Brief Summary
This is an open-label, multi-center, Phase 1/2 clinical trial evaluating the safety, tolerability, and efficacy of ECT204, an investigational ARTEMIS® T-cell therapy, in adult subjects with GPC3-positive hepatocellular carcinoma (HCC) who have experienced disease progression on, or intolerance to, prior systemic therapy.
Brief Title
GPC3-Targeted T-Cell Therapy (ECT204) in Adults With Advanced HCC
Detailed Description
ECT204 is an autologous T-cell product built on the ARTEMIS® Cell Receptor platform, incorporating two GPC3-targeting surface components: an antibody-T-cell receptor (AbTCR) and a chimeric stimulating receptor (CSR). Each subject's T cells are collected and genetically modified ex vivo to co-express these receptors, then re-administered to selectively recognize and eliminate GPC3-expressing HCC tumor cells.
The study consists of a completed Phase 1 and a Phase 2 expansion cohort. Phase 1 used a traditional 3+3 dose-escalation design to determine the recommended Phase 2 dose (RP2D), followed by an RP2D confirmatory cohort to further characterize safety. Phase 2 evaluates a multi-infusion strategy of up to four ECT204 infusions administered across two treatment cycles, with the second cycle administered to subjects who achieve stable disease or better at the Month 2 assessment.
The active assessment period extends for 2 years (24 months) after the first ECT204 infusion (Day 0). Subjects then enter long-term follow-up (LTFU) for ongoing safety and overall survival assessments through Year 15.
The study consists of a completed Phase 1 and a Phase 2 expansion cohort. Phase 1 used a traditional 3+3 dose-escalation design to determine the recommended Phase 2 dose (RP2D), followed by an RP2D confirmatory cohort to further characterize safety. Phase 2 evaluates a multi-infusion strategy of up to four ECT204 infusions administered across two treatment cycles, with the second cycle administered to subjects who achieve stable disease or better at the Month 2 assessment.
The active assessment period extends for 2 years (24 months) after the first ECT204 infusion (Day 0). Subjects then enter long-term follow-up (LTFU) for ongoing safety and overall survival assessments through Year 15.
Categories
Central Contacts
Central Contact Role
Contact
Central Contact Phone
925-949-9314
Central Contact Email
Teresa.Klask@eurekainc.com
Central Contact Role
Contact
Central Contact Phone
510-654-7045
Central Contact Email
Pei.Wang@eurekainc.com
Completion Date
Completion Date Type
Estimated
Conditions
HEPATOCELLULAR CARCINOMA
LIVER CANCER, ADULT
LIVER NEOPLASM
METASTATIC LIVER CANCER
Eligibility Criteria
Inclusion Criteria:
* Histologically confirmed HCC, that is unresectable, recurrent, and/or metastatic.
* GPC3-positive tumor expression confirmed by immunohistochemistry (IHC).
* For the dose-escalation cohort: ≥10-20% tumor cells, ≥2+ IHC.
* Beginning with the RP2D confirmatory cohort: ≥ 50% tumor cells, 2+/3+ IHC.
* Must have received at least first-line systemic therapy for HCC and have experienced disease progression on, or intolerance to, that therapy.
* Life expectancy of at least 4 months per the Investigator's opinion.
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
* Measurable disease by RECIST v1.1.
* Child-Pugh score of A6 or better.
* Adequate organ function.
Exclusion Criteria:
* Pre-existing illness (e.g., symptomatic congestive heart failure) that would limit compliance with study requirements.
* Active, uncontrolled systemic bacterial, fungal, or viral infection. Subjects with Human Immunodeficiency Virus (HIV), hepatitis B, or hepatitis C are eligible provided their infection is being treated and the viral load is controlled.
* History of malignancy other than HCC within 5 years before screening, except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other malignancies with low risk of recurrence.
* Known brain metastases or other active central nervous system (CNS) involvement, including leptomeningeal disease. Subjects with brain metastases that have been adequately treated (no evident neurological deficit and no steroid or anti-epileptic therapy for brain metastases) are eligible.
