Clinical trial NCT06479239: Study of EGFRBi Armed Fresh PBMC in Metastatic or Unresectable Pancreatic Cancer
Official title: Phase I/II Study of Anti-CD3 x Anti-EGFR Bispecific Antibody (EGFRBi) Armed Fresh Peripheral Blood Mononuclear Cells (EGFR FPBMC) in Metastatic or Unresectable Pancreatic Cancer
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE1
PHASE2
Conditions: Pancreas Cancer
Pancreatic Cancer
Lead sponsor: University of Virginia
Sponsor class: OTHER
First posted: 2024-06-28
Enrollment: 23
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to understand the safety and estimate the efficacy of combining anti-cluster of differentiation 3 (CD3) x anti-Epidermal Growth Factor Receptor (EGFR) bispecific antibody fresh peripheral blood mononuclear cells (EGFR FPBMC) for patients with relapsed and/or refractory pancreas cancer. Participants receive 8 weekly doses and then 8 more doses every 2 weeks of EGFR FPBMC by intravenous infusion.

Detailed description: Once subjects are determined to be eligible, white blood cells (lymphocytes) are collected via leukapheresis procedure. The T cells in the mononuclear cells are coated with bispecific antibody to activate the T cells and the mononuclear cells are reinfused into the patients so the T cells can multiply and kill tumors.

About 72 hours after the leukapheresis procedure, EGFR FPBMC infusions will start. After about 8-9 weeks, participants will have another leukapheresis procedure and then receive doses every 2 weeks for 8 more doses. Before, throughout and following EGFR FPBMC, research blood will be collected to better understand immune response. Disease status will be checked regularly during and after study treatment.

Eligibility criteria: Inclusion Criteria:

1. Histologically confirmed locally advanced pancreatic cancer (LAPC)/unresectable pancreatic cancer (UPC) or metastatic pancreatic cancer (MPC) not eligible for curative intent therapy
2. Received at least 1 line of chemotherapy and have stable disease (SD) or better for 3 months prior to enrollment. Therapy should consist of either a gemcitabine, 5FU-based (including capecitabine) or albumin-bound paclitaxel-based regimen. Patients with actionable mutations should have received targeted therapy prior to enrollment on trial. Patients who qualify for immunotherapy due to mismatch repair protein/microsatellite stable and tumor mutational burden status should also have received immunotherapy prior to enrollment on trial.
3. Measurable disease by immune-related Response Evaluation Criteria in Solid Tumors (irRECIST)
4. Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1
5. Age ≥ 18 years
6. Females of childbearing potential must have a negative pregnancy test within 7 days prior to enrollment/registration
7. Females of childbearing potential and males must agree to use an effective method for contraception for the duration of the treatment with study drug plus 90 days (duration of sperm turnover). Males must also abstain from sperm donations during study treatment and for at least 90 days after the last dose of study drug.
8. Adequate organ function within 14 days prior to registration, defined as the following:

   * Absolute neutrophil count \>= 500/mm3
   * Absolute lymphocyte count \>= 400/mm3
   * Platelets \>= 75,000/mm3
   * Hemoglobin \>= 8 g/dL
   * Serum creatinine \< 2.0mg/dL or calculated/measured creatinine clearance \>= 50 ml/min
   * Bilirubin \<= 2 mg/dL
   * Aspartate transferase (AST) and Alanine transaminase (ALT) \<= 5.0 x upper limit of normal (ULN)
   * Alpha gal \< 0.35 IU/ml or "negative"
9. Ability to provide informed consent and provision of written informed consent
10. Stated willingness to comply with all study procedures and availability for the duration of the study
11. Adequate cardiac function as defined as:

    * No uncontrolled angina or severe ventricular arrhythmias
    * No clinically significant pericardial disease
    * No history of myocardial infarction (MI) in the last year before registration
    * No Class 3 or higher New York Heart Association Congestive Heart Failure

Exclusion Criteria:

1. Known hypersensitivity to cetuximab
2. Treatment with investigational agent within 3 weeks prior to registration
3. Serious non-healing wound, ulcer, bone fracture, major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to registration
4. Known active liver disease, human immunodeficiency virus (HIV)+ or evidence of active Hepatitis C or B virus; bleeding or condition associated with high-risk bleeding (anticoagulation is allowed)
5. Active infection; prior antibiotic/antifungal/antiviral therapies within 2 weeks prior to registration
6. History of a myocardial infarction within 1 year prior to registration
7. Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
8. Autoimmune disease that has required systemic treatment with chronic steroids or immunosuppressive therapy in the 2 years prior to registration (thyroxine, insulin, or corticosteroid replacement is allowed)
9. History or evidence of any condition that might confound the results of the trial, interfere with the subject's participation, or is not in the best interest of the subject to participate, in the opinion of the treating investigator
10. Females must not be currently breast feeding.
11. The treating investigator feels the patient is not able to be compliant.
12. History of active Bacillus Tuberculosis (TB).
13. Has received a live vaccine within 30 days of registration.
14. Prisoners or patients who are incarcerated.
15. Patients who are compulsorily detained for treatment of a psychiatric or physical illness.

Primary outcomes:
measure: Dose limiting toxicities (DLTs) during the dose escalation phase (during the first 8 infusions only)
timeFrame: Through the dose escalation phase (during the first 8 infusions only, about 8 weeks after starting study treatment))
Secondary outcomes:
measure: Overall Response Rate
timeFrame: Through the dose escalation phase (during the first 8 infusions only, about 8 weeks after starting study treatment))
measure: Progression free survival
timeFrame: Through 3 years after last infusion for each participant (a maximum of about 3 1/2 years)
measure: Overall Survival
timeFrame: Through 3 years after last infusion for each participant (a maximum of about 3 1/2 years)
measure: Specific cytotoxicity by PBMCs against pancreatic cancer cell lines
timeFrame: Before study treatment, about 8-9 weeks into study treatment, then 30-45 days, 6 months and 12 months after completion of study treatment
measure: Development of antibodies to pancreatic cancer antigens
timeFrame: Before study treatment, about 8-9 weeks into study treatment, then 30-45 days, 6 months and 12 months after completion of study treatment
measure: Survival of EGFR FPBMCs after multiple infusions
timeFrame: Prior to study treatment, prior to each of the first 5 infusions, (optionally) about 1-2 days after each of the first 8 infusions, and about 8-10 weeks after starting study treatment
Other outcomes:
Locations:
city: Charlottesville
country: United States
facility: University of Virginia
state: Virginia
Study officials:
affiliation: University of Virginia
name: Tri Le, MD, DSc
role: PRINCIPAL_INVESTIGATOR
References: