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A Trial to Evaluate Safety and Tolerability of TST001 in Advanced or Metastatic Solid Tumors

Phase 1
Active, not recruiting
Conditions
Advanced Cancer
Gastric Cancer
Gastroesophageal-junction Cancer
Pancreatic Cancer
Interventions
Drug: TST001
Drug: Nivolumab Injection [Opdivo]
Drug: Gemcitabine
Drug: mFOLFOX6
Drug: Albumin-Bound Paclitaxel
Registration Number
NCT04396821
Lead Sponsor
Suzhou Transcenta Therapeutics Co., Ltd.
Brief Summary

This is an open label Phase I/IIa, First in Human trial of TST001, a recombinant humanized anti-Claudin 18.2 (CLDN18.2) IgG1 monoclonal antibody as monotherapy or in combination with nivolumab or standard of care. It is being tested against advanced and/or metastatic solid tumors including gastric, gastroesophageal junction, pancreatic cancers.

Detailed Description

Part A of the trial will consist of two cohorts, one dosed every 2 weeks and one dosed every 3 weeks in a standard 3+3 design. Part A is the dose finding portion of the trial.

18 to 36 participants will be enrolled.

Part B consists of 3 cohorts:

Cohort A is for patients with previously untreated, unresectable, locally advanced or metastatic GC/GEJ adenocarcinoma. Patients will receive TST001 at 2mg/kg or 4mg/kg Q2W plus Nivolumab and mFOLFOX6. Alternative allocation of patients between the 2 doses will be performed. The first 6 patients at each dose level as the lead-in phase will not be selected on the basis of their tumor's CLDN18.2 expression. Approximately 12-42 patients will be enrolled in Cohort A.

Cohort B is for patients with GC/GEJ adenocarcinoma who have radiologically progressed following one or two prior systemic therapies. Patient will receive TST001 plus Nivolumab. No selection based on CLDN18.2 expression will be required for the safety run-in (3-6 patients). Patients with CLDN18.2 expression in tumor tissue tested by the central laboratory will be enrolled in the expansion phase. Safety run-in phase will follow 3+3 rule with two dose levels, TST001 3mg/kg and 6mg/kg Q3W combined with nivolumab. Approximately 30 patients will be enrolled in Cohort B including the patients in the safety run-in phase.

Cohort C is for patients with previously untreated, unresectable, locally advanced or metastatic histologically confirmed pancreatic adenocarcinoma; Patients will receive TST001 at 2mg/kg or 4mg/kg Q2W plus gemcitabine and albumin-bound paclitaxel. Alternative allocation of patients between the 2 doses will be performed. The first 6 patients at each dose level as the lead-in phase will not be selected on the basis of their tumor's CLDN18.2 expression. Approximately 12-42 patients will be enrolled in Cohort C.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Male or female ≥ 18 years.
  • Patients with histologically or cytologically confirmed, locally advanced or metastatic solid tumors.

Part A only:

* Patients must be: a) progressed after standard therapies, b) intolerant of standard therapies, or c) with a tumor type without standard therapy.

Part B only:

  • Cohort A: Patients with previously untreated, unresectable, locally advanced or metastatic GC/GEJ adenocarcinoma; prior adjuvant or neoadjuvant therapy are allowed only if disease progressed or recurred at least 6 months after completion of these treatments. Patients may have received one infusion of mFOLFOX6 plus nivolumab during the screening period.
  • Cohort B: Patients with GC/GEJ adenocarcinoma who have radiologically progressed following one or two prior systemic therapies; adjuvant or neoadjuvant therapy could be regarded as one line of therapy only if disease progressed or recurred during these treatments or within 6 months or less after completion of these treatments.
  • Cohort C: Patients with previously untreated, unresectable, locally advanced or metastatic histologically confirmed pancreatic adenocarcinoma; prior adjuvant or neoadjuvant therapy are allowed only if disease progressed or recurred at least 6 months after completion of these treatments. Patients may have received up to 2 infusions of Gemcitabine + albumin-bound paclitaxel (with one week between each infusion) during the screening period.
  • Eastern Cooperative Oncology Group Performance Status (ECOG PS): 0-1 .
  • Patients with adequate cardiac, liver, renal function, etc.

Exclusion Criteria

  • Symptomatic central nervous system metastases.
  • Prior treatment with any CLDN18.2 target agents
  • Allergy or sensitivity to TST001 or known allergies to comparable drugs
  • Documented history of multiple other allergies requiring interventions
  • Severe cardiovascular disease, including CVA, TIA, myocardial infarction, or unstable angina, NYHA class III or IV heart failure or uncontrolled arrhythmia within 6 months of study entry, severe QTc prolongation, concomitant risks for QTc prolongation.
  • Concurrent malignancy within 5 years prior to entry except adequately treated certain types of cancer
  • Active and clinically significant infections, known uncontrolled infections with hepatitis B, hepatitis C, known human immunodeficiency virus with acquired immunodeficiency syndrome related illness
  • Any condition that the investigator or primary physician believes may not be appropriate for participating in the study.