* Pregnant or lactating women.
* Currently receiving or ending (\< 14 days from date of consent) liver tumor-directed therapy (e.g., radiation, ablation, embolization), or hepatic surgery.
* Concurrently receiving other investigational agents, biological, chemical, or radiation therapies, while participating in the study.
* Active autoimmune disease requiring systemic immunosuppressive therapy.
* Presence of portal vein tumor thrombus (PVTT) classified as grade Vp4, or any invasion into the inferior vena cava (IVC), except for subjects with IVC invasion who have been treated and radiographically stable for at least 6 months prior to screening.
* Ascites requiring active treatment, such as a requirement for paracentesis or escalation of diuretic doses. Exception: Subjects maintained on a stable dose of diuretics with controlled, asymptomatic ascites are eligible.
* Active gastrointestinal (GI) bleeding event ≥ Grade 3 per National Cancer Institute (NCI) Common Terminology for Adverse Events (CTCAE), version 5.0, within 6 months prior to screening.
* Coagulation abnormality defined as international normalized ratio (INR) \> 1.7, unless the elevation is due to therapeutic anticoagulation that, in the Investigator's judgment, can be safely managed in the context of study procedures.
* History of organ transplant.
* HCC involving greater than 50% of the liver volume.
* Experienced allergies to any component of the study drug (ECT204), mouse immunoglobulin, or iron-dextran, or have a history of severe hypersensitivity, including anaphylaxis.
* Previously received other gene therapy (e.g., chimeric antigen receptor T-cell \[CAR-T\] therapy); exception: prior oncolytic virus therapy is permitted.).
* Contraindication for undergoing leukapheresis procedure or receipt of conditioning agents
* Histologically confirmed HCC, that is unresectable, recurrent, and/or metastatic.
* GPC3-positive tumor expression confirmed by immunohistochemistry (IHC).
* For the dose-escalation cohort: ≥10-20% tumor cells, ≥2+ IHC.
* Beginning with the RP2D confirmatory cohort: ≥ 50% tumor cells, 2+/3+ IHC.
* Must have received at least first-line systemic therapy for HCC and have experienced disease progression on, or intolerance to, that therapy.
* Life expectancy of at least 4 months per the Investigator's opinion.
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
* Measurable disease by RECIST v1.1.
* Child-Pugh score of A6 or better.
* Adequate organ function.
Exclusion Criteria:
* Pre-existing illness (e.g., symptomatic congestive heart failure) that would limit compliance with study requirements.
* Active, uncontrolled systemic bacterial, fungal, or viral infection. Subjects with Human Immunodeficiency Virus (HIV), hepatitis B, or hepatitis C are eligible provided their infection is being treated and the viral load is controlled.
* History of malignancy other than HCC within 5 years before screening, except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other malignancies with low risk of recurrence.
* Known brain metastases or other active central nervous system (CNS) involvement, including leptomeningeal disease. Subjects with brain metastases that have been adequately treated (no evident neurological deficit and no steroid or anti-epileptic therapy for brain metastases) are eligible.
* Pregnant or lactating women.
* Currently receiving or ending (\< 14 days from date of consent) liver tumor-directed therapy (e.g., radiation, ablation, embolization), or hepatic surgery.
* Concurrently receiving other investigational agents, biological, chemical, or radiation therapies, while participating in the study.
* Active autoimmune disease requiring systemic immunosuppressive therapy.
* Presence of portal vein tumor thrombus (PVTT) classified as grade Vp4, or any invasion into the inferior vena cava (IVC), except for subjects with IVC invasion who have been treated and radiographically stable for at least 6 months prior to screening.
* Ascites requiring active treatment, such as a requirement for paracentesis or escalation of diuretic doses. Exception: Subjects maintained on a stable dose of diuretics with controlled, asymptomatic ascites are eligible.
* Active gastrointestinal (GI) bleeding event ≥ Grade 3 per National Cancer Institute (NCI) Common Terminology for Adverse Events (CTCAE), version 5.0, within 6 months prior to screening.
