Dual-Target CAR-NK Cells Targeting Mesothelin (MSLN) and MUC1 in Advanced Pancreatic Ductal Adenocarcinoma (DUAL-NK-PDAC)
A Phase 1/2, Open-label, Biomarker-guided, Dose-escalation and Expansion Study of Dual-targeting CAR-NK Cells Directed Against Mesothelin (MSLN) and MUC1, With an Exploratory CLDN18.2/MUC1 Dual-target Cohort, in Patients With Unresectable or Metastatic Pancreatic Ductal Adenocarcinoma (PDAC)
調査の概要
状態
詳細な説明
- Rationale: PDAC is characterized by aggressive biology, antigen heterogeneity, and an immunosuppressive tumor microenvironment. Dual-targeting CAR designs aim to reduce antigen-escape by enabling recognition of either target antigen on tumor cells.
- Investigational products: Two off-the-shelf (allogeneic) CAR-NK products are evaluated. EB-DNK101 targets MSLN and MUC1. EB-DNK102 targets CLDN18.2 and MUC1. Both products are engineered to enhance persistence and incorporate an inducible safety switch .
- Target assessment and cohort assignment: Tumor tissue (archival or fresh biopsy) is tested centrally by immunohistochemistry (IHC) for MSLN, MUC1, and CLDN18.2. Participants are assigned to Arm A (MSLN/MUC1) or Arm B (CLDN18.2/MUC1) based on predefined positivity thresholds. If more than one cohort is eligible, assignment prioritizes the strongest antigen expression and product availability.
- Conditioning and administration: Participants receive lymphodepleting chemotherapy followed by intravenous infusion of the assigned CAR-NK product.
Repeat infusions (up to 3 total) may be permitted in the absence of prohibitive toxicity and with at least stable disease. Safety monitoring: Participants are monitored closely for cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), infusion reactions, and other adverse events.
Dose-limiting toxicities (DLTs) are assessed during the first 28 days after first infusion.
- Efficacy and biomarker assessments: Tumor response is assessed by imaging (RECIST v1.1) at regular intervals (every 8 weeks). Exploratory endpoints include CAR-NK expansion/persistence, cytokine profiling, and association of antigen density with response.
- Target down-selection plan: After completion of Part 1 and an initial subset of Part 2 expansion participants, an internal scientific review compares antigen prevalence, manufacturability, safety, and preliminary activity across cohorts to prioritize the lead dual-target construct for subsequent confirmatory development.
研究の種類
入学 (推定)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究連絡先
- 名前:Seni S Lu, Phd
- 電話番号:+86 13076790030
- メール:Seni-Lu@beijing-biotech.com
研究場所
-
-
Guangdong
-
Shenzhen、Guangdong、中国、518036
- 募集
- Peking University Shenzhen Hospital
-
コンタクト:
- Zhen J Peng, Phd
- 電話番号:+86 13076790039
- メール:Zhen-Peng@beijing-biotech.com
-
-
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Age 18 to 75 years at the time of consent.
- Histologically or cytologically confirmed pancreatic ductal adenocarcinoma (PDAC).
- Unresectable locally advanced or metastatic disease with progression after at least 1 prior standard systemic therapy regimen, or intolerance/ineligibility for standard therapy.
- At least 1 measurable lesion per RECIST v1.1.
- Tumor antigen expression by central IHC (archival or fresh biopsy): • Arm A eligibility: MSLN positive and/or MUC1 positive. • Arm B eligibility: CLDN18.2 positive and/or MUC1 positive. (Example threshold: IHC 2+ or 3+ staining in >=50% of tumor cells, or H-score above protocol-defined cutoff.)
- ECOG performance status 0-1.
- Adequate organ function (example): ANC >= 1.0 x 10^9/L; platelets >= 75 x 10^9/L; hemoglobin >= 8 g/dL; AST/ALT <= 3x ULN (<= 5x ULN with liver metastases); total bilirubin <= 1.5x ULN; creatinine clearance >= 50 mL/min.
- Life expectancy >= 12 weeks.
- Negative pregnancy test for individuals of childbearing potential; agreement to use effective contraception during study participation and for a protocol-defined follow-up period.
- Ability to understand and willingness to sign written informed consent.
Exclusion Criteria:
- Active or untreated CNS metastases or carcinomatous meningitis.
- Clinically significant uncontrolled infection (including uncontrolled bacterial, fungal, or viral infection).
- Known active hepatitis B or hepatitis C with detectable viral load; known uncontrolled HIV infection.
- Prior allogeneic hematopoietic stem cell transplant or solid organ transplant.
- Prior gene-modified cellular therapy (e.g., CAR-T/CAR-NK) within 6 months or prior therapy targeting the same antigen(s) Ongoing requirement for systemic immunosuppressive therapy (e.g., chronic corticosteroids above physiologic replacement).
- Clinically significant cardiovascular disease (e.g., recent myocardial infarction, uncontrolled arrhythmia, or NYHA class III/IV heart failure) within a protocol-defined period.
- Active autoimmune disease requiring systemic treatment in the past 2 years (replacement therapy allowed).
- Pregnant or breastfeeding.
- Any medical, psychiatric, or social condition that, in the investigator's opinion, would interfere with safe participation or interpretation of results.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Arm A: EB-DNK101 (MSLN/MUC1 Dual-CAR NK)
Participants with PDAC whose tumors express MSLN and/or MUC1 per central IHC are assigned to Arm A.
|
MSLNとMUC1を標的とする二重認識CARを搭載した同種異系CAR-NK細胞。
Day 0(投与量レベル依存)に静脈内点滴投与として投与される。
他の名前:
Allogeneic CAR-NK cells engineered with a dual-recognition CAR targeting CLDN18.2 and MUC1.
Administered as an IV infusion on Day 0 (dose level dependent).
他の名前:
fludarabine (Days -5 to -3) and cyclophosphamide (Days -5 to -4) prior to CAR-NK infusion.
他の名前:
|
|
実験的:Arm B: EB-DNK102 (CLDN18.2/MUC1 Dual-CAR NK)
Participants with PDAC whose tumors express CLDN18.2
and/or MUC1 per central IHC are assigned to Arm B.
|
MSLNとMUC1を標的とする二重認識CARを搭載した同種異系CAR-NK細胞。
Day 0(投与量レベル依存)に静脈内点滴投与として投与される。
他の名前:
Allogeneic CAR-NK cells engineered with a dual-recognition CAR targeting CLDN18.2 and MUC1.
Administered as an IV infusion on Day 0 (dose level dependent).
他の名前:
fludarabine (Days -5 to -3) and cyclophosphamide (Days -5 to -4) prior to CAR-NK infusion.
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
|
最大耐量 (MTD)
時間枠:12ヶ月
|
12ヶ月
|
|
用量制限毒性(DLT)の発現率
時間枠:28日
|
28日
|
|
治療関連有害事象(TEAE)の発現率と重症度
時間枠:12ヶ月
|
12ヶ月
|
二次結果の測定
結果測定 |
時間枠 |
|---|---|
|
疾病制御率 (DCR)
時間枠:12ヶ月
|
12ヶ月
|
|
RECIST v1.1による客観的奏効率(ORR)
時間枠:12ヶ月
|
12ヶ月
|
|
治療効果持続期間(DOR)
時間枠:24ヶ月
|
24ヶ月
|
協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- ESSEN-PDAC-DNK-008
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。