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Metastatic HER2 Positive Gastroesophageal Junction CancerPhase 1/2NCT05207722

CYNK-101 in Combination with Trastuzumab and Pembrolizumab in Patients with Locally Advanced Unresectable or Metastatic HER2-Positive Gastric or Gastroesophageal Junction (G/GEJ) Adenocarcinoma

A Phase 1/2 study testing CYNK-101, Pembrolizumab and Trastuzumab in people with Metastatic HER2 Positive Gastroesophageal Junction Cancer, run by Celularity Incorporated at 3 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This study will find the maximum tolerated dose (MTD) of CYNK-101 which contains Natural Killer (NK) cells derived from human placental CD34+ cells and culture-expanded. CYNK-101 will be administered as first-line treatment, following induction therapy consisting of Pembrolizumab, Trastuzumab and a Fluoropyrimidine /… Read more about this study

Who is it for?
Ages 18 to 75 years
What is being tested?
CYNK-101, Pembrolizumab and Trastuzumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1 participants
Where
3 sitesUnited States
Study dates
14 Apr 2022to 15 Feb 2024
Phase
Phase 1/2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Be at least 18 years of age on the day of signing informed consent.
  • Have cytologically or histologically confirmed diagnosis for the first-line treatment of patients with locally advanced unresectable or metastatic HER2-Positive Gastric or Gastroesophageal junction (G/GEJ) adenocarcinoma.
  • Patients who have received adjuvant therapy more than 12 months prior to Visit 2 will be allowed to participate in the study. Any patient who has completed an INDUCTION regimen prior to study entry and achieved best tumor response as either (1) Stable Disease per RECIST after 6 cycles or (2) Progressive Disease per RECIST and meets all other inclusion/exclusion criteria per protocol, will be eligible for enrollment in this clinical trial to continue with LYMPHODEPLETION and NK CELL INDUCTION and MAINTENANCE.
  • Patients will be required to undergo a biopsy for confirmation of HER2 expression prior to study entry.
  • HER2 overexpression is defined by immunohistochemistry (IHC) or in situ hybridization (ISH) for amplification of HER2 gene.
  • Patients must have either IHC 3+ or IHC 2+ with a positive fluorescent in-situ hybridization (FISH) or FISH + alone, as assessed locally on primary or metastatic tumor.
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  • Due to differences in tumor histopathology, use of FDA-approved tests, specific for Gastric Cancers, will be required when assessing HER2 Expression [HERCEPTIN package insert; 202120].
  • Have measurable disease as assessed by the investigator according to RECIST 1.1 [Eisenhauer EA et al, 200913].
  • Have a performance status of 0-1 on the Eastern Cooperative Oncology Group (ECOG) performance scale.
  • Have a life expectancy of ≥ 6 months.
  • Patients must agree to use a highly effective method of contraception from the start of the study until 1 year after the last dose of lymphodepletion or 4 months from last dose of pembrolizumab, or 6 months from last dose of trastuzumab; whichever comes later.
  • Have adequate cardiac function, defined as left ventricular ejection fraction > 45% as determined by MUGA scan or ECHO and QT interval calculated according to the Fridericia method (≤ 470 ms for men and ≤480 ms for women).
  • Demonstrate adequate organ function by laboratory values as follows:
  • Hematological:
  • Absolute neutrophil count (ANC) ≥ 1.5 x 109/L,
  • Platelet count ≥ 100 x 109/L
  • Hemoglobin ≥ 9 g/dL or ≥ 5.6 mmol/L
  • Renal:
  • o Calculated creatinine clearance (Cockcroft-Gault Formula) ≥ 50 mL/min
  • Hepatic:
  • o Total bilirubin ≤1.5 x ULN
  • Exception: Patients with Gilbert's disease total bilirubin ≤ 3.0 x ULN
  • o Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN
  • Exception: AST and ALT ≤ 5 x ULN for patients with liver metastases.
  • Coagulation:
  • Prothrombin Time (PT) ≤ 1.5 x ULN unless patient is receiving anticoagulant therapy if PT or PTT is within therapeutic range of intended use of anticoagulants
  • activated Partial Thromboplastin Time (aPTT) ≤ 1.5 x ULN unless patient is receiving anticoagulant therapy if PT or PTT is within therapeutic range of intended use of anticoagulants