* Coagulation abnormality defined as international normalized ratio (INR) \> 1.7, unless the elevation is due to therapeutic anticoagulation that, in the Investigator's judgment, can be safely managed in the context of study procedures.
* History of organ transplant.
* HCC involving greater than 50% of the liver volume.
* Experienced allergies to any component of the study drug (ECT204), mouse immunoglobulin, or iron-dextran, or have a history of severe hypersensitivity, including anaphylaxis.
* Previously received other gene therapy (e.g., chimeric antigen receptor T-cell \[CAR-T\] therapy); exception: prior oncolytic virus therapy is permitted.).
* Contraindication for undergoing leukapheresis procedure or receipt of conditioning agents
Inclusion Criteria
Inclusion Criteria:
* Histologically confirmed HCC, that is unresectable, recurrent, and/or metastatic.
* GPC3-positive tumor expression confirmed by immunohistochemistry (IHC).
* For the dose-escalation cohort: ≥10-20% tumor cells, ≥2+ IHC.
* Beginning with the RP2D confirmatory cohort: ≥ 50% tumor cells, 2+/3+ IHC.
* Must have received at least first-line systemic therapy for HCC and have experienced disease progression on, or intolerance to, that therapy.
* Life expectancy of at least 4 months per the Investigator's opinion.
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
* Measurable disease by RECIST v1.1.
* Child-Pugh score of A6 or better.
* Adequate organ function.
* Histologically confirmed HCC, that is unresectable, recurrent, and/or metastatic.
* GPC3-positive tumor expression confirmed by immunohistochemistry (IHC).
* For the dose-escalation cohort: ≥10-20% tumor cells, ≥2+ IHC.
* Beginning with the RP2D confirmatory cohort: ≥ 50% tumor cells, 2+/3+ IHC.
* Must have received at least first-line systemic therapy for HCC and have experienced disease progression on, or intolerance to, that therapy.
* Life expectancy of at least 4 months per the Investigator's opinion.
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
* Measurable disease by RECIST v1.1.
* Child-Pugh score of A6 or better.
* Adequate organ function.
Gender
All
Gender Based
false
Keywords
Hepatocellular Carcinoma
Advanced HCC
Late-Stage HCC
Liver Cancer
Liver Neoplasm
Metastatic Liver Cancer
Metastatic HCC
T-cell therapy
Immunotherapy
HCC
Healthy Volunteers
No
Last Update Post Date
Last Update Post Date Type
Actual
Last Update Submit Date
Minimum Age
18 Years
NCT Id
NCT04864054
Org Class
Industry
Org Full Name
Eureka Therapeutics Inc.
Org Study Id
ETUS20GPC3AR124
Overall Status
Recruiting
Phases
Phase 1
Phase 2
Primary Completion Date
Primary Completion Date Type
Estimated
Official Title
An Open-Label, Dose Escalation, Multi-Center Phase I/II Clinical Trial of ECT204 T-Cell Therapy in Adults With Advanced Hepatocellular Carcinoma (HCC)
Primary Outcomes
Outcome Description
Type, frequency, and severity of adverse events (AEs), including treatment-emergent AEs (TEAEs), treatment-related AEs (TRAEs), serious adverse events (SAEs), adverse events of special interest (AESIs), clinically significant laboratory abnormalities recorded as AEs, and AEs leading to permanent discontinuation.
Outcome Measure
To assess the safety and tolerability of ECT204.
Outcome Time Frame
Up to 2 years (active assessment period); additional long-term follow-up (LTFU) up to 15 years
Secondary Outcomes
Outcome Description
ORR, defined as the proportion of subjects with a best overall response (BOR) of either CR or PR.
Outcome Time Frame
Up to 15 years
Outcome Measure
To assess the efficacy of ECT204 using RECIST v1.1 | Overall Response Rate (ORR)
Outcome Description
DOR, defined as the time from first documented occurrence of CR or PR to PD or death from any cause, whichever occurs first.
