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A Phase 1b Study of WU-NK-101 in Combination With Cetuximab

Primary Purpose

Colorectal Cancer Metastatic, Squamous Cell Carcinoma of Head and Neck

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
WU-NK-101 - Dose Escalation
Cetuximab - Dose Escalation
WU-NK-101 - Cohort Expansion
Cetuximab - Cohort Expansion
Sponsored by
Wugen, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer Metastatic focused on measuring NK cells, allogeneic NK cells, cetuximab

Eligibility Criteria

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

Inclusion Criteria: Patients must have a histologically confirmed diagnosis of advanced and/or metastatic CRC that has failed or progressed beyond first line or higher line standard of care therapy including bevacizumab combination, cetuximab combination, 5-FU based regimens, or checkpoint inhibitors alone or in combination. Patients must have received all targeted therapies for which they are eligible. Patients may be included in this study regardless of mutation status (e.g., RAS-mutant, wild-type, or unknown status, BRAF V600E, etc.) and EGFR expression. Or, Patients must have a histologically confirmed diagnosis of SCCHN that has failed or progressed beyond first or higher line standard of care therapy including cetuximab alone or in combination, checkpoint inhibitors alone and in combination, or regimens containing radiotherapy. Patients may be included in this study regardless of EGFR expression. Measurable disease, in accordance with RECIST 1.1. Eastern Cooperative Oncology Group Performance (ECOG) Status ≤ 2 at screening. Adequate organ function as defined in the protocol. Ejection fraction ≥ 45%. Life expectancy >12 weeks. Exclusion Criteria: Experienced toxicities related to prior cetuximab treatment which required permanent discontinuation of cetuximab per the current label. Active autoimmune disorder requiring immunosuppression (physiologic steroids defined as ≤ 15 mg prednisone or equivalent are acceptable). Symptomatic central nervous system (CNS) metastases. Patients with a history of CNS metastasis must have been treated, must be asymptomatic, and must not have any of the following at the time of enrollment: No concurrent treatment for the CNS disease (e.g., surgery, radiation, corticosteroids > 10 mg prednisone/day or equivalent). No progression of CNS metastases on magnetic resonance imaging (MRI) or computed tomography (CT) for at least 14 days after last day of prior therapy for the CNS metastases, no concurrent leptomeningeal disease or cord compression. Known hypersensitivity to one or more of the study agents. Known hypersensitivity to IL-2 or any component of IL-2 formulation. Patients with organ allografts. Uncontrolled or untreated bacterial, fungal, or viral infections, including but not limited to human immunodeficiency virus, hepatitis B or C infection, or uncontrolled infection of any etiology. Uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiogram (ECG) suggestive of acute ischemia, active conduction system abnormalities, or abnormal cardiac stress test. New progressive pulmonary infiltrates on screening chest x-ray or chest CT scan that have not been evaluated with bronchoscopy. Infiltrates attributed to infection must be stable/ improving after 1 week of appropriate therapy (4 weeks for presumed or proven fungal infections). Received any investigational drugs within the 14 days or 5 half- lives (whichever is longer) prior to the first dose of fludarabine. Radiotherapy or chemotherapy within 2 weeks prior to the first dose of fludarabine. Severe renal impairment, defined as creatinine clearance <40 mL/min. Pregnant and/or breastfeeding women. Any condition that, in the opinion of the investigator, would prevent the participant from consenting to or participating in the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    WU-NK-101 Monotherapy/Cetuximab combo Run-in

    WU-NK-101 /Cetuximab Combo

    Arm Description

    WU-NK-101 is a non-engineered Natural Killer (NK) cell derived from peripheral blood mononuclear cells (PBMC) that is cytokine-reprogrammed, expanded, and cryopreserved to create an allogeneic enhanced memory-like anti-tumor NK cell therapy product. Each 8 week cycle in dose escalation is divided into two 28- days segments. Patients will receive WU-NK-101 (Days 1 and 15) in the first segment and a combination of cetuximab (500mg/m2 on Days 29 and 43) plus WU-NK-101 (Days 30 and 44) in the second segment.

    Patients will receive cetuximab dosed at 500 mg/m2 on Days 1 and 15, and WU-NK-101 on Days 2 and 16, in each 4-week cycle. Depending on response patients may receive up to 6 cycles of treatment.

