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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)
Studie Overzicht
Toestand
Conditie
Gedetailleerde beschrijving
- 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.
Studietype
Inschrijving (Geschat)
Fase
- Fase 2
- Fase 1
Contacten en locaties
Studiecontact
- Naam: Seni S Lu, Phd
- Telefoonnummer: +86 13076790030
- E-mail: Seni-Lu@beijing-biotech.com
Studie Locaties
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Guangdong
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Shenzhen, Guangdong, China, 518036
- Werving
- Peking University Shenzhen Hospital
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Contact:
- Zhen J Peng, Phd
- Telefoonnummer: +86 13076790039
- E-mail: Zhen-Peng@beijing-biotech.com
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Niet-gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: 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.
|
Allogeneïsche CAR-NK-cellen ontwikkeld met een dual-recognition CAR gericht op MSLN en MUC1.
Toegediend als een IV-infusie op dag 0 (afhankelijk van de doseringsniveau).
Andere namen:
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).
Andere namen:
fludarabine (Days -5 to -3) and cyclophosphamide (Days -5 to -4) prior to CAR-NK infusion.
Andere namen:
|
|
Experimenteel: 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.
|
Allogeneïsche CAR-NK-cellen ontwikkeld met een dual-recognition CAR gericht op MSLN en MUC1.
Toegediend als een IV-infusie op dag 0 (afhankelijk van de doseringsniveau).
Andere namen:
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).
Andere namen:
fludarabine (Days -5 to -3) and cyclophosphamide (Days -5 to -4) prior to CAR-NK infusion.
Andere namen:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
|
Maximaal getolereerde dosis (MTD)
Tijdsspanne: 12 maanden
|
12 maanden
|
|
Incidentie van dosisbeperkende toxiciteiten (DLT's)
Tijdsspanne: 28 Dagen
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28 Dagen
|
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Incidentie en ernst van behandeling-gerelateerde bijwerkingen (TEAEs)
Tijdsspanne: 12 maanden
|
12 maanden
|
Secundaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
|
Ziektebestrijdingspercentage (DCR)
Tijdsspanne: 12 maanden
|
12 maanden
|
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Objectieve responsratio (ORR) volgens RECIST v1.1
Tijdsspanne: 12 maanden
|
12 maanden
|
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Duur van respons (DOR)
Tijdsspanne: 24 maanden
|
24 maanden
|
Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Endocriene systeemziekten
- Pathologische processen
- Neoplasmata per site
- Neoplasmata
- Neoplasmata van het spijsverteringsstelsel
- Ziekten van het spijsverteringsstelsel
- Endocriene klierneoplasmata
- Alvleesklier Ziekten
- Neoplastische processen
- Pathologische aandoeningen, tekenen en symptomen
- Neoplasma metastase
- Pancreasneoplasmata
- Organische chemicaliën
- Onderzoekstechnieken
- Therapeutica
- Koolwaterstoffen
- Fosforamide mosterd
- Stikstofmosterdverbindingen
- Mosterdverbindingen
- Koolwaterstoffen, gehalogeneerd
- Fosforamides
- Organofosforverbindingen
- Biologische therapie
- Immunologische technieken
- Immunomodulatie
- Immunotherapie
- Immunosuppressietherapie
- Cyclofosfamide
- fludarabine
- Transplantatieconditionering
Andere studie-ID-nummers
- ESSEN-PDAC-DNK-008
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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