A Phase 1/2, Open-Label, Biomarker-Driven Study of Allogeneic Donor-Derived CAR-NK Cells With Antigen Selection by Tissue Biopsy and/or Liquid Biopsy Profiling in Participants With Relapsed/Refractory Advanced Solid Tumors (Single-Target vs Dual-Target Strategy)
Overview
- Phase
- Phase 1
- Status
- Recruiting
- Sponsor
- Essen Biotech
- Enrollment
- 85
- Locations
- 1
- Primary Endpoint
- Incidence, type, and severity of adverse events (AEs), graded by CTCAE v5.0
Overview
Brief Summary
This Phase 1/2 study evaluates the safety, feasibility, and preliminary anti-tumor activity of allogeneic donor-derived CAR-NK cells in participants with advanced solid tumors. The CAR target antigen is selected for each participant after tumor profiling using a tissue biopsy and/or liquid biopsy. Participants will receive either a single-target or dual-target CAR-NK product based on the antigen profile.
Detailed Description
This is an open-label, biomarker-driven adoptive cell therapy study.
Screening / Target Selection (Precision Step):
Participants undergo tumor antigen profiling using:
Tissue biopsy (preferred when safely feasible), and/or Liquid biopsy (e.g., circulating tumor DNA plus circulating tumor cells/exosome protein assay, as available in the platform).
Antigen profiling determines eligibility and assigns participants to:
Single-target CAR-NK if one antigen meets positivity thresholds, or Dual-target CAR-NK if two antigens meet thresholds or if heterogeneity is suspected.
Pre-specified target menu :
TROP2, Mesothelin (MSLN), B7-H3 (CD276), HER2, EGFR, GD2, Claudin18.2, GPC3, PSMA ("Target menu" can be expanded in amendments.)
Cell Source / Manufacturing Concept:
NK cells are obtained from a healthy allogeneic donor (unrelated or partially matched per site policy).
Donor NK cells are collected by leukapheresis, activated/expanded, and genetically modified to express:
a single CAR (Arm A) or a dual CAR / dual-target construct (Arm B). Final product is cryopreserved and released after sterility/identity/potency testing.
Conditioning & Treatment:
Participants receive lymphodepleting chemotherapy followed by CAR-NK infusion(s). Many CAR-NK solid-tumor trials use conditioning regimens such as fludarabine and cyclophosphamide before infusion.
Optional cytokine support (e.g., low-dose IL-2) may be used per protocol to support NK persistence, consistent with approaches used in some CAR-NK studies.
Follow-up:
Intensive safety monitoring during the first 28 days. Tumor imaging at protocol-defined intervals. Correlative studies including CAR-NK persistence and ctDNA dynamics.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Masking Description
Open-label due to the nature of personalized antigen assignment and cell product differences
Eligibility Criteria
- Ages
- 8 Years to 85 Years (Child, Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age 18-75 years.
- •Histologically or cytologically confirmed advanced/unresectable or metastatic solid tumor that is relapsed/refractory after standard therapy, or no standard therapy available.
- •Targetable antigen positivity from the protocol target menu based on:
- •tissue biopsy and/or liquid biopsy platform (as defined in the lab manual).
- •Arm assignment rules :
- •Arm A: ≥1 antigen meets "positive" threshold
- •Arm B: ≥2 antigens meet "positive" threshold
- •ECOG performance status 0-1 (or 0-2 ).
- •At least one measurable lesion by RECIST 1.
- •Adequate organ function (hematologic, renal, hepatic, cardiac) within protocol-defined limits.
Exclusion Criteria
- •Prior treatment with gene-modified cellular therapy (e.g., CAR-T, CAR-NK) within a defined washout period .
- •Active, uncontrolled infection requiring IV antibiotics; known uncontrolled HIV; active HBV/HCV with detectable viral load (per local policy).
- •Active CNS metastases requiring escalating steroids or urgent intervention (stable treated CNS disease may be allowed ).
- •Active autoimmune disease requiring systemic immunosuppression, or chronic systemic steroids above protocol threshold.
- •Clinically significant cardiovascular disease (e.g., recent MI, unstable arrhythmia), uncontrolled pulmonary disease, or other serious comorbidity that increases risk.
- •Major surgery or anticancer therapy too close to lymphodepletion (protocol-defined washout).
- •Pregnant or breastfeeding.
Arms & Interventions
Single-Target Antigen-Selected CAR-NK
Participants whose profiling identifies one dominant actionable antigen.
Intervention: EB-SELECT Single-Target CAR-NK Cells (Biological)
Dual-Target Antigen-Selected CAR-NK
Participants whose profiling identifies two actionable antigens, or strong evidence of antigen heterogeneity.
Intervention: Dual-Target Antigen-Selected CAR-NK (Biological)
Outcomes
Primary Outcomes
Incidence, type, and severity of adverse events (AEs), graded by CTCAE v5.0
Time Frame: 28 DAYS
Incidence of Dose-Limiting Toxicities (DLTs)
Time Frame: 28 DAYS
Secondary Outcomes
- Objective Response Rate (ORR) (RECIST 1.1)(12 months)
- Disease Control Rate (DCR)(12 months)