This is a Phase I, open-label dose finding study to assess the safety, manufacturing feasibility, and preliminary efficacy of TCR1020-CD8 T cells in patients with KRAS-mutated cancers. Initially, patients with KRAS G12V mutation positive metastatic pancreatic adenocarcinoma or colorectal cancer will be targeted for participation. Up to 4 total dose levels will be evaluated using a 3+3 dose escalation design.
This is a Phase I, open-label dose finding study to assess the safety, manufacturing feasibility, and preliminary efficacy of TCR1020-CD8 T cells in patients with KRAS-mutated cancers. Initially, patients with KRAS G12V mutation positive metastatic pancreatic adenocarcinoma or colorectal cancer will be targeted for participation. Up to 4 total dose levels will be evaluated using a 3+3 dose escalation design as described in protocol Section 3.1. In order to allow for appropriate monitoring/assessment of toxicities, the TCR1020-CD8 T cell infusions will be staggered as follows: * The TCR1020-CD8 T cell infusions for the first two subjects treated at each dose level must be staggered by at least 28 days. * If there are no emergent safety concerns identified in the first subject treated at each dose level, infusions of the 2ⁿᵈ and 3ʳᵈ subjects at that dose level may occur in parallel. * A stagger will occur after every 3ʳᵈ subject is infused to allow for formal DLT assessments to be performed and the dose level assignment for the next subject to be confirmed. * In the event 1 DLT is identified at a dose level (e.g., 1 DLT/3 evaluable subjects), formal DLT evaluations must be completed after each additional TCR1020-CD8 T cell infusion to evaluate potential dose de-escalation rules. As such, subsequent TCR1020-CD8 T cell infusions within that same dose level must be staggered by a minimum of 28 days. * If emergent safety concerns are identified, an ad hoc DLT evaluation may be triggered at the request of the Safety Review Committee (SRC). The purpose, scope and composition of the SRC is further defined in protocol Section 3.3. The DLT observation period is 28 days post-TCR1020-CD8 T cell infusion (Day 0). Formal DLT evaluations will be performed after the 3ʳᵈ DLT-evaluable subject at each dose level completes this 28-day DLT monitoring window. These assessments will be performed by the Safety Review Committee (SRC), comprised of the Clinical PI and Sponsor Medical Director, in accordance with the definitions/requirements in protocol Section 8.1.6. The SRC will trigger a decision regarding dose level advancement, expansion, or dose de-escalation. The highest dose at which 0 or 1 DLT occurs in 6 DLT-evaluable subjects will be declared the maximum tolerated dose (MTD). Subjects must receive the dose of TCR1020-CD8 T cells as per their dose level assignment in order to be considered DLT-evaluable for dose escalation decisions and MTD determination. Subjects who do not receive the dose of TCR1020-CD8 T cells as per their dose level assignment will not be considered DLT-evaluable for this purpose and will be replaced at that dose level. However, these subjects will still be followed per protocol and included in the overall safety analysis, as wellas the analyses of secondary and exploratory endpoints. Retreatment Infusions: The Retreatment Phase will remain closed until sufficient safety data is available in initial subjects, and DSMB and FDA approval to open Retreatment has been received. Subjects who have demonstrated clinical benefit after their initial TCR1020-CD8 T cell infusion(e.g., minimum disease response of stable disease, etc.) may also be eligible to receiveretreatment with TCR1020-CD8 cells at the physician-investigator's discretion. The TCR1020-CD8retreatment dose administered must either be a). the T cell dose that the subject previouslyreceived without DLTs, or b). a T cell dose that is less than or equal to a dose level that has beenevaluated for safety in ≥ 3 other subjects without evidence of DLTs. As retreatment infusions willnot be used for formal DLT assessments/MTD determination, there are no protocol-definedstaggering requirements.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
TCR1020-CD8 T cells are autologous mKRAS-redirected CD8+ T cells engineered using a lentiviral vector to express a TCR with specificity for HLA-restricted mKRAS G12V epitopes restricted to the HLA-A\*11:01 molecule.
Number of Subjects with dose limiting toxicities (DLTs)
Time frame: 28 days after TCR1020-CD8 T cells
Determination of maximum tolerated does (MTD)
Time frame: 28 days after TCR1020-CD8 T cells
Incidence of Adverse Events as assessed by CTCAE v5.0
Time frame: Up to 15 years
Percentage of manufacturing products that meet release criteria
Time frame: Up to 3 years
Overall Response Rate (ORR)
Time frame: Up to one year
Duration of Response (DOR)
Time frame: Up to one year
Progression Free Survival (PFS)
Time frame: Up to 15 years
Overall Survival (OS)
Time frame: Up to 15 years
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