TCR-T cells armored with immune checkpoint blockade in EBV-positive nasopharyngeal carcinoma: The first-in-human phase 1/2 trial.

Authors

null

Qingzhu Jia

Institute of Cancer, Xinqiao Hospital, Chongqing, China

Qingzhu Jia , Ling Peng , Gang Chen , Haiyang Wu , Dong Zeng , Tao Liu , Yunpeng Zhan , Si Li , Frank Su , Bo Zhu , Qi-Jing Li

Organizations

Institute of Cancer, Xinqiao Hospital, Chongqing, China, Guangdong TCRCure Biopharma Technology Co., Ltd, Guangzhou, China, Biomedical Analysis Center, Chongqing, China, TCRCure Biopharma Corp., Los Angeles, CA, CA, Institute of Molecular and Cell biology & Singapore Immunology Network, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore

Research Funding

Pharmaceutical/Biotech Company
Guangdong TCRCure Biopharma Technology Co., Ltd, Guangzhou, China

Background: Nasopharyngeal carcinoma (NPC) refraction and metastasis is common, but therapeutics are limited. As adoptive immunotherapy has emerged as effective against other cancers, engineered T cells bearing a transgenic Epstein-Barr virus (EBV)-specific TCR (TCR-T) represent a viable approach to treat EBV-associated NPC. Given PD-1/PD-L1 induced T cell hypofunction, we herein report preliminary findings of a phase I trial of EBV-targeting TCR-T cells armored with secreted PD-1 blockade for patients who failed in two or more lines of standard therapies. Methods: Patients with advanced NPCs were consented and screened for EBV serotype and HLA haplotype. EBV+/HLA-A*02+ patients were enrolled in a rapid titration setting to escalate the single infusion dose from 5x106 to 1.0x107 and 5.0x107 /kg TCR-T cells. After safety evaluation, the 5.0X107 /kg cohort was expanded for further investigation of combining with IL-2 administration. Fludarabine/cyclophosphamide were administered prior to TCR-T cell transfer as pre-conditioning. Patient monitoring and peripheral blood analysis occurred weekly over the first month and then monthly until disease progression or patient withdrawal. The primary objective was to determine safety and a recommended phase 2 dose (RP2D), while the secondary objective was investigator assessed ORR (RECIST v1.1). Results: One patient per TCR-T dose was treated, and, as no dose-limiting toxicity (DLT) has been observed, dose level 3 (5.0x107 /kg) was expanded with IL-2 administration upon TCR-T cell infusion. As of January 2023, six patients have been treated. One patient (16.7%) exhibited grade 1 CRS (n=6). No grade 4 treatment-related adverse events (TRAEs) have been observed, with leukopenia and fever being the most common AEs. Two patients (33.3%) were assessed as partial response (PR), with one reaching a response duration of 9 months to date. Three patients (50%) were assessed as stable disease (SD). For all patients, pharmacokinetic analysis revealed that levels of TCR-T cells in peripheral blood peak between 3- and 14-days post-infusion, with a maximum duration of 180 days. Conclusions: EBV-targeting TCR-T cells armored with PD-1 blockade are well tolerated. Initial results from this ongoing study indicate that EBV proteins may be safe and effective TCR-T targets to achieve superior outcomes in advanced EBV-positive NPC patients. Clinical trial information: NCT04139057.

Clinical adverse events and efficacy (5.0x107 /kg TCR-T cells, n=6).

Treatment-Related Adverse Events (TRAEs)Efficacy
All gradesGrade 3Grade 4
Leukopenia6 (100%)2 (33.3%)0Complete response (CR)0 (0)
Fever5 (83.3%)2 (33.3%)0Partial response (PR)2 (33.3%)
Chills3 (50%)00Stable disease (SD)3 (50%)
Anemia4 (66.7%)00Progressive disease (PD)1 (16.7%)
Vomiting2 (33.3%)00Disease control rate (DCR)6 (100%)
Hypoalbuminemia3 (50%)00
Hypokalemia1 (16.7%)00
Hyponatremia2 (33.3%)00

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Head and Neck Cancer

Track

Head and Neck Cancer

Sub Track

Advanced/Metastatic Disease

Clinical Trial Registration Number

NCT04139057

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 6047)

DOI

10.1200/JCO.2023.41.16_suppl.6047

Abstract #

6047

Poster Bd #

39

Abstract Disclosures