Phase I/II Study: Allogeneic NK-cell Therapy With Chemotherapy for Post-Surgery PDA or Cholangiocarcinoma Patients

A Dose-Finding Phase I Followed by a Phase II Study to Evaluate the Safety and Efficacy of Allogeneic NK-cell Combined With Chemotherapy in Patients With PDA or Cholangiocarcinoma After Surgery

This is a phase I/II study which intends to characterize the safety, tolerability, and preliminary efficacy of Allogeneic Magicell-NK infusion in PDA or cholangiocarcinoma patients after surgery. Subjects will receive a total of 6 intravenous (IV) infusions of the IP on the 11th day of each chemotherapy cycle. A total of 6 cycles of IP infusions are planned.

The phase I part of the study is a first-in-human phase I trial of Allogeneic Magicell-NK and is therefore designed in an open-label, dose-escalation manner. A standard 3+3 design will be employed to assess the safety profile of Allogeneic Magicell-NK and to determine the MTD/MFD. Two dose cohorts are planned: the starting dose is 10 × 10^8 cells (Cohort 1), and escalates to 20 × 10^8 cells (Cohort 2).

The phase II part of the study is designed as an open-label, two-arm, randomized clinical trial comparing the combination of SLOG and Allogeneic Magicell-NK with SLOG alone when used as adjuvant therapy following resection for PDA or Cholangiocarcinoma. Approximately 30 subjects will be randomized at a 2:1 ratio between the two arms: Arm 1: SLOG and Allogeneic Magicell-NK (20 subjects); Arm 2: SLOG alone (10 subjects). Subjects will then receive 12 weeks of SLOG chemotherapy with or without Allogeneic Magicell-NK infusion.

Study Overview

• Status: Recruiting
• Conditions: Pancreatic Carcinoma Stage II; Cholangiocarcinoma Resectable
• Intervention / Treatment: Biological: SLOG + Allogeneic NK cell; Drug: SLOG chemotherapy

• Study Type: Interventional
• Enrollment (Estimated): 42
• Phase: Phase 2; Phase 1

Contacts and Locations

• Study Contact: Name: Jude Chen; Phone Number: 610 886-2-77225200; Email: jude@medigen.com.tw
• Study Contact Backup: Name: Doris Huang; Phone Number: 650 886-2-77225200; Email: doris.huang@medigen.com.tw

Study Locations

• Taiwan
  • Tainan, Taiwan, 138
    • Recruiting
    • National Cheng Kung University Hospital
    • Sub-Investigator: Chien Jui Huang, M.D.
    • Contact: Yan Shen Shan, MD, PhD; Phone Number: 3116 886-6-2353535; Email: ysshan@mail.ncku.edu.tw
    • Principal Investigator: Yan Shen Shan, MD, PhD
    • Sub-Investigator: Chia Jui Yen, M.D.

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. Dated and signed informed consent.
2. Either sex, aged older than 18 years old (inclusive) at date of consent.

3. Subject with a macroscopic resection of the primary tumor and residual primary tumor that satisfies all of the items below according to the Union for International Cancer Control (UICC) histopathologic staging system:

   • At or before the surgery, stage II or stage III.
   • Local residual tumor classified as R0 or R1.
   • Cytologic examination negative upon intraoperative peritoneal lavage.
4. Histologically confirmed PDA or cholangiocarcinoma.
5. Received curative resection within 12 weeks prior to screening visit and will receive adjuvant SLOG chemotherapy. Note: Subjects with cancer who had undergone surgery with or without prior neo-adjuvant therapy will be recruited.
6. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1.

7. Subject with adequate hematology function at Visit 1:

   • Total white blood cell (WBC) ≥ 3,000 cells/mm3.
   • Absolute neutrophil count (ANC) ≥ 1,500 cells/mm3.
   • Platelets ≥ 100,000 counts/mm3.
   • Hemoglobin ≥ 9 g/dL.
   • International normalized ratio (INR) of prothrombin time within normal range. Note: Re-test for eligibility is allowed during the screening period.

