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A Study of CNA3103 (LGR5-targeted, Autologous CAR-T Cells) Administered to Subjects With Metastatic Colorectal Cancer

Primary Purpose

Colorectal Cancer Metastatic

Status
Recruiting
Phase
Phase 1
Locations
Australia
Study Type
Interventional
Intervention
CNA3103: 5 x 10^7 cells
CNA3103: 1.5 x 10^8 cells
CNA3103: 4.5 x 10^8 cells
CNA3103: 1.5 x 10^9 cells
CNA3103: 2.5 x 10^7 cells
Sponsored by
Carina Biotech Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer Metastatic focused on measuring CAR-T, LGR5

Eligibility Criteria

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

Inclusion Criteria: Signed written Informed Consent. Male and female subjects aged greater than or equal to18 years. Eastern Cooperative Oncology Group (ECOG) Performance Score 0 to 1. Histologically or cytologically confirmed metastatic colorectal cancer previously treated with 5-FU, oxaliplatin and irinotecan-based regimens for metastatic disease and least 4 weeks from last chemotherapy, biologic, radiotherapy, or investigational therapy, with resolution of all lingering toxicities to Grade <1, with the exception of neuropathy and alopecia. Positive for any level of LGR5 expression in tumor biopsies. Measurable or evaluable disease per RECIST version 1.1 . Life expectancy of at least >12 weeks. Normal organ and marrow function. No clinically significant abnormalities in urinalysis results at Screening. No known clinically significant gastrointestinal disease within 28 days prior to beginning study treatment. No ongoing requirement for anti-diarrheal therapy. For female subjects of childbearing potential and male subjects with partners of childbearing potential, agreement (by subject and/or partner) to use a highly effective form of contraception and to continue its use for 6 months after the last dose of IP. Women of childbearing potential must have a negative serum pregnancy test within 72 hours prior to CNA3103 administration. Exclusion Criteria: Inability to comply with study and follow-up procedures. Women who are pregnant or lactating. Has BRAF-mutated colorectal cancer. Has received any third line treatment regimen or received trifluridine/tipiracil (TAS-102) and regorafenib for metastatic disease. Treatment with chemotherapy, hormonal therapy, immunotherapy, biologic therapy, or radiation therapy as cancer therapy within 4 weeks before initiation of study treatment. Treatment with any other investigational agent or participation in another clinical trial with therapeutic intent in the previous 28 days. Have received antibody-based therapies within the previous 28 days or 5 half-lives of the agent, whichever is shorter. Major surgery, other than diagnostic surgery, in the previous 4 weeks. Clinically detectable third-space fluid collections that cannot be controlled by drainage or other procedures prior to study entry. Any uncontrolled medical or psychiatric risk factors which would contraindicate the use or impair the ability of the subject to provide informed consent, receive protocol therapy or may impose excessive risk to the subject. Known central nervous system (CNS) disease. Current use of medications that may have the potential of QTc prolongation. Uncontrolled bacterial, viral, or fungal infection, requiring systemic therapy. Has a known infection with human immunodeficiency virus (HIV), Hepatitis B or Hepatitis C, alcoholic or other hepatitis, or cirrhosis. Inability to be venipunctured and/or tolerate venous access. Second malignancies within 5 years prior to enrollment, except for those with a negligible risk of metastasis or death, such as adequately treated carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer treated surgically with curative intent, ductal carcinoma in situ treated surgically with curative intent. Active autoimmune disease that is not controlled by non-steroidal anti-inflammatory drugs (NSAIDs), inhaled corticosteroids, or the equivalent of ≤10 mg/day prednisone. History of inflammatory bowel disease (active or past) or active peptic ulcer disease. History of connective tissue disorders. History of chronic leukemias. History of previous, whole abdomen radiation therapy (or total pelvic radiation therapy) or more than Grade 1 residual toxicity from previous radiation therapy. High cardiovascular risk, including, but not limited to, recent coronary stenting or myocardial infarction in the past year Left ventricular ejection fraction <50%. Have had a venous thromboembolic event requiring anticoagulation. Congenital or acquired long QT syndrome. QTc prolongation. History of interstitial lung disease, history of slowly progressive dyspnea and unproductive cough, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary hypersensitivity pneumonitis or multiple allergies.

Sites / Locations

  • Carina Biotech InvestigatorsRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CNA3103 Monotherapy

Arm Description

Single intravenous dose of CNA3103 at Day 0

Outcomes

Primary Outcome Measures

To determine the safety of treatment with CNA3103.
Incidence of Treatment-Emergent Adverse Events
To determine the overall best response to CNA3103.
Best response per Response Evaluation Criteria in Solid Tumors (RECIST).

