NCT06149481

Brief Summary

Background: Each year, more than 32,000 people in the United States are diagnosed with colorectal cancer that has returned or progressed after treatment and spread to other organs. This is called metastatic colorectal cancer (mCRC). Most people with mCRC survive only about 2 years. Objective: To test the ability of a combination of up to 4 experimental anti-cancer drugs treat mCRC. The names of these drugs are retifanlimab, TriAdeno vaccine, N-803, and SX-682. They are described below. Eligibility: Adults aged 18 years or older with mCRC. Participants must have Design: Participants will be screened. This includes having a physical exam, blood tests, urine tests, and imaging tests. If signed on to the study, participants will have 2 tumor biopsies. One when starting the study and once about 8 weeks after bring on the study. Participants will receive $500 for each biopsy. Participants will be treated with either 3 or 4 drugs and will receive a detailed calendar explaining when each drug is given. Retifanlimab is given every 4 weeks through an IV (an IV is tube attached to a needle inserted into a vein in the arm). N-803 is injected under the skin on the abdomen every 4 weeks. TriAdeno vaccine is injected under the skin of the upper arm or thigh once a month for 3 doses and then once every 3 months. Some participants will also receive a 4th drug. SX-682 is a pill taken by mouth. Participants will take this drug 2 times a day at home for about 3 weeks of each month. Study treatment will continue up to 2 years. Follow-up phone calls/emails may continue for 3 more years.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
60

participants targeted

Target at P75+ for phase_1

Timeline
54mo left

Started Mar 2024

Longer than P75 for phase_1

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress32%
Mar 2024Oct 2030

First Submitted

Initial submission to the registry

November 28, 2023

Completed
1 day until next milestone

First Posted

Study publicly available on registry

November 29, 2023

Completed
4 months until next milestone

Study Start

First participant enrolled

March 26, 2024

Completed
3.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 31, 2027

Expected
3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

October 31, 2030

Last Updated

May 1, 2026

Status Verified

November 18, 2025

Enrollment Period

3.6 years

First QC Date

November 28, 2023

Last Update Submit

April 30, 2026

Conditions

Keywords

Monoclonal AntibodyBrachyuryMUC-1Immunoglobulin G cytokine fusion proteinchemokine antagonistSmall Molecule

Outcome Measures

Primary Outcomes (2)

  • Phase I: Safety profiles of the IO regimens consisting of retifanlimab, TriAdeno vaccine, N-803 (A1), and retifanlimab, TriAdeno vaccine, N-803, SX-682 (A2) in participants with metastatic colorectal cancer

    Number of DLTs within DLT period (C1 days 1-28). Any toxicities identified.

    Day 1 of Cycle 1 through 30 days after the last study drug administration

  • Phase II: Overall response rate (ORR) defined as the CR+PR of the IO regimen in mCRC

    The fraction of participants with a CR or PR (per RECIST v1.1) in Phase II will be reported along with a 95% confidence interval.

    Every 8 weeks until either disease progression or 2 years after initiation of study therapy.

Secondary Outcomes (4)

  • Progression Free Survival (PFS) at 6, 12, and 24 months

    Every 8 weeks until disease progression or for 2 years after initiation of study therapy

  • Disease control rate (DCR) at 6 and 12 months

    Every 8 weeks until disease progression or 1 year after initiation of study therapy

  • Safety during Phase II

    From Day 1 to 30 days of the last study drug administration

  • Overall survival

    Up to 2 years after start of study therapy

Study Arms (2)

Arm 1

EXPERIMENTAL

Retifanlimab + TriAdeno Vaccine + N-803

Drug: RetifanlimabBiological: Therapeutic CEA, Brachyury and MUC1 TriAdeno Vaccine PlatformDrug: N-803

Arm 2

EXPERIMENTAL

Retifanlimab + TriAdeno Vaccine + N-803 + SX-682

Drug: RetifanlimabBiological: Therapeutic CEA, Brachyury and MUC1 TriAdeno Vaccine PlatformDrug: N-803Drug: SX-682

Interventions

N-803DRUG

15 ug/kg administered via subcutaneous injection to the abdomen every 28 days

Arm 1Arm 2
SX-682DRUG

100 mg administered orally twice per day on days 6-26 of every cycle

Arm 2

500 mg infused via IV over 30 minutes every 28 days

Arm 1Arm 2

5x10\^11 virus particles per 1 mL administered via subcutaneous injection in the upper arm and anterolateral upper thigh on Day 1 of Cycles 1, 2, 3 and every 3 cycles after that

