GPC3-directed CAR-T in the Treatment Amongst Subjects With Advanced Hepatocellular Carcinoma

JWATM214，an Armored GPC3-directed CAR-T ，in the Treatment Amongst Subjects With Advanced Hepatocellular Carcinoma ：a Single-arm, Open-label，Dose-escalation Study

This is a single arm, open-label, dose escalation clinical study to evaluate the safety and efficacy of infused autologous armored GPC3-directed CAR-T in patients with advanced hepatocellular carcinoma refractory to prior systematic treatments.

Study Overview

• Status: Recruiting
• Conditions: Hepatocellular Carcinoma
• Intervention / Treatment: Biological: CAR-GPC3 T cells

• Study Type: Interventional
• Enrollment (Estimated): 12
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Hao Feng, MD.,Ph.D; Phone Number: 008615000901110; Email: surgeonfeng@live.com

Study Locations

• China
  • Shanghai, China, 200127
    • Recruiting
    • Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University
    • Contact: Hao Feng, MD, PhD; Email: surgeonfeng@live.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. 18-75 years-old, male or female
2. Voluntarily willing to participate in the study and sign the written informed consent form
3. Life expectation ≥12 weeks
4. Eastern Cooperative Oncology Group (ECOG) performance status scale ≤1
5. Histologically-confirmed hepatocellular carcinoma (HCC)
6. No benefits from curative surgery or other local therapies are expected at screening, judged by investigators
7. Radiologically-confirmed progression disease after at least one prior line of systematic treatment and limited benefits from current guideline or consensus for hepatocellular carcinoma are expected at screening, judged by investigators
8. Fresh samples or FFPE, immunohistochemistry (IHC)-stained GPC-3 positive with intensity ++ or +++
9. Per RECIST v1.1, at least one measurable lesion
10. Manageable lung metastasis
11. Barcelona Clinic Liver Cancer (BCLC) stage C or B and Child-Pugh ≤7
12. No active HBV infections
13. Adequate organ functions
14. Adequate venous access for APH
15. Non-hematological AEs induced by previous treatment must have recovered to CTCAE ≤1, except for alopecia and peripheral neuropathy
16. Women of childbearing potential must agree to use an effective and reliable contraceptive method during 28 days prior to lymphodepletion to 1 year post infusion; Male patients who have not undergone vasectomy and have sexual activity with women of childbearing potential must agree to the use of a barrier contraceptive method since lymphodepletion to 1year post infusion, and sperm donation is prohibited during the study
17. Women of childbearing potential must have negative serum β-hCG test result at screening and 48 hours prior to lymphodepletion

Exclusion Criteria:

1. Cholangiocarcinoma or histological-mixed hepatocellular cholangiocarcinoma
2. Active brain metastasis
3. Primary lesion or infused lesions with the longest diameter ≥15cm, or other potential risk which might not be appropriate for further study treatment judged by the investigator
4. Another primary malignancy within 3 years (with some exceptions for completely-resected early-stage tumors)
5. Systematic autoimmune disorders requiring long-term systematic immunosuppression
6. Previously treated with any genetically engineered modified T cell therapy (TCR-T/CAR-T) or other CGT
7. Active HCV, HIV, or syphilis
8. History of organ transplant
9. Uncontrolled or active infection at screening, prior to APH, 72 hours prior to lymphodepletion or 5 days prior to JWATM214 infusion
10. With severe cardiovascular disease
11. History or presence of clinically-relevant CNS disorders
12. Current presence of hepatic encephalopathy
13. ≥G2 hemorrhage within 30 days prior to screening, or in need of long-term anticoagulants
14. Active digestive ulcer or gastrointestinal bleeding within 3 months prior to screening
15. Pregnant or lactating women
16. Not satisfying wash-out period for APH
17. Unable or unwilling to comply with the study protocol, judged by the investigator
18. Other situations implying that the subject might not be appropriate to participate in the study
19. Previously allergic or intolerable to JWATM214 or its components

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: CAR-GPC3 T cells; The safety and efficacy of JWATM214 will be evaluated in a 'BOIN'-designed dose escalation approach. 3 CAR-T dose levels will be tested in this study: 1×10^8, 3×10^8, and 10×10^8, whereas the dosage 0.5×10^8 and 30×10^8 CAR-T cells will be selected as optional back-up doses for potential escalation or de-escalation.