Secondary Outcome Measures

To determine the recommended Phase 2a dose (RP2D) of CNA3103
Determined by dose limiting toxicities (DLTs)
To monitor for replication competent viral construct in blood specimens
Viral construct presence will be monitored
To determine the Pharmacokinetics of CNA3103
Levels of CNA3103 cells measured
To determine overall survival
Survival will be calculated from the onset of CNA3103 therapy.
Failure to treat
Caused by manufacturing issues or patient related issues.
To determine progression-free survival
Calculated from the onset of therapy to disease progression.

Full Information

First Posted
February 13, 2023
Last Updated
October 19, 2023
Sponsor
Carina Biotech Limited
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1. Study Identification

Unique Protocol Identification Number
NCT05759728
Brief Title
A Study of CNA3103 (LGR5-targeted, Autologous CAR-T Cells) Administered to Subjects With Metastatic Colorectal Cancer
Official Title
A Phase 1/2a, Multicenter, Open-Label, Dose Escalation and Expansion Study of CNA3103 (LGR5-targeted, Autologous CAR-T Cells) Administered to Adult Subjects With Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 19, 2023 (Anticipated)
Primary Completion Date
December 2027 (Anticipated)
Study Completion Date
December 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Carina Biotech Limited

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
This study aims to determine the safety and best response of treatment with CNA3103 (Leucine-rich repeat-containing G protein-coupled receptor 5 [LGR5]-targeted, Autologous Chimeric Antigen Receptor (CAR) -T Cells), for participants with Metastatic Colorectal Cancer. Participants may undergo a pre-screening biopsy procedure to determine expression of LGR5. Participants will undergo screening procedures, including leukapheresis (collection of T cells) and lymphodepletion (chemotherapy), up to 40 days prior to CNA3103 dosing. Participants will receive a single Intravenous dose of CNA3103. Expansion cohorts will open after determination of the maximum tolerated dose and recommended phase 2 dose in the dose escalation stage. Participants will be followed up, monitored and will attend study visits for safety and research related tests and procedures for 2 years until disease progression, unacceptable toxicity or intolerable adverse event/s, death or withdrawal of consent.
Detailed Description
This is a Phase 1/2a, multicenter, open-label study in adult subjects with metastatic colorectal cancer. (CRC). The study will consist of 2 segments: Phase 1 Segment (Dose Escalation): a Bayesian Optimal Interval (BOIN) study design will be used to minimize any risks of exposure to the novel CNA3103 CAR-T cells during dose escalation while determining the Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D). A minimum of 3 subjects per cohort will be enrolled at each dose level, with appropriate staggering of subjects within and between dose levels. Phase 2a Segment (Dose Expansion): After determination of the MTD/RP2D, additional subjects will be enrolled and treated with CNA3103 at that dose to further assess the safety, PK, pharmacodynamic, and anti-tumor properties of CNA3103. Based upon safety data of these additional subjects, the Sponsor, in consult with the Investigators, may choose to enroll additional subjects at the same or a different dose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer Metastatic
Keywords
CAR-T, LGR5

