Clinical trial NCT06861543: The Purpose of This Study is to Evaluate the Safety, Tolerability and Efficacy of TMT101 Injection Monotherapy in Patients with Advanced Pancreatic Cancer or Non-small Cell Lung Cancer(NSCLC)
Official title: A Single Arm, Open Label, Dose-escalating, Prospective Phase I Clinical Trial Evaluating the Safety, Tolerability and Efficacy of TMT101 Injection Alone in Patients with Advanced Pancreatic Cancer or Non-small Cell Lung Cancer(NSCLC) After Standard Treatment Failure
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: PHASE1
Conditions: Non-small Cell Lung Cancer
Keywords: TMT101 Injection
mRNA
advanced pancreatic cancer or NSCLC
Lead sponsor: Peking Union Medical College Hospital
Sponsor class: OTHER
First posted: 2025-03-06
Enrollment: 18
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: TMT101 Injection alone
Primary purpose: TREATMENT

Brief summary: This is a first-in-human, single-arm, open-label, dose escalation prospective phase I clinical study to evaluate the Safety, Tolerability and Efficacy of TMT101 Injection Alone in patients with Unresectable, Metastatic or Advanced pancreatic cancer or Non-small Cell Lung Cancer(NSCLC) after Standard Treatment Failure. The primary objective is to evaluate the safety and tolerability of TMT101 Injection as monotherapy in patients with advanced pancreatic cancer and NSCLC, and to determine the recommended therapeutic dose (RD) of TMT101 Injection as monotherapy

Detailed description: The dose escalation trial adopts the "3+3" design , and about 3\~6 patients with advanced pancreatic cancer or non-small cell lung cancer are enrolled in each dose level to evaluate the safety of TMT101 Injection alone. Three dose levels are planned to be explored: 0.1 mg, 0.2 mg, and 0.4 mg. Once a week, intramuscular Injection , a total of 9 times (the first tumor assessment is performed in the 6th week (±7 days), the investigator can decide the follow-up medication arrangement according to the tumor evaluation results). Dose-limiting toxicities (DLTs) will be assessed for each dose level, and the DLT observation period will be within 21 days from the first dose. The initial dose is 0.1 mg with a dose reduction for safety reasons, the level of dose reduction will be discussed jointly between the investigator and the sponsor. If the highest dose level of 0.4 mg is not confirmed as a possible recommended therapeutic dose (RD), it may be escalated a higher dose to determine the possible RD under the condition that investigator and the sponsor to decide together

Eligibility criteria: Inclusion Criteria:

1. Agrees to follow the trial protocol and visit schedule, has signed informed consent;
2. Subjects must be ≥18 years of age at time of informed consent,regardless of gender;
3. Patients with advanced/unresectable or metastatic pancreatic cancer or non-small cell lung cancer that requires histologically and/or cytologically confirmed according to the American Joint Committee on Cancer 8th edition; pancreatic cancer:Previous failure or intolerance of two or more lines of chemotherapy; NSCLC:Previous failure or intolerance of platinum-containing chemotherapy and anti-PD-1/PD-L1 monoclonal antibodies, regardless of combination therapy or sequential therapy, if the previous test for EGFR-sensitive mutations or ALK fusion genes is positive, treatment with a third-generation TKI must be failed or intolerant;
4. ECOG≤1;
5. Estimated life expectancy≥12 weeks;
6. Adequate organ function, meet the following laboratory standards:

   1. ANC≥1.5×109/L;PLT≥100×109/L;
   2. Hb≥90 g/L;
   3. TBIL≤1.5×ULN, Patients with Gilbert's syndrome ; without liver metastases, AST and ALT ≤ 2.5×ULN;liver metastases, AST and ALT ≤5×ULN ;
   4. Ccr≥50 mL/min;
   5. INR≤1.5×ULN, APTT≤1.5×ULN;
7. Males of childbearing potential and females of childbearing potential who are willing to use effective contraception since signing the informed consent until 6 months after the last dose of the trial drug. Females of childbearing potential must have a negative pregnancy test result within 7 days prior to the first dose.

