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This is a Phase I, first-in-human, open-label study of CRPA1A2, a bispecific T-cell engager, in participants with HLA-A*02:01-positive and MAGE-A1-positive advanced solid tumors. The study is designed to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary anti-tumor activity of CRPA1A2, and to identify recommended dose(s) for further evaluation.
The study consists of 2 parts: a dose escalation part (Part A) and a dose optimization part (Part B). In Part A, participants will receive escalating doses of CRPA1A2 to determine the recommended dose(s) for optimization, with additional backfill cohorts permitted. In Part B, 2 to 3 selected recommended dose(s) will be further evaluated in participants with selected tumor types to better characterize safety and preliminary anti-tumor activity.
CRPA1A2 will be administered by intravenous infusion in 28-day cycles, starting at 0.0003 mg/kg. Weekly dosing is planned, although alternative dosing schedules may be explored based on emerging data. Treatment will continue until disease progression, intolerable toxicity, initiation of new anti-tumor therapy, other discontinuation criteria are met, or study termination.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part A Dose Escalation | Experimental | Participants will receive CRPA1A2 by intravenous infusion in 28-day cycles in the dose-escalation part of the study. Treatment will start at 0.0003 mg/kg and proceed through protocol-defined escalating dose levels using a standard dosing approach and/or a step-up dosing strategy, as applicable. This arm is designed to evaluate safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD), and preliminary anti-tumor activity and to support identification of the recommended dose(s) for optimization (RDO[s]). |
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| Part B RDO 1 | Experimental | Participants with selected tumor types will be randomized in Part B to receive CRPA1A2 at Recommended Dose for Optimization 1 (RDO 1), administered by intravenous infusion in 28-day cycles according to the protocol-defined regimen, to further characterize safety and preliminary anti-tumor activity. |
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| Part B RDO 2 | Experimental | Participants with selected tumor types will be randomized in Part B to receive CRPA1A2 at Recommended Dose for Optimization 2 (RDO 2), administered by intravenous infusion in 28-day cycles according to the protocol-defined regimen, to further characterize safety and preliminary anti-tumor activity. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CRPA1A2 | Drug | CRPA1A2 is an investigational bispecific T-cell engager administered by intravenous infusion in 28-day cycles. In Part A, treatment will start at 0.0003 mg/kg and proceed according to protocol-defined escalating dose levels. Weekly dosing is planned, although alternative dosing schedules may be explored during Part A based on emerging PK/PD, safety, tolerability, and efficacy data. A standard dosing approach and/or a step-up dosing strategy may be used. In Part B, participants will receive protocol-defined selected recommended dose(s) for optimization. Treatment will continue until disease progression, intolerable toxicity, initiation of new anti-tumor therapy, fulfillment of other protocol-defined discontinuation criteria, or study termination, whichever occurs first. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of dose-limiting toxicities (DLTs) in Part A | Frequency and type of dose-limiting toxicities (DLTs) during the protocol-defined DLT evaluation period in the dose-escalation phase (Part A). | Day 28 |
| Incidence of treatment-emergent adverse events (TEAEs), treatment-related adverse events (TRAEs), and clinically significant changes in safety tests | Frequency and type of treatment-emergent adverse events, treatment-related adverse events, and clinically significant changes in protocol-specified safety tests in Parts A and B. | up tp 30 months |
| Maximum tolerated dose (MTD) and/or recommended dose(s) for optimization (RDO[s]) and dosing schedule in Part A | Identification of the maximum tolerated dose and/or recommended dose(s) for optimization and dosing schedule of CRPA1A2 based on an integrated assessment of safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary anti-tumor activity in the dose-escalation phase (Part A). | Day 1, Day 8, Day 15, Day 28 |
| Objective response rate (ORR) per RECIST v1.1 in Part B | Proportion of participants with a best overall response of complete response or partial response according to RECIST v1.1 in the dose-optimization phase (Part B). | up to 30 months |
| Duration of response (DoR) per RECIST v1.1 in Part B | Time from the first documented objective response to the first documented disease progression or death, whichever occurs first, according to RECIST v1.1 in the dose-optimization phase (Part B). | up to 30 months |
| Measure | Description | Time Frame |
|---|---|---|
| Peak Plasma concentration (Cmax) of CRPA1A2 | Peak Plasma concentration (Cmax) of CRPA1A2 in Parts A and B. | Day 1, Day 3, Day 5, Day 8,Day15, Day 22 |
| Area under the plasma concentration versus time curve (AUC) of CRPA1A2 |
| Measure | Description | Time Frame |
|---|---|---|
| Immunogenicity | Incidence of detectable anti-CRPA1A2 antibodies | up to 30 months |
Inclusion Criteria:
Exclusion Criteria:
Patients with history of other malignancies (within 2 years prior to signing the ICF) are excluded, except for those with cured stage IB or earlier stage cervical cancer, non-invasive basal cell or squamous cell skin cancer, malignant melanoma in complete remission (CR) for over 10 years, or other malignancies in complete remission (CR) for over 5 years.
