A Dose-Finding Phase I Followed by a Phase II Study to Evaluate the Safety and Efficacy of Allogeneic NK-cell Combined With Chemotherapy in Patients With PDA or Cholangiocarcinoma After Surgery
Overview
- Phase
- Phase 1
- Intervention
- SLOG + Allogeneic NK cell
- Conditions
- Pancreatic Carcinoma Stage II
- Sponsor
- Medigen Biotechnology Corporation
- Enrollment
- 42
- Locations
- 1
- Primary Endpoint
- Ph I Evaluation of safety parameters, numbers of participants with Treatment-Emergent Adverse Events (TEAEs).
- Status
- Recruiting
- Last Updated
- 4 months ago
Overview
Brief Summary
This is a phase I/II study which intends to characterize the safety, tolerability, and preliminary efficacy of Allogeneic Magicell-NK infusion in PDA or cholangiocarcinoma patients after surgery. Subjects will receive a total of 6 intravenous (IV) infusions of the IP on the 11th day of each chemotherapy cycle. A total of 6 cycles of IP infusions are planned.
The phase I part of the study is a first-in-human phase I trial of Allogeneic Magicell-NK and is therefore designed in an open-label, dose-escalation manner. A standard 3+3 design will be employed to assess the safety profile of Allogeneic Magicell-NK and to determine the MTD/MFD. Two dose cohorts are planned: the starting dose is 10 × 10^8 cells (Cohort 1), and escalates to 20 × 10^8 cells (Cohort 2).
The phase II part of the study is designed as an open-label, two-arm, randomized clinical trial comparing the combination of SLOG and Allogeneic Magicell-NK with SLOG alone when used as adjuvant therapy following resection for PDA or Cholangiocarcinoma. Approximately 30 subjects will be randomized at a 2:1 ratio between the two arms: Arm 1: SLOG and Allogeneic Magicell-NK (20 subjects); Arm 2: SLOG alone (10 subjects). Subjects will then receive 12 weeks of SLOG chemotherapy with or without Allogeneic Magicell-NK infusion.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Dated and signed informed consent.
- •Either sex, aged older than 18 years old (inclusive) at date of consent.
- •Subject with a macroscopic resection of the primary tumor and residual primary tumor that satisfies all of the items below according to the Union for International Cancer Control (UICC) histopathologic staging system:
- •At or before the surgery, stage II or stage III.
- •Local residual tumor classified as R0 or R
- •Cytologic examination negative upon intraoperative peritoneal lavage.
- •Histologically confirmed PDA or cholangiocarcinoma.
- •Received curative resection within 12 weeks prior to screening visit and will receive adjuvant SLOG chemotherapy. Note: Subjects with cancer who had undergone surgery with or without prior neo-adjuvant therapy will be recruited.
- •Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-
- •Subject with adequate hematology function at Visit 1:
Exclusion Criteria
- •Received any other investigational, anti-neoplastic medications, or immune cell therapy within 28 days prior to screening visit.
- •Any prior history of malignant neoplasm, except:
- •Non-invasive, non-melanomatous skin cancer (including squamous cell carcinoma, basal cell carcinoma, or carcinoma in situ), curatively treated with cryosurgery or surgical excision only.
- •Other primary malignant neoplasm diagnosed as disease free for more than 5 years.
- •Immunocompromized, currently under immunosuppressive treatment for autoimmune disease, or have received systemic steroid of equivalent dosage higher than prednisolone 30 mg/day for more than 7 days within 14 days prior to Day
- •With known metastases.
- •With ongoing acute diseases, or serious medical conditions within the past 2 years prior to screening, such as cardiovascular (e.g., New York Heart Association grade III or IV), hepatic (e.g., Child-Pugh Class C), psychiatric condition (e.g., alcoholism, drug abuse), medical history, physical findings, or laboratory abnormality that in the investigators' opinion could interfere with the results of the trial or adversely affect the safety of the subject.
- •Hypercoagulable state that may lead to clinically apparent thrombosis.
- •With known hypersensitivity to aminoglycoside (e.g., streptomycin, gentamicin) or bacitracin.
- •With known hypersensitivity to any of the components of Allogeneic Magicell-NK, including human serum albumin.
Arms & Interventions
SLOG + Allogeneic NK cells
Ph I SLOG + Allogeneic NK cell dose escalation (Cohort 1:10 × 10\^8 cells ; Cohort 2:20 × 10\^8 cells) Ph II Arm 1 SLOG + Allogeneic NK cell
Intervention: SLOG + Allogeneic NK cell
SLOG chemotherapy
Ph II Arm 2
Intervention: SLOG chemotherapy
Outcomes
Primary Outcomes
Ph I Evaluation of safety parameters, numbers of participants with Treatment-Emergent Adverse Events (TEAEs).
Time Frame: 15 months
The number of participants with Treatment-Emergent Adverse Events (TEAEs) was assessed using the Common Terminology Criteria for Adverse Events (CTCAE v5.0) to assess the tolerability of Magicell-NK treatment.
Ph I Laboratory tests
Time Frame: 15 months
Number of participants with abnormal laboratory test results.
Ph I Body weight
Time Frame: 5 months
Body weight (KG) will be measured at baseline, treatment, and F1 visits. The number of participants with abnormal body weight change.
Ph I Vital signs
Time Frame: 15 months
Number of participants with abnormal vital signs.
Ph I Dose-limiting toxicities
Time Frame: 4 months
Adverse events were assessed according to NCI-CTCAE v5.0 criteria.
Ph I Maximum Tolerated Dose (MTD) and Recommended Phase II Dose
Time Frame: 4 months
MTD is defined as the highest dose level at which ≤ 1/6 of subjects experienced DLT.
Ph II Disease-free survival (DFS)
Time Frame: 15 months
The time from the date of the first Magicell-NK infusion to the date of the first disease-free survival event (recurrence, second primary PDA or Cholangiocarcinoma, or death from any cause).
Secondary Outcomes
- Ph I Disease-free survival (DFS)(15 months)
- Ph II Evaluation of safety parameters, numbers of participants with Treatment-Emergent Adverse Events (TEAEs)(15 months)
- Ph II Laboratory tests(15 months)
- Ph II Body weight(5 months)
- Ph II Vital signs(15 months)
- Ph I/II Tumor recurrence rate (TRR)(15 months)
- Ph I/II Changes in Frequency and Duration of ctDNA(Up to 15 months)
- Ph I/II Changes in Frequency and Duration of Circulating Tumor Count (CTC)(Up to 15 months)
- Ph I/II Changes in Biomarkers (CA19-9 and CEA)(Up to 15 months)