Arm 1Arm 2

Eligibility Criteria

Age18 Years - 120 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Participants with histologically confirmed colorectal cancer and evidence of metastatic disease.
  • Participants must have received, been ineligible to receive, or refused to receive two lines of standard systemic therapy i.e., a fluoropyrimidine with oxaliplatin or irinotecan with bevacizumab, regorafenib, trifluridine, and (if history of RAS wild-type) EGFR-targeted therapy. Participants must have received one line of systemic checkpoint inhibitor if history of advanced microsatellite instability-high \[MSI-H/dMMR\]) metastatic colon cancer.
  • Participants who had progressive disease within 6 months before study treatment following standard adjuvant therapy are eligible if they have not received systemic therapy for metastatic disease. Participants with a history of MSI-H/dMMR must have also received one line of checkpoint inhibitor therapy.
  • Age \>= 18 years.
  • Measurable disease per RECIST 1.1.
  • ECOG performance status \<= 2.
  • Adequate organ and marrow as a function defined below:
  • absolute neutrophil count (ANC) \>= 1,500 cells/mm\^3
  • platelet count \>= 100,000 cells/mm\^3
  • hemoglobin (Hgb) \>= 9 g/dL
  • total bilirubin level \< 1.5 x upper limit of normal (ULN)
  • alanine aminotransferase (ALT) \<= 2.5 x ULN OR \<= 5 x ULN for participants with liver metastases
  • aspartate aminotransferase (AST) level \<= 2.5 x ULN OR \<= 5 x ULN for participants with liver metastases
  • creatinine clearance (CrCl) calculated by Cockroft-Gault formula \>= 50 mL/min
  • Resolution of toxic effect(s) of prior anti-cancer therapy (except alopecia and neuropathy) to Grade \<=1 or to \<=2 if effective medical management of those toxicities is in place such that they are controlled per standard of care (e.g., grade 2 hypothyroidism requiring oral thyroid replacement).
  • +7 more criteria

You may not qualify if:

  • Participants with prior investigational drug, chemotherapy, immunotherapy, or any prior therapeutic radiotherapy within 14 days prior to study treatment initiation.
  • Participants with palliative radiotherapy performed within 7 days prior to study treatment initiation.
  • Active autoimmune disease requiring systemic immunosuppression in excess of physiologic maintenance doses of corticosteroids (\> 10 mg/day of prednisone or equivalent) with the exception of:
  • intermittent use of bronchodilators, inhaled corticosteroids, or local corticosteroid injections in participants with asthma
  • using topical, ocular, intra-articular, or intranasal corticosteroids (with minimal systemic absorption
  • brief courses of corticosteroids for prophylaxis (e.g., contrast dye allergy).
  • Evidence of interstitial lung disease, history of interstitial lung disease, or active, noninfectious pneumonitis. Participants with chronic post-radiation pulmonary changes/scarring that is asymptomatic are eligible.
  • Active infections requiring systemic antibiotics or antifungal or antiviral treatment within 8 days prior to treatment initiation. Participants who have had appropriate antibiotics initiated but are still completing the treatment course are eligible if clinically improved or had minimal symptoms at presentation (e.g., urinary tract infection or pharyngeal streptococcal infection without evidence of systemic inflammatory response).
  • History of organ transplant, including allogeneic stem cell transplantation.
  • Participants who experienced immune-related toxicity during prior checkpoint inhibitor therapy for which permanent discontinuation of therapy was recommended (per product label or consensus guidelines) or any immune-related toxicity requiring systemic corticosteroids (with the exception of endocrinopathy that is well controlled on replacement hormones).
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to the study drugs.
  • Receipt of a live vaccine within 28 days prior to treatment initiation. Note: Examples of live vaccines include but are not limited to measles, mumps, rubella, varicella-zoster (chickenpox), yellow fever, rabies, BCG, and typhoid vaccines. Seasonal influenza vaccines for injection are generally killed-virus vaccines and are allowed; however, intranasal influenza vaccines are live, attenuated vaccines and are not allowed.
  • History of infection with Hepatitis B virus (HBV) unless on suppressive therapy. Individuals with serologic evidence of a resolved prior HBV infection (i.e., HBsAgnegative and anti-HBc positive) are eligible.
  • Pregnancy confirmed with Beta-human chorionic gonadotropin (Beta-HCG) serum or urine pregnancy test performed in IOCBP at screening.
  • Uncontrolled intercurrent illness that would limit compliance with study requirements.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

National Institutes of Health Clinical Center

Bethesda, Maryland, 20892, United States

RECRUITING

Related Links

MeSH Terms

Conditions

Colorectal Neoplasms

Interventions

Brachyury ProteinALT-803

Condition Hierarchy (Ancestors)

Intestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal DiseasesRectal Diseases

Intervention Hierarchy (Ancestors)

T-Box Domain ProteinsDNA-Binding ProteinsProteinsAmino Acids, Peptides, and ProteinsTranscription Factors

Study Officials

  • Nicholas P Tschernia, M.D.

    National Cancer Institute (NCI)

    PRINCIPAL INVESTIGATOR

Central Study Contacts

NCI Referral Office

CONTACT

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
SEQUENTIAL
Sponsor Type
NIH
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 28, 2023

First Posted

November 29, 2023

Study Start

March 26, 2024

Primary Completion (Estimated)

October 31, 2027

Study Completion (Estimated)

October 31, 2030

Last Updated

May 1, 2026

Record last verified: 2025-11-18

Data Sharing

IPD Sharing
Will share

All collected IPD will be shared. All IPD recorded in the medical record will be shared with intramural investigators upon request. In addition, all large scale genomic sequencing data will be shared with subscribers to dbGaP.

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
Data from this study may be requested from other researchers within 10 years after the completion of the primary endpoint. Genomic data are available once genomic data are uploaded per protocol GDS plan for as long as database is active.
Access Criteria
Data from this study may be requested by contacting the PI. Genomic data are made available via dbGaP through requests to the data custodians.

Locations