TAC01-HER2 is a novel cell therapy that consists of genetically engineered autologous T cells expressing T-cell Antigen Coupler (TAC) that recognizes human epidermal growth factor receptor 2 (HER2). TAC directs T-cells to the targeted antigen (HER2), and once engaged with the target, activates them via the endogenous T cell receptor. This is an open-label, multicenter Phase 1/2 study that aims to establish safety, maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D), pharmacokinetic profile and efficacy of TAC01-HER2 as a monotherapy, and in combination with pembrolizumab, in subjects with HER2 positive gastric and gastroesophageal adenocarcinoma.
The TAC technology is a novel approach to modifying T cells, herein referred to as TAC T cells, and using them in the treatment of solid tumors. TAC T cells are produced through genetic engineering, incorporating TAC receptors into a patient's own T cells. This redirects these enhanced T cells to specific cancer antigens, and upon recognition, activates them through the natural signaling pathways of the endogenous TCR. In the TAC01-HER2 engineered T cell product; TAC T cells recognize the HER2 protein present on the surface of tumor cells, and eradicate them. Consequently, it is hypothesized TAC01-HER2 will be potentially safe and effective in treating patients with HER2+ solid tumors and provide a clinically meaningful therapeutic benefit in patient populations with high unmet medical need. This is a first-in-human study investigating TAC01-HER2 to evaluate the safety, MTD or RP2D, PK, and efficacy in subjects with HER2+ solid tumors who have been treated after at least 2 lines of prior therapy in Phase 1 and after at least 2 lines and no more than 4 lines of prior therapy in Phase 2. In Phase 1, escalating doses of TAC01-HER2 will be evaluated to identify the RP2D using the classic keyboard design method. The monotherapy arm will treat all subjects with HER2-positive solid tumors that meet the eligibility criteria (completed). The combination arm will treat all 2+ or 3+ HER2-positive subjects with gastric or gastroesophageal AC who meet the eligibility criteria. In Phase 2, dose expansion groups will further evaluate the efficacy, safety, and PK of the MTD or RP2D for TAC01-CLDN18.2 in subjects with gastric and esophageal adenocarcinoma. In Phase 2, a Simon 3-stage design will be used to enroll up to 36 subjects in Group A (monotherapy arm) and 34 subjects in Group B (combination arm). In summary: * Phase I monotherapy arm: Dose escalation in any HER2-positive solid tumor (completed). * Phase I combination therapy arm: Dose escalation in combination with pembrolizumab in 2+ or 3+ HER2-positive gastric and gastroesophageal adenocarcinoma * Phase II: Dose expansion cohorts: 2+ or 3+ HER2-positive gastric or gastroesophageal adenocarcinoma treated with TAC01-HER2 as a monotherapy (Group A) or in combination with pembrolizumab (Group B).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
28
TAC01-HER2 and: * fludarabine and cyclophosphamide, or * clofarabine and cyclophosphamide, or * bendamustine, or * cyclophosphamide
TAC01-HER2 plus pembrolizumab and: * fludarabine and cyclophosphamide, or * clofarabine and cyclophosphamide, or * bendamustine, or * cyclophosphamide
Lurie Cancer Center - Northwestern University
Chicago, Illinois, United States
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, United States
Dana Farber Cancer Institute
Boston, Massachusetts, United States
Rutgers Cancer Institute of New Jersey
Newark, New Jersey, United States
Roswell Park Comprehensive Cancer Center
Buffalo, New York, United States
Memorial Sloan Kettering Cancer Center
New York, New York, United States
University of Cincinnati Cancer Center
Cincinnati, Ohio, United States
Sidney Kimmel Cancer Center - Thomas Jefferson University
Philadelphia, Pennsylvania, United States
MD Anderson Cancer Center
Houston, Texas, United States
Princess Margaret Cancer Centre
Toronto, Ontario, Canada
...and 1 more locations
Phase 1: Incidence of Dose Limiting Toxicities (DLTs)
A DLT is defined as: * Grade 4 or 5 events determined by the Investigator to be related to the investigational product, with the exception of Grade 4 laboratory abnormalities that are rapidly reversible or correctable without substantial safety concerns. * Grade ≥3 TAC T cell-associated acute infusion reactions persisting for ≥24 hours * Grade ≥3 TAC T cell-associated CRS or neurotoxicity persisting for ≥72 hours * Grade ≥3 cardiovascular or pulmonary toxicity persisting for ≥72 hours * Grade ≥3 immune-related toxicities * Grade ≥3 organ toxicities or non-hematologic toxicities that do not improve to baseline within 7 days * Clinically consequential Grade ≥3 neutropenia or thrombocytopenia lasting ≥30 days from TAC01-HER2 administration. Clinically consequential is defined as febrile neutropenia, serious infection, or bleeding events.
Time frame: 28 days
Phase 1: Determine Recommended Phase 2 Dose (RP2D) for TAC01-HER2 Monotherapy
RP2D was determined by the Data and Safety Monitoring Committee using the keyboard design method (\<95% chance that the DLT rate exceeds 30%).
Time frame: Up to 28 Days Post TAC01-HER2 infusion
Phase 1: Evaluate Overall Response Rate (ORR)
Defined as the percentage of treated subjects with a complete or partial response (CR or PR) as assessed by imaging using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1.
Time frame: 24 months
Phase 1: Evaluate Duration of Response (DoR)
Defined as time from first response to disease progression, end of study, start of another anticancer therapy, or death
Time frame: 24 months
Phase 1: Evaluate Overall Survival (OS)
Defined as participants alive after 6 months
Time frame: 6 months
Phase 1: Evaluate Disease Control Rate (DCR)
Defined as the percentage of treated subjects with stable disease (SD), PR, and CR as assessed by imaging using Response Evaluation Criteria in Solid Tumors (RECIST)Version 1.1.
Time frame: 24 months
Phase 1: Progression-Free Survival (PFS) or Time to Progression (TTP)
Defined as time from infusion to disease progression or death from any cause
Time frame: 24 months
Phase 1: Cmax of TAC01-HER2 (Pharmacokinetics; PK)
Defined as the maximum concentration of TAC T cells after infusion; assessed by vector copy number
Time frame: Pre-treatment, days 3, 4 or 5, 8, 11, 14 or15, 18, 21 or 22, 25, 29, 42, months 3, 6, 9, 12, 18, 24 or end of study, and at the confirmatory progressive disease visit
Phase 1 and Phase 2: Tmax of TAC01-HER2 (PK)
Defined as the the first study day the Cmax is reached
Time frame: Pre-treatment, days 3, 4 or 5, 8, 11, 14 or15, 18, 21 or 22, 25, 29, 42, months 3, 6, 9, 12, 18, 24 or end of study, and at the confirmatory progressive disease visit
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.