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CholangiocarcinomaPhase 1NCT06490198

Phase 2 Study: OBI-833/OBI-821 Maintenance for Globo H+ Advanced Biliary Tract Cancer After Gemcitabine/Cisplatin

A Phase 1 study testing OBI-833/OBI-821 in people with Cholangiocarcinoma and Chemotherapy Effect, run by Chang Gung Memorial Hospital at 2 sites in Taiwan.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

A Phase 2 clinical trial protocol for evaluating the efficacy and safety of OBI-833/OBI-821, a carbohydrate-conjugate vaccine combined with an immune adjuvant, as maintenance therapy in combination with first-line gemcitabine and cisplatin chemotherapy for patients with Globo H-positive advanced biliary tract cancer. Read more about this study

Who is it for?
Ages 20 to 99 years
What is being tested?
OBI-833/OBI-821
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
2 sitesTaiwan
Study dates
31 Jul 2024to 31 Jul 2027
Phase
Phase 1
Are there results?
Not yet: the study is under way

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 20 to 99 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged ≥ 20 years.
  • Histologically confirmed, unresectable advanced or metastatic biliary tract cancer, including cholangiocarcinoma (intrahepatic or extrahepatic) and gallbladder carcinoma.
  • Patient with previously untreated disease if unresectable or metastatic at initial diagnosis will be eligible.
  • Patient with recurrent disease >6 months after curative surgery or >6 months after the completion of adjuvant therapy (chemotherapy and/or radiation) will be eligible.
  • Patient must have a documented Globo H H-score of at least 80 using a validated central IHC assay.
  • Patient must have received 3±1 months of the first-line GemCis regimen (gemcitabine, 1000 mg/m2 and cisplatin, 25 mg/m2 on days 1 and 8 of each 21-day cycle), have achieved SD, PR, or CR before enrollment (as confirmed by the Investigator), and plan to continue the GemCis regimen.
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  • At least one measurable tumor lesion according to RECIST version 1.1 as assessed by the Investigator (local radiological image assessment).
  • Life expectancy ≥ 6 months.
  • East Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Organ function requirements - Subjects must have adequate organ functions as defined below:
  • AST/ALT ≤ 3X ULN (upper limit of normal); AST/ALT ≤ 5X ULN in the presence of liver metastases Total bilirubin ≤ 2.0 X ULN Serum creatinine ≤ 1.5X ULN ANC ≥ 1,5500 /µL Platelets ≥ 100,000/µL
  • All eligible patients of childbearing potential must use effective contraception during study treatment, and for at least 2 months after the last dose of OBI-833/OBI-821. Subjects not of childbearing potential (i.e., permanently sterilized, postmenopausal) can be included in the study. Postmenopausal is defined as 12 months with no menses without an alternative medical cause.
  • Understand and provide a written informed consent document according to institutional guidelines.

Who cannot join

  • Patient who has CNS metastasis or spinal cord compression.
  • Patient who is pregnant or breast-feeding at entry.
  • Patient with splenectomy.
  • Patient with HIV infection, active hepatitis B infection, or active hepatitis C infection. Patients with hepatitis B infection under anti-HBV medications are exceptionalcan be included in the study. Patients with hepatitis C infection history but inactive status are exceptionalcan be included in the study.
  • Patient with any autoimmune or other disorders requiring IV/oral steroids or immunosuppressive or immunomodulatory therapies.
  • (e.g., type 1 juvenile onset diabetes mellitus, antibody positive for rheumatoid arthritis, Graves disease, Hashimoto thyroiditis, lupus, scleroderma, systemic vasculitis, hemolytic anemia, immune mediated thrombocytopenia, Crohn disease, ulcerative colitis, and psoriasis).
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  • Unresolved toxicities from prior anticancer therapy, defined as having not resolved to Grade 0 or 1 (using National Cancer Institute Common Terminology Criteria for Adverse Events [NCI CTCAE] version 5.0), except for alopecia and laboratory values listed in the inclusion criteria.
  • A history of other malignancies (except non-melanoma skin carcinoma, carcinoma in situ of the uterine cervix, follicular or papillary thyroid cancer) within 5 years.
  • Patient with any known uncontrolled comorbid illness including ongoing or active infections, symptomatic congestive heart failure (NYHA>2), unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Treatment with any of the following therapies within 4 weeks prior to the first dose of OBI-833/OBI-821:
  • Anti-cancer therapies, including chemotherapy and targeted therapy (except the GemCis regimen).
  • Radiotherapy.
  • Immunotherapy, including monoclonal antibodies, cytokines, interferons, and checkpoint inhibitors.
  • Immunosuppressants, including cyclosporin, rapamycin, tacrolimus, rituximab, alemtuzumab, natalizumab, and cyclophosphamide.
  • Other biologics, including G-CSF and other hematopoietic growth factors.
  • Live attenuated vaccines.
  • IV/oral steroids except single prophylactic use in CT/MRI scan or other one-time use in approved indications. Use of inhaled and topical (except on the injection site) steroids is allowed.
  • Alternative and complementary medicine that may affect the immune system.
  • Other investigational drugs.
  • Patient with any known severe allergies (e.g., anaphylaxis) to any active or inactive ingredients in the study drugs.
  • Any other reason that the investigator deems the patient to be unsuitable for the study.

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Chun-Nan Yeh, MD contact

886-33281200

yehchunnan@gmail.com

Wen-Kuan Huang, PhD contact

886-33281200

Taiwan2 sites
  • Chang Gung Memorial Hospital Linkou Branch

    Taoyuan, 333

  • Chang-Gung Memorial Hospital, Linkou Branch

    Taoyuan

Other trials in Taiwan

About this study

Official title: A Single-Arm, Phase 2 Study to Evaluate OBI-833/OBI-821 Maintenance Therapy in Patients With Globo H-Positive Advanced Biliary Tract Cancer Not Progresseding Under First-Line Gemcitabine and Cisplatin

A Phase 2 clinical trial protocol for evaluating the efficacy and safety of OBI-833/OBI-821, a carbohydrate-conjugate vaccine combined with an immune adjuvant, as maintenance therapy in combination with first-line gemcitabine and cisplatin chemotherapy for patients with Globo H-positive advanced biliary tract cancer. The study is designed as a single-arm trial with 30 patients who have achieved stable disease, partial response, or complete response after 3±1 months of initial chemotherapy. The primary endpoint is progression-free survival, with secondary endpoints including overall survival, tumor response, and safety profile. The treatment regimen involves subcutaneous injections of OBI-833/OBI-821 on a gradually decreasing frequency schedule for up to 80 weeks. The trial also includes exploratory objectives to assess immune responses and biomarkers. This study aims to address the unmet need for improved treatment options in advanced biliary tract cancer by leveraging the potential of immunotherapy targeting the Globo H antigen.

Read the detailed description

This clinical trial is a single-arm, phase 2 study evaluating OBI-833/OBI-821 as maintenance therapy in patients with Globo H-positive advanced biliary tract cancer who have not progressed on first-line gemcitabine and cisplatin chemotherapy. The study is grounded in the challenging prognosis of biliary tract cancer, including cholangiocarcinoma, which has limited treatment options. Currently, the standard first-line therapy is gemcitabine plus cisplatin, but progression-free survival remains short at around 6 months, highlighting the need for improved treatment strategies.

The investigational therapy, OBI-833, is a glycoconjugate vaccine targeting Globo H, a tumor-associated carbohydrate antigen expressed in many epithelial cancers. It is used in combination with OBI-821, an adjuvant designed to enhance the immune response. Previous studies have demonstrated that OBI-833/OBI-821 can elicit immune responses and provide disease stabilization in some cancer patients. Notably, Globo H expression has been detected in about 41% of intrahepatic cholangiocarcinoma specimens, providing a rationale for investigating this approach in biliary tract cancer.

The study design involves enrolling 30 patients in a single-arm trial. Eligible patients must have Globo H-positive advanced biliary tract cancer that has not progressed after 3±1 months of first-line gemcitabine/cisplatin therapy. Patients will receive OBI-833/OBI-821 subcutaneously on a gradually decreasing frequency schedule for up to 80 weeks, while continuing their gemcitabine/cisplatin regimen. The primary endpoint of the study is progression-free survival, with secondary endpoints including overall survival, tumor response, safety, and correlations between Globo H expression/antibodies and survival outcomes.