8. Subject with adequate hepatic and renal function at Visit 1:

   • Serum creatinine ≤ 1.5× Upper Limit of Normal (ULN).
   • Blood urea nitrogen (BUN) ≤ 1.5× ULN.
   • Total bilirubin ≤ 1.5× ULN.
   • Alanine transaminase (ALT) and aspartate transaminase (AST) ≤ 2.5× ULN.
   • Alkaline phosphatase (ALP) ≤ 5× ULN.
   • Albumin ≥ 3.0 g/dL. Note: Re-test for eligibility is allowed during the screening period.
9. Negative response in human immunodeficiency virus (HIV) and treponema pallidum (rapid plasma reagin [RPR]/venereal disease research laboratory [VDRL] and treponema pallidum hemagglutination [TPHA]).
10. Subject confirmed with past cytomegalovirus (CMV) infection in terms of having positive CMV immunoglobin G (CMV IgG).

11. Subject with childbearing potential must agree to use at least two contraceptive precautions, one of which must be a condom or other adequate barrier method, from

    • signing informed consent until 28 days after the last dose of investigational product (IP) administration.
    • initiation of oxaliplatin treatment until at least 15 months (female) or 12 months (male) following the last dose.
    • initiation of gemcitabine treatment until at least 6 months (female) or 3 months (male) following the last dose.
12. Agree to be in compliance with clinical protocol-planned treatment. Note: Anti-virus treatment is allowed if active hepatitis B is presented.

Exclusion Criteria:

1. Received any other investigational, anti-neoplastic medications, or immune cell therapy within 28 days prior to screening visit.

2. Any prior history of malignant neoplasm, except:

   1. Non-invasive, non-melanomatous skin cancer (including squamous cell carcinoma, basal cell carcinoma, or carcinoma in situ), curatively treated with cryosurgery or surgical excision only.
   2. Other primary malignant neoplasm diagnosed as disease free for more than 5 years.
3. Immunocompromized, currently under immunosuppressive treatment for autoimmune disease, or have received systemic steroid of equivalent dosage higher than prednisolone 30 mg/day for more than 7 days within 14 days prior to Day 1.
4. With known metastases.
5. With ongoing acute diseases, or serious medical conditions within the past 2 years prior to screening, such as cardiovascular (e.g., New York Heart Association grade III or IV), hepatic (e.g., Child-Pugh Class C), psychiatric condition (e.g., alcoholism, drug abuse), medical history, physical findings, or laboratory abnormality that in the investigators' opinion could interfere with the results of the trial or adversely affect the safety of the subject.
6. Hypercoagulable state that may lead to clinically apparent thrombosis.
7. With known hypersensitivity to aminoglycoside (e.g., streptomycin, gentamicin) or bacitracin.
8. With known hypersensitivity to any of the components of Allogeneic Magicell-NK, including human serum albumin.
9. With known hypersensitivity to any of the components of S-1, leucovorin, oxaliplatin, or gemcitabine.

10. With any contraindication to S-1, leucovorin, oxaliplatin, or gemcitabine, including:

    - Severe myelosuppression or myelosuppression that probably exacerbates.

11. With symptomatic CMV disease.
12. With any history of diagnosed or suspected cardiac arrhythmia or QT interval prolongation.
13. Male subject with a corrected QT interval (QTc) ≥ 450 ms and female subject with a QTc ≥ 470 ms as determined by electrocardiogram (ECG) examination at screening.
14. Received any drugs associated with QT prolongation within 28 days prior to the Screening Visit (refer to Appendix 3. Drugs Associated with QT Prolongation, including but not limited to the drug listed therein).
15. Received brivudine or its analogs (e.g., sorivudine) or any live vaccines within 28 days prior to the Screening Visit.
16. Female subject who is lactating or has positive serum or urine pregnancy test at screening.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SLOG + Allogeneic NK cells; Ph I SLOG + Allogeneic NK cell dose escalation (Cohort 1:10 × 10^8 cells ; Cohort 2:20 × 10^8 cells) Ph II Arm 1 SLOG + Allogeneic NK cell	Biological: SLOG + Allogeneic NK cell; Drug: SLOG chemotherapy S-1, leucovorin, oxaliplatin, and gemcitabine (SLOG) Biological: Allogeneic Magicell-NK contains NK cells suspended in 100 mL of normal saline Ph I dose starts at 10 × 10^8 cells (Cohort 1) and escalates to 20 × 10^8 cells (Cohort 2). Ph II dose will be determined lower than or equal to Ph I MTD/MFD.
Active Comparator: SLOG chemotherapy; Ph II Arm 2	Drug: SLOG chemotherapy; Drug: SLOG chemotherapy S-1, leucovorin, oxaliplatin, and gemcitabine (SLOG)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ph I Evaluation of safety parameters, numbers of participants with Treatment-Emergent Adverse Events (TEAEs).	The number of participants with Treatment-Emergent Adverse Events (TEAEs) was assessed using the Common Terminology Criteria for Adverse Events (CTCAE v5.0) to assess the tolerability of Magicell-NK treatment.	15 months
Ph I Laboratory tests	Number of participants with abnormal laboratory test results.	15 months
Ph I Body weight	Body weight (KG) will be measured at baseline, treatment, and F1 visits. The number of participants with abnormal body weight change.	5 months
Ph I Vital signs	Number of participants with abnormal vital signs.	15 months
Ph I Dose-limiting toxicities	Adverse events were assessed according to NCI-CTCAE v5.0 criteria.	4 months
Ph I Maximum Tolerated Dose (MTD) and Recommended Phase II Dose	MTD is defined as the highest dose level at which ≤ 1/6 of subjects experienced DLT.	4 months
Ph II Disease-free survival (DFS)	The time from the date of the first Magicell-NK infusion to the date of the first disease-free survival event (recurrence, second primary PDA or Cholangiocarcinoma, or death from any cause).	15 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ph I Disease-free survival (DFS)	The time from the date of the first Magicell-NK infusion to the date of the first disease-free survival event (recurrence, second primary PDA or Cholangiocarcinoma, or death from any cause)	15 months
Ph II Evaluation of safety parameters, numbers of participants with Treatment-Emergent Adverse Events (TEAEs)	The number of participants with Treatment-Emergent Adverse Events (TEAEs) was assessed using the Common Terminology Criteria for Adverse Events (CTCAE v5.0) to assess the tolerability of Magicell-NK treatment.	15 months
Ph II Laboratory tests	Number of participants with abnormal laboratory test results.	15 months
Ph II Body weight	Body weight (KG) will be measured at baseline, treatment, and F1 visits. The number of participants with abnormal body weight change.	5 months
Ph II Vital signs	Number of participants with abnormal vital signs.	15 months
Ph I/II Tumor recurrence rate (TRR)	To evaluate the Tumor recurrence rate (TRR) during the study period	15 months
Ph I/II Changes in Frequency and Duration of ctDNA	Number of participants experiencing ctDNA seroconversion (i.e. ctDNA+ that become ctDNA-) after any Allogeneic Magicell-NK regimen remaining disease free	Up to 15 months
Ph I/II Changes in Frequency and Duration of Circulating Tumor Count (CTC)	Determine the effect of Allogeneic Magicell-NK on reducing CTC of whole blood in the subject with elevated baseline CTC count to identify the least effective dose that clears CTCs. The baseline count of CTC will be recorded before Allogeneic Magicell-NK therapy in a whole blood sample. In the treatment, the count of CTC will be measured at C4D1 and each follow-up visit after Allogeneic Magicell-NK therapy in a whole blood sample. All of these values will be compared.	Up to 15 months
Ph I/II Changes in Biomarkers (CA19-9 and CEA)	Determine the effect of Allogeneic Magicell-NK on CEA and CA 19-9 in the subject with elevated baseline CEA and CA 19-9 to identify the least effective dose that clears CEA and CA 19-9. The baseline count of CEA and CA 19-9 will be recorded before Allogeneic Magicell-NK therapy. In the treatment, the count of CEA and CA 19-9 will be measured at C4D1. And each follow-up visit after Allogeneic Magicell-NK therapy. All of these values will be compared.	Up to 15 months

Collaborators and Investigators

• Sponsor: Medigen Biotechnology Corporation
• Investigators: Study Chair: Stanley Chang, PhD, Medigen Biotechnology Corporation

Study record dates

Study Major Dates

• Study Start (Actual): October 21, 2024
• Primary Completion (Estimated): January 31, 2029
• Study Completion (Estimated): August 31, 2029

Study Registration Dates

• First Submitted: December 2, 2024
• First Submitted That Met QC Criteria: December 9, 2024
• First Posted (Actual): December 12, 2024

Study Record Updates

• Last Update Posted (Actual): December 17, 2025
• Last Update Submitted That Met QC Criteria: December 9, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Endocrine System Diseases; Neoplasms by Site; Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Endocrine Gland Neoplasms; Pancreatic Diseases; Pancreatic Neoplasms
• Other Study ID Numbers: CT-ANK-21

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No