    Outcomes

    Primary Outcome Measures

    Incidence of Adverse Events of WU-NK-101 in combination with cetuximab as assessed by by CTCAE v5
    Safety is based on evaluation of adverse events (AEs) and serious adverse events (SAEs) from the time of consent until the end of the study visit or at the end of treatment visit.
    Maximum Tolerated Dose
    Maximum tolerated or administered dose of WU-NK-101 in combination with cetuximab

    Secondary Outcome Measures

    Duration of Response
    Time of response to the time of disease relapse, progression or death due to any cause
    Overall Response Rate
    ORR is defined as the proportion of patients that achieve complete remission (CR) + partial response (PR) using modified Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1)

    Full Information

    First Posted
    December 30, 2022
    Last Updated
    July 5, 2023
    Sponsor
    Wugen, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05674526
    Brief Title
    A Phase 1b Study of WU-NK-101 in Combination With Cetuximab
    Official Title
    A Phase 1b Study of WU-NK-101 in Combination With Cetuximab for Advanced and/or Metastatic Colorectal Cancer (CRC) and Advanced and/or Metastatic Squamous Cell Carcinoma of the Head and Neck (SCCHN)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    November 1, 2023 (Anticipated)
    Primary Completion Date
    February 28, 2025 (Anticipated)
    Study Completion Date
    June 1, 2026 (Anticipated)

    3. Sponsor/Collaborators

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

    4. Oversight

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

    5. Study Description

    Brief Summary
    This study is a Phase 1b open-label study designed to characterize the safety, tolerability, and preliminary anti-tumor activity of WU-NK-101 in combination with cetuximab in patients with advanced and/or metastatic CRC (Cohort 1), and in patients with advanced and/or metastatic SCCHN (Cohort 2). The overall study will be comprised of two phases, a Dose Escalation Phase, and a Cohort Expansion Phase.
    Detailed Description
    In the Dose Escalation Phase, up to 12 patients with either advanced and/or metastatic CRC or advanced and/or metastatic SCCHN will be treated with WU-NK-101, alone and in combination with cetuximab, in successive cohorts of 3 to 6 patients using a standard 3 + 3 design. Intra-patient dose escalation is not permitted. Patients may receive up to one 8-week cycle of treatment. Each 8-week cycle is divided into two 28-day segments, (Segments A and B). During Segment A, only WU-NK-101 (monotherapy) will be administered. Segment A will consist of two doses of WU-NK-101 infused on Day 1 and Day 15. Patients that do not experience a dose limiting toxicity (DLT) will proceed to Segment B. During Segment B, WU-NK-101 will be administered in combination with cetuximab (combination therapy). WU-NK-101 cells will be administered on Days 30 and 44. Cetuximab will be administered on Days 29 and 43 at 500 mg/m2 (FDA-approved dose). Once the MTD/MAD is defined in the Dose Escalation Phase, up to 9 additional patients will be enrolled in 2 parallel, disease specific, expansion cohorts (Cohort 1 [patients with CRC] and Cohort 2 [patients with SCCHN]) to further characterize the safety, tolerability, and preliminary anti-tumor activity of WU-NK-101 cells in combination with cetuximab. Patients will receive cetuximab dosed at 500 mg/m2 on Days 1 and 15, and WU-NK-101 on Days 2 and 16, in each 4-week cycle. At the end of Cycle 2, patients who achieve a partial response (PR) or stable disease (SD) may receive up to 4 additional cycles of treatment of WU-NK-101 cells in combination with cetuximab with disease assessments on Day 28 (+/- 3 days) of each even numbered cycle, for a maximum of 6 cycles.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Colorectal Cancer Metastatic, Squamous Cell Carcinoma of Head and Neck
    Keywords
    NK cells, allogeneic NK cells, cetuximab

