A Study to Evaluate the Safety and Efficacy of Mesothelin-Targeting Logic-gated CAR T, in Participants With Solid Tumors That Express MSLN and Have Lost HLA-A*02 Expression

NCT06051695RecruitingPHASE1, PHASE2INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

A2 Biotherapeutics Inc.

Enrollment

474

Start Date

2024-04-03

Completion Date

2028-06-01

Study Type

INTERVENTIONAL

Official Title

A Seamless Phase 1/2 Study to Evaluate the Safety and Efficacy of Mesothelin-Targeting Autologous Logic-gated Tmod™ CAR T Products, in Heterozygous HLA-A*02 Adults With Recurrent Unresectable, Locally Advanced, or Metastatic Solid Tumors That Express MSLN and Have Lost HLA-A*02 Expression

Interventions

A2B694A2B543xT CDx with HLA-LOH Assay

Conditions

Solid TumorAdultColorectal CancerNSCLCNon Small Cell Lung CancerNSCLCRecurrentNon-Small Cell Squamous Lung CancerPancreas CancerPancreatic NeoplasmColorectal AdenocarcinomaCRCColon CancerRectal CancerCancerOvarian CancerOvarian NeoplasmsMesotheliomaMesotheliomaMalignantOvary CancerLung CancerMESOM

Eligibility

Age Range

18 Years+

Sex

ALL

Inclusion Criteria:

Key Inclusion Criteria:

1. Appropriately enrolled in the BASECAMP-1 A2 Biotherapeutics, Inc. study, with tissue demonstrating LOH of HLA-A\*02 by NGS (whenever possible from the primary site), successful apheresis and PBMC processing, and with sufficient stored cells available for Tmod CAR T-cell therapy
2. Histologically confirmed recurrent unresectable, locally advanced, or metastatic CRC, NSCLC, PANC, OVCA, MESO, or other solid tumors with MSLN expression. Measurable disease is required with lesions of ≥1.0 cm by CT.
3. Received previous required therapy for the appropriate solid tumor disease as described in the protocol
4. Has adequate organ function as described in the protocol
5. ECOG performance status of 0 to 1
6. Life expectancy of ≥3 months
7. Willing to comply with study schedule of assessments including long term safety follow up

Key Exclusion Criteria:

1. Has disease that is suitable for local therapy or able to receive standard of care therapy that is therapeutic and not palliative
2. Prior allogeneic stem cell transplant
3. Prior solid organ transplant
4. MESO with pleural involvement extending into the peritoneum
5. Cancer therapy within 3 weeks or 3 half lives of infusion
6. Radiotherapy within 28 days of infusion
7. Unstable angina, arrhythmia, myocardial infarction, or any other significant cardiac disease within the last 6 months
8. Any new symptomatic pulmonary embolism (PE) or a deep vein thrombosis (DVT) within 3 months of enrollment. Therapeutic dosing of anticoagulants is allowed for history of PE or DVT if greater than 3 months from time of enrollment, and adequately treated
9. History of interstitial lung disease including drug-induced interstitial lung disease and radiation pneumonitis that requires treatment with prolonged steroids or other immune suppressive agents within 1 year
10. Requires supplemental home oxygen
11. Females of childbearing potential who are pregnant or breastfeeding
12. Subjects, both male and female, of childbearing potential who are not willing to practice birth control from the time of consent through 6 months post infusion

Outcome Measures

Primary Outcomes

Phase 1: Rate of adverse events and dose limiting toxicities (DLTs) by dose level

Adverse Events and toxicity will be evaluated according to the Cancer Therapy Evaluation Program Common Terminology Criteria for Adverse Events version (CTCAE) 5.0 (or current version). Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) events will be graded according to the criteria described in the current protocol.

Time frame: From the time of Informed consent until 24 months (2 years) post infusion

Phase 1: Recommended Phase 2 Dose (RP2D)

The RP2D will be identified utilizing a BOIN study design in addition to considering safety and biomarker analysis.

Time frame: 21 days post infusion

Phase 2: The Overall Response Rate (ORR) for patients

The ORR will be evaluated per RECIST v1.1 and assessed by independent central review.

Time frame: 24 months post infusion

Secondary Outcomes

Persistence of Tmod product

Number of Tmod CAR T cells present as assessed by polymerase chain reaction (PCR) (or similar method) on participant blood samples

Time frame: up to 24 months post infusion

Cytokine analysis

Cytokine levels such as interferon-gamma (IFN-γ) and interleukin-6 (IL-6) assessed by cytokine analysis on participant blood samples

Time frame: up to 24 months post infusion

Locations

Banner Health, Gilbert, United States

UCSD Moores Cancer Center, La Jolla, United States

UCLA Medical Center, Los Angeles, United States

Stanford University, Stanford, United States

Mayo Clinic, Jacksonville, United States

Moffitt Cancer Center, Tampa, United States

Mayo Clinic Rochester, Rochester, United States

Washington University, St Louis, United States

NYU Langone Medical Center, New York, United States

The Ohio State University Comprehensive Cancer Center, Columbus, United States

Vanderbilt University Medical Center, Nashville, United States

Fred Hutchinson Cancer Center, Seattle, United States

A Study to Evaluate the Safety and Efficacy of Mesothelin-Targeting Logic-gated CAR T, in Participants With Solid Tumors That Express MSLN and Have Lost HLA-A*02 Expression