Who cannot join

  • Patients who have received prior systemic therapy for locally advanced unresectable or metastatic disease.
  • Has had major surgery, open biopsy, or significant traumatic injury within 28 days prior to Visit 2, or anticipation of the need for major surgery during the course of study treatment.
  • Has had radiotherapy within 14 days prior to Visit 2.
  • Has a known additional malignancy that is progressing or has required active treatment within the past 3 years.
  • Exceptions: Squamous or Basal cell carcinoma of the skin, superficial bladder cancer, and prostate cancer not requiring treatment.
  • Patients with symptomatic, untreated, or actively progressing CNS metastases. Patients with a history of CNS metastases are eligible if they have not received radiotherapy within 7 days or whole-brain radiation for the past 14 days. Patients should not be receiving ongoing treatment with either corticosteroids or anticonvulsants. Patients with new CNS metastases detected during the Screening period, may participate in the study if they receive radiotherapy or surgery resulting in stable metastatic disease.
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  • Has an active autoimmune disease that has required systemic treatment in the past 2 years.
  • Patients with hypothyroidism who are on stable replacement therapy will be allowed.
  • Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy greater than 10 mg per day of prednisone or equivalent.
  • Patients who require replacement for adrenal insufficiency will be allowed.
  • Has a history of (non-infectious) pneumonitis that requires steroids or current pneumonitis.
  • Has a known history of active tuberculosis.
  • Has an active infection requiring systemic therapy.
  • Accumulation of pleural, ascitic, or pericardial fluid requiring drainage or diuretic drugs within 14 days prior to Visit 2. If the participant is receiving diuretic drugs for other reasons, it is acceptable.
  • Has peripheral neuropathy > Grade 1.
  • Has a known psychiatric or substance abuse disorder that would interfere with cooperation with the requirements of the trial.
  • Has active or clinically significant cardiac disease including:
  • History of myocarditis
  • History or presence of serious uncontrolled cardiac arrhythmias.
  • Clinically significant resting bradycardia.
  • Left ventricular ejection fraction (LVEF) as determined by echocardiogram (ECHO) < 45% or multiple gated acquisition scan (MUGA) < 45%.
  • Any of the following within 6 months prior to the start of the study treatments:
  • myocardial infarction (MI), severe/unstable angina, congestive heart failure (CHF), cerebrovascular accident (CVA), transient ischemic attack (TIA).
  • Patients with history of human immunodeficiency virus (HIV) infection must be seronegative.
  • Known active infection with hepatitis B, hepatitis C, SARS-CoV-2, or other viral infections requiring systemic therapy.
  • Patients having a potential hypersensitivity (≥ Grade 3) to pembrolizumab, trastuzumab, study chemotherapy agents, rhIL-2 and/or to any excipients, murine proteins, or platinum-containing products. NOTE: any adverse events which has occurred because of prior therapy MUST have resolved to ≤ Grade 1 according to CTCAE (NCI Common Terminology Criteria for Adverse Events) Version 5 prior to study entry.
  • Has had an allogeneic tissue/solid organ transplant.
  • Immunized with live vaccine ≤ 28 days before Visit 2.
  • Participation in study of investigational agent or device ≤ 28 day prior to Visit 2.
  • Patient is pregnant or breastfeeding.

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • John Theurer Cancer Center at Hackensack University Medical Center

    Hackensack, New Jersey, 07601

  • Scripps Health

    La Jolla, California, 92037

  • Georgetown

    Washington D.C., District of Columbia, 20057

Other trials in United States

About this study

Official title: A Phase I/IIa Open Label, Non-Randomized, Multicenter Study of CYNK-101 in Combination with Trastuzumab and Pembrolizumab in Patients with Locally Advanced Unresectable or Metastatic HER2-Positive Gastric or Gastroesophageal Junction (G/GEJ) Aenocarcinoma

This study will find the maximum tolerated dose (MTD) of CYNK-101 which contains Natural Killer (NK) cells derived from human placental CD34+ cells and culture-expanded. CYNK-101 will be administered as first-line treatment, following induction therapy consisting of Pembrolizumab, Trastuzumab and a Fluoropyrimidine / Platinum based Chemotherapy regimen. Patients are required to undergo a biopsy for confirmation of HER2 positivity defined as either IHC 3+ or IHC 2+ with a positive fluorescent in-situ hybridization (FISH) or FISH + alone. The safety of this treatment will be evaluated, and researchers will want to learn if NK cells will help in treating patients with Locally Advanced Unresectable or Metastatic HER2-Positive Gastric or Gastroesophageal Junction (G/GEJ) Adenocarcinoma.

Being tested
CYNK-101, Pembrolizumab, Trastuzumab, Recombinant Human Interleukin-2, Cyclophosphamide
Keywords
CYNK-101, Natural Killer Cells, Cell Therapy, Metastatic HER2-positive Gastric Cancer, Gastric Cancer, Gastroesophageal Junction Adenocarcinoma
Medical subject headings
Stomach Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CYNK-101Biological

    CYNK-101 is a human placental hematopoietic stem/progenitor cell derived NK cell product, that is genetically modified to express a variant of CD16, Fc gamma receptor III (FcγRIII).

  • PembrolizumabDrug

    Also called Keytruda®

    200 mg on Day 1 of each 3-week cycle as an IV infusion.

  • TrastuzumabDrug

    Also called Herceptin®

    8 mg/kg loading dose and then 6 mg/kg maintenance dose administered IV on day 1 of each 3-week cycle.

  • Recombinant Human Interleukin-2Drug

    Also called proleukin

    6 million (M) international units (IU) of rhIL-2 administered subcutaneously (SC) on each CYNK-101 infusion day.

  • CyclophosphamideDrug

    Also called cytoxan

    Cyclophosphamide: 900 mg/m2 administered IV as part of a 3-day lymphodepletion regimen.

  • FludarabineDrug

    Also called fludara

    Fludarabine: 30 mg/m2 administered IV as part of a 3-day lymphodepletion regimen.

  • MesnaDrug

    MESNA: shall be administered as part of a 3-day lymphodepletion regimen for the inhibition of hemorrhagic cystitis induced by cyclophosphamide. Route of administration, dosage, and frequency of Mesna should be based on institutional standards.

Study groups in NCT05207722
Study groupRoleWhat they receive
Phase I Dose EscalationExperimentalUp to two dosing cohorts of CYNK-101 in combination with rhIL2 will be evaluated following an initial induction and lymphodepletion regimen.
Receives: Biological: CYNK-101; Drug: Pembrolizumab; Drug: Trastuzumab; Drug: Recombinant Human Interleukin-2; Drug: Cyclophosphamide; Drug: Fludarabine; Drug: Mesna
Phase IIa ExpansionExperimentalOnce the Maximum Tolerated Dose (MTD) or Recommended Phase 2 Dose (RP2D) is determined in Phase I, the Phase IIa portion of the study will commence.
Receives: Biological: CYNK-101; Drug: Pembrolizumab; Drug: Trastuzumab; Drug: Recombinant Human Interleukin-2; Drug: Cyclophosphamide; Drug: Fludarabine; Drug: Mesna

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Dose-Limiting Toxicity (DLT)

    Phase I

    Measured: up to 28 days

  2. Maximum Tolerated Dose (MTD)

    Phase I

    Measured: up to 28 days

  3. Overall Response Rate (ORR) as determined by the RECIST 1.1 Investigator using RECIST 1.1.

    Phase IIa

    Measured: up to 12 months

Secondary outcomes (8)
  1. Progression Free Survival (PFS)

    Phase I/IIa

    Measured: at 6 and 12 months

  2. Duration of Response (DoR)

    Phase I/IIa

    Measured: up to 12 months

  3. Overall Response Rate (ORR) as determined by the RECIST 1.1

    Phase I

    Measured: up to 12 months

  4. Incidence of Response conversion post CYNK-101 infusion

    Phase I/IIa

    Measured: up to 12 months

  5. Incidence of Treatment Emergent adverse events (TEAE)

    Phase I/IIa

    Measured: up to 12 months

  6. Incidence and Severity of adverse events (AEs) and clinically significant changes in laboratory values

    Phase I/IIa

    Measured: up to 12 months

  7. Incidence of replication competent lentivirus (RCL)

    Phase I/IIa

    Measured: up to 12 months

  8. Overall Survival (OS)

    Phase I/IIa

    Measured: up to 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jan 2022
  2. Study start14 Apr 2022
  3. Primary completion15 Feb 2024
  4. Study completion15 Feb 2024

Why it stopped: for business reasons

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Model description
This Phase I/IIa study will utilize a 3+3 open label design, and will evaluate two escalating dosing Cohort levels of CYNK-101 in combination with rhIL2 following and initial induction and lymphodepletion regimen. Once the Maximum Tolerated Dose (MTD) or Recommended Phase 2 Dose (RP2D) is determined in Phase I, the Phase IIa portion of the study will commence.
Masking
None (open label)
Enrolment
1 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05207722
Sponsor's protocol ID
CYNK-101-HER2-001
Status last verified
Feb 2024
First submitted
12 Jan 2022
Last updated
12 Dec 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing CYNK-101, Pembrolizumab and Trastuzumab in people with Metastatic HER2 Positive Gastroesophageal Junction Cancer, run by Celularity Incorporated at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 27 inclusion and 30 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 12 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: for business reasons). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Dose-Limiting Toxicity (DLT) (time frame: up to 28 days). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Dec 2024.

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