Phase I/II Study of TROP2 CAR Engineered IL15-transduced Cord Blood-derived NK Cells Delivered Intraperitoneally for the Management of Platinum Resistant Ovarian Cancer, Mesonephric-like Adenocarcinoma, and Pancreatic Cancer
To find the recommended dose of TROP2- CAR-NK given intraperitoneally (directly into the abdominal cavity) to patients with highgrade serous ovarian cancer that has not responded to previous treatment or is resistant to treatment.
⁃ Subjects must be 18 years or older.
⁃ Subjects must be willing and able to provide informed consent.
⁃ Subjects must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
⁃ A female participant is eligible to participate if at least one of the following conditions applies:
• Not a woman of childbearing potential (WOCBP) as defined in Appendix 1
∙ A WOCBP who agrees to follow the contraceptive guidelines in Appendix 1 during the treatment period and for at least 3 months after the last dose of study treatment.
⁃ Subjects must have measurable disease present as defined by modified RECIST v1.1 criterion, and have disease present in the peritoneal cavity or retroperitoneal lymph nodes. Disease outside the peritoneal cavity is allowed as long as metastases are present within the peritoneal cavity or retroperitoneum.
⁃ Subject tumors must demonstrate at least 1+ TROP2 expression by immunohistochemistry.
⁃ Subjects must be at least 3 weeks from last cytotoxic chemotherapy at the time of starting lymphodepleting chemotherapy.
⁃ Subjects must be willing to undergo intraperitoneal port placement and scheduled peritoneal fluid and peripheral blood draws.
⁃ Subjects must have adequate organ function as defined in the following table (Table 1). Specimens must be collected within 10 days prior to the start of study treatment.
• Table 1. Adequate Organ Function Laboratory Values Systemic Function Test Laboratory Value Hematologic Absolute neutrophil count (ANC) ≥1500/µL Platelets ≥100,000/µL Hemoglobin ≥8.0 g/dL (transfusion is allowed)a Renal Creatinine OR Creatinine clearance (CrCl) by Cockroft-Gault
• 1.5 x ULNb
‣ 30 mL/min for participants with creatinine \> 1.5 x ULNb Hepatic Total bilirubin ≤1.5 x ULN OR direct bilirubin ≤ULN for participants with total bilirubin levels \>1.5 x ULN AST (SGOT) and ALT (SGPT) ≤2.5 x ULN (≤5 x ULN for participants with liver metastases) Coagulation International normalized ratio (INR) OR prothrombin time (PT) Activated partial thromboplastin time (aPTT) ≤1.5 x ULN unless participate is receiving anticoagulant therapy as long as PT or aPTT is within therapeutic range of intended use of anticoagulants ALT (SGPT) = alanine aminotransferase (serum glutamic pyruvic transaminase);AST (SGOT)=aspartate aminotransferase (serum glutamic oxaloacetic transaminase); GFR=glomerular filtration rate; ULN=upper limit of normal.
⁃ Criteria must be met without erythropoietin dependency and without packed red blood cell (pRBC) transfusion within last 2 weeks of the screening test. Participants may be on a stable dose of erythropoietin (≥ approximately 3 months).
• Serum creatinine and creatinine clearance (CrCl) should be interpreted and calculated per institutional standard.
⁃ Note: This table includes eligibility-defining laboratory value requirements for treatment; laboratory value requirements should be adapted according to local regulations and guidelines for the administration of specific chemotherapies.
⁃ Ovarian Cancer:
‣ Subjects must have a histology confirming diagnosis of high grade serous ovarian/peritoneal/fallopian tube cancer with pathology reviewed at MD Anderson Cancer Center.
‣ Subjects must have failed at least two prior lines of chemotherapy (i.e. frontline adjuvant chemotherapy plus one additional line for recurrent/progressive disease), or have platinumresistant disease defined as disease progression on a platinum-containing agent or recurrence within 180 days of prior dose of a platinum-containing chemotherapeutic regimen.
‣ To be eligible, germline/somatic BRCA1/2 mutation carriers should have received prior PARPi therapy.
∙ Mesonephric-like adenocarcinoma:
⁃ <!-- -->
∙ A histology confirming diagnosis of mesonephric-like adenocarcinoma (MLA) originating from the female reproductive tract or peritoneal lining (including MLA arising from endometriosis) with pathology reviewed at MD Anderson Cancer Center.
‣ Subjects must have failed at least one prior line of platinum-containing chemotherapy.
∙ Pancreatic Cancer:
⁃ <!-- -->
∙ Subjects with histologically confirmed diagnosis of pancreatic ductal adenocarcinoma or ampullary-type carcinoma
‣ Subjects who have progressive disease after receiving initial treatment with either FOLFIRINOX, and/or a gemcitabine-based therapy