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
45 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
CNA3103 Monotherapy
Arm Type
Experimental
Arm Description
Single intravenous dose of CNA3103 at Day 0
Intervention Type
Biological
Intervention Name(s)
CNA3103: 5 x 10^7 cells
Intervention Description
CNA3103: 5 x 10^7 cells - intravenous infusion
Intervention Type
Biological
Intervention Name(s)
CNA3103: 1.5 x 10^8 cells
Intervention Description
CNA3103: 1.5 x 10^8 cells - intravenous infusion
Intervention Type
Biological
Intervention Name(s)
CNA3103: 4.5 x 10^8 cells
Intervention Description
CNA3103: 4.5 x 10^8 cells - intravenous infusion
Intervention Type
Biological
Intervention Name(s)
CNA3103: 1.5 x 10^9 cells
Intervention Description
CNA3103: 1.5 x 10^9 cells - intravenous infusion
Intervention Type
Biological
Intervention Name(s)
CNA3103: 2.5 x 10^7 cells
Intervention Description
CNA3103: 2.5 x 10^7 cells - intravenous infusion
Primary Outcome Measure Information:
Title
To determine the safety of treatment with CNA3103.
Description
Incidence of Treatment-Emergent Adverse Events
Time Frame
24 Months
Title
To determine the overall best response to CNA3103.
Description
Best response per Response Evaluation Criteria in Solid Tumors (RECIST).
Time Frame
24 Months
Secondary Outcome Measure Information:
Title
To determine the recommended Phase 2a dose (RP2D) of CNA3103
Description
Determined by dose limiting toxicities (DLTs)
Time Frame
28 days
Title
To monitor for replication competent viral construct in blood specimens
Description
Viral construct presence will be monitored
Time Frame
24 Months
Title
To determine the Pharmacokinetics of CNA3103
Description
Levels of CNA3103 cells measured
Time Frame
24 Months
Title
To determine overall survival
Description
Survival will be calculated from the onset of CNA3103 therapy.
Time Frame
24 Months
Title
Failure to treat
Description
Caused by manufacturing issues or patient related issues.
Time Frame
8 Weeks
Title
To determine progression-free survival
Description
Calculated from the onset of therapy to disease progression.
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed written Informed Consent. Male and female subjects aged greater than or equal to18 years. Eastern Cooperative Oncology Group (ECOG) Performance Score 0 to 1. Histologically or cytologically confirmed metastatic colorectal cancer previously treated with 5-FU, oxaliplatin and irinotecan-based regimens for metastatic disease and least 4 weeks from last chemotherapy, biologic, radiotherapy, or investigational therapy, with resolution of all lingering toxicities to Grade <1, with the exception of neuropathy and alopecia. Positive for any level of LGR5 expression in tumor biopsies. Measurable or evaluable disease per RECIST version 1.1 . Life expectancy of at least >12 weeks. Normal organ and marrow function. No clinically significant abnormalities in urinalysis results at Screening. No known clinically significant gastrointestinal disease within 28 days prior to beginning study treatment. No ongoing requirement for anti-diarrheal therapy. For female subjects of childbearing potential and male subjects with partners of childbearing potential, agreement (by subject and/or partner) to use a highly effective form of contraception and to continue its use for 6 months after the last dose of IP. Women of childbearing potential must have a negative serum pregnancy test within 72 hours prior to CNA3103 administration. Exclusion Criteria: Inability to comply with study and follow-up procedures. Women who are pregnant or lactating. Has BRAF-mutated colorectal cancer. Has received any third line treatment regimen or received trifluridine/tipiracil (TAS-102) and regorafenib for metastatic disease. Treatment with chemotherapy, hormonal therapy, immunotherapy, biologic therapy, or radiation therapy as cancer therapy within 4 weeks before initiation of study treatment. Treatment with any other investigational agent or participation in another clinical trial with therapeutic intent in the previous 28 days. Have received antibody-based therapies within the previous 28 days or 5 half-lives of the agent, whichever is shorter. Major surgery, other than diagnostic surgery, in the previous 4 weeks. Clinically detectable third-space fluid collections that cannot be controlled by drainage or other procedures prior to study entry. Any uncontrolled medical or psychiatric risk factors which would contraindicate the use or impair the ability of the subject to provide informed consent, receive protocol therapy or may impose excessive risk to the subject. Known central nervous system (CNS) disease. Current use of medications that may have the potential of QTc prolongation. Uncontrolled bacterial, viral, or fungal infection, requiring systemic therapy. Has a known infection with human immunodeficiency virus (HIV), Hepatitis B or Hepatitis C, alcoholic or other hepatitis, or cirrhosis. Inability to be venipunctured and/or tolerate venous access. Second malignancies within 5 years prior to enrollment, except for those with a negligible risk of metastasis or death, such as adequately treated carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer treated surgically with curative intent, ductal carcinoma in situ treated surgically with curative intent. Active autoimmune disease that is not controlled by non-steroidal anti-inflammatory drugs (NSAIDs), inhaled corticosteroids, or the equivalent of ≤10 mg/day prednisone. History of inflammatory bowel disease (active or past) or active peptic ulcer disease. History of connective tissue disorders. History of chronic leukemias. History of previous, whole abdomen radiation therapy (or total pelvic radiation therapy) or more than Grade 1 residual toxicity from previous radiation therapy. High cardiovascular risk, including, but not limited to, recent coronary stenting or myocardial infarction in the past year Left ventricular ejection fraction <50%. Have had a venous thromboembolic event requiring anticoagulation. Congenital or acquired long QT syndrome. QTc prolongation. History of interstitial lung disease, history of slowly progressive dyspnea and unproductive cough, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary hypersensitivity pneumonitis or multiple allergies.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lina T Jablonskis, PhD
Phone
+ 61 8 7110 0883
Email
lina@carinabiotech.com
Facility Information:
Facility Name
Carina Biotech Investigators
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lina T Jablonskis, PhD
Phone
+ 61 8 7110 0883
Email
lina@carinabiotech.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of CNA3103 (LGR5-targeted, Autologous CAR-T Cells) Administered to Subjects With Metastatic Colorectal Cancer

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