EMITT-1 (ERAP Mediated Immunopeptidome Targeting Trial - 1)

Last updated: January 26, 2026
Sponsor: Grey Wolf Therapeutics
Overall Status: Active - Recruiting

Phase

1/2

Condition

Uterine Disorders

Liver Cancer

Digestive System Neoplasms

Treatment

Module 1 (GRWD5769 on its own as monotherapy)

Module 2 (GRWD5769 in combination with cemiplimab, administered IV)

Clinical Study ID

NCT06923761
GRWD5769-ST-01
  • Ages > 18
  • All Genders

Study Summary

This is a Phase I/II, open-label, first-in human study of GRWD5769 alone, and in combination with another anti-cancer agent in advanced solid cancers.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Provision of written informed consent.

  2. Male or female, ≥ 18 years of age.

  3. An ECOG performance status of 0 or 1.

  4. Willing to permit access to stored historical tumour tissue and prior tumourradiological assessments and tumour biomarker data (if available).

  5. Able to take oral medications and be willing to record daily adherence to the studydrug.

  6. Female participants must be of non-child-bearing potential, or, if of childbearingpotential must have a negative pregnancy test (as required by protocol), must use ahighly effective method of contraception combined with a condom and not donate ova (for the protocol specified period of time).

  7. Male participants must use a condom and their female participant must also use ahighly effective method of contraception (for the protocol specified period oftime), if engaging in sexual intercourse with a female partner who could becomepregnant and not donate sperm.

  8. Estimated life expectancy of at least 3 months, in the opinion of the PI.

  9. Willing and able to comply with all scheduled visits, treatment plans, laboratorytests, and other study procedures.

  10. Participant has measurable disease per RECIST 1.1/iRECIST

  11. Participant has cytologically or histologically confirmed locally advanced ormetastatic solid malignancy for which no further standard of care (SoC) therapy isavailable (or no SoC therapy exists), or who have been offered and declined SoCtherapy, or are intolerant of SoC therapy. Module 1 (Part B) and Module 2 (Part B) Only

  12. Participant has at least one tumour lesion amenable to serial biopsies and iswilling to provide consent for biopsies and has measurable disease per RECIST 1.1/iRECIST, excluding the lesion(s) identified for biopsy. Module 2 (Part C and Part D) Cohort 1 (Cervical)

  13. Participants with histologically confirmed persistent, recurrent or metastaticcervical cancer who are not amenable to curative therapy.

  14. Participants should have received at least 3 months first line anti-PD(L)-1 therapy (± bevacizumab, chemotherapy, ADC or other immunotherapy e.g. anti-CTLA-4) and thisshould have included at least a 10-week period without progression.

  15. Participants may enrol in the study immediately following progression on the firstline CPI or may have received 1 further line of systemic cancer therapy afterprogression on CPI. Cohort 2 (Hepatocellular Carcinoma)

  16. Participants with histologically confirmed hepatocellular carcinoma who are notamenable to curative therapy and ineligible for loco-regional therapy.

  17. Participants should have received at least 3 months first line anti-PD(L)-1containing therapy and this should have included at least a 10-week period withoutprogression per Investigator assessment.

  18. Participants may enrol in the study immediately following progression on the firstline CPI or may have received 1 further line of systemic cancer therapy afterprogression on CPI.

  19. Participant has Child-Pugh score class A liver function. Cohort 3 (Moderate to High TMB)

  20. Participants with cytologically or histologically confirmed advanced, recurrent ormetastatic disease, which is not amenable to curative therapy, in up to 5 types ofsolid tumour with moderate to high median TMB (NSCLC, urothelial, SCCHN,gastric/gastro-oesophageal adenocarcinoma, oesophageal SCC).

  21. Participants should have received at least ≥ 3 months first line anti-PD(L)-1 (±chemotherapy, ADC, pemetrexed or other immunotherapy e.g. anti-CTLA-4) and thisshould have included at least a 10-week period without progression.