Biological: CAR-GPC3 T cells; Subjects will undergo leukapheresis to isolate peripheral blood mononuclear cells (PBMCs) for the production of JWATM214 . During JWATM214 production, subjects will receive a preconditioning chemotherapy regimen of cyclophosphamide and fludarabine to deplete the lymphocytes. After lymphodepletion, subjects will receive single-dose treatment with JWATM214 by intravenous (IV) injection.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment-related adverse events (AEs)	An AE is defined as any unfavorable and unintended sign, symptom, or disease (new or worsening) temporally associated with the use of study therapy, regardless of whether or not a causal relationship with the study therapy can be determined.	2 years
Dose-limiting toxicities	DLT (Dose-limiting toxicity) was an adverse event that occurred within 28 days after JWATM214 infusion that met any of the following criteria.; Any grade ≥3 nonhematologic toxicity associated with JWATM214 that has not resolved to ≤ grade 2 within 7 days, excluding clinically insignificant abnormalities in laboratory indicators; Hematologic toxicity; Grade ≥3 anaphylaxis; Grade ≥3 infection did not resolve to grade ≤2 within 7 days after anti-infective treatment.; ≥ grade 3 autoimmune toxicity during treatment; Grade ≥3 cytokine release syndrome (CRS) during treatment that did not resolve to grade ≤2 within 72 hours.; Grade ≥3 CAR-T cell-associated encephalopathy syndrome/immune effector cell-associated neurotoxicity syndrome (CRES/ICANS) that did not resolve to grade ≤2 within 72 hours.; Grade 5 events of any nonmalignant cause.	28 days
RP2D of JWATM214 in HCC patients	Recommended phase 2 dose of JWATM214	2 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PK of JWATM214 in the peripheral blood (qPCR)	The pharmacokinetic parameters of JWATM214 will be evaluated by qPCR for the copy number of the vector transgene of JWATM214 in peripheral blood to evaluate T-cell expansion and persistence.	1 years
Objective response rate (ORR).	Proportion of patients whose tumor volume has reached a predetermined value and can maintain a minimum time limit, including complete response and partial response patients.	1 years
Disease Control Rate	the percentage of patients with advanced or metastatic cancer who have achieved complete response, partial response and stable disease to a therapeutic intervention in clinical trials of anticancer agents.	2 years
progression-free survival (PFS)	Defined as time from randomisation to first progression by investigator assessment using modified RECIST 1.1 or death (by any cause in the absence of progression)	2 years
overall survival (OS)	Defined as the time from randomisation to death due to any cause	2 years

Collaborators and Investigators

• Sponsor: RenJi Hospital
• Investigators: Study Chair: Qiang Xia, Prof. MD, Dept. Liver Surgery, Renji Hospital, School of Medicine, SJTU; Principal Investigator: Hao Feng, MD.,Ph.D., Dept. Liver Surgery, Renji Hospital, School of Medicine, SJTU

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2023
• Primary Completion (Estimated): December 31, 2025
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: April 4, 2023
• First Submitted That Met QC Criteria: June 22, 2023
• First Posted (Actual): July 3, 2023

Study Record Updates

• Last Update Posted (Actual): July 3, 2023
• Last Update Submitted That Met QC Criteria: June 22, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms by Histologic Type; Neoplasms; Neoplasms by Site; Adenocarcinoma; Neoplasms, Glandular and Epithelial; Digestive System Neoplasms; Liver Diseases; Liver Neoplasms; Carcinoma; Carcinoma, Hepatocellular
• Other Study ID Numbers: JWATM214001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No