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  • Cancer Type: Gastrointestinal Tumor
  • Study Type: Treatment
  • NCT#: NCT05360680
  • Phase: Phase I
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  • Overview

    Study Title:

    A Phase 1, Open-Label, Dose Escalation and Expansion Study of CUE-102 Monotherapy in HLA-A*0201 Positive Patients with WTl Positive Recurrent/Metastatic Cancers

    Summary:

    This is a Phase 1, open-label, 2-part, multi-center study evaluating the safety, tolerability, PK, pharmacodynamics (PD), immunogenicity, and antitumor activity of CUE-102 intravenous (IV) monotherapy in HLA-A*0201 positive patients with WT1 positive recurrent/metastatic solid tumors who have failed conventional therapies.

    Objective:

    Part A: To evaluate dose-limiting toxicities (DLTs) and maximum tolerated dose (MTD) during the first cycle of treatment with CUE-102, and to establish a recommended Phase 2 dose (RP2D) Parts A & B: To evaluate the pharmacokinetics (PK) of CUE-102

  • Treatments

    Therapies:

    Immunotherapy

    Medications:

    CUE-102 ()

  • Inclusion Criteria

      Inclusion Criteria:
    • Ability to provide informed consent and documentation of informed consent prior to initiation of any study-related tests or procedures that are not part of standard of care for the patient's disease.
    • Age 18 years old or older
    • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
    • Life expectancy greater than or equal to 12 weeks
    • Measurable disease as per RECIST 1.1 and documented by CT and/or MRI.
    • All tumors must have histologically or cytologically confirmed cancer diagnosis
    • Patients must have any of the following cancers to be eligible: A. Colorectal cancer
    • Histologically or cytologically documented adenocarcinoma of colon or rectum at the time of initial presentation
    • Metastatic or locally advanced/unresectable disease
    • Documented disease progression after the last administration of standard therapies or intolerance to at least 2 prior systemic treatment regimens (CUE-102 will be 3rd line therapy or greater). B. Gastric cancer (including gastroesophageal junction)
    • Histologically or cytologically documented gastric cancer at the time of initial presentation
    • Metastatic or locally advanced/unresectable disease
    • Documented disease progression after last administration of standard therapies or intolerance to standard therapies. (CUE-102 will be 2nd line therapy or greater). C. Pancreatic cancer
    • Histologically or cytologically documented pancreatic adenocarcinoma at the time of initial presentation
    • Patients with metastatic or locally advanced/unresectable disease.
    • Prior systemic treatment must include either a fluoropyrimidine-based or gemcitabine-based regimen in either the (neo)adjuvant or relapsed setting. (CUE-102 will be 2nd line therapy or greater). D. Ovarian Cancer (including Fallopian Tube Cancer) (not currently accruing at Moffitt)
    • Patient must have HLA-A*0201 genotype as determined by genomic testing.
    • Patient must have histologically and/or cytologically proven tumor(s) that is WT1 positive.
    • Acceptable laboratory parameters.
    • Female patients of childbearing potential must agree to use acceptable contraceptive measures from the time of main study consent through 90 days after discontinuation of study drug administration.
    • Non-vasectomized male patients with partners of childbearing potential must use barrier contraception from the time of main study consent through 90 days after discontinuation of study drug.
    • Patients who have previously received an immune CPI (e.g., anti-programmed cell death ligand 1 (anti PD-L1), anti-programmed cell death 1 (anti-PD-1), anti-cytotoxic T lymphocyte-associated antigen 4 [CTLA-4]) prior to enrollment must have toxicities related to the CPI resolved to CTCAE ≤ Grade 1 or baseline (level prior to the CPI) to be eligible for enrollment. Patients who have experienced CPI-related endocrinopathies (e.g., diabetes, adrenal insufficiency) may participate if endocrinopathies are controlled (CTCAE ≤ Grade 1) with endocrinology support and appropriate repletion. Note: Patients who experienced previous hypothyroidism toxicity on a CPI are eligible to enter study regardless of CTCAE grade resolution as long as the patient is well controlled on thyroid replacement hormone.
  • Exclusion Criteria

      Exclusion Criteria:
    • Female patients who are pregnant or plan to become pregnant during the course of the trial
    • Female patients who are breastfeeding
    • Patients with symptomatic central nervous system (CNS) metastases must have been treated, be asymptomatic, and not have any of the following at the time of enrollment: (a) Need for concurrent treatment for the CNS disease (e.g., surgery, radiation, corticosteroids >10 mg prednisone/day or equivalent) (b) Progression of CNS metastases on CT or MRI for at least 28 days after last day of prior therapy for the CNS metastases (c) Concurrent leptomeningeal disease or cord compression.
    • Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is permitted.
    • History of prior allogeneic bone marrow, stem-cell, or solid organ transplantation
    • Treatment with any systemic anti-neoplastic therapy, or investigational therapy within the 14 days (or 28 days, for antibody drugs), before the first dose of CUE-102.
    • Treatment with radiation therapy within 14 days before the first dose of CUE-102
    • Treatment with corticosteroids (> 10 mg per day prednisone or equivalent) or other immune suppressive drugs within 14 days before the first dose of CUE-102. Steroids for topical, ophthalmic, inhaled, or nasal administration are permitted. > Physiological replacement with up to a maximum dose of 5 mg equivalence of prednisone per day is permitted.
    • History of clinically significant cardiovascular disease
    • Clinically significant pulmonary compromise (e.g., requirement for supplemental oxygen)
    • Clinically significant gastrointestinal (GI) disorders
    • Patients who experienced the following immune CPI-related AEs are ineligible even if the AE resolved to ≤ Grade 1 or baseline: (a) Grade 3 ocular AE (b) Changes in liver function tests that met the criteria for Hy's Law (> 3× ULN of either ALT/AST with concurrent > 2× ULN of total bilirubin (total and direct) and without alternate etiology) (c) >/=Grade 3 neurologic toxicity (d) ≥ Grade 3 colitis (e) ≥ Grade 3 renal toxicity
    • Evidence of active viral, bacterial, or systemic fungal infection requiring parenteral treatment within 7 days before the first dose of CUE-102.
    • No known history of infection or positive test for HIV, Hepatitis B or Hepatitis C, testing prior to enrollment is not required unless mandated by local authority
    • Second primary invasive malignancy that has not been in remission for > 2 years.
    • History of trauma or major surgery within 28 days before the first dose of CUE-102
    • Any serious underlying medical or psychiatric condition that would impair the ability of the patient to receive or tolerate the planned treatment at the investigational site
    • Known hypersensitivity to recombinant proteins, polysorbate 80 or any excipient contained in the drug formulation for CUE-102
    • Vaccination with any live virus vaccine within 28 days before the first dose of CUE-102. Inactivated annual influenza vaccination is allowed.
    • Dementia or altered mental status that would preclude understanding and rendering of informed consent
    • Active or history of significant alcohol or other substance abuse within 1 year before the first dose of CUE-102

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