Claudin 18.2-Targeted Chimeric Antigen Receptor T-cells in Subjects With Unresectable, Locally Advanced, or Metastatic Gastric, Gastroesophageal Junction (GEJ), Esophageal, or Pancreatic Adenocarcinoma

Last updated: April 17, 2025
Sponsor: Legend Biotech USA Inc
Overall Status: Active - Recruiting

Phase

1

Condition

Esophageal Cancer

Pancreatic Cancer

Pancreatitis

Treatment

LB1908

Clinical Study ID

NCT05539430
LB1908-1001
  • Ages 18-75
  • All Genders

Study Summary

This is a Phase 1, Open-Label, Dose Escalation and Expansion, Multicenter Study of Claudin 18.2-Targeted Chimeric Antigen Receptor T-cells in Subjects with Unresectable, Locally Advanced, or Metastatic Gastric, Gastroesophageal Junction (GEJ), Esophageal, or Pancreatic Adenocarcinoma

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Be willing and able to provide written informed consent

  2. Be a female or male ≥ 18 and ≤ 75 years old at the time of signing of the informedconsent

  3. For Part A and B: subjects with histologically/cytologically confirmed unresectable,locally advanced or metastatic adenocarcinoma of the stomach, GEJ, or distalesophagus for which standard treatment is considered intolerable, unlikely to confersignificant clinical benefit, is no longer effective, does not exist, or subject isineligible or declines standard therapy. For Part B only: subjects with histologically/cytological confirmed unresectable,locally advanced or metastatic adenocarcinoma of the pancreas for which standardtreatment is considered intolerable, unlikely to confer significant clinicalbenefit, is no longer effective, does not exist, or subject is ineligible ordeclines standard therapy.

  4. Subjects must have received prior therapy as follows:

  • For gastric, GEJ, or esophageal adenocarcinoma, previous treatment must haveincluded a fluoropyrimidine and/or platinum containing regimen. Subjects withHER2-neu-positive (HER2+) disease must have also received prior anti-HER2+therapy.

  • For pancreatic adenocarcinoma, previous treatment must have includedfluoropyrimidine and/or gemcitabine containing regimen.

  1. Presence of CLDN18.2 positive tumors with staining intensity of ≥ 1+ in ≥ 50% oftumor cells by immunohistochemistry (performed by central laboratory duringPrescreening)

  2. Presence of ≥ 1 radiologically measurable lesion per Response Evaluation Criteria InSolid Tumors (RECIST) Version 1.1.

  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

  4. Life expectancy of at least 4 months per investigator judgment.

  5. Have adequate organ function

  6. Women of childbearing potential must have a negative pregnancy test at screening

  7. All Subject must agree to practice a highly effective method of contraception fromthe time of signing the ICF to 1 year after receiving a LB1908 infusion.

  8. Women and men must agree not to donate eggs (ova, oocytes) or sperm, respectively,until at least 1 year after receiving a LB1908 infusion.

Exclusion

Exclusion Criteria:

  1. Prior treatment with cellular immunotherapy (e.g., CAR-T) or gene therapy product.

  2. Prior treatment with claudin 18.2-targeted therapy.

  3. Antitumor therapy prior to apheresis during the protocol-defined window

  4. Subjects who have a history of esophageal or gastric resection that the investigatorconsiders is at increased risk of bleeding or perforation;

  5. Unstable/active ulcer, varices, or digestive tract bleeding or recent digestivesurgery that may have increased risk of bleeding;

  6. Clinically significant ascites, pleural or peritoneal effusions requiring weeklyclinical intervention at screening.

  7. Patients requiring anticoagulant therapy such as warfarin or heparin

  8. Patients requiring long-term antiplatelet therapy

  9. Primary immunodeficiency

  10. Known brain metastasis or leptomeningeal metastasis.

  11. Subjects with heavy tumor burden such as significant lung disease or extensive livermetastases.

  12. Active autoimmune disease receiving immunosuppressants (e.g., cyclosporine or highdose systemic steroids) within 2 weeks or 5 half-lives prior to screening

  13. Impaired cardiac function or clinically significant cardiac disease as defined bythe protocol

  14. Previous or concurrent malignancy not meeting protocol-defined exceptions

  15. Serious and /or uncontrolled medical condition that, in the Investigator's judgment,would cause unacceptable safety risk, interfere with study procedures or results, orcompromise compliance with the protocol:

  16. Current known active infection with human immunodeficiency virus (HIV), hepatitis B,and/or hepatitis C virus (HBV/HCV).

  17. Contraindications or life-threatening allergies, hypersensitivity, or intolerance toLB1908 excipients, such as dimethyl sulfoxide; or to fludarabine, cyclophosphamide,or tocilizumab.

  18. Ongoing toxicity from previous anticancer therapy that has not resolved to Grade 2or less, except for alopecia, fatigue, nausea, and constipation.

  19. Major surgery within 4 weeks prior to apheresis, or planned within 4 weeks afterLB1908 administration.

  20. Pregnant or breast-feeding.

  21. Plans to become pregnant or breastfeed, or father a child within 1 year afterreceiving a LB1908 infusion.

  22. Previous history of allogeneic HSCT, organ transplant, or in preparation for organtransplant.

Study Design

Total Participants: 56
Treatment Group(s): 1
Primary Treatment: LB1908
Phase: 1
Study Start date:
April 18, 2023
Estimated Completion Date:
December 31, 2027

Study Description

This is a Phase 1, open label, multicenter study to evaluate Claudin 18.2-targeting CAR-T cells (LB1908) in adult subjects with unresectable, locally advanced or metastatic gastric, GEJ, esophageal, or pancreatic adenocarcinoma. Patients will be confirmed to have sufficient expression of Claudin 18.2 as part of a prescreening. The study comprises a dose-escalation component (Part A) and a dose-expansion component (Part B). In part A, patients with gastric, GEJ, or esophageal adenocarcinoma will be treated with LB1908 at protocol-defined dose level, with escalation to higher doses in subsequent patients guided by evaluation of protocol-defined dose limiting toxicities (DLTs). Part A will identify the recommended dose for expansion (RDE) to be tested in part B in two cohorts: a gastric, GEJ and esophageal adenocarcinoma cohort as well as a pancreatic adenocarcinoma cohort. Part B will aim to identify the recommended dose for phase 2 (RP2D).

Connect with a study center

  • Moffitt Cancer Center

    Tampa, Florida 33612
    United States

    Active - Recruiting

  • Karmanos Cancer Institute

    Detroit, Michigan 48201
    United States

    Active - Recruiting

  • John Theurer Cancer Center at HackensackUMC

    Hackensack, New Jersey 07601
    United States

    Active - Recruiting

  • Roswell Park Comprehensive Cancer Center

    Buffalo, New York 14263
    United States

    Active - Recruiting

  • OHSU Knight Cancer Institute

    Portland, Oregon 97239
    United States

    Active - Recruiting

  • Vanderbilt-Ingram Cancer Center

    Nashville, Tennessee 37232
    United States

    Active - Recruiting

  • Fred Hutchinson Cancer Center

    Seattle, Washington 98109
    United States

    Active - Recruiting

  • Medical College of Wisconsin

    Milwaukee, Wisconsin 53226
    United States

    Active - Recruiting

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