Exclusion Criteria:

1. Allergic to TMT101 Injection or any of the components in the prescription;
2. Uncontrolled illness including, but not limited to, active infection requiring systemic therapy, uncontrolled hypertensionuncontrolled hyperglycemia, decompensated congestive heart failure , unstable angina, arrhythmias that require clinical intervention; ascites or uncontrolled pleural effusion (CTCAE 5.0≥grade 2), thrombosis (such as pulmonary embolism, cerebral infarction, myocardial infarction) or history of stroke, active autoimmune disease, psychiatric disease, active peptic ulcer disease, active bleeding disorder, which would limit compliance with study requirements or impair the patient's ability to sign informed consent in writing;
3. Patients who used immunosuppressive drugs within 3 weeks prior to the first dose, or patients who have achieved immunosuppressive intent (dose \> 10 mg/day prednisone or other equivalent hormones) on systemic hormonal therapy or absorbable topical hormonal therapy, with the exception of physiologic doses of intranasal and inhaled corticosteroids;
4. Patients with prior or concurrent occurrence of other malignancies, with the following exceptions: a) Carcinoma in situ of the cervix or breast, curatively treated with no signs of recurrence for at least 3 years prior to the study; b) The primary malignancy was completely resected and in complete remission for ≥ 5 years;
5. History of interstitial lung disease or current interstitial lung disease or suspected of such disease by imaging during screening. and pneumonitis that previously required systemic corticosteroid treatment;
6. Treponema pallidum antibody or human immunodeficiency virus (HIV) antibody positive, positive for hepatitis C virus antibody and hepatitis C virus (HCV) RNA, or active hepatitis B (positive for hepatitis B surface antigen and HBV DNA ≥ upper limit of normal);
7. Received live vaccines within 4 weeks before the first dose or planned to receive live vaccines during the study period and within 4 weeks after the last dose, including but not limited to: measles, mumps, rubella, chickenpox, yellow fever, rabies, BCG and typhoid vaccines;
8. History of allogeneic organ transplantation and allogeneic hematopoietic stem cell transplantation;
9. Interventional therapy in other clinical trials 3 weeks before the first dose, and it is judged by the investigator and medical monitor to be unsuitable for inclusion in the study;
10. Patients who have had a previous ≥grade 3 immune-related adverse event or immunotherapy-related serious adverse event (SAE) leading to permanent discontinuation;
11. Pregnant or lactating females;
12. In the opinion of the investigator, the subject has other conditions that may affect compliance or are not suitable for participation in this study;
13. Patient has active central nervous system metastases (with or without treatment), including symptomatic brain metastases or meningeal metastases or spinal cord compression, but asymptomatic brain metastases except;
14. Within 4 weeks prior to the first dose, all toxicities from prior antineoplastic therapy have not recovered to grade 1 or less, with the following exceptions: a. alopecia, b. long-term toxicity caused by radiotherapy, c. other toxicities that cannot be recovered in the judgment of the investigator but have no effect on the subject's administration
15. Major surgery within 4 weeks prior to the first dose;
16. Transsplenectomy which is not suitable is judged by the investigator.

Primary outcomes:
measure: dose-limiting toxicities (DLTs)
timeFrame: within 21 days since the first dose
measure: treatment-emergent adverse events (TEAEs)
timeFrame: up to 2 years
measure: treatment related adverse event (TRAE)
timeFrame: up to 2 years
measure: immune-related Adverse Event(irAE）
timeFrame: up to 2 years
measure: Serious Adverse Event(SAE）
timeFrame: up to 2 years
measure: Recommended Dose（RD）
timeFrame: the whole escalation phase within 21 days since the first dose
Secondary outcomes:
measure: Objective response rate (ORR)
timeFrame: up to 2 years
measure: Disease control rate (DCR)
timeFrame: up to 2 years
measure: Progression-free survival (PFS)
timeFrame: up to 2 years
measure: Overall survival (OS)
timeFrame: up to 2 years
measure: Peak time (Tmax) of cationic lipids
timeFrame: up to 9 weeks
measure: Peak concentration (Cmax) of cationic lipids
timeFrame: up to 9 weeks
measure: Area under the drug concentration -time curve (AUC) of cationic lipids
timeFrame: up to 9 weeks
Other outcomes:
Locations:
city: Beijing
country: China
facility: Peking Union Medical College Hospital
state: Beijing
Study officials:
affiliation: Peking Union Medical College Hospital
name: Wenming Wu, PhD
role: PRINCIPAL_INVESTIGATOR
References: