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652 A phase 1 dose escalation study of GCC19CART a novel CoupledCAR® therapy for subjects with metastatic colorectal cancer
  1. Naifei Chen1,
  2. Chengfei Pu2,
  3. Lingling Zhao1,
  4. Ning Li3,
  5. Chang Wang1,
  6. Yusheng Huang4,
  7. Suxia Luo3,
  8. Xun Li5,
  9. Zhenzhou Yang4,
  10. Jun Bie6,
  11. Ruihong Zhu2,
  12. Xi Huang2,
  13. Haiyang Tang2,
  14. Tingting Liang1,
  15. Yizhuo Wang1,
  16. Beibei Jia2,
  17. Dongqi Chen2,
  18. Eugene Kennedy2,
  19. Zhao Wu2,
  20. Yongping Song3,
  21. Lei Xiao2,
  22. Jiuwei Cui1,
  23. Lei Xiao2 and
  24. Victor Lu2
  1. 1The First Bethune Hospital of JLU, Changchun, China
  2. 2Innovative Cellular Therapeutics, Shanghai, China
  3. 3Henan Cancer Hospital, Zhengzhou, China
  4. 4The Second Affiliated Hospital of CQMU, Chongqing, China
  5. 5The First Hospital of Lanzhou University, Lanzhou, China
  6. 6Nanchong Central Hospital, Nanchong, China


Background Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable clinical efficacy in hematologic malignancies but limited success in solid tumors. GCC19CART, the first clinical candidate from the CoupledCAR® solid tumor platform, is designed to overcome the limitations of conventional CAR T-cells in solid tumor malignancies by pairing solid tumor CAR T-cells with CD19 targeting CAR T-cells to amplify proliferation and activation of the solid tumor CAR T component. GCC19CART targets guanylate cyclase-C (GCC) which is expressed in the metastatic lesions of 70%-80% of subjects with colorectal cancers. A Phase 1 investigator-initiated clinical trial is underway in China for patients with relapsed or refractory metastatic colorectal cancer who have received at least 2 prior lines of therapy. Based on a data cutoff on December 13, 2021, 21 subjects have been enrolled in 2 dose escalation groups at 5 hospitals in China.

Methods Subjects are screened for GCC expression by immunohistochemistry. Eligible subjects undergo leukapheresis, a single dose of lymphodepleting chemotherapy (fludarabine 30mg/m2 and cyclophosphamide 300mg/m2) 3 days prior to infusion, and then administration of a single infusion of GCC19CART at one of two preassigned doses: 1x106 or 2x106 CAR T-cells/kg. Endpoints are safety and preliminary evidence of efficacy as determined by CT or PET/CT per RECIST 1.1 or PERCIST 1.0. All responses were confirmed by an independent third-party imaging contract research organization (CRO).

Results 13 subjects have been enrolled to dose level 1 (1x106 cells/kg) and 8 subjects have been enrolled to dose level 2 (2x106 cells/kg). The most common adverse events were cytokine release syndrome (CRS) in 21/21 subjects (Grade 1 19/21 (90.48%) or Grade 2 2/21 (9.52%)) and diarrhea in 21/21 subjects (Grade 1 6/21 (28.57%) Grade 2 5/21 (23.81%) Grade 3 9/21 (42.86%) or Grade 4 1/21 (4.76%)). Neurotoxicity was observed in 2/21 (9.52%) subjects at Grade 3 or 4 and resolved with corticosteroids. The combined overall response rate (ORR) for both dose levels was 28.6% (6/21). For dose level 1, the overall response rate (ORR) per RECIST 1.1 was 15.4% (2/13). Two subjects demonstrated a partial response (PR) while 3 additional subjects had partial metabolic response (PMR) on PET/CT with stable disease (SD) or progressive disease (PD) per RECIST 1.1. For dose level 2, The ORR per RECIST 1.1 was 50% (4/8). 4 subjects demonstrated a PR (3 at month 1, 1 at month 3 after being SD at month 1) and 2 additional subjects had PMR on PET/CT with SD per RECIST 1.1.

Conclusions GCC19CART demonstrated meaningful dose dependent clinical activity and an acceptable safety profile in relapsed or refractory metastatic colorectal cancer. This trial is ongoing and updated data will be presented. A United States based Phase 1 trial of GCC19CART is anticipated for mid-2022.

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