A Clinical Trial Assessing the Safety and Efficacy of Intravenous HNF4α SrRNA for the Treatment of Patients With Metastatic Colorectal Cancer
Overview
- Phase
- Early Phase 1
- Intervention
- HNF4α srRNA
- Conditions
- Metastatic Colorectal Cancer (mCRC)
- Sponsor
- Shanghai Changzheng Hospital
- Enrollment
- 9
- Locations
- 1
- Primary Endpoint
- To evaluate the tolerability and safety for intravenous HNF4α srRNA in subjects with metastatic colorectal cancer
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
This trial is a single-arm, open-label, exploratory first-in-human clinical study designed to evaluate the safety and tolerability of HNF4α srRNA injection in patients with locally unresectable or metastatic colorectal cancer, and to preliminarily explore its effectiveness in treating metastatic colorectal cancer.
Detailed Description
This study will administer HNF4α srRNA via intravenous injection to treat locally unresectable or metastatic colorectal cancer. The second treatment will be conducted 14 ± 3 days after the initial treatment, with subsequent treatment cycles every 28 ± 7 days (the dosing interval will be adjusted based on the tolerability, safety, and therapeutic effect of the subjects). The dose-escalation trial will employ the i3+3 design method, with three dose groups, tentatively setting the injection dose of HNF4α srRNA at 25 μg, 50 μg, and 100 μg per administration, and each group is expected to include up to 3 subjects. According to Amendment 1, after enrollment, the investigator will determine the HNF4α srRNA dose, whether to combine it with immunotherapy, and the dose and schedule of the combination, based on the patient's treatment history and the safety/efficacy data of HNF4α srRNA (CD-801/CD-GA-102) administered via peripheral vein for hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), or colorectal cancer (CRC). Participants initially on HNF4α srRNA monotherapy who are considered for combination with immunotherapy must complete at least two treatment cycles and the post - treatment safety assessment. Then, the investigator can decide whether to add immunotherapy after a comprehensive review of their treatment history.
Investigators
Wei-Fen Xie
Director, Department of Gastroenterology, Changzheng Hospital
Shanghai Changzheng Hospital
Eligibility Criteria
Inclusion Criteria
- •Males or females, aged 18 years or older.
- •Patients with histologically confirmed colorectal cancer that has been determined to be unresectable or metastatic.
- •Colorectal cancer subjects who are unsuitable or unable to tolerate standard systemic therapy, or who have received standard systemic therapy but have disease progression based on RECIST (version 1.1) criteria, including chemotherapy based on fluorouracil, oxaliplatin, or irinotecan, and targeted therapies with anti-VEGF/EGFR monoclonal antibodies.
- •Patients with confirmed deficient mismatch repair (dMMR) or high microsatellite instability (MSI-H) in tumor tissue, who have been treated with immune checkpoint inhibitors (anti-PD-1 or anti-PD-L1 antibodies) and are assessed with disease progression.
- •According to the RECIST (version 1.1) criteria, there are measurable target lesions suitable for repeated measurements for assessment.
- •Life expectancy of 12 weeks or more.
- •Subjects must have an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 to
- •Males with fertility and females of childbearing potential are willing to use a highly effective method of contraception for the entire study period and for 6 months after study drug discontinuation. Females of childbearing age, including premenopausal females and within 2 years after menopause, must have a negative serum pregnancy test result within 7 days prior to the first dose of study treatment.
- •Subjects who had a voluntary agreement to provide written informed consent and the willingness and ability to comply with all aspects of the protocol.
Exclusion Criteria
- •Patients with any of the following criteria were excluded from participation in this study
- •Patients who have undergone standard adjuvant chemotherapy after tumor resection, and have experienced recurrence or metastasis within 6 months after discontinuing the medication, and have not received standard systemic therapy.
- •Clinical or imaging indications suggest the current presence of intestinal obstruction, perforation, or bleeding; or those who, upon investigator assessment, are at a higher risk of perforation or bleeding.
- •Inadequate liver function：serum bilirubin \> 3 × the upper limit of normal (ULN), or aspartate aminotransferase (AST), alkaline phosphatase (ALP), or alanine aminotransferase (ALT) \> 5 × ULN.
- •Inadequate renal function defined as creatinine \>1.5 × ULN or calculated creatinine clearance \< 40 mL/min.
- •Absolute neutrophil count (ANC) \< 1.5×109/L, or Platelets \< 50×109/L, or Hemoglobin \< 9.0 g/dL.
- •International normalized ratio (INR) \> 2.
- •Patients with confirmed tumor brain metastases.
- •Poorly controlled hypertension, diabetes or other serious heart or lung diseases, or with serious dysfunction.
- •Patients who have received local or systemic anti-tumor treatments such as immunotherapy, targeted therapy, and chemotherapy within 4 weeks, or radiation therapy within 3 weeks, except for treatment regimens assessed as disease progression according to RECIST v1.
Arms & Interventions
HNF4α srRNA treatment
The subjects with metastatic colorectal cancer will be treated by HNF4α srRNA intravenously via a peripheral vein. According to Amendment 1, the HNF4α srRNA preparation CD-801 used in the original protocol will expire on December 31, 2024. For participants receiving treatment after this date, the preparation will be switched to CD-GA-102, with the treatment dose converted on a 1:1 basis.
Intervention: HNF4α srRNA
Outcomes
Primary Outcomes
To evaluate the tolerability and safety for intravenous HNF4α srRNA in subjects with metastatic colorectal cancer
Time Frame: Through study completion, an average of 2 years
Safety and tolerability are assessed based on the incidence of Dose-Limiting Toxicities (DLTs) within 14 days post-initial drug administration, along with the frequency and severity of adverse events (AEs), serious adverse events (SAEs), and events leading to treatment discontinuation throughout the treatment period, all evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. According to Amendment 1, the primary endpoint has been amended from assessing the incidence and severity of DLTs, adverse events (AEs), serious adverse events (SAEs), and AEs leading to treatment discontinuation (evaluated per NCI-CTCAE 5.0) with HNF4α srRNA therapy to assessing these outcomes for both HNF4α srRNA monotherapy and combination therapy.
Secondary Outcomes
- Duration of response based on RECIST v1.1(up to 24 months)
- To assess the objective response rate (ORR) by RECIST v1.1(From the first study dose date until the date of documented complete response or partial response, assessed up to 24 months.)
- Progression-free survival based on RECIST v1.1(up to 24 months)
- Time to response based on RECIST v1.1(up to 24 months)
- Clinical benefit rate based on RECIST v1.1(up to 24 months)
- Overall Survival(Throughout the entire course of treatment until the end of the follow-up period, an average of 2 years)
- Patient Reported Outcome-1(Through study completion, an average of 2 years)
- Patient Reported Outcome-2(Through study completion, an average of 2 years)
- Patient Reported Outcome-3(Through study completion, an average of 2 years)
- The impact of HNF4α srRNA treatment on tumor biomarkers in serum(Through study completion, an average of 2 years)