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A Clinical Study of CEA-targeted CAR-T in the Treatment of CEA-positive Advanced Malignant Solid Tumors

Primary Purpose

Colorectal Cancer, Esophageal Cancer, Stomach Cancer

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CEA CAR-T cells
Sponsored by
Weijia Fang, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring CAR-T, CEA, CEA-positive advanced malignant solid tumors

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥18 years old, male or female;
  2. Advanced, metastatic or recurrent malignant tumors diagnosed by histology or pathology, mainly colorectal cancer, esophageal cancer, gastric cancer, and pancreatic cancer;
  3. After receiving at least second-line standard treatment and failing (disease progression or intolerance, such as surgery, chemotherapy, radiotherapy, etc.) or lack of effective treatment methods;
  4. Immunohistochemical staining of tumor samples within 3 months confirmed that the tumor was CEA positive (clear membrane staining, positive rate ≥ 10%); the patient's serum CEA should exceed 10ug/L.
  5. At least one assessable lesion according to RECIST 1.1 criteria;
  6. ECOG score 0-2 points;
  7. No serious mental disorder;
  8. Unless otherwise specified, the function of the vital organs of the subject shall meet the following conditions:

    1. Blood routine: white blood cells>2.0×109/L, neutrophils>0.8×109/L, lymphocytes cells>0.5×109/L, platelets>50×109/L, hemoglobin>90g/L;
    2. Cardiac function: echocardiography showed cardiac ejection fraction ≥50%, and no obvious abnormality was found on electrocardiogram;
    3. Renal function: serum creatinine≤2.0×ULN;
    4. Liver function: ALT and AST ≤3.0×ULN (for those with liver tumor infiltration, it can be relaxed to≤5.0×ULN);
    5. Total bilirubin≤2.0×ULN;
    6. Oxygen saturation > 92% in non-oxygen state.
  9. Have apheresis or venous blood collection standards, and have no other contraindications for cell collection;
  10. Subjects agree to use reliable and effective contraceptive methods for contraception within 1 year after signing the informed consent form to receiving CAR-T cell infusion (excluding rhythm contraception);
  11. The patients themselves or their guardians agree to participate in this clinical trial and sign the ICF, indicating that they understand the purpose and procedures of this clinical trial and are willing to participate in the research.

Exclusion Criteria:

  1. CNS metastases or meningeal metastases with clinical symptoms at the time of screening, or there is other evidence that the patient's central nervous system metastases or meningeal metastases have not been controlled, and are judged by the investigator to be unsuitable for inclusion;
  2. Participated in other clinical studies within 1 month before screening;
  3. vaccinated with live attenuated vaccine within 4 weeks before screening;
  4. Received the following anti-tumor treatments before screening: Received chemotherapy, targeted therapy or other experimental drug treatments within 14 days or at least 5 half-lives (whichever is shorter);
  5. Active infection or uncontrollable infection requiring systemic treatment;
  6. Patients with intestinal obstruction, active gastrointestinal bleeding, or a history of gastrointestinal bleeding within 3 months;
  7. Except for alopecia or peripheral neuropathy, the toxicity of previous anti-tumor therapy has not improved to the baseline level or ≤ grade 1;
  8. Suffering from any of the following heart diseases:

    1. New York Heart Association (NYHA) stage III or IV congestive heart failure;
    2. Myocardial infarction or coronary artery bypass grafting (CABG) within 6 months before enrollment;
    3. Clinically significant ventricular arrhythmia, or history of syncope of unknown origin (caused by vasovagal except those caused by neurosis or dehydration);
    4. History of severe non-ischemic cardiomyopathy;
  9. Patients with active autoimmune disease, or other patients requiring long-term immunosuppressive therapy;
  10. Suffering from other uncured malignant tumors in the past 3 years or at the same time, except cervical carcinoma in situ and basal cell carcinoma of the skin;
  11. Hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood hepatitis B virus (HBV) DNA titer is greater than the normal range; hepatitis C virus (HCV) antibody positive and peripheral blood hepatitis C Virus (HCV) RNA test is greater than the normal range; human immunodeficiency virus (HIV) antibody positive; syphilis test positive;
  12. Women who are pregnant or breastfeeding;
  13. Other investigators deem it unsuitable to participate in the study.

Sites / Locations

  • First affiliated hospital, Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Intravenous of CEA-targeted CAR-T

intraperitoneal injection of CEA-targeted CAR-T

Arm Description

Infusion of CEA-targeted CAR-T cells by dose of 3-10x106 cells/kg

Infusion of CEA-targeted CAR-T cells by dose of 3-10x106 cells/kg

Outcomes

Primary Outcome Measures

Incidence of Adverse events after CEA-CAR-T cells infusion [Safety and Tolerability]
Therapy-related adverse events were recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0)
Obtain the maximum tolerated dose of CEA-CAR-T cells[Safety and Tolerability]
Dose-limiting toxicity after cell infusion

