An armored GPC3-directed CAR-T for refractory or relapsed hepatocellular carcinoma in China: A phase I trial.

Authors

null

Zhongwei Zhao

Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Affiliated Lishui Hospital of Zhejiang University/the Fifth Affiliated Hospital of Wenzhou Medical University /The Central Hospital of Zhejiang Lishui, Lishui, China

Zhongwei Zhao , Wenyuan Guo , Shiji Fang , Shaohua Song , Jingjing Song , Fei Teng , Liyun Zheng , Jianting Mao , Hao Guo , Wang Huajing , Xiaofeng Feng , xiaowen he , Guoshan Ding , Jiansong Ji

Organizations

Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Affiliated Lishui Hospital of Zhejiang University/the Fifth Affiliated Hospital of Wenzhou Medical University /The Central Hospital of Zhejiang Lishui, Lishui, China, Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China, Department of Radiology, Affiliated Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, The Central Hospital of Zhejiang Lishui, Lishui, China, Interventional Department of Lishui Central Hospital, the Fifth Affiliated Hospital of Wenzhou Medical University, the Southern Research Institute of Imaging, Zhejiang Province, Lishui, China, Shanghai Origincell Therapeutics Co., Ltd., Shanghai, China, Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), Shanghai, China

Research Funding

Pharmaceutical/Biotech Company
Shanghai Origincell Therapeutics Co., Ltd. Shanghai, 201210, China

Background: HCC is a leading cause of cancer-related morbidity and mortality worldwide, of which glypican 3 is a highly specific marker. GPC3-directed CAR-T had shown promising safety but limited efficacy in the treatment of HCC. We developed an armored GPC3-directed CAR-T G3-CAR-ori2 by inserting of a novel and proprietary Ori2 element following the 4-1BB and CD3ζ domains in a second-generation CAR-T. Pre-clinical studies showed a significantly higher memory stem cell ratio and dramatically improved proliferation and persistence, compared with traditional CAR-T, thus offering prolonged efficacy in vitro and in vivo and potentiality leading to improved activity in the clinical setting (ChiCTR1900028121). Methods: This is an open-label, dose-escalation study of G3-CAR-ori2 cell HCC patients in two centers. Eligible patients were aged 18-70 years with histologically confirmed GPC3+ HCC, Child-Pugh score A or B, ECOG≤1, relapsed or refractory to standard therapies. Patients were pre-conditioned with fludarabine (25̃30 mg/m2) and cyclophosphamide (200̃300 mg/m2) daily for 3 days. G3-CAR-Ori2 was administered as a single infusion via intrahepatic or intravenous route with a total dose of 0.9 to 3x10e8 CAR-T. The objective was to assess the safety, preliminary efficacy, persistence and cytokine profiling of G3-CAR-ori2. Adverse events were graded using the Common Terminology Criteria for Adverse Events (version 5.0). Tumor responses were evaluated per RECIST (version 1.1). CAR-T cell expansion and persistence were measured by qPCR and flow cytometry. Results: As of Jan 21, 2021, 10 patients had received single infusion, in which 6 received G3-CAR-ori2 via intravenous route and 4 via intrahepatic route. 7 patients received the highest dose level of 3x10e8. 9 patients reached at least 1 month of follow-up and tolerated the treatment well with no dose-limiting toxicity. All patients experienced transient grade 4 decrease in lymphocyte count resulted from the lymphodepletion regimen. Cytokine release syndrome (CRS) was observed in 8 patients, in which 6 at grade 1 or 2 and 2 at grade 4 notably infused with 3 x10e8 both via intravenous route and reversed within 7 days by administering high-dose steroids and tocilizumab. Other grade 4 hematologic toxicities include thrombocytopenia (2/9) and neutropenia (1/9). No neurotoxicity was observed. Two subjects were not evaluable due to early withdrawal from the trial. Among the 7 evaluable subjects, the best responses achieved are 3 PR, 2 SD, 2 PD. The duration of remission of one patient with PR is more than 4 months, follow up is ongoing. CAR-T gene detected by q-PCR provide preliminary indication that G3-CAR-ori2 is able to expand and persist well in the clinical setting. Conclusions: These initial data provide evidence that G3-CAR-ori2 is safe and holds promising antitumor potential, and supports its continuing development in the treatment of r/r GPC3+HCC. Clinical trial information: ChiCTR1900028121.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Hepatobiliary Cancer

Clinical Trial Registration Number

ChiCTR1900028121

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 4095)

DOI

10.1200/JCO.2021.39.15_suppl.4095

Abstract #

4095

Poster Bd #

Online Only

Abstract Disclosures