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This is an open-label, multi-centre, single-arm Phase 1/2 clinical trial of the safety, expansion, persistence and clinical activity of a set of engineered autologous T cells products each capable of recognizing a specific combination mutated KRAS and HLA, activating the T cells and exerting anti- tumour activity in patients with metastatic or locally advanced PDAC.
This is a phase 1/2 study of engineered autologous T cells (TCR targeting KRAS G12V (ANOC-001 sub-study 1), (ANOC-002 sub-study 2) and KRAS 12D (ANOC-003 sub-study 3) capable of recognizing the tumour antigen(s), activating the T cells and exerting anti-tumour activity in patients with metastatic or locally advanced PDAC following a SoC first-line therapy.
The protocol procedures will be performed in two parts. Part 1 includes pre- screening/screening eligibility, enrolment and leukapheresis. Part 2 includes lymphodepletion, TCR-T cell infusion and all study assessments until the end-of-treatment or early discontinuation .
In the dose escalation part of each sub-study, two doses will be assessed in a classical 3+3 dose escalation design to assess the safety and tolerability of TCR-T cells with the goal to identify the optimal safe dose for each product.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ANOC-001 | Other | Treatment |
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| ANOC-002 | Other | Treatment |
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| ANOC-003 | Other | Treatment |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ANOC-001 (TCR-T cells targeting KRAS G12V mutation presented by specific HLA alleles) | Biological | The cells will be gene edited and administered by a single IV infusion on Day 1. Drugs: Cyclophosphamide and Fludarabine will be used as a lymphodepleting chemotherapy. |
| Measure | Description | Time Frame |
|---|---|---|
| Phase 1-Proportion of participants with dose limiting toxicity of ANOC-001, ANOC-002 and ANOC-003, graded according to American Society of Transplantation and Cellular Therapy (ASTCT) consensus criteria. | First infusion through Day 28 | |
| Phase 1-Number of participants with adverse events graded according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), v5.0. | First infusion through Day 28 | |
| Phase 1- Identification of the Maximum tolerated dose/Maximum administered dose and Recommended Phase 2 Dose of ANOC-001/ANOC-002/ANOC-003 cells that can be administered safely in patients with metastatic and locally advanced PDAC. | First infusion through Day 28 | |
| Phase 2-Number of participants with adverse events of special interest (AESI) according to NCI CTCAE v5.0. | Baseline through 24 months post-treatment | |
| Phase 2- Proportion of participants with Objective Response Rate (ORR) defined as the number of patients with a Best Overall Response (BOR) of Complete Response (CR) or Partial Response (PR) per RECIST v1.1 divided by the number of treated patients. | Baseline through 24 months post-treatment | |
| Phase 2-Proportion of participants with Clinical benefit rate (CBR) defined as percentage of patients with stable disease (SD) more than 3 months, or PR/CR from the time of study treatment. | Baseline through 24 months post-treatment | |
| Phase 2-Proportion of participants with Clinical benefit determined by the investigator, assessed anytime at 8- to 12-week intervals post TCR-T cell infusion. | Baseline through 24 months post-treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Phase 1 and Phase 2: Percentage of patients who receive protocol-defined target dose of ANOC-001, ANOC-002 and ANOC-003. | From leukapheresis through product release and infusion (Day 1), on an average of 2-4 months for each participant | |
| Phase 1 and Phase 2: Proportion of investigational product- ANOC-001, ANOC-002 and ANOC-003 that comply with the specifications as compared to the total number of the IMP manufactured |
| Measure | Description | Time Frame |
|---|---|---|
| Exploratory-Phase 1 and 2-To evaluate correlation of T cell persistence with safety and clinical response and with phenotype of infused T cells | Baseline through 24 months post-treatment | |
| Exploratory-Phase 1 and 2-To evaluate types and levels of cytokines in peripheral blood |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Amu Wang | Contact | +46703784946 | amu.wang@anocca.com | |
| Anocca AB | Contact | +46841080701 | clinical.trials@anocca.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Herlev and Gentofte University Hospital | Recruiting | Copenhagen | Denmark |
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| ANOC-002 (TCR-T cells targeting KRAS G12V mutation presented by specific HLA alleles) | Biological | The cells will be gene edited and administered by a single IV infusion on Day 1. Drugs: Cyclophosphamide and Fludarabine will be used as a lymphodepleting chemotherapy. |
|
| ANOC-003 (TCR-T cells targeting KRAS G12D mutation presented by specific HLA alleles) | Biological | The cells will be gene edited and administered by a single IV infusion on Day 1. Drugs: Cyclophosphamide and Fludarabine will be used as a lymphodepleting chemotherapy |
|
| From leukapheresis through product release and infusion (Day 1), on an average of 2-4 months for each participant |
| Phase 1 and Phase 2-Maximum expansion and persistence of TCR T cells following infusion by quantitative PCR | Baseline through 24 months post-treatment |
| Phase 1 and Phase 2- Proportion of participants achieving Progression Free Survival (PFS) defined as the time from study treatment to the first occurrence of disease progression or death, whichever occurs first. | Baseline through 24 months post-treatment |
| Phase 1 and Phase 2- Proportion of participants achieving Overall Survival (OS) defined as the time from study treatment to death from any cause. | Baseline through 24 months post-treatment |
| Phase 1 and Phase 2- Proportion of participants achieving Duration of Response (DoR) defined as the time from study treatment to disease progression or death in patients who achieve CR or PR. | Baseline through 24 months post-treatment |
| Baseline through 24 months post-treatment |
| Exploratory-Phase 1 and 2-To evaluate change in ctDNA and CTC/exosome load | Baseline through 24 months post-treatment |
| Exploratory-Phase 1 and 2-Conventional serum markers e.g., CA19-9, CEA and exploratory/emerging biomarkers, e.g. but not limited to PRO-C3, for PDAC will be tested locally | Baseline through 24 months post-treatment |
| Exploratory-Phase 1 and 2-CD8 ImmunoPET imaging will be considered as an ad-hoc basis to assess TCR-T cell immune infiltration into primary tumour and metastases | Baseline through 24 months post-treatment |
| Exploratory-Phase 1 and 2-To evaluate longitudinal biopsy if possible to study the TME by the means of immunohistochemistry (IHC) and RNA-bulk sequencing methods. | Baseline through 24 months post-treatment |
| Charité Universitätsmedizin Berlin | Recruiting | Berlin | Germany |
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| Technische Universitaet Dresden - Universitaetsklinikum Carl Gustav Carus | Recruiting | Dresden | Germany |
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| Universitaetsklinikum Heidelberg | Recruiting | Heidelberg | Germany |
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| Universitaetsklinikum Leipzig - Universitaeren Krebszentrum (UCCL) | Not yet recruiting | Leipzig | Germany |
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| Ludwig-Maximilians-Universitaet Muenchen (LMU) Klinikum der Universitaet Muenchen - Campus Grosshadern - Medizinische Klinik und Poliklinik III | Not yet recruiting | München | Germany |
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| University Hospital and Faculty of Medicine Eberhard Karls University Tübingen | Recruiting | Tübingen | Germany |
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| Amsterdam UMC - VU Medical Center | Recruiting | Amsterdam | Netherlands |
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| Radboud University Medical Center | Recruiting | Nijmegen | Netherlands |
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| Karolinska University Hospital | Recruiting | Stockholm | Sweden |
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