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Claudin18.2 CAR-T (CT041) in Patients With Gastric, Pancreatic Cancer, or Other Specified Digestive Cancers

Primary Purpose

Gastric Cancer, Pancreatic Cancer

Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
CT041
Sponsored by
CARsgen Therapeutics 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

Eligibility Criteria

18 Years - 76 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Patients are eligible for screening for potential inclusion in the study:

  1. Voluntarily signed the ICF;
  2. Age ≥ 18 and < 76 years with pathologically/histologically confirmed diagnosis of adenocarcinoma of the stomach or gastroesophageal junction, referred to collectively as STAD, or pancreatic adenocarcinoma (PAAD);
  3. Must have CLDN18.2-positive tumor expression as determined by the CLDN18.2 IHC assay;
  4. Failed or been intolerant of prior lines of systemic therapy;
  5. Estimated life expectancy > 4 months;
  6. At least 1 measurable lesion per RECIST 1.1;
  7. ECOG performance status of 0 or 1;
  8. Sufficient venous access for leukapheresis collection and no other contraindications to leukapheresis;
  9. Patients should have reasonable CBC counts, renal and hepatic functions;
  10. Women of childbearing age must undergo a serum pregnancy test with negative results before screening and infusion and be willing to use effective and reliable method of contraception;
  11. Men must be willing to use effective and reliable method of contraception for at least 12-months after T-cell infusion;
  12. Sufficient nutritional status.

Exclusion Criteria:

  1. Pregnant or lactating women;
  2. HIV, active hepatitis C virus (HCV), or active hepatitis B virus (HBV) infusion;
  3. Any uncontrolled active infection;
  4. AEs from previous treatment that have not recovered;
  5. Patients who have clinically significant thyroid dysfunction;
  6. Patients allergic to any drugs of the preconditioning regimen, tocilizumab, dimethyl sulfoxide (DMSO), or CT041 CAR-CLDN18.2 T-cell;
  7. Patients who have received prior cellular therapy such as (CAR T, TCR, tumor-infiltrating lymphocytes) or organ transplantation; Untreated central nervous system (CNS) metastatic disease, leptomeningeal disease, or cord compression;
  8. Untreated CNS, leptomeningeal disease or cord compression
  9. Patients with heavy tumor burden such as significant lung disease
  10. Unstable/active ulcer or digestive tract bleeding or recent digestive surgery that may have increased risk of bleeding;
  11. Patients who have a history of esophageal or gastric resection with increased risk of bleeding or perforation;
  12. Patients requiring anticoagulant therapy such as warfarin or heparin;
  13. Patients requiring long-term antiplatelet therapy;
  14. Use of prednisone or other equivalent within 14 days before leukapheresis or preconditioning;
  15. Anticancer treatment within approximately 2 weeks prior to leukapheresis or approximately preconditioning;
  16. Major surgery less than 1 week prior to leukapheresis or 3 weeks prior to preconditioning;
  17. Patients have clinical significant cardiac conditions that researchers believe that participating in this clinical trial may endanger the health of the patients;
  18. Patients have clinical significant pulmonary conditions;
  19. Patients known to have active autoimmune diseases;
  20. Patients with second malignancies in addition to STAD or PAAD;
  21. Patients have significant neurologic disorders;
  22. Patients are unable or unwilling to comply with the requirements of clinical trial.

Sites / Locations

  • City of HopeRecruiting
  • University of Southern California
  • UCSDRecruiting
  • UCSFRecruiting
  • Moffitt Cancer CenterRecruiting
  • University of Kansas Cancer CenterRecruiting
  • Karmanos Cancer CenterRecruiting
  • Mayo Cancer HospitalRecruiting
  • Northwell Cancer InstituteRecruiting
  • The Mount Sinai HospitalRecruiting
  • Memorial Sloan Kettering Cancer CenterRecruiting
  • Ohio State UniversityRecruiting
  • TX Oncology-Baylor Charles Sammons Cancer CenterRecruiting
  • MD Anderson Cancer CenterRecruiting
  • Froedtert Hospital and the Medical College of WisconsinRecruiting
  • Princess Margaret HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

anti-claudin18.2 chimeric antigen receptor T-cell therapy

Arm Description

Phase 1b will include two parts, dose escalation phase (Cohort A) followed by a dose expansion phase (Cohort B). Phase 2 (Cohort C) will evaluate the chosen dose in patients with advanced gastric cancer.

Outcomes

Primary Outcome Measures

Phase 1b: Incidence of Treatment Related adverse events (AEs)
Incidence of Treatment Related AEs, AEs of special interest and serious adverse events (SAEs)
Phase 1b: Identification of Maximum Tolerated Dose (MTD) & incidence of Dose-limiting Toxicities (DLTs)
Incidence of dose-limiting toxicities (DLTs)
Phase 2: Objective Response Rate (ORR) per independent central read
Rate of subjects experiencing >/= to PR per RECIST 1.1 as determined by IRC assessment

Secondary Outcome Measures

Phase 1b: Objective Response Rate (ORR) per local assessment
Rate of subjects experiencing >/= to PR per RECIST 1.1 as determined by investigator
Phase 1b/2: Duration of Response
Duration of time from first response to progression of disease as determined by investigator
Phase 1b/2: Disease Control Rate
Percentage of patients response at least 90 days as determined by investigator
Phase 1b/2: Progression free survival
duration time after CT041 treatment that patient lives without worsening of disease as determined by investigator
Phase 1b/2: Overall survival
duration time after CT041 treatment that patient lives as determined by investigator
Phase 1b/2: Utilization of Hospital Resources
Days of hospitalization during & after CT041 infusion; days of hospitalization in ICU
Phase 1b/2: Health-related Quality of Life (HRQoL)
Change from baseline in how subjects report the satisfaction with their health as reported on the EORTC QLQ-C30; scoring uses a linear transformation to standardize the raw score such that scores range from 0-100 with a higher score requesting a higher level or function or a higher level of symptoms.
Phase 2: Incidence of Treatment Related adverse events (AEs)
Rate of subjects experiencing >/= to PR per RECIST 1.1 as determined by investigator
Phase 1b/2: PK and bio-distribution of CT041
Persistence of CAR transgene copy number
Phase 1b/2: CLDN18.2 ICH Assay Performance
Correlation of CLDN18.2 expression level with tumor response
Phase 1b/2: Anti-CT041 drug antibodies
Number of subjects with anit-CT041 drug antibodies
Phase 1b/2: Cytokine expression level in blood after CT041 infusion
evaluate cytokine (IL-6 et al) expression levels in patients treated with CT041

Full Information

First Posted
May 19, 2020
Last Updated
July 3, 2023
Sponsor
CARsgen Therapeutics Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04404595
Brief Title
Claudin18.2 CAR-T (CT041) in Patients With Gastric, Pancreatic Cancer, or Other Specified Digestive Cancers
Official Title
Open-label, Multicenter, Phase 1b/2 Clinical Trial to Evaluate the Safety and Efficacy of Autologous Anti-claudin 18.2 Chimeric Antigen Receptor T-cell Therapy in Subjects With Advanced Gastric, Pancreatic, or Other Specified Digestive System Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 23, 2020 (Actual)
Primary Completion Date
June 1, 2025 (Anticipated)
Study Completion Date
September 1, 2035 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CARsgen Therapeutics Co., Ltd.

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
A Phase 1b/2, open label, multi-center, clinical study of Chimeric Antigen Receptor T Cells (CAR-T) targeting claudin18.2 in patients with advanced gastric, pancreatic or other specified digestive system cancers
Detailed Description
This is an open label, multi-center, Phase 1b/2 clinical trial to evaluate the safety and efficacy of autologous claudin18.2 chimeric antigen receptor T-cell therapy in patients with advanced gastric, pancreatic or other specified digestive system cancers. Following consent, patients must have tumor tissue evaluated by CLDN18.2 IHC assay. Patients meeting all eligibility criteria will undergo a leukapheresis procedure to collect autologous mononuclear cells for manufacture of investigational drug product (CT041). Following manufacture of the drug product, subjects will receive preconditioning prior to CT041 infusion. All subjects will be asked to continue to undergo long-term gene safety follow-up.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Cancer, Pancreatic Cancer
Keywords
CAR-T

