Overview
This phase studies the engineered red blood cells with PD-1 inhibitor pembrolizumab（WTX212）, the natural biological metabolic function of red blood cells can make the carried pembrolizumab directionally distributed in the spleen tissue and activitate T cells, suggesting that this product may solve the problem that PD-1 treatment failure.
Description
The present study has 2 parts. The dose increasing stage is carried out according to the "3+3" increasing principle. A total of 3 dose groups are preset (calculated by the number of red blood cells of the pabolizumab loaded), which are respectively 20 × e10、60 × e10 and 100 × e10。 Subjects with IO resistant advanced solid tumor and recurrent refractory lymphoma were studied. After the subjects passed the screening, blood was taken to prepare the engineered red blood cell WTX212, and the test drug was administered once every 21 days. Subjects completed the collection of PK, PD, biomarkers and immunogenicity samples during the observation period of dose limiting toxicity (DLT) (within 21 days after the first administration) and the continuous treatment period. After the end of DLT period of the first subject in each dose group, the second subject can be accepted. The subject continues to receive treatment until the subject suffers from intolerable toxicity, or withdraws informed consent, or disease progression, or solid tumor subjects up to 12 months after the first administration (lymphoma subjects can complete up to 6 administration cycles), or the end of the study, or the investigator comprehensively decides to withdraw and start new anti-tumor treatment according to the benefit of the subject, whichever occurs first.
Eligibility
Inclusion Criteria:
- 1.Histologically- or cytologically-proven advanced malignancies;
- 2.Male or female, 18 years of age or older but no more than 75 at the time of signing informed consent;
- 3.Dose escalation stage: (1) patients with advanced solid tumors who have received at least 2 regimens, and PDx monotherapy or combination therapy is included in the last regimen ; or patients received 1st regimen or above who cannot tolerate standard therapy but PDx monotherapy or combination therapy should be included in the last regimen.(2)Patients with relapsed and refractory malignant lymphomas (including: classic Hodgkin lymphoma (cHL), primary mediastinal large B-cell lymphoma PMBCL , Extranodal NK/T-cell lymphoma ENKTCL, mycosis fungoides/Sezari syndrome MF/SS) , or patients have no standard therapy, or are unable to receive standard therapy, PDx monotherapy or combination therapy is used in the last regimen.(3)The above patients should experience secondary resistance to immunotherapy , all patients did not receive systemic therapy after disease progression and the time of disease progression cannot exceed 3 months, radiotherapy was acceptable (definition of secondary resistance: achieved disease control (including CR/PR/ SD), but then disease progression after PDx therapy);
- 4.Dose expansion stage:(1)patients with advanced solid tumors who have received at least 1 regimen or these is no standard systematic therapy or patients can not recieve standard therapy, but PDx monotherapy or combination therapy should be included in the last regimen.(2)patients with relapsed and refractory malignant lymphomas who have no standard therapy or can not receive standard therapy, but PDx monotherapy or combination therapy should be included in the last regimen.(3)The above patients should experience secondary resistance to immunotherapy , all patients did not receive systemic therapy after disease progression and the time of disease progression cannot exceed 3 months, radiotherapy was acceptable (definition of secondary resistance: achieved disease control (including CR/PR/ SD), but then disease progression after PDx therapy);
- 5.Solid tumor：at least one lesion that is measurable according to RECIST 1.1;lymphomas:at least one visble or evaluable lesion that is measurable according to Lugano2014;
- 6.Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1;
- 7.Take the shorter one as the washout period before experimental treatment (28 days after the last tumor treatment, or 5 half lives);
- 8.Resolution of all acute reversible toxic effects of prior therapy or surgical procedure to baseline or Grade ≤1 (except alopecia and peripheral neurotoxicity);
- 9.Adequate organ function;
- 10.Estimated life expectancy of ≥12 weeks;
- 11.Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF).
Exclusion Criteria:
- 1.Any active or recently diagnosed clear or suspected autoimmune disorder disease;
- 2. Other serious medical diseases, including but not limited to: uncontrolled diabetes, active peptic ulcer, liver cirrhosis, active bleeding, etc., and those with uncontrolled or serious cardiovascular disease, such as the NYHA II or higher heart failure, unstable angina, myocardial infarction and other cardiovascular disease within 6 months before first administration, and uncontrolled hypertension (systolic blood pressure ≥ 180 mmHg and/or diastolic blood pressure ≥ 100 mmHg);
- 3.Has known active Hepatitis B or Hepatitis C or HIV;
- 4.Active brain metastases and/or cancerous meningitis;
- 5.Known history of any diseases affecting the quality and stability of erythropoiesis;
- 6.The spleen has been removed or, as judged by the investigator, a splenectomy may be planned during the trial;
- 7.Received at least one alive virus vaccination within 6 months before the first dose (except for the COVID-19 inactivated vaccine);
- 8.Known history of pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, radiation pneumonia, drug-related pneumonia, severely impaired lung function, etc.