  22. Participants may enrol in the study immediately following progression on the firstline CPI or may have received 1 further line of systemic cancer therapy afterprogression on CPI. Module 2 Part D only (pMMR/MSS-CRC)

  23. Participants with histologically confirmed unresectable pMMR/MSS-CRC, withoutcurrent or prior liver metastases

  24. Participants should have received at least one line of therapy in theadvanced/metastatic setting and should have received therapies according to localstandard practice, unless ineligible or intolerant to the treatment

  25. Participants may not have received more than 2 lines of cytotoxic chemotherapy

Exclusion

Exclusion Criteria:

  1. Prior therapy with an ERAP1 inhibitor.

  2. Any other malignancy within the past 3 years, with the exception of cervicalintraepithelial neoplasia and nonmelanoma skin cancer.

  3. Any unresolved toxicity (except alopecia) from prior therapy of ≥ CTCAE Grade 1.Participants with Grade 2 toxicity that is not clinically significant (e.g.,alopecia, vitiligo), or that is deemed stable or irreversible (e.g., peripheralneuropathy) can be enrolled.

  4. Active or documented history of autoimmune disease (within 2 years) requiringsystemic immunosuppressive therapy, or participant is immunocompromised for anyother reason (as determined by the Investigator).

  5. Spinal cord compression or brain metastases, unless asymptomatic, stable, and notrequiring steroids for at least 4 weeks (if stable and requiring no intervention,the participant can be enrolled in the study).

  6. Uncontrolled seizures.

  7. Active infection requiring therapy within 14 days prior to the day of first dose ofIMP.

  8. Severe or uncontrolled medical condition (e.g., severe chronic obstructive pulmonarydisease, severe Parkinson's disease, active inflammatory bowel disease) orpsychiatric condition.

  9. Active bleeding diatheses.

  10. Participant has received an organ transplant.

  11. Known active hepatitis B, hepatitis C, or human immunodeficiency virus infection (HIV).

  12. Participant is breastfeeding or pregnant.

  13. Receipt of licenced or unlicenced cytotoxic, noncytotoxic or small moleculetreatment for the malignancy within 28 days or 5 half-lives, whichever is shorterprior to the day of first dose of IMP.

  14. Receipt of oral corticosteroids (at a dose > 10 mg prednisone/day or equivalent)within 14 days (except for subjects receiving corticosteroids for adrenalinsufficiency).

  15. Receipt of St John's Wort or of another concomitant medication, herbal supplement,or food that is a strong inhibitor or inducer of CYP3A4 enzymes within 14 days.

  16. Receipt of a blood transfusion (blood or blood products) within 7 days.

  17. Impaired hepatic or renal function.

  18. Liver function deteriorating in a manner that would likely make the participantineligible per protocol specified requirements.

  19. Other evidence of impaired hepatic synthesis function.

  20. Inadequate bone marrow reserve or organ function.

  21. Any prior history of persistent (> 4 weeks) severe pancytopenia due to previoustherapy rather than to disease (ANC < 0.5 × 10^9/L or platelets < 50 x 10^9/L).

  22. Cardiac dysfunction or other clinically significant cardiac pathology likely toimpair the participants ability to participate in the study.

  23. Mean QTcF > 450 ms for males or > 470 ms for females.

  24. Any clinically important abnormalities in rhythm, conduction, or morphology onresting ECG. Controlled atrial fibrillation is permitted.

  25. Any factor that in the Investigator's opinion increases the risk of QTc prolongationor arrythmic events.

  26. In the opinion of the Investigator, unlikely to comply with study procedures,restrictions, or requirements.

  27. A history of haemolytic anaemia or marrow aplasia.

  28. Has received a live-virus vaccination within 28 days. Note: seasonal flu or COVIDvaccines that do not contain live virus are permitted.

  29. History of Grade 3 or 4 pneumonitis or interstitial lung disease within the last 5years, or other clinically significant pulmonary pathology likely to impair abilityto participate in the study. Module 2 all Parts and Module 1A Crossover Participants Only

  30. Has discontinued a prior checkpoint inhibitor due to toxicity.

  31. Hypersensitivity to cemiplimab or any of its excipients, or contraindicated tocemiplimab per approved local labelling.

  32. Has experienced ≥ Grade 2 immune-mediated AE on this study (applies to crossoverparticipants only). Module 2 Part D only - pMMR/MSS CRC dose optimisation cohort

  33. Participants with unresectable pMMR/MSS CRC may not have purely peritoneal disease

  34. Participants with unresectable pMMR/MSS CRC may not have had prior CPI /immunotherapy

Study Design

Total Participants: 300
Treatment Group(s): 2
Primary Treatment: Module 1 (GRWD5769 on its own as monotherapy)
Phase: 1/2
Study Start date:
May 21, 2023
Estimated Completion Date:
April 30, 2028

Study Description

GRWD5769 is as a potential new treatment for advanced or metastatic solid malignancies. GRWD5769 works by stopping an enzyme in the body, called endoplasmic reticulum aminopeptidase 1 (ERAP1), from working. ERAP1 is part of how the body recognizes the presence of a cancer tumour and helps trigger the immune system to fight the cancer. However, in patients with cancer, the immune system cells can become exhausted and no longer work effectively. By blocking ERAP1 it makes the tumour look different to the immune system and so the immune system starts fighting the cancer again. GRWD5769 has the potential of producing clinically meaningful improvements in monotherapy and in combination with therapy like cemiplimab (Libtayo®) by enhancing the antitumour immune response.

Who can participate? Patients with advanced or metastatic solid malignancy aged 18 years or older.

What does the study involve? This study consists of Module 1 (Parts A to D), which will look at the effects of GRWD5769 when given alone and Module 2 (Parts A to D) which will look at the effects of GRWD5769 when given in combination with another anticancer drug called Libtayo® (cemiplimab).

Connect with a study center

  • GenesisCare Research

    Adelaide,
    Australia

    Site Not Available

  • GenesisCare Research

    Adelaide 2078025,
    Australia

    Site Not Available

  • Southern Oncology Clinical Research Unit (SOCRU)

    Bedford Park,
    Australia

    Site Not Available

  • Southern Oncology Clinical Research Unit (SOCRU)

    Bedford Park 2076918,
    Australia

    Active - Recruiting

  • Blacktown Hospital

    Blacktown,
    Australia

    Site Not Available

  • Blacktown Hospital

    Blacktown 2175411,
    Australia

    Active - Recruiting

  • Kinghorn Cancer Centre (KCC)

    Darlinghurst,
    Australia

    Site Not Available

  • Kinghorn Cancer Centre (KCC)

    Darlinghurst 2169378,
    Australia

    Active - Recruiting

  • Austin Health

    Heidelberg,
    Australia

    Site Not Available

  • Austin Health

    Heidelberg 2163654,
    Australia

    Active - Recruiting

  • Alfred Health

    Melbourne,
    Australia

    Site Not Available

  • Alfred Health

    Melbourne 2158177,
    Australia

    Active - Recruiting

  • Mater Research

    South Brisbane,
    Australia

    Site Not Available

  • Mater Research

    South Brisbane 2207259,
    Australia

    Active - Recruiting

  • Cancer Care Wollongong

    Wollongong,
    Australia

    Site Not Available

  • Cancer Care Wollongong

    Wollongong 2171507,
    Australia

    Active - Recruiting

  • Centre Léon Bérard

    Lyon 2996944,
    France

    Active - Recruiting

  • Centre Léon Bérard

    Lyon Cedex,
    France

    Site Not Available

  • Institut Paoli-Calmettes

    Marseille,
    France

    Site Not Available

  • Institut Paoli-Calmettes

    Marseille 2995469,
    France

    Active - Recruiting

  • Centre Eugène Marquis

    Rennes,
    France

    Site Not Available

  • Centre Eugène Marquis

    Rennes 2983990,
    France

    Active - Recruiting

  • Institut de Cancérologie de l'Ouest (ICO)

    Saint-Herblain 2979590,
    France

    Active - Recruiting

  • Institut de Cancérologie de l'Ouest (ICO)