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
3+3 dose escalation and expansion
Masking
None (Open Label)
Allocation
N/A
Enrollment
110 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
anti-claudin18.2 chimeric antigen receptor T-cell therapy
Arm Type
Experimental
Arm Description
Phase 1b will include two parts, dose escalation phase (Cohort A) followed by a dose expansion phase (Cohort B). Phase 2 (Cohort C) will evaluate the chosen dose in patients with advanced gastric cancer.
Intervention Type
Biological
Intervention Name(s)
CT041
Intervention Description
treatment with anti-claudin18.2 chimeric antigen receptor T-cell infusion
Primary Outcome Measure Information:
Title
Phase 1b: 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 mos
Title
Phase 1b: Identification of Maximum Tolerated Dose (MTD) & incidence of Dose-limiting Toxicities (DLTs)
Description
Incidence of dose-limiting toxicities (DLTs)
Time Frame
day 1 - day 28
Title
Phase 2: Objective Response Rate (ORR) per independent central read
Description
Rate of subjects experiencing >/= to PR per RECIST 1.1 as determined by IRC assessment
Time Frame
up to 18 mos
Secondary Outcome Measure Information:
Title
Phase 1b: Objective Response Rate (ORR) per local assessment
Description
Rate of subjects experiencing >/= to PR per RECIST 1.1 as determined by investigator
Time Frame
up to 18 mos
Title
Phase 1b/2: Duration of Response
Description
Duration of time from first response to progression of disease as determined by investigator
Time Frame
up to 18 mos
Title
Phase 1b/2: Disease Control Rate
Description
Percentage of patients response at least 90 days as determined by investigator
Time Frame
up to 18 mos
Title
Phase 1b/2: Progression free survival
Description
duration time after CT041 treatment that patient lives without worsening of disease as determined by investigator
Time Frame
up to 18 mos
Title
Phase 1b/2: Overall survival
Description
duration time after CT041 treatment that patient lives as determined by investigator
Time Frame
up to 18 mos
Title
Phase 1b/2: Utilization of Hospital Resources
Description
Days of hospitalization during & after CT041 infusion; days of hospitalization in ICU
Time Frame
up to 18 mos
Title
Phase 1b/2: Health-related Quality of Life (HRQoL)
Description
Change from baseline in how subjects report the satisfaction with their health as reported on the EORTC QLQ-C30; scoring uses a linear transformation to standardize the raw score such that scores range from 0-100 with a higher score requesting a higher level or function or a higher level of symptoms.
Time Frame
Baseline - month 18
Title
Phase 2: Incidence of Treatment Related adverse events (AEs)
Description
Rate of subjects experiencing >/= to PR per RECIST 1.1 as determined by investigator
Time Frame
up to 18 mos
Title
Phase 1b/2: PK and bio-distribution of CT041
Description
Persistence of CAR transgene copy number
Time Frame
Baseline - month 18
Title
Phase 1b/2: CLDN18.2 ICH Assay Performance
Description
Correlation of CLDN18.2 expression level with tumor response
Time Frame
Baseline - month 18
Title
Phase 1b/2: Anti-CT041 drug antibodies
Description
Number of subjects with anit-CT041 drug antibodies
Time Frame
day 0 - month 18
Title
Phase 1b/2: Cytokine expression level in blood after CT041 infusion
Description
evaluate cytokine (IL-6 et al) expression levels in patients treated with CT041
Time Frame
day 0 - month 6

