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Clinical Study of CEA-targeted CAR-T Therapy for CEA-positive Advanced/Metastatic Malignant Solid Tumors

Primary Purpose

Gastric Cancer, Colon Cancer, Pancreas Cancer

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CEA CAR-T cells
CEA CAR-T cells
Sponsored by
Chongqing Precision Biotech Co., Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastric Cancer focused on measuring CAR-T, CEA

Eligibility Criteria

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

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 failure (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 positive rate ≥ 10%), the serum CEA of the patient is required to 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>3.0×10^9/L, neutrophils>0.8×10^9/L, lymphocytes cells>0.5×10^9/L, platelets>75×10^9/L, hemoglobin>80g/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 patients with liver tumor infiltration, it can be relaxed to ≤5.0×ULN); Total bilirubin≤3.0×ULN; Oxygen saturation ≥95% 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: Those who have central nervous system metastasis or meningeal metastasis at the time of screening 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 a history of unexplained syncope (except those caused by vasovagal 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 test 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 research.

Sites / Locations

  • The First Affiliated Hospital of Nanchang 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 1-10x106 cells/kg

Infusion of CEA-targeted CAR-T cells by dose of 1-10x106 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: The proportion of subjects who achieved CR, PR, SD after treatment accounted for all treated subjects (Assessed based on RECIST criteria),the minimum value is 0%,maximum value is 100%, and higher scores mean a better outcome.
Objective response rate (ORR) of CEA CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness]
Objective response rate includes:The proportion of subjects who achieved CR, PR after treatment accounted for all treated subjects (Assessed based on RECIST criteria),the minimum value is 0%,maximum value is 100%, and higher scores mean a better outcome.
Duration of Response (DOR) of CEA CAR-T treatment in patients with CEA-positive advanced malignancies[Effectiveness]
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
Overall survival(OS)of CEA CAR-T treatment in patients with CEA-positive advanced malignancies[Effectiveness]
OS will be assessed from the first CEA-CAR-T cell infusion to death from any cause (Assessed based on RECIST criteria)
Progress-free survival(PFS) of CEA CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness]
PFS will be assessed from the first CEA-CAR-T cell infusion to death from any cause or the first assessment of progression(Assessed based on RECIST criteria)
AUCS of CEA CAR-T cells [Cell dynamics]
AUCS is defined as the area under the curve in 90 days
CMAX of CEA CAR-T cells [Cell dynamics]
CMAX is defined as the highest concentration of CEA CAR-T cells expanded in
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]
Concentration levels of CAR-T-related serum cytokines such as CRP, IL-6, ferritin at each time point

Full Information

First Posted
August 18, 2023
Last Updated
August 23, 2023
Sponsor
Chongqing Precision Biotech Co., Ltd
Collaborators
The First Affiliated Hospital of Nanchang University
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1. Study Identification

Unique Protocol Identification Number
NCT06010862
Brief Title
Clinical Study of CEA-targeted CAR-T Therapy for CEA-positive Advanced/Metastatic Malignant Solid Tumors
Official Title
A Safety and Efficacy Clinical Study of CEA-targeted CAR-T Therapy forCEA-positive Advanced/Metastatic Malignant Solid Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 30, 2023 (Anticipated)
Primary Completion Date
December 31, 2025 (Anticipated)
Study Completion Date
September 30, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chongqing Precision Biotech Co., Ltd
Collaborators
The First Affiliated Hospital of Nanchang University

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/metastatic 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 4 dose groups, adopting a dose-escalating 3+3 design, and plan to recruit about 12 subjects with CEA-positive advanced/metastatic solid tumors.Intraperitoneal injection group have 4 dose groups, adopting a dose-escalating 3+3 design, and plan to recruit about 12 subjects with CD70-positive advanced/metastatic solid tumors.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Cancer, Colon Cancer, Pancreas Cancer, Esophagus Cancer, Cholangiocarcinoma, Lung Cancer, Breast Cancer
Keywords
CAR-T, CEA

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
36 (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 1-10x106 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 1-10x106 cells/kg
Intervention Type
Biological
Intervention Name(s)
CEA CAR-T cells
Intervention Description
After lymphodepletion with Fludarabine and Cyclophosphamide,CAR T cells were transfused intravenically
Intervention Type
Biological
Intervention Name(s)
CEA CAR-T cells
Intervention Description
After lymphodepletion with Fludarabine and Cyclophosphamide,CAR T cells were injected intraperitoneally
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: The proportion of subjects who achieved CR, PR, SD after treatment accounted for all treated subjects (Assessed based on RECIST criteria),the minimum value is 0%,maximum value is 100%, and higher scores mean a better outcome.
Time Frame
3 months
Title
Objective response rate (ORR) of CEA CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness]
Description
Objective response rate includes:The proportion of subjects who achieved CR, PR after treatment accounted for all treated subjects (Assessed based on RECIST criteria),the minimum value is 0%,maximum value is 100%, and higher scores mean a better outcome.
Time Frame
3 months
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
3 months
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 (Assessed based on RECIST criteria)
Time Frame
2 years
Title
Progress-free survival(PFS) of CEA CAR-T treatment in patients with CD70-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(Assessed based on RECIST criteria)
Time Frame
2 years
Title
AUCS of CEA CAR-T cells [Cell dynamics]
Description
AUCS is defined as the area under the curve in 90 days
Time Frame
3 months
Title
CMAX of CEA CAR-T cells [Cell dynamics]
Description
CMAX is defined as the highest concentration of CEA CAR-T cells expanded in
Time Frame
3 months
Title
TMAX of CEA CAR-T cells[Cell dynamics]
Description
TMAX is defined as the time to reach the highest concentration
Time Frame
3 months
Title
Pharmacodynamics of CEA CAR-T cells[Cell dynamics]
Description
Concentration levels of CAR-T-related serum cytokines such as CRP, IL-6, ferritin at each time point
Time Frame
3 months
Other Pre-specified Outcome Measures:
Title
The correlation between CEA positive rate and safety
Description
assessment the correlation between CEA positive rate and the incidence of CRA and ICANS
Time Frame
2 years
Title
Correlation between CEA positive rate and efficacy
Description
assessment the correlation between CEA positive rate and the disease control rate,Disease control rate: including CR, PR and SD
Time Frame
2 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 (Assessed by investigators based on IRECIST criteria)
Time Frame
2 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 (Assessed by investigators based on IRECIST criteria)
Time Frame
2 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 (Assessed by investigators based on IRECIST criteria)
Time Frame
2 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 failure (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 positive rate ≥ 10%), the serum CEA of the patient is required to 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>3.0×10^9/L, neutrophils>0.8×10^9/L, lymphocytes cells>0.5×10^9/L, platelets>75×10^9/L, hemoglobin>80g/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 patients with liver tumor infiltration, it can be relaxed to ≤5.0×ULN); Total bilirubin≤3.0×ULN; Oxygen saturation ≥95% 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: Those who have central nervous system metastasis or meningeal metastasis at the time of screening 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 a history of unexplained syncope (except those caused by vasovagal 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 test 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 research.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Fei Li, M.D
Phone
13970038386
Email
691058841@qq.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Fei Li, M.D
Organizational Affiliation
The First Affiliated Hospital of Nanchang University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The First Affiliated Hospital of Nanchang University
City
Nanchang
State/Province
Jiangxi
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Fei Li, MD
Phone
13970038386
Email
691058841@qq.com

12. IPD Sharing Statement

Learn more about this trial

Clinical Study of CEA-targeted CAR-T Therapy for CEA-positive Advanced/Metastatic Malignant Solid Tumors

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