Other protocol-defined Inclusion/Exclusion Criteria could apply.

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Exclusion Criteria

Not provided

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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part A Q3WTST001Dosed every 3 weeks IV with TST001, starting dose is 3 mg/kg, and multiple dose levels will be tested.
Part B Cohort ATST001Patients with previously untreated, unresectable, locally advanced or metastatic GC/GEJ adenocarcinoma.
Part A Q2WTST001Dosed every 2 weeks IV with TST001, starting dose is 1 mg/kg, multiple dose levels will be tested.
Part B Cohort BTST001Patients with GC/GEJ adenocarcinoma who have radiologically progressed following one or two prior systemic therapies.
Part B Cohort BNivolumab Injection [Opdivo]Patients with GC/GEJ adenocarcinoma who have radiologically progressed following one or two prior systemic therapies.
Part B Cohort CTST001Patients with previously untreated, unresectable, locally advanced or metastatic histologically confirmed pancreatic adenocarcinoma.
Part B Cohort ANivolumab Injection [Opdivo]Patients with previously untreated, unresectable, locally advanced or metastatic GC/GEJ adenocarcinoma.
Part B Cohort AmFOLFOX6Patients with previously untreated, unresectable, locally advanced or metastatic GC/GEJ adenocarcinoma.
Part B Cohort CAlbumin-Bound PaclitaxelPatients with previously untreated, unresectable, locally advanced or metastatic histologically confirmed pancreatic adenocarcinoma.
Part B Cohort CGemcitabinePatients with previously untreated, unresectable, locally advanced or metastatic histologically confirmed pancreatic adenocarcinoma.
Primary Outcome Measures
NameTimeMethod
Participant Safety as characterized by frequency and severity of adverse eventsup to 100 days following last dose

Characterization of TST001 safety profile including frequency and severity of adverse events that are related to treatment.

Maximum Tolerated Dose (MTD or Recommended Phase 2 Dose (RP2D)up to 100 days following last dose

As measured by number of participants experiencing dose related toxicity (DLT) in each escalating cohort

Participant Safety and Tolerability of TST001 in combination with Nivolumab as characterized by frequency and severity of adverse eventsUp to 100 days following last dose

Characterization of TST001 + Nivolumab safety profile including frequency and severity of adverse events that are related to treatment.

Participant Safety and Tolerability of TST001 in combination with Nivolumab and mFOLFOX6 as characterized by frequency and severity of adverse eventsUp to 100 days following last dose

Characterization of TST001 + Nivolumab + mFOLFOX6 safety profile including frequency and severity of adverse events that are related to treatment.

Participant Safety and Tolerability of TST001 in combination with gemcitabine and albumin-bound paclitaxel as characterized by frequency and severity of adverse eventsUp to 100 days following last dose

Characterization of TST001 + Gemcitabine + albumin-bound paclitaxel safety profile including frequency and severity of adverse events that are related to treatment.

Secondary Outcome Measures
NameTimeMethod
Immunogenicityup to 30 days following last dose

by measurement of Incidence of anti-drug antibodies (ADA)

Objective response rate (ORR)up to 24 months, until disease progression or start of another anti-cancer therapy

as measured by RECIST 1.1

Duration of Response (DOR)up to 24 months, until disease progression or start of another anti-cancer therapy

duration of response (DOR)

Progression free survival (PFS)up to 24 months, until disease progression or start of another anti-cancer therapy

as measured by RECIST v1.1

PK parametersUp to 30 days following last dose

Maximum serum concentration (Cmax)

PKUp to 30 days following last dose

Area Under the Curve

Trial Locations

Locations (18)

Banner MD Anderson

🇺🇸

Gilbert, Arizona, United States

University of Arizona

🇺🇸

Tucson, Arizona, United States

Yale University

🇺🇸

New Haven, Connecticut, United States

Florida Cancer Specialists

🇺🇸

Sarasota, Florida, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

University of Kansas, School of Medicine

🇺🇸

Kansas City, Kansas, United States

Washington University

🇺🇸

Saint Louis, Missouri, United States

Memorial Sloan Kettering

🇺🇸

New York, New York, United States

Stony Brook Cancer Center

🇺🇸

Stony Brook, New York, United States

Wake Forest Baptist Comprehensive Cancer Center

🇺🇸

Winston-Salem, North Carolina, United States

Gabrail Cancer Research

🇺🇸

Canton, Ohio, United States

Pennsylvania Cancer Specialist Research Institute

🇺🇸

Gettysburg, Pennsylvania, United States

Allegheny Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

Sarah Cannon Research Institute

🇺🇸

Nashville, Tennessee, United States

Vanderbilt University

🇺🇸

Nashville, Tennessee, United States

NEXT Oncology

🇺🇸

Austin, Texas, United States

Swedish Cancer Institute

🇺🇸

Seattle, Washington, United States

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

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