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
76 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients are eligible for screening for potential inclusion in the study: Voluntarily signed the ICF; Age ≥ 18 and < 76 years with pathologically/histologically confirmed diagnosis of adenocarcinoma of the stomach or gastroesophageal junction, referred to collectively as STAD, or pancreatic adenocarcinoma (PAAD); Must have CLDN18.2-positive tumor expression as determined by the CLDN18.2 IHC assay; Failed or been intolerant of prior lines of systemic therapy; Estimated life expectancy > 4 months; At least 1 measurable lesion per RECIST 1.1; ECOG performance status of 0 or 1; Sufficient venous access for leukapheresis collection and no other contraindications to leukapheresis; Patients should have reasonable CBC counts, renal and hepatic functions; Women of childbearing age must undergo a serum pregnancy test with negative results before screening and infusion and be willing to use effective and reliable method of contraception; Men must be willing to use effective and reliable method of contraception for at least 12-months after T-cell infusion; Sufficient nutritional status. Exclusion Criteria: Pregnant or lactating women; HIV, active hepatitis C virus (HCV), or active hepatitis B virus (HBV) infusion; Any uncontrolled active infection; AEs from previous treatment that have not recovered; Patients who have clinically significant thyroid dysfunction; Patients allergic to any drugs of the preconditioning regimen, tocilizumab, dimethyl sulfoxide (DMSO), or CT041 CAR-CLDN18.2 T-cell; Patients who have received prior cellular therapy such as (CAR T, TCR, tumor-infiltrating lymphocytes) or organ transplantation; Untreated central nervous system (CNS) metastatic disease, leptomeningeal disease, or cord compression; Untreated CNS, leptomeningeal disease or cord compression Patients with heavy tumor burden such as significant lung disease Unstable/active ulcer or digestive tract bleeding or recent digestive surgery that may have increased risk of bleeding; Patients who have a history of esophageal or gastric resection with increased risk of bleeding or perforation; Patients requiring anticoagulant therapy such as warfarin or heparin; Patients requiring long-term antiplatelet therapy; Use of prednisone or other equivalent within 14 days before leukapheresis or preconditioning; Anticancer treatment within approximately 2 weeks prior to leukapheresis or approximately preconditioning; Major surgery less than 1 week prior to leukapheresis or 3 weeks prior to preconditioning; Patients have clinical significant cardiac conditions that researchers believe that participating in this clinical trial may endanger the health of the patients; Patients have clinical significant pulmonary conditions; Patients known to have active autoimmune diseases; Patients with second malignancies in addition to STAD or PAAD; Patients have significant neurologic disorders; Patients are unable or unwilling to comply with the requirements of clinical trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hong Ma, MD
Phone
Central Phone
Email
clinicalUS@carsgen.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Harry H Yoon, MD
Organizational Affiliation
Mayo
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dae Won Kim, MD
Organizational Affiliation
Moffitt
Official's Role
Principal Investigator
Facility Information:
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joseph Chao
Email
lbatrow@coh.org
Facility Name
University of Southern California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90089
Country
United States
Individual Site Status
Completed
Facility Name
UCSD
City
San Diego
State/Province
California
ZIP/Postal Code
92093
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
G Botta
Email
gbotta@health.ucsd.edu
Facility Name
UCSF
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marissa Gin
Email
hdfccc.cip@ucsf.edu
Facility Name
Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
K Sprenger
Email
kimberly.sprenger@moffitt.org
Facility Name
University of Kansas Cancer Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kasi Anup Kasi
Facility Name
Karmanos Cancer Center
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mohammed Al Hallak
Facility Name
Mayo Cancer Hospital
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
A Schimek
Email
schimek.amanda@mayo.edu
Facility Name
Northwell Cancer Institute
City
New Hyde Park
State/Province
New York
ZIP/Postal Code
11042
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Daniel King
Facility Name
The Mount Sinai Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Diedre Cohen
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Geoffrey Ku
Facility Name
Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anne Noonan
Facility Name
TX Oncology-Baylor Charles Sammons Cancer Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
A. Rodriguez
Email
Aimee.Rodriguez@BSWHealth.org
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
M David
Email
mfdavid@mdanderson.org
Facility Name
Froedtert Hospital and the Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cancer Center Clinical Trials Office
Phone
414-805-8900
Email
CCCTO@mcw.edu
Facility Name
Princess Margaret Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5GH 2C1
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Eric Chen

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Claudin18.2 CAR-T (CT041) in Patients With Gastric, Pancreatic Cancer, or Other Specified Digestive Cancers

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