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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 metastatic or unresectable pancreas cancer. Participants receive 8 twice weekly doses and then 8 more doses every 2 weeks of EGFR FPBMC by intravenous infusion.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EGFR Fresh Peripheral Blood Mononuclear Cells | Experimental | Participants will undergo apheresis to collect cells to make EGFR fresh peripheral blood mononuclear cells (FPBMC). These cells will be activated in the lab to fight against pancreas cancer. About 3-4 days after apheresis, participants will start receiving infusions of EGFR FPBMC. Throughout treatment, participants will have blood taken for labs, to check disease status and also to look at immune response. Study treatment will stop if the participant has disease progression. Participants that have disease progression after the first 8 infusions may receive chemotherapy and then continue study treatment with the other 8 infusions. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EGFR FPBMC | Drug | Participants will receive 8 twice weekly infusions of EGFR FPBMC, then 8 additional infusions every 2 weeks. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Dose limiting toxicities (DLTs) during the dose escalation phase (during the first 8 infusions only) | As defined in the protocol | Through the dose escalation phase (during the first 8 infusions only, about 4 weeks after starting study treatment)) |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Response Rate | Number/Percentage of participants that have a partial or complete response to study treatment | Through the dose escalation phase (during the first 8 infusions only, about 4 weeks after starting study treatment)) |
| Progression free survival |
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Inclusion Criteria:
Histologically confirmed locally advanced pancreatic cancer (LAPC)/unresectable pancreatic cancer (UPC) or metastatic pancreatic cancer (MPC) not eligible for curative intent therapy
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.
Measurable disease by immune-related Response Evaluation Criteria in Solid Tumors (irRECIST)
Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1
Age ≥ 18 years
Females of childbearing potential must have a negative pregnancy test within 7 days prior to enrollment/registration
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.
Adequate organ function within 14 days prior to registration, defined as the following:
Ability to provide informed consent and provision of written informed consent
Stated willingness to comply with all study procedures and availability for the duration of the study
Adequate cardiac function as defined as:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ashley Donihee | Contact | 434-243-6377 | zwz6jm@uvahealth.org |
| Name | Affiliation | Role |
|---|---|---|
| Tri Le, MD, DSc | University of Virginia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Virginia | Recruiting | Charlottesville | Virginia | 22903 | United States |
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| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
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Time from start of treatment to time of progression or death from any cause, whichever occurs first. |
| Through 3 years after last infusion for each participant (a maximum of about 3 1/2 years) |
| Overall Survival | Time from start of treatment to time of death from any cause. | Through 3 years after last infusion for each participant (a maximum of about 3 1/2 years) |
| Specific cytotoxicity by PBMCs against pancreatic cancer cell lines | In blood samples | Before study treatment, about 8-9 weeks into study treatment, then 30-45 days, 6 months and 12 months after completion of study treatment |
| Development of antibodies to pancreatic cancer antigens | In blood samples | Before study treatment, about 8-9 weeks into study treatment, then 30-45 days, 6 months and 12 months after completion of study treatment |
| Survival of EGFR FPBMCs after multiple infusions | In blood samples | 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 |
| D004066 |
| Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |