Dual-target CLDN18.2/HER2 CAR-NK Cells for Advanced Gastric/GEJ Cancer

NCT07551362 | Recruiting Phase 1 DMC

• 1 other identifier: ESSEN-DUET-GEJ-117
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

This example planning study proposes a phase 1/2 evaluation of an allogeneic, cord-blood-derived dual-target CAR-NK product directed against CLDN18.2 and HER2 (ERBB2) in adults with unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma after prior standard systemic therapy. CLDN18.2 is selected as the anchor antigen because it has the more disease-specific gastric/GEJ cell-therapy development footprint, while HER2 is retained as the complementary second antigen to address co-expressing or heterogeneous disease. Phase 1 uses a 3+3 dose-escalation design after fludarabine/cyclophosphamide lymphodepletion followed by three intravenous CAR-NK infusions on Days 0, 3, and 7. Phase 2 expansion evaluates the recommended phase 2 dose and preliminary antitumor activity

Conditions

Advanced Gastric Adenocarcinoma; Advanced Gastroesophageal Junction Adenocarcinoma

Keywords

Solid tumor immunotherapy; Gastric cancer; GEJ cancer; Adoptive cellular immunotherapy; CAR-NK; Allogeneic NK cell therapy; CLDN18.2; HER2; ERBB2

Outcome Measures

Primary Outcomes (3)

• Incidence of dose-limiting toxicities (DLTs)

  DLTs graded by CTCAE v5.0, with CRS and ICANS graded using ASTCT criteria.

  28 days

• Determination of MTD

  Dose-escalation decision based on DLT frequency and overall tolerability across planned cohorts.

  6 months

• Objective response rate (ORR)

  Confirmed complete response plus partial response according to RECIST v1.1 in evaluable subjects in the expansion cohort.

  12 months

Secondary Outcomes (2)

• Progression-free survival (PFS)

  12 months

• Overall survival (OS)

  24 months

Study Arms (2)

Dose Escalation Cohort

EXPERIMENTAL

Participants receive fludarabine and cyclophosphamide lymphodepletion on Days -5 to -3, followed by EB-DT-CAR-NK infusions on Days 0, 3, and 7. Three planned dose levels are explored using a 3+3 design.

Biological: EB-DT-CAR-NK; Drug: Fludarabine; Drug: Cyclophosphamide

Dose Expansion Cohort

EXPERIMENTAL

Participants receive the recommended phase 2 dose (RP2D) on the same lymphodepletion and infusion schedule. Expansion is centered on CLDN18.2-positive gastric/GEJ adenocarcinoma, with HER2 status captured for exploratory subgroup analysis.

Biological: EB-DT-CAR-NK; Drug: Fludarabine; Drug: Cyclophosphamide

Interventions

EB-DT-CAR-NK BIOLOGICAL

Allogeneic, cord-blood-derived CAR-NK cells engineered to target CLDN18.2 and HER2 (ERBB2). Planned phase 1 dose levels: 2 x 10\^6, 4 x 10\^6, and 8 x 10\^6 cells/kg/infusion. Administered intravenously on Days 0, 3, and 7.

Dose Escalation Cohort; Dose Expansion Cohort

Fludarabine DRUG

Lymphodepleting chemotherapy administered intravenously at 30 mg/m\^2/day on Days -5 to -3.

Also known as: FC lymphodepletion regimen

Dose Escalation Cohort; Dose Expansion Cohort

Cyclophosphamide DRUG

Lymphodepleting chemotherapy administered intravenously at 500 mg/m\^2/day on Days -5 to -3.