Secondary Outcome Measures

Disease control rate of CAR-T cell preparations in CEA-positive advanced malignancies [Effectiveness]
Disease control rate: including CR, PR and SD
Changes in serum tumor markers of CAR-T cell preparations in CEA-positive advanced malignancies [Effectiveness]
Changes in serum tumor markers:CEA、 CA199、 CA125
AUCS of CEA-CAR-T cells [Cell dynamics]
AUCS is defined as the area under the curve in 28 days and 90 days
CMAX of CEA-CAR-T cells [Cell dynamics]
CMAX is defined as the highest concentration of CEA-CAR-T cells expanded in peripheral blood
TMAX of CEA-CAR-T cells[Cell dynamics]
TMAX is defined as the time to reach the highest concentration
Pharmacodynamics of CEA-CAR-T cells[Cell dynamics]
The content of free CEA in peripheral blood at each time point measured by Chemiluminescence immunoassay

Full Information

First Posted
May 25, 2022
Last Updated
July 14, 2023
Sponsor
Weijia Fang, MD
Collaborators
Chongqing Precision Biotech Co., Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT05396300
Brief Title
A Clinical Study of CEA-targeted CAR-T in the Treatment of CEA-positive Advanced Malignant Solid Tumors
Official Title
A Phase I Clinical Study of Anti-CEA CAR-T Therapy in the Treatment of CEA-positive Advanced Malignant Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 25, 2022 (Actual)
Primary Completion Date
May 15, 2024 (Anticipated)
Study Completion Date
May 15, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Weijia Fang, MD
Collaborators
Chongqing Precision Biotech Co., Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a phase I clinical study to evaluate the safety and tolerability of CAR-T in patients with CEA-positive advanced malignant solid tumors, and to obtain the maximum tolerated dose of CAR-T and phase II Recommended dose.
Detailed Description
This is a single-center, double-arm, open-label study. The study plans to set up 2 groups,Intravenous infusion group have 3 dose groups, adopting a dose-escalating 3+3 design, and plan to recruit about 9-18 subjects with CEA-positive advanced malignant solid tumors.Intraperitoneal injection group have 4 dose groups, adopting a dose-escalating 3+3 design, and plan to recruit about 12-24 subjects with CEA-positive advanced malignant solid tumors.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer, Esophageal Cancer, Stomach Cancer, Pancreatic Cancer, Metastatic Tumor, Recurrent Cancer
Keywords
CAR-T, CEA, CEA-positive advanced malignant solid tumors

