On January 24, 2023 Carina Biotech Pty Ltd ("Carina," "the Company"), a cell therapy immuno-oncology company developing CAR-T and other adoptive cell therapies for the treatment of solid cancers, reported that it has received the "safe to proceed" letter from the U.S. FDA for its Investigational New Drug (NDA) application to conduct a first-in-human Phase 1/2a clinical trial of CNA3103, its LGR5-targeted chimeric antigen receptor T cell (CAR-T) therapy candidate, in patients with advanced colorectal cancer (CRC) (Press release, Carina Biotech, JAN 24, 2023, View Source [SID1234629093]).
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The Phase 1/2a clinical trial will enroll a total of 44 patients with metastatic disease failing prior lines of chemotherapy and who express LGR5 on their cancer cells. Twenty-four patients in the Phase 1 segment will be enrolled in select Australian centers. Following a BOIN (Bayesian Optimal Interval) design, ascending CAR-T cell doses will be administered to cohorts of three patients each, to assess the safety and tolerability of CNA3103, and to determine its optimal dose. The subsequent Phase 2 segment will enroll 20 patients at the optimal dose, in both Australia and the U.S., to characterize the activity of CNA3103, in terms of antitumor response, duration of response and time to disease progression.
"Our positive engagement with the FDA marks a major step forward for Carina and our continued efforts to develop CNA3103 as a potential treatment for the third most common cancer in the U.S. and worldwide, colorectal cancer," said Deborah Rathjen, Carina’s Chief Executive Officer. "The FDA’s letter provides the pathway for this clinical trial and further validates that a significant unmet need exists for more effective treatment options for colorectal cancer. Preparations, including site selection, are underway as we aim to commence enrolling patients during the first half of 2023."
"This interaction with the FDA corroborates our ability to gain the agency’s support for our proposed trial of CNA3103 in metastatic colorectal cancer patients," said José Iglesias, MD, Carina’s Chief Medical Officer. "Our approach is doubly innovative, in being one of the of emergent CAR-T treatment protocols in solid tumors and in utilizing a novel, and to our knowledge, unique CAR-T construct against LGR5 – an important cancer stem cell-associated antigen linked to the pathogenesis, dissemination, and treatment resistance of colorectal cancer."
About CNA3103
Carina’s proprietary CNA3103 CAR-T cell targets LGR5, a cancer stem cell marker that is highly expressed on advanced colorectal cancer and some other cancers. In colorectal cancer patients, LGR5 expression has been correlated with poor prognosis. Cancer stem cells are a small sub-population of cells within a tumor with the ability to self-renew, differentiate into the many cell types of a tumor, initiate new tumors, and resist chemotherapy and radiotherapy (leading to relapses). By targeting cancer stem cells, it is hoped that this therapy will reduce the tumor’s ability to generate new cancer cells, resulting in durable tumor suppression and preventing the relapses that are very common in patients with colorectal cancer. Carina’s pre-clinical studies of CNA3103 have shown promising results with complete tumor regression and no tumor recurrence following a single administration. CNA3103 has also demonstrated impressive tumor access and prolonged survival, enabling rejection of new tumors.