A Phase 1 in Patients With HLA-A*0201+ and WT1+ Recurrent/Metastatic Cancers

Overview

About this study

The purpose of Part A of this study is to characterize the safety, tolerability, and biological effects of CUE-102. The goal of Part B is to expand the safety and immune activity data at the RP2D identified in Part A, and to evaluate antitumor activity at this dose.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

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.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Life expectancy ≥ 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:
    • 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).
    • 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).
    • 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).
    • Ovarian cancer (including fallopian tube cancer)
      • Has progressed following at least 1 prior systemic therapy for advanced or metastatic disease (CUE-102 will be 2nd line therapy or greater). Patients with ovarian cancer of germ cell origin are excluded. Patient must meet the following:
        • Histologically or cytologically documented ovarian cancer at the time of initial presentation;
        • Metastatic or locally advanced/unresectable disease, with documented disease progression after last administration of standard therapies or intolerance to standard therapies;
        • Prior systemic treatment must include a platinum-based regimen. For patients determined to have platinum-sensitive disease, treatment with a second platinum-based combination regimen +/- bevacizumab should be considered prior to treatment with CUE-102 (CUE-102 will be 3rd line therapy or greater).
      • For the purposes of this study. platinum-resistant disease is defined as:
        • Progression on primary, maintenance, or recurrent therapy;
        • Stable or persistent disease;
        • Complete remission and relapse < 6 months after completing chemotherapy.
      • Platinum-sensitive disease is defined as:
        • Complete remission and relapse ≥ 6 months after completing chemotherapy.
      • Note: Patients with known:
        • NTRK gene fusions should be offered entrectinib class of drugs prior to being offered CUE-102;
        • MSI-H tumors should be offered a CPI prior to being offered CUE-102;
        • Deleterious germline BRCA1/2 mutations may benefit from poly (ADP-ribose) polymerase inhibitors (PARPi) therapy in relapse or maintenance setting, but prior treatment with a PARPi is not required.
  • 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:

  • 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:
  • Need for concurrent treatment for the CNS disease (e.g., surgery, radiation, corticosteroids > 10 mg prednisone/day or equivalent);
  • Progression of CNS metastases on CT or MRI for at least 28 days after last day of prior therapy for the CNS metastases;
  • 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:
    • ≥ Grade 3 ocular AE;
    • 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);
    • ≥ Grade 3 neurologic toxicity;
    • ≥ Grade 3 colitis;
    • ≥ 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.

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 12/27/23. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Zhaohui Jin, M.D.

Open for enrollment

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

Scottsdale/Phoenix, Ariz.

Mayo Clinic principal investigator

Tanios Bekaii-Saab, M.D.

Open for enrollment

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

More information

Publications

Publications are currently not available
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CLS-20541944

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