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Intravenous of CEA-targeted CAR-T
Arm Type
Experimental
Arm Description
Infusion of CEA-targeted CAR-T cells by dose of 3-10x106 cells/kg
Arm Title
intraperitoneal injection of CEA-targeted CAR-T
Arm Type
Experimental
Arm Description
Infusion of CEA-targeted CAR-T cells by dose of 3-10x106 cells/kg
Intervention Type
Biological
Intervention Name(s)
CEA CAR-T cells
Intervention Description
Administration method: intravenous infusion or intraperitoneal injection; Subjects will be treated with Fludarabine and Cyclophosphamide before cell infusion.
Primary Outcome Measure Information:
Title
Incidence of Adverse events after CEA-CAR-T cells infusion [Safety and Tolerability]
Description
Therapy-related adverse events were recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0)
Time Frame
28 days
Title
Obtain the maximum tolerated dose of CEA-CAR-T cells[Safety and Tolerability]
Description
Dose-limiting toxicity after cell infusion
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Disease control rate of CAR-T cell preparations in CEA-positive advanced malignancies [Effectiveness]
Description
Disease control rate: including CR, PR and SD
Time Frame
3 months
Title
Changes in serum tumor markers of CAR-T cell preparations in CEA-positive advanced malignancies [Effectiveness]
Description
Changes in serum tumor markers:CEA、 CA199、 CA125
Time Frame
3 months
Title
AUCS of CEA-CAR-T cells [Cell dynamics]
Description
AUCS is defined as the area under the curve in 28 days and 90 days
Time Frame
1 years
Title
CMAX of CEA-CAR-T cells [Cell dynamics]
Description
CMAX is defined as the highest concentration of CEA-CAR-T cells expanded in peripheral blood
Time Frame
1 years
Title
TMAX of CEA-CAR-T cells[Cell dynamics]
Description
TMAX is defined as the time to reach the highest concentration
Time Frame
1 years
Title
Pharmacodynamics of CEA-CAR-T cells[Cell dynamics]
Description
The content of free CEA in peripheral blood at each time point measured by Chemiluminescence immunoassay
Time Frame
1 years
Other Pre-specified Outcome Measures:
Title
Objective response rate (ORR) of CEA- CAR-T treatment in patients with CEA-positive advanced malignancies[Effectiveness]
Description
Objective response rate includes:CR、PR
Time Frame
1 years
Title
Duration of Response (DOR) of CEA- CAR-T treatment in patients with CEA-positive advanced malignancies[Effectiveness]
Description
DOR will be assessed from the first assessment of CR/PR/SD to the first assessment of recurrence or progression of the disease or death from any cause
Time Frame
1 years
Title
Progress-free survival(PFS) of CEA- CAR-T treatment in patients with CEA-positive advanced malignancies[Effectiveness]
Description
PFS will be assessed from the first CEA-CAR-T cell infusion to death from any cause or the first assessment of progression.
Time Frame
1 years
Title
Overall survival(OS)of CEA- CAR-T treatment in patients with CEA-positive advanced malignancies[Effectiveness]
Description
OS will be assessed from the first CEA-CAR-T cell infusion to death from any cause
Time Frame
1 years
Title
Proportion of tumor cells in tumor tissue of CEA- CAR-T treatment in patients with CEA-positive advanced malignancies
Description
The rate of tumor cell in tumor tissue will be measured by biopsy and immunohistochemistry
Time Frame
1 years
Title
CEA expression level of CEA- CAR-T treatment in patients with CEA-positive advanced malignancies
Description
The CEA expression in tumor tissue will be measured by biopsy and immunohistochemistry
Time Frame
1 years
Title
Changes in the number of tumor-infiltrating immune cells of CEA- CAR-T treatment in patients with CEA-positive
Description
the number of tumor-infiltrating immune cells will be measured by biopsy and immunohistochemistry
Time Frame
1 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years old, male or female; Advanced, metastatic or recurrent malignant tumors diagnosed by histology or pathology, mainly colorectal cancer, esophageal cancer, gastric cancer, and pancreatic cancer; After receiving at least second-line standard treatment and failing (disease progression or intolerance, such as surgery, chemotherapy, radiotherapy, etc.) or lack of effective treatment methods; Immunohistochemical staining of tumor samples within 3 months confirmed that the tumor was CEA positive (clear membrane staining, positive rate ≥ 10%); the patient's serum CEA should exceed 10ug/L. At least one assessable lesion according to RECIST 1.1 criteria; ECOG score 0-2 points; No serious mental disorder; Unless otherwise specified, the function of the vital organs of the subject shall meet the following conditions: Blood routine: white blood cells>2.0×109/L, neutrophils>0.8×109/L, lymphocytes cells>0.5×109/L, platelets>50×109/L, hemoglobin>90g/L; Cardiac function: echocardiography showed cardiac ejection fraction ≥50%, and no obvious abnormality was found on electrocardiogram; Renal function: serum creatinine≤2.0×ULN; Liver function: ALT and AST ≤3.0×ULN (for those with liver tumor infiltration, it can be relaxed to≤5.0×ULN); Total bilirubin≤2.0×ULN; Oxygen saturation > 92% in non-oxygen state. Have apheresis or venous blood collection standards, and have no other contraindications for cell collection; Subjects agree to use reliable and effective contraceptive methods for contraception within 1 year after signing the informed consent form to receiving CAR-T cell infusion (excluding rhythm contraception); The patients themselves or their guardians agree to participate in this clinical trial and sign the ICF, indicating that they understand the purpose and procedures of this clinical trial and are willing to participate in the research. Exclusion Criteria: CNS metastases or meningeal metastases with clinical symptoms at the time of screening, or there is other evidence that the patient's central nervous system metastases or meningeal metastases have not been controlled, and are judged by the investigator to be unsuitable for inclusion; Participated in other clinical studies within 1 month before screening; vaccinated with live attenuated vaccine within 4 weeks before screening; Received the following anti-tumor treatments before screening: Received chemotherapy, targeted therapy or other experimental drug treatments within 14 days or at least 5 half-lives (whichever is shorter); Active infection or uncontrollable infection requiring systemic treatment; Patients with intestinal obstruction, active gastrointestinal bleeding, or a history of gastrointestinal bleeding within 3 months; Except for alopecia or peripheral neuropathy, the toxicity of previous anti-tumor therapy has not improved to the baseline level or ≤ grade 1; Suffering from any of the following heart diseases: New York Heart Association (NYHA) stage III or IV congestive heart failure; Myocardial infarction or coronary artery bypass grafting (CABG) within 6 months before enrollment; Clinically significant ventricular arrhythmia, or history of syncope of unknown origin (caused by vasovagal except those caused by neurosis or dehydration); History of severe non-ischemic cardiomyopathy; Patients with active autoimmune disease, or other patients requiring long-term immunosuppressive therapy; Suffering from other uncured malignant tumors in the past 3 years or at the same time, except cervical carcinoma in situ and basal cell carcinoma of the skin; Hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood hepatitis B virus (HBV) DNA titer is greater than the normal range; hepatitis C virus (HCV) antibody positive and peripheral blood hepatitis C Virus (HCV) RNA test is greater than the normal range; human immunodeficiency virus (HIV) antibody positive; syphilis test positive; Women who are pregnant or breastfeeding; Other investigators deem it unsuitable to participate in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Weijia Fang, M.D
Phone
13758211655
Email
weijiafang@zju.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Weijia Fang, M.D
Organizational Affiliation
The First Affiliated Hospital, Zhejiang University
Official's Role
Principal Investigator
Facility Information:
Facility Name
First affiliated hospital, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310006
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Weijia fang, MD
Phone
13758211655
Email
weijia.fang@163.com
First Name & Middle Initial & Last Name & Degree
Weijia fang, MD

12. IPD Sharing Statement

Learn more about this trial

A Clinical Study of CEA-targeted CAR-T in the Treatment of CEA-positive Advanced Malignant Solid Tumors

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