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Model Description
    In dose expansion patients will be enrolled in 2 parallel, disease specific cohorts to further characterize the safety, tolerability and preliminary anti- tumor activity of WU-NK-101 in combination with cetuximab
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    30 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    WU-NK-101 Monotherapy/Cetuximab combo Run-in
    Arm Type
    Experimental
    Arm Description
    WU-NK-101 is a non-engineered Natural Killer (NK) cell derived from peripheral blood mononuclear cells (PBMC) that is cytokine-reprogrammed, expanded, and cryopreserved to create an allogeneic enhanced memory-like anti-tumor NK cell therapy product. Each 8 week cycle in dose escalation is divided into two 28- days segments. Patients will receive WU-NK-101 (Days 1 and 15) in the first segment and a combination of cetuximab (500mg/m2 on Days 29 and 43) plus WU-NK-101 (Days 30 and 44) in the second segment.
    Arm Title
    WU-NK-101 /Cetuximab Combo
    Arm Type
    Experimental
    Arm Description
    Patients will receive cetuximab dosed at 500 mg/m2 on Days 1 and 15, and WU-NK-101 on Days 2 and 16, in each 4-week cycle. Depending on response patients may receive up to 6 cycles of treatment.
    Intervention Type
    Biological
    Intervention Name(s)
    WU-NK-101 - Dose Escalation
    Intervention Description
    WU-NK-101 administered on Days 1, 15, 30 and 44
    Intervention Type
    Drug
    Intervention Name(s)
    Cetuximab - Dose Escalation
    Intervention Description
    Cetuximab 500mg/m2 administered on Days 29 and 43
    Intervention Type
    Biological
    Intervention Name(s)
    WU-NK-101 - Cohort Expansion
    Intervention Description
    WU-NK-101 administered on Days 2 and 16
    Intervention Type
    Biological
    Intervention Name(s)
    Cetuximab - Cohort Expansion
    Intervention Description
    Cetuximab 500mg/m2 administered on Days 1 and 15
    Primary Outcome Measure Information:
    Title
    Incidence of Adverse Events of WU-NK-101 in combination with cetuximab as assessed by by CTCAE v5
    Description
    Safety is based on evaluation of adverse events (AEs) and serious adverse events (SAEs) from the time of consent until the end of the study visit or at the end of treatment visit.
    Time Frame
    24 months
    Title
    Maximum Tolerated Dose
    Description
    Maximum tolerated or administered dose of WU-NK-101 in combination with cetuximab
    Time Frame
    up to 56 days from first dose
    Secondary Outcome Measure Information:
    Title
    Duration of Response
    Description
    Time of response to the time of disease relapse, progression or death due to any cause
    Time Frame
    24 months
    Title
    Overall Response Rate
    Description
    ORR is defined as the proportion of patients that achieve complete remission (CR) + partial response (PR) using modified Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1)
    Time Frame
    24 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients must have a histologically confirmed diagnosis of advanced and/or metastatic CRC that has failed or progressed beyond first line or higher line standard of care therapy including bevacizumab combination, cetuximab combination, 5-FU based regimens, or checkpoint inhibitors alone or in combination. Patients must have received all targeted therapies for which they are eligible. Patients may be included in this study regardless of mutation status (e.g., RAS-mutant, wild-type, or unknown status, BRAF V600E, etc.) and EGFR expression. Or, Patients must have a histologically confirmed diagnosis of SCCHN that has failed or progressed beyond first or higher line standard of care therapy including cetuximab alone or in combination, checkpoint inhibitors alone and in combination, or regimens containing radiotherapy. Patients may be included in this study regardless of EGFR expression. Measurable disease, in accordance with RECIST 1.1. Eastern Cooperative Oncology Group Performance (ECOG) Status ≤ 2 at screening. Adequate organ function as defined in the protocol. Ejection fraction ≥ 45%. Life expectancy >12 weeks. Exclusion Criteria: Experienced toxicities related to prior cetuximab treatment which required permanent discontinuation of cetuximab per the current label. Active autoimmune disorder requiring immunosuppression (physiologic steroids defined as ≤ 15 mg prednisone or equivalent are acceptable). Symptomatic central nervous system (CNS) metastases. Patients with a history of CNS metastasis must have been treated, must be asymptomatic, and must not have any of the following at the time of enrollment: No concurrent treatment for the CNS disease (e.g., surgery, radiation, corticosteroids > 10 mg prednisone/day or equivalent). No progression of CNS metastases on magnetic resonance imaging (MRI) or computed tomography (CT) for at least 14 days after last day of prior therapy for the CNS metastases, no concurrent leptomeningeal disease or cord compression. Known hypersensitivity to one or more of the study agents. Known hypersensitivity to IL-2 or any component of IL-2 formulation. Patients with organ allografts. Uncontrolled or untreated bacterial, fungal, or viral infections, including but not limited to human immunodeficiency virus, hepatitis B or C infection, or uncontrolled infection of any etiology. Uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiogram (ECG) suggestive of acute ischemia, active conduction system abnormalities, or abnormal cardiac stress test. New progressive pulmonary infiltrates on screening chest x-ray or chest CT scan that have not been evaluated with bronchoscopy. Infiltrates attributed to infection must be stable/ improving after 1 week of appropriate therapy (4 weeks for presumed or proven fungal infections). Received any investigational drugs within the 14 days or 5 half- lives (whichever is longer) prior to the first dose of fludarabine. Radiotherapy or chemotherapy within 2 weeks prior to the first dose of fludarabine. Severe renal impairment, defined as creatinine clearance <40 mL/min. Pregnant and/or breastfeeding women. Any condition that, in the opinion of the investigator, would prevent the participant from consenting to or participating in the study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Eileen McNulty
    Phone
    314-501-1968
    Email
    emcnulty@wugen.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Jan Davidson, MD, PhD
    Organizational Affiliation
    Wugen, Inc.
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    A Phase 1b Study of WU-NK-101 in Combination With Cetuximab

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