Phase 1 Study With Dose Expansion of the Anti-Mesothelin TNaive/SCM hYP218 (TNhYP218) CAR T Cells in Participants With Mesothelin-Expressing Solid Tumors Including Mesothelioma

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Trial Details

Sponsor: National Cancer Institute (NCI) (federal)

Phase: 1

Start date: July 8, 2025

Planned enrollment: 100

Trial ID: NCT06885697
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More trial details at ClinicalTrials.gov More info

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Investigational Drug AI Analysis

No investigational drugs.

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Goal: The goal of this trial is to evaluate the safety, feasibility, and preliminary efficacy of TNhYP218 CAR T cells targeting mesothelin in participants with mesothelin-expressing solid tumors, including mesothelioma. The trial aims to determine the recommended phase 2 dose based on dose-limiting toxicity and assess early anti-tumor activity.

Patients: Eligible participants are adults (18 years or older) with unresectable, locally advanced, metastatic, or recurrent mesothelioma of epithelioid or biphasic histology (with >80% epithelioid component), or other solid tumors with high mesothelin expression. All must have tumors positive for mesothelin expression in ≥50% of cancer cells, measurable disease, an ECOG performance status of 0-1, and adequate organ function. Patients must have progressed after prior standard therapies.

Design: This is a non-randomized, open-label, phase 1 clinical trial with two parts: a dose escalation phase to establish the recommended phase 2 dose based on dose-limiting toxicity, followed by a dose expansion phase to assess preliminary objective response at the determined dose. Participants are closely monitored for safety and followed for up to 15 years per regulatory requirements.

Treatments: Participants undergo leukapheresis, lymphodepleting chemotherapy with fludarabine and cyclophosphamide, then receive a single infusion of autologous TNhYP218 CAR T cells. TNhYP218 CAR T cells are engineered to target a membrane-proximal epitope of mesothelin, using naive/stem cell memory (SCM) T cells to potentially enhance cell persistence, reduce exhaustion, and improve anti-tumor activity; preclinical studies have shown increased tumor killing compared to CAR T cells targeting distal epitopes. The intervention is investigational and no clinical efficacy data is yet available as this is a first-in-human study.

Outcomes: Primary endpoints are the determination of the recommended phase 2 dose (using dose-limiting toxicity) and the preliminary objective response rate in expansion cohorts. Secondary endpoints include near and long-term safety (including reporting of adverse events and replication-competent lentivirus), objective response rates at non-selected doses, progression-free survival, duration of response, overall survival, manufacturing feasibility of the cell product, and tolerability of the treatment sequence.

Burden on patient: Patient burden is high. Participants must undergo repeated invasive procedures, including tumor biopsy for mesothelin confirmation and potentially for follow-up, as well as frequent laboratory and imaging assessments. The trial involves leukapheresis, inpatient stays for lymphodepletion and CAR T cell infusion, and prolonged inpatient monitoring for acute toxicity. Long-term follow-up entails regular clinic visits, scans, and laboratory tests for up to 5 years, with annual monitoring through 15 years, consistent with gene-modified cell therapy trials. The intensity of monitoring, required hospitalizations, invasive biopsies, and long-term surveillance will significantly impact patient time and travel.

Last updated: Aug 2025

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National Institutes of Health Clinical Center

Bethesda, Maryland, 20892, United States

[email protected] / 888-624-1937

Status: Recruiting

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