Patients with positive HLA-A*02:05 (confirmed by the central lab).
Patients with known sensitivity or immediate hypersensitivity to any components of CRPA1A2 or ingredients of CRPA1A2 injection.
Patients who have been exposed to other MAGE-A1 targeted therapy.
With clinically significant cardiovascular diseases, including but not limited to:
With clinically significant active hepatitis B, HBsAg or HBcAb positive and have an HBV-DNA level above the detection limit at screening (i.e., the upper limit of normal values at each research center's laboratory). With the exception for those that have achieved HBV-DNA negativity after antiviral treatment and have received at least 2 weeks of antiviral therapy before the initial dosing. Additionally, they must be willing to continue antiviral therapy for hepatitis B throughout the study period. For patients with hepatocellular carcinoma, HBV DNA must be <1000 IU/mL for study eligibility.
Clinically significant active hepatitis C, indicated by positive HCV antibodies and HCV-RNA levels higher than the detection limit at screening (upper limit of normal values).
Positive Treponema pallidum antibodies (TP-Ab) and positive result for nonspecific syphilis antibodies titer (RPR) at screening.
Prior or concurrent therapies/procedures that may confound study evaluation or increase risk, including recent participation in another clinical study; recent anticancer therapy, investigational treatment, or invasive investigational medical device use; major surgery without full recovery; prior solid organ transplantation or allogeneic hematopoietic stem cell transplantation; recent autologous hematopoietic stem cell transplantation; or planned transplantation during the study period.
Active, uncontrolled, or clinically significant medical conditions that may increase the risk of study participation or interfere with study assessments, including severe infection; symptomatic or uncontrolled central nervous system or leptomeningeal metastases; clinically significant pulmonary disease (e.g., interstitial lung disease/pneumonitis); coagulation or bleeding disorders; autoimmune disease or immunodeficiency (including HIV infection); or significant neurologic or psychiatric disorders.
Unresolved toxicities or other conditions considered by the investigator to make the participant unsuitable for the study, including failure to recover adequately from prior anticancer treatment-related toxicities, prior Grade ≥2 ICANS after T-cell engager or CAR-T therapy, clinically significant abnormal laboratory findings, or other severe/uncontrolled acute or chronic diseases, alcohol abuse, or substance misuse.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Cancer Hospital | Beijing | Beijing Municipality | 100142 | China |
No individual participant data are planned to be shared at this time.
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This study consists of 2 parts. Part A is a sequential dose-escalation phase in which participants receive escalating dose levels of CRPA1A2, with optional backfill cohorts to further characterize safety, tolerability, PK/PD, and preliminary anti-tumor activity and to support selection of the recommended dose(s) for optimization (RDO[s]). Part B is a dose-optimization phase in which participants with selected tumor types are randomized to 2 to 3 selected RDO(s) to further evaluate safety and preliminary anti-tumor activity.
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Area under the plasma concentration versus time curve (AUC) of CRPA1A2 in Part A and Part B
| Day 1, Day 3, Day 5, Day 8, Day 15, Day 22 |
| Disease control rate (DCR) and progression-free survival (PFS) per RECIST v1.1 in Part A and Part B. | Preliminary anti-tumor activity of CRPA1A2 assessed by DCR and PFS according to RECIST v1.1. | up tp 30 months |
| Objective response rate (ORR) and duration of response (DoR) per RECIST v1.1 in Part A. | Preliminary anti-tumor activity of CRPA1A2 assessed by ORR and DoR according to RECIST v1.1 in the dose-escalation phase (Part A). | up to 30 months |
| Objective response rate (ORR), duration of response (DoR), disease control rate (DCR), and progression-free survival (PFS) per iRECIST | Preliminary anti-tumor activity of CRPA1A2 assessed by ORR, DoR, DCR, and PFS according to iRECIST. | up to 30 months |
| Overall survival (OS) | Time from first dose to death from any cause in Parts A and B. | up to 30 months |
| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| D009362 | Neoplasm Metastasis |
| D004938 | Esophageal Neoplasms |
| D006258 | Head and Neck Neoplasms |
| D006528 | Carcinoma, Hepatocellular |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D009385 | Neoplastic Processes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D004066 | Digestive System Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D008113 | Liver Neoplasms |
| D008107 | Liver Diseases |
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