    Saint-Herblain Cedex,
    France

    Site Not Available

  • ICANS - Institut de Cancérologie Strasbourg

    Strasbourg,
    France

    Site Not Available

  • ICANS - Institut de Cancérologie Strasbourg

    Strasbourg 2973783,
    France

    Active - Recruiting

  • IUCT Oncopole - Institut Claudius Regaud

    Toulouse,
    France

    Site Not Available

  • IUCT Oncopole - Institut Claudius Regaud

    Toulouse 2972315,
    France

    Active - Recruiting

  • Institut Gustave Roussy

    Villejuif,
    France

    Site Not Available

  • Institut Gustave Roussy

    Villejuif 2968705,
    France

    Active - Recruiting

  • Hospital Universitario Vall d'Hebrón (VHIO)

    Barcelona,
    Spain

    Site Not Available

  • START Barcelona - Hospital HM Nou Delfos

    Barcelona,
    Spain

    Active - Recruiting

  • Hospital Universitario Vall d'Hebrón (VHIO)

    Barcelona 3128760,
    Spain

    Active - Recruiting

  • START Barcelona - Hospital HM Nou Delfos

    Barcelona 3128760,
    Spain

    Active - Recruiting

  • Clinica Universitaria de Navarra Madrid

    Madrid,
    Spain

    Active - Recruiting

  • START Madrid - Centro Integral Oncológico Clara Campal (HM CIOCC)

    Madrid,
    Spain

    Site Not Available

  • START Madrid - Hospital Universitario Fundacion Jimenez Diaz

    Madrid,
    Spain

    Active - Recruiting

  • Clinica Universitaria de Navarra Madrid

    Madrid 3117735,
    Spain

    Active - Recruiting

  • START Madrid - Centro Integral Oncológico Clara Campal (HM CIOCC)

    Madrid 3117735,
    Spain

    Active - Recruiting

  • START Madrid - Hospital Universitario Fundacion Jimenez Diaz

    Madrid 3117735,
    Spain

    Active - Recruiting

  • Hospital Universitario Virgen de la Victoria

    Malaga,
    Spain

    Site Not Available

  • Hospital Universitario Virgen de la Victoria

    Málaga 2514256,
    Spain

    Active - Recruiting

  • Clinica Universitaria de Navarra Pamplona

    Pamplona,
    Spain

    Site Not Available

  • Clinica Universitaria de Navarra Pamplona

    Pamplona 3114472,
    Spain

    Active - Recruiting

  • INCLIVA-Hospital Clínico Universitario de Valencia

    Valencia,
    Spain

    Site Not Available

  • INCLIVA-Hospital Clínico Universitario de Valencia

    Valencia 2509954,
    Spain

    Active - Recruiting

  • Western General Hospital

    Edinburgh,
    United Kingdom

    Site Not Available

  • Western General Hospital

    Edinburgh 2650225,
    United Kingdom

    Active - Recruiting

  • Clatterbridge Cancer Centre

    Liverpool,
    United Kingdom

    Site Not Available

  • Clatterbridge Cancer Centre

    Liverpool 2644210,
    United Kingdom

    Active - Recruiting

  • Hammersmith Hospitals NHS Trust

    London,
    United Kingdom

    Active - Recruiting

  • Royal Free Hospital

    London,
    United Kingdom

    Site Not Available

  • Hammersmith Hospitals NHS Trust

    London 2643743,
    United Kingdom

    Active - Recruiting

  • Royal Free Hospital

    London 2643743,
    United Kingdom

    Active - Recruiting

  • Christie NHS Foundation Trust

    Manchester,
    United Kingdom

    Site Not Available

  • Christie NHS Foundation Trust

    Manchester 2643123,
    United Kingdom

    Active - Recruiting

  • Newcastle Upon Tyne Hospital

    Newcastle,
    United Kingdom

    Site Not Available

  • Newcastle Upon Tyne Hospital

    Newcastle 6695976,
    United Kingdom

    Active - Recruiting

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