Facility Name
Harbin medical university Affiliated Cancer Hospital
City
Harbin
State/Province
Heilongjia
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yanqiao Zhang, Professor
Facility Name
Henan Tumor Hospital
City
Zhengzhou
State/Province
Henan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ning Li, Professor
Facility Name
Nanjing Drum Tower Hospital
City
Nanjing
State/Province
Jiangsu
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jia Wei, Professor
Facility Name
Ruijin Hospital, affiliated to Shanghai Jiaotong University, school of medicine
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200025
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jun Zhang, Professor
Facility Name
Fudan University Shanghai Cancer Center
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xianjun Yu, Professor
First Name & Middle Initial & Last Name & Degree
Jian Zhang, Professor
Facility Name
Shanghai Zhongshan Hospital
City
Shanghai
State/Province
Shanghai
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tianshu Liu, Professor
Facility Name
West China Hospital, Sichuan University
City
Chengdu
State/Province
Sichuan
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Meng Qiu, Professor
Facility Name
Tianjin Medical University Cancer Institute and Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300060
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yi Ba, Professor

12. IPD Sharing Statement

Plan to Share IPD
No

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Study to Evaluate the Efficacy, Safety and Pharmacokinetics of CT041 Autologous CAR T-cell Injection

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