Attamage-A1: Phase I/II study of autologous CD8+ and CD4+ transgenic t cells expressing high affinity MAGE-A1-specific T-cell receptor (TCR) combined with anti-PD(L)1 in patients with metastatic MAGE-A1 expressing cancer.

Authors

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Michael Thomas Schweizer

University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA

Michael Thomas Schweizer , Ted Gooley , Sylvia Lee , William R Gwin III, Monica Dherin , Megan Hickner , Jennifer Casserd , Megan McAfee , Thomas Schmitt , Cecilia CS Yeung , Vijayakrishna K. Gadi , Aude Chapuis

Organizations

University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA, Fred Hutchinson Cancer Research Center, Seattle, WA, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, Duke University, Durham, NC, University of Washington, Seattle, WA

Research Funding

Pharmaceutical/Biotech Company

Background: Adoptive cellular therapies can lead to durable responses in treatment refractory leukemias and lymphomas; however, these approaches are still in early stage development for metastatic solid tumors. FH-MagIC TCR-T is an autologous CD8+ and CD4+ T cell product transduced with a transgenic T cell receptor (TCR) targeting MAGE-A1. MAGE-A proteins are classified within the “testis restricted” cancer testis antigens and are broadly expressed in a wide range of malignancies, including urothelial carcinomas, triple negative breast cancers (TNBCs) and non-small cell lung cancers (NSCLCs). Importantly, MAGE-A1 is undetectable in most normal tissues exclusive of the immune privileged testes, thereby making MAGE-A1 an ideal target for T cell immunotherapy approaches. Of note, FH-MagIC TCR-T is specific to the Class I HLA A*02:01-restricted MAGE-A1 epitope. Based on preclinical studies testing FH-MagIC-T in MAGE-A1 expressing tumor models, we have launched a Phase I/II study evaluating this autologous transgenic TCR therapy. Methods: This is a Phase I/II study testing FH-MagIC TCR-T cells in patients with metastatic urothelial carcinoma, TNBC or NSCLC. Eligible patients must have HLA type HLA-A*02:01 and demonstrate expression of MAGE-A1 on archival tumor tissue (≥1+ by immunohistochemistry). Patients must have been offered or received: i) anti-PD(L)1 therapy; ii) enfortumab vedotin (urothelial carcinoma patients); and iii) FDA-approved targeted therapies (e.g. NSCLC patients with actionable mutations in EGFR, ROS1, etc.). For each dose level (DL) in the Phase 1 portion, 1 patient will be treated without lymphodepletion (LD). If no dose limiting toxicities (DLT) are observed, the next 3 patients will receive LD with cyclophosphamide 300mg/m2 and fludarabine 30mg/m2 IV days -4 to -2 before T cell infusion. The first 4 patients will be treated at DL1: 1 x 109 cells. If no DLTs are observed, the next 4 patients will be treated at DL2: 5 x 109 cells. Otherwise, if a DLT is observed at DL1, the next 4 patients will be treated at DL-1: 5 x 108 cells. The Phase 2 portion of the trial will test FH-MagIC-TCR T cell product at the RP2D with the addition of standard of care anti-PD(L)1 therapy. Primary objectives are to assess safety (Phase 1) and radiographic response rate (Phase 2) per RECIST v1.1. Secondary objectives will evaluate progression free survival, overall survival, persistence of transgenic T cells in peripheral blood and migration into tumor tissue. For the Phase 2 portion, we assume a 5% null response rate (H0). If the true response rate with TCR-transduced cells is 25% (H1), 15 patients will yield 84% power at a one-sided alpha =.05. Clinical trial information: NCT04639245.

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Abstract Details

Meeting

2022 ASCO Genitourinary Cancers Symposium

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session B: Urothelial Carcinoma

Track

Urothelial Carcinoma

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT04639245

Citation

J Clin Oncol 40, 2022 (suppl 6; abstr TPS592)

DOI

10.1200/JCO.2022.40.6_suppl.TPS592

Abstract #

TPS592

Poster Bd #

M9

Abstract Disclosures