Phase 1 Trial of AZD6422 in CLDN18.2+ GI Tumors

Study Overview
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Brief Summary
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This is a FTiH, Phase 1 IIT to evaluate the safety, feasibility, cellular kinetics (CK), pharmacodynamics (PD), immunogenicity, and preliminary antitumor activity of AZD6422 in adult participants with advanced or metastatic CLDN18.2+ GI tumors.

Detailed Description
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Qualified researchers can request access to anonymized individual patient-level data from sponsor or the collaborator group of companies sponsored clinical trials via the request portal. All requests will be evaluated as per the sponsor disclosure commitment. Yes, indicates that sponsors are accepting requests for IPD, but this does not mean all requests will be shared.

Official Title
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FTiH, Phase 1 Investigator-Initiated Trial (IIT) to Evaluate the Safety, Feasibility, Cellular Kinetics, and Preliminary Antitumor Activity of AZD6422 in Adult Participants With Advanced or Metastatic CLDN18.2+ GI Tumors

Conditions
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Gastrointestinal Tumors

Intervention / Treatment
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* Biological: AZD6422 CLDN18.2 CAR-T product


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1Capable of giving signed informed consent and keep compliance with the requirements and restrictions listed in the ICF and in this protocol. 2Age ≥ 18 years at the time of signing the informed consent. 3At least 1 lesion, that qualifies as a RECIST v1.1 target lesion at baseline. Histologically confirmed diagnosis of unresectable or metastatic GI adenocarcinoma that has failed prior lines systemic treatment or with standard anticancer therapy. 4Confirmation of CLDN18.2 expression determined by IHC . 5ECOG PS of 0 to 1. 6 Life expectancy of > 12 weeks. 7Evidence of appropriate organ function, as determined by clinical laboratory values. 8Participants of childbearing potential (including woman of childbearing potential and males who have a partner) must take highly effective contraception measure. Exclusion Criteria: 1.Prior treatment with any CAR-T cell therapy. 2.History of upper digestive tract bleeding secondary to previous CLDN18.2-targeting therapies; clinically significant unstable or active peptic ulcer disease or upper digestive tract bleeding 3.Cancer-related spinal cord compression, leptomeningeal disease, or brain metastases. 4.Receipt of the last dose of anticancer therapy within 5 half-lives or ≤ 21 days prior to apheresis, treatment radiotherapy within 6 weeks (loco-regional palliative radiotherapy within 7 days) prior to apheresis. 5.Treatment with any anticoagulant or antiplatelet therapy. 6.History of, or active, bleeding diatheses. 7.Active or chronic infection disease (s). 8.History of another primary malignancy ≤ 3 years before enrolment. 9.Any history of autoimmune neurological conditions. 10.Other active autoimmune or inflammatory disorders. 11.Stroke, intracranial haemorrhage, or seizure within 6 months of apheresis. 12.Active uncontrolled epilepsy. 13.Cardiac disease, including arrhythmias, QT prolongation, cardiomyopathy and unstable ischaemic heart disease. 14.Uncontrolled intercurrent illness. 15.Steroids or other immunomodulators of systemic therapeutic dose within 14 days prior to apheresis. 16.Prior pegylated G-CSF within 60 days before apheresis. Prior G-CSF/granulocyte-macrophage colony stimulating factor (GM-CSF) within 14 days before apheresis. 17.Any prohibited medication. 18.Major surgery within 2 weeks prior to apheresis, or planned surgery within 4 weeks after study intervention. 19.Any history of life-threatening allergies, hypersensitivity, or severe infusion reaction to monoclonal antibodies or biological therapies, or intolerance to the CAR-T product or its excipients. 20.Toxicity from previous anticancer therapy that has not resolved to baseline levels or to ≤ Grade 1 prior to apheresis. 21.Female participants who are pregnant or breastfeeding or expect to be pregnant or breastfeeding during the study. 22.Judgment by the investigator that the participant should not participate in the study if the participant is unlikely to comply with study procedures, restrictions, and requirements. 23.Receipt of live or live attenuated vaccine within 30 days prior to the start of lymphodepletion. 24.Participant has any medical or psychiatric condition.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: AZD6422<br>It is anti-CLDN18.2 CAR-T cell therapy and the study consists of two parts: dose escalation (part 1) and dose expansion (part 2) | Biological: AZD6422 CLDN18.2 CAR-T product<br>* AZD6422 CAR-T product infusion after pre-conditioning<br>* Other names: AZD6422;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of treatment-emergent AEs, AESIs, and SAEs. | Incidence of treatment-emergent AEs, AESIs, and SAEs. | Within 24 months of the last AZD6422 infusion or the start of a new anticancer treatment | 
| Occurrence of Dose limiting toxicity. | Occurrence of DLTs (Dose limiting toxicity). | Within 28 days after the first infusion | 
| Changes from baseline in vital signs, laboratory parameters, physical examination, and 12-lead ECG. | Changes from baseline in vital signs, laboratory parameters, physical examination, and 12-lead ECG. | Within 28 days after the first infusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ORR | The proportion of participants who have a confirmed CR or confirmed PR as determined by the investigator at local site per RECIST v1.1. | 24 months post AZD6422 infusion | 
| DoR | The time from first documented confirmed response until date of documented progression of disease per RECIST v1.1 as determined by investigator at local site or death due to any cause. | 24 months post AZD6422 infusion | 
| DCR | The proportion of participants who have a confirmed CR, confirmed PR, or who have SD per RECIST v1.1 as assessed by the investigator at local site and derived from the raw tumor data for at least 11 weeks after infusion date. | 24 months post AZD6422 infusion | 
| PFS | Time from infusion date until progression per RECIST v1.1 as assessed by the investigator at local site, or death due to any cause. | 24 months post AZD6422 infusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CLDN18.2+ GI Tumors Solid tumor CAR-T Cell therapy AZD6422