To ensure safety, the study incorporates a lead-in safety cohort of 6 patients before proceeding to full enrollment. Following the treatment period, patients will be followed for survival for up to 12 months after the end of treatment. This single-arm design allows for an efficient assessment of efficacy signals that could inform potential further development of this therapeutic approach.

The overall aim of the study is to evaluate whether adding OBI-833/OBI-821 maintenance therapy can prolong disease control in this patient population with high unmet medical need. By focusing on patients with Globo H-positive tumors who have initially responded to standard chemotherapy, the study seeks to explore a potentially targeted approach to maintaining and extending the benefits of first-line treatment in advanced biliary tract cancer.

Being tested
OBI-833/OBI-821
Keywords
Cholangiocarcinoma, Immunotherapy, Chemotherapy, Globo-H
Medical subject headings
Cholangiocarcinoma

What participants receive

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

  • OBI-833/OBI-821Drug

    Also called Globo H-CRM197

    OBI-833 is a glycoconjugate that consists of Globo H, a unique tumor-associated carbohydrate antigen (TACA), covalently linked to cross-reacting material 197 (CRM197), an inactive and nontoxic form of diphtheria toxin (DT) acting as the carrier protein.

    OBI-821 is a saponin-based adjuvant derived from the bark of the Quillaja saponaria Molina tree. It is a purified saponin adjuvant structurally similar to adjuvant QS-21. The OBI-833/OBI-821 combination represents a carbohydrate-conjugate vaccine combined with an immune adjuvant, intended to serve as an active cancer immunotherapy.

Study groups in NCT06490198
Study groupRoleWhat they receive
Globo-HExperimentalOBI-833, 30 μg/ OBI-821 100 μg, Subcutaneous injection at Weeks 1, 2, 3, 4, 6, 8, 12, 16, 20, 24, 32, 40, 48, 56, 64, 72, and 80 weeks
Receives: Drug: OBI-833/OBI-821

What is being measured

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

  1. Progression-free survival

    The time from start of treatment until disease progression or death from any cause

    Measured: 12 to 18 months of subject recruitment, 80 weeks of OBI-833/OBI-821 treatment, and another 1 year for overall survival follow-up.

Secondary outcomes (4)
  1. Overall survival

    The time from start of treatment until death from any cause

    Measured: 12 to 18 months of subject recruitment, 80 weeks of OBI-833/OBI-821 treatment, and another 1 year for overall survival follow-up.

  2. Best overall tumor response

    by RECIST 1.1 criteria

    Measured: 12 to 18 months of subject recruitment, 80 weeks of OBI-833/OBI-821 treatment, and another 1 year for overall survival follow-up.

  3. Adverse events

    Incidences of adverse events and serious adverse events, Local injection site reaction, Changes in laboratory tests, including hematology and serum chemistry, Changes in vital signs, Changes in physical examination

    Measured: 12 to 18 months of subject recruitment, 80 weeks of OBI-833/OBI-821 treatment, and another 1 year for overall survival follow-up.

  4. Correlation between anti-Globo H IgM and IgG concentrations and survival

    biomarker response and survival correlation analysis

    Measured: 12 to 18 months of subject recruitment, 80 weeks of OBI-833/OBI-821 treatment, and another 1 year for overall survival follow-up.

Timeline

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

  1. First posted8 Jul 2024
  2. Study start31 Jul 2024 (estimated)
  3. Primary completion31 Jul 2026 (estimated)
  4. Study completion31 Jul 2027 (estimated)

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
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06490198
Sponsor's protocol ID
202400601A0C601
Status last verified
Jun 2024
First submitted
30 Jun 2024
Last updated
8 Jul 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing OBI-833/OBI-821 in people with Cholangiocarcinoma and Chemotherapy Effect, run by Chang Gung Memorial Hospital at 2 sites in Taiwan.

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 13 inclusion and 21 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: opening soon, as of the sponsor's last update on 8 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Taiwan. 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 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.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Chun-Nan Yeh, MD (886-33281200, yehchunnan@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression-free survival (time frame: 12 to 18 months of subject recruitment, 80 weeks of OBI-833/OBI-821 treatment, and another 1 year for overall survival follow-up.). 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 8 Jul 2024.

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