Dual-Targeting CAR-NK Cells in Biomarker-Selected Advanced Colorectal Cancer (DUO-CRC-NK-111)
A Phase 1/2, Biomarker-Assigned, Open-Label Dose Escalation and Expansion Study of Allogeneic Dual-Target CAR-NK Cells Targeting CEA (CEACAM5) and/or GUCY2C (GCC) With an Exploratory HER2/ERBB2-Positive Cohort in Subjects With Advanced or Metastatic Colorectal Cancer
연구 개요
상세 설명
Colorectal cancer remains a major cause of cancer-related morbidity and mortality. CAR-NK therapy is being explored as a potentially safer, 'off-the-shelf' adoptive cell therapy platform with lower risk of graft-versus-host disease and typically less severe cytokine release than CAR-T in early experiences.
Target selection for solid tumors is limited by tumor heterogeneity and on-target/off-tumor expression. To reduce antigen escape and increase tumor selectivity, this study tests dual-target recognition against CRC-associated antigens: CEA (CEACAM5) and GUCY2C (GCC), with a HER2/ERBB2-positive subset as an exploratory population. GUCY2C is frequently retained in primary and metastatic CRC and is a well-established CRC target antigen. HER2 amplification/overexpression occurs in a minority of metastatic CRC and can be identified by validated IHC/ISH or genomic assays.
Biomarker assessment and target-pair selection: Tumor tissue (archival or fresh) is tested by central laboratory immunohistochemistry (IHC) for CEA and GUCY2C, and by HER2 testing per colorectal cancer criteria (IHC with reflex amplification testing as needed). Participants must meet co-expression thresholds for one antigen pair and are assigned accordingly. After Part A (dose escalation), a prespecified selection algorithm will nominate the target pair for expansion using a composite score including DLT rate, feasibility/manufacturing success, ORR/DCR signals, CAR-NK persistence, and evidence of target engagement. Treatment plan: Participants receive lymphodepleting chemotherapy followed by infusion of the assigned dual-target CAR-NK cells. A second infusion in the same cycle may be permitted in selected dose levels if safety criteria are met. Hospitalization/close monitoring is required during the early post-infusion period.
연구 유형
등록 (추정된)
단계
- 2 단계
- 1단계
연락처 및 위치
연구 연락처
- 이름: Seni S Lu, Phd
- 전화번호: +86 13076790030
- 이메일: Seni-Lu@beijing-biotech.com
연구 장소
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Guangdong
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Shenzhen, Guangdong, 중국, 518036
- 모병
- Peking University Shenzhen Hospital
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연락하다:
- Zhen J Peng, Phd
- 전화번호: +86 13076790039
- 이메일: Zhen-Peng@beijing-biotech.com
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참여기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
Inclusion Criteria:
- Histologically confirmed colorectal adenocarcinoma that is unresectable or metastatic and has progressed after, is intolerant to, or is ineligible for standard therapies.
- Measurable disease per RECIST v1.1 (unless in minimal residual disease (MRD) or post-resection cohorts if a future amendment is planned).
- Tumor antigen co-expression meeting central lab thresholds for one of the following pairs: CEA+GUCY2C, CEA+HER2, or GUCY2C+HER2.
- ECOG performance status 0-1.
- Adequate organ function (hematologic, renal, hepatic, and cardiac) as defined in protocol.
- Recovered to Grade ≤1 from prior therapy-related toxicities (except stable Grade 2 neuropathy or alopecia).
- Life expectancy ≥ 12 weeks.
- Willingness to use effective contraception during study and for a protocol-defined period after cell infusion.
Exclusion Criteria:
- Active, uncontrolled infection (including uncontrolled HBV/HCV) or known uncontrolled HIV infection.
- Active CNS metastases that are symptomatic or require escalating steroids. (Stable treated CNS disease may be allowed per protocol.)
- Prior gene-modified cellular therapy (CAR-T/CAR-NK/TCR-T) within 6 months, or any prior therapy that in the investigator's judgment increases risk of severe toxicity.
- Clinically significant autoimmune disease requiring systemic immunosuppression within the past 6 months.
- Concurrent anti-cancer therapy (other than protocol-permitted bridging) during the DLT window.
- Pregnant or breastfeeding.
- Significant cardiovascular disease (e.g., recent MI, uncontrolled arrhythmia), uncontrolled pulmonary disease, or other severe comorbidity that would increase risk.
- Known hypersensitivity to study chemotherapy components (fludarabine/cyclophosphamide) or required supportive medications.
- Any condition that, in the investigator's opinion, would interfere with study participation, safety monitoring, or interpretation of results.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위화되지 않음
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: Arm A: CEA+GUCY2C Dual CAR-NK
CRC with tumor co-expression of CEA (CEACAM5) and GUCY2C (GCC) above prespecified thresholds
|
ogeneic dual-target CAR-NK cells manufactured from cord blood-derived NK cells, genetically engineered to express a tandem (dual-binding) CAR, an IL-15 support element (e.g., membrane-bound IL-15 or IL-15/IL-15R fusion), and an inducible suicide switch
Lymphodepleting chemotherapy ( fludarabine and cyclophosphamide) administered pre-infusion to facilitate CAR-NK cell engraftment.
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실험적: CEA+HER2 Dual CAR-NK
CRC with CEA expression and HER2/ERBB2 positivity
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ogeneic dual-target CAR-NK cells manufactured from cord blood-derived NK cells, genetically engineered to express a tandem (dual-binding) CAR, an IL-15 support element (e.g., membrane-bound IL-15 or IL-15/IL-15R fusion), and an inducible suicide switch
Lymphodepleting chemotherapy ( fludarabine and cyclophosphamide) administered pre-infusion to facilitate CAR-NK cell engraftment.
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실험적: GUCY2C+HER2 Dual CAR-NK
CRC with GUCY2C expression and HER2/ERBB2 positivity
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ogeneic dual-target CAR-NK cells manufactured from cord blood-derived NK cells, genetically engineered to express a tandem (dual-binding) CAR, an IL-15 support element (e.g., membrane-bound IL-15 or IL-15/IL-15R fusion), and an inducible suicide switch
Lymphodepleting chemotherapy ( fludarabine and cyclophosphamide) administered pre-infusion to facilitate CAR-NK cell engraftment.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
|---|---|
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CTCAE v5.0으로 등급이 매겨진 용량 제한 독성(DLT)의 발생률.
기간: 28일
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28일
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|
최대 내약 용량 (MTD)
기간: 28일
|
28일
|
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확장 코호트에서 RECIST v1.1 기준의 객관적 반응률 (ORR).
기간: 12주
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12주
|
2차 결과 측정
결과 측정 |
기간 |
|---|---|
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무진행생존기간(PFS)
기간: 24개월
|
24개월
|
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부작용(AE)의 발생률 및 심각도
기간: 24개월
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24개월
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Disease control rate (DCR) and duration of response (DoR) by RECIST v1.1.
기간: 24 months
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24 months
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공동 작업자 및 조사자
스폰서
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
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