Outcome Time Frame
Up to 15 years
Outcome Measure
To assess the efficacy of ECT204 using RECIST v1.1 | Duration of Response (DOR)
Outcome Description
PFS, defined as the time from first ECT204 infusion to PD or death from any cause, whichever occurs first.
Outcome Time Frame
Up to 15 years
Outcome Measure
To assess the efficacy of ECT204 using RECIST v1.1 | Progression-Free Survival (PFS)
Outcome Description
DCR, defined as the proportion of subjects with BOR of CR, PR, or SD.
Outcome Time Frame
Up to 15 years
Outcome Measure
To assess the efficacy of ECT204 using RECIST v1.1 | Disease Control Rate (DCR)
Outcome Description
TTR, defined as the time from first ECT204 infusion to the first documented occurrence of CR or PR, among subjects who achieve an objective response.
Outcome Time Frame
Up to 15 years
Outcome Measure
To assess the efficacy of ECT204 using RECIST v1.1 | Time to Response (TTR)
Outcome Description
TTP, defined as the time from first ECT204 infusion to PD.
Outcome Time Frame
Up to 15 years
Outcome Measure
To assess the efficacy of ECT204 using RECIST v1.1 | Time to Progression (TTP)
Outcome Description
OS, defined as the time from first ECT204 infusion to death from any cause.
Outcome Time Frame
Up to 15 years
Outcome Measure
To assess the efficacy of ECT204 using RECIST v1.1 | Overall Survival (OS)
Outcome Description
Change from baseline in serum GPC3 over time; association between dynamic changes in serum GPC3 and radiographic tumor response by RECIST v1.1.
Outcome Time Frame
Up to 2 years
Outcome Measure
To evaluate changes in serum GPC3 as a pharmacodynamic marker of ECT204 activity.
Outcome Description
Cmax will be determined
Outcome Time Frame
Up to 2 years
Outcome Measure
To characterize the pharmacokinetic (PK) profile of ECT204, including the expansion and persistence of ECT204 | Peak exposure (Cmax)
Outcome Description
Tmax will be determined
Outcome Time Frame
Up to 2 years
Outcome Measure
To characterize the pharmacokinetic (PK) profile of ECT204, including the expansion and persistence of ECT204 | Time to reach peak exposure (Tmax)
Outcome Description
AUCt will be determined
Outcome Time Frame
Up to 2 years
Outcome Measure
To characterize the pharmacokinetic (PK) profile of ECT204, including the expansion and persistence of ECT204 | Area under the concentration-time curve to the last quantifiable concentration (AUCt)
Start Date
Start Date Type
Actual
Status Verified Date
First Post Date
First Post Date Type
Actual
First Submit Date
First Submit QC Date
Std Ages
Adult
Older Adult
Maximum Age Number (converted to Years and rounded down)
999
Minimum Age Number (converted to Years and rounded down)
18
Investigators
Investigator Type
Principal Investigator
Investigator Name
Roberto Alejandro Sica
Investigator Email
asica@montefiore.org
Investigator Department
Medicine
Investigator Division
Oncology
Investigator Sponsor Organization
External
Study Department
Oncology (Medical/Hematologic)
Study Division
Medical and Hematologic Oncology
Categories Mesh Debug
Cancer --- CARCINOMA
Cancer --- NEOPLASMS
Gastrointestinal (GI) Cancers --- DIGESTIVE SYSTEM NEOPLASMS
Cancer --- NEOPLASMS BY SITE
Digestive System --- DIGESTIVE SYSTEM DISEASES
Liver --- DIGESTIVE SYSTEM DISEASES
Digestive System --- LIVER DISEASES
Liver --- LIVER DISEASES
MeSH Terms
CARCINOMA, HEPATOCELLULAR
LIVER NEOPLASMS
ADENOCARCINOMA
CARCINOMA
NEOPLASMS, GLANDULAR AND EPITHELIAL
NEOPLASMS BY HISTOLOGIC TYPE
NEOPLASMS
DIGESTIVE SYSTEM NEOPLASMS
NEOPLASMS BY SITE
DIGESTIVE SYSTEM DISEASES
LIVER DISEASES