Also known as: FC lymphodepletion regimen

Dose Escalation Cohort; Dose Expansion Cohort

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Signed informed consent before any study-specific procedure.
• Age 18 to 75 years.
• Histologically confirmed unresectable locally advanced or metastatic gastric adenocarcinoma or gastroesophageal junction adenocarcinoma.
• Central confirmation of CLDN18.2-positive disease by immunohistochemistry, defined for this draft as membranous CLDN18.2 expression in at least 10% of tumor cells. HER2 testing is required for all subjects; HER2-positive disease is defined as IHC 3+ or IHC 2+/ISH+ using gastric/GEJ testing criteria.
• Disease progression after at least 2 prior systemic regimens for advanced disease, including a fluoropyrimidine and platinum agent unless contraindicated or not tolerated. If HER2-positive, prior HER2-directed therapy is expected unless unavailable, contraindicated, or not tolerated.
• At least 1 measurable lesion according to RECIST v1.1.
• ECOG performance status 0 or 1.
• Life expectancy of at least 12 weeks.
• Adequate hematologic, renal, hepatic, pulmonary, and cardiac function.
• Recovery of prior treatment-related toxicities to Grade 1 or baseline, except alopecia or stable endocrine replacement therapy.
• Willingness to provide archival tumor tissue or fresh biopsy material if archival tissue is inadequate for central biomarker confirmation.
• Negative pregnancy test for women of childbearing potential and agreement to use effective contraception during the protocol-defined period

You may not qualify if:

• Prior CLDN18.2-targeted or HER2-targeted genetically modified cell therapy (CAR-T, CAR-NK, TCR-T, or similar).
• Active or untreated central nervous system metastases or leptomeningeal disease.
• Active uncontrolled infection, including uncontrolled HBV, HCV, or HIV viremia.
• Active autoimmune disease requiring systemic immunosuppression.
• Clinically significant uncontrolled cardiovascular disease, including recent myocardial infarction, unstable angina, uncontrolled arrhythmia, or severe heart failure.
• Active gastrointestinal perforation, uncontrolled upper GI bleeding, clinically significant bowel obstruction, or unstable gastric ulcer.
• History of solid-organ transplantation or prior allogeneic hematopoietic stem-cell transplantation with active graft-versus-host disease.
• Requirement for systemic corticosteroids above physiologic replacement (for example, \>10 mg/day prednisone equivalent) within 7 days before lymphodepletion.
• Pregnancy or breastfeeding.
• Another active malignancy requiring systemic therapy, except for adequately treated non-melanoma skin cancer, carcinoma in situ, or other protocol-allowed low-risk malignancies.
• Any medical, psychiatric, or social condition that, in the investigator's judgment, would make study participation unsafe or would interfere with interpretation of study results.

Sponsors & Collaborators

• Beijing Biotech: lead

Study Sites (1)

Peking University Shenzhen Hospital

Shenzhen, Guangdong, 518036, China

RECRUITING

MeSH Terms

Conditions

Stomach Neoplasms

Interventions

fludarabine; Cyclophosphamide

Condition Hierarchy (Ancestors)

Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases

Intervention Hierarchy (Ancestors)

Phosphoramide Mustards; Nitrogen Mustard Compounds; Mustard Compounds; Hydrocarbons, Halogenated; Hydrocarbons; Organic Chemicals; Phosphoramides; Organophosphorus Compounds

Central Study Contacts

shan S Lu, Phd

CONTACT

+86 13076790030; Seni-Lu@beijing-biotech.com

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Masking Details: No masking is planned. Investigators, site staff, and participants will know cohort assignment because all enrolled patients receive the active cellular product and are assigned according to dose level or expansion stage.
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Model Details: Phase 1 will use a non-randomized 3+3 dose-escalation design with three planned dose levels of the dual-target CAR-NK product after fludarabine/cyclophosphamide lymphodepletion. Phase 2 will enroll an expansion cohort at the recommended phase 2 dose using the same schedule. Cohort progression is sequential: dose-escalation first, then dose-expansion. All patients receive active study treatment; there is no placebo or standard-of-care control arm in this planning draft.

Study Record Dates

• First Submitted: April 18, 2026
• First Posted: April 24, 2026
• Study Start: March 2, 2026
• Primary Completion (Estimated): March 14, 2027
• Study Completion (Estimated): March 17, 2028
• Last Updated: April 24, 2026

Record last verified: 2026-04

Locations

CN (1)