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Study Population: Adult subjects aged 18-75 years with relapsed/refractory advanced solid tumors (including liver, gastric, colorectal, ovarian cancer, etc.) and malignant ascites confirmed by cytology, who have failed at least 2 lines of standard systemic therapy.
Study Design: This is a dose-escalation, single-center, open-label, prospective Phase 1 study. A total of 18 subjects will be enrolled and assigned to 2 administration groups (9 subjects each):
Group A (Intravenous infusion): For subjects with small-volume malignant ascites.
Group B (Intraperitoneal perfusion): For subjects with large-volume symptomatic malignant ascites.
Each group will follow a conventional "3+3" dose-escalation design with 3 dose levels (1×10⁹, 3×10⁹, 6×10⁹ NK cells per dose), administered once weekly, 3 weeks per cycle, for 2 consecutive cycles.
Primary Objectives: To evaluate the safety and tolerability, and to determine the dose-limiting toxicity (DLT) of NK521 administered intravenously and intraperitoneally.
Secondary Objectives: To assess the preliminary anti-tumor efficacy including objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), duration of response (DOR), puncture-free survival (PuFS), and changes in tumor markers, as well as health-related quality of life (HRQoL).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intravenous NK521 | Experimental | Intervention: NK521 Cell Injection Route: Intravenous infusion Dose: 1×10⁹, 3×10⁹, 6×10⁹ cells |
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| Intraperitoneal NK521 | Experimental | Intervention: NK521 Cell Injection Route: Intraperitoneal perfusion Dose: 1×10⁹, 3×10⁹, 6×10⁹ NK cells per administration Regimen: Once weekly, 3 weeks per cycle, for 2 consecutive cycles, plus investigator-selected systemic therapy |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NK521 Cell Injection | Biological | Gene-edited natural killer (NK) cell product with knockout of TIGIT, NKG2A, and TGF-β, administered via intravenous infusion or intraperitoneal perfusion for the treatment of malignant ascites associated with advanced solid tumors. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Treatment-Emergent Adverse Events and dose-limiting toxicities [Safety and Tolerability] | The incidence and severity of treatment-emergent adverse events, the occurrence of dose-limiting toxicities, and clinically significant laboratory abnormalities, to evaluate the safety and tolerability of the study treatment. | Treatment-emergent adverse events are recorded from the first administration until the final follow-up visit, up to 24 months, and dose-limiting toxicities are monitored within the 28-day period after the last administration. |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) | The proportion of subjects achieving complete response (CR) or partial response (PR) as assessed by the investigator using RECIST v1.1 criteria. | From the first administration, assessed every 6 weeks until disease progression or death, whichever comes first, up to 24 months. |
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Inclusion Criteria:
Exclusion Criteria:
Not fully recovered from major surgery or trauma within 2 weeks before enrollment.
-Participated in another investigational drug trial and received investigational therapy or used an investigational device within 4 weeks before enrollment.
Received cellular antineoplastic therapy within 1 year before dosing; received other antineoplastic therapy outside this protocol within 4 weeks before dosing, including but not limited to chemotherapy, molecular targeted therapy, hormonal therapy, immunotherapy, biotherapy, or Chinese herbal patent medicine with antineoplastic indications.
Received blood transfusion, erythropoietin, granulocyte colony-stimulating factor (G-CSF), or granulocyte-macrophage colony-stimulating factor therapy within 2 weeks before enrollment.
Received systemic therapy with corticosteroids (prednisone >10 mg/day or equivalent) or other immunomodulatory agents (e.g., thymosin, interleukin-2, interferon) within 2 weeks before enrollment. Inhaled or topical corticosteroids are allowed in subjects without active autoimmune disease.
Positive virology test for hepatitis B or hepatitis C at screening, meeting any of the following:
Known hypersensitivity or intolerance to PD-1 monoclonal antibody.
Meeting any of the following laboratory criteria:
Hematology: Absolute neutrophil count <1.5×10⁹/L; platelet count <75×10⁹/L; hemoglobin <90 g/L.
Hepatic function: ALT >3×ULN (≥5×ULN for liver metastasis); AST >3×ULN (≥5×ULN for liver metastasis); TBIL >1.5×ULN, or TBIL >2.5×ULN (3.0 mg/dL) for subjects with Gilbert syndrome.
Renal function: Serum creatinine >1.5×ULN or creatinine clearance <50 mL/min.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cancer Hospital, Chinese Academy of Medical Sciences | Recruiting | Beijing | Beijing Municipality | 010 | China |
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Arm 1: Intravenous NK521 Intervention: NK521 Cell Injection Route: Intravenous infusion Dose: 1×10⁹, 3×10⁹, 6×10⁹ cells Arm 2: Intraperitoneal NK521 Intervention: NK521 Cell Injection Route: Intraperitoneal perfusion Dose: 1×10⁹, 3×10⁹, 6×10⁹ cells
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| Progression-Free Survival (PFS) |
Time from first administration to documented disease progression (per RECIST v1.1) or death from any cause, whichever occurs first. |
| From the first administration, assessed every 6 weeks until progression or death, up to 24 months. |
| Overall Survival (OS) | Time from first administration to death from any cause. | From the first administration, followed up every 3-6 months until death or study closure, up to 24 months. |
| Malignant Ascites Control Rate | The proportion of subjects with reduction in ascites volume (≥50%) and decreased need for paracentesis, assessed using clinical and imaging criteria. | From the first intraperitoneal administration, assessed every 3 weeks until the end of treatment, up to 24 months. |