About this trial
In recent years, there is increasing interest in antibodies for imaging, antibody-drug conjugates (ADC) and targeted radionuclide therapy (TRT). With these techniques, antibodies are used as a vector to deliver a cytotoxic drug or radionuclide for therapy or nuclear medicine imaging. One such antibody-based vector suitable for delivering a cytotoxic drug or radionuclide is trastuzumab, which targets HER2 that is overexpressed in cancers such as breast, gastric and gastroesophageal junction carcinomas. Unfortunately, antibodies generally have a very long circulation time (\>20-30 days) that often result in unfavorable background noise in the healthy organs in imaging or toxicity when trastuzumab is bound to a therapeutic radionuclide for radioimmunotherapy. There is thus a need to increase the speed of excretion of antibodies or release the antibody from its payload. Ideally, the clinician would like to appropriately time the elimination of radioactivity to achieve an optimal tumor to non-tumor ratio. To this aim, Tagworks Pharmaceuticals developed a new class of chemically cleavable radiolabeled conjugates that release the radiolabel on demand upon reaction with a small molecule "the trigger" (TRG001).
Eligibility criteria
Qualifiers
Signed, written informed consent and willing and able to comply with study requirements.
Male or Female aged ≥ 18 years.
Histologically confirmed HER2-positive cancer (IHC 3+ or IHC 2+ AND FISH+) with at least 1 measurable target lesion of at least 10 mm on CT or MRI based on RECIST v1.1, assessed by the investigator to enable adequate SPECT/CT imaging.
WHO performance status (ECOG) of 0 or 1.
Disqualifiers
Medical history of myocardial infarction within 6 months before participation or symptomatic CHF (New York Heart Association Class III to IV).
QT interval corrected by Fridericia's formula (QTcF) ≥ 470 msec on screening ECG or congenital long QT syndrome.
Has a history of (non-infectious) ILD/pneumonitis that required steroids or has current or suspected ILD/pneumonitis.
Lung-specific intercurrent clinically significant illnesses including, but not limited to, any underlying pulmonary disorder (e.g, pulmonary embolism within 3 months of trial participation, severe asthma, severe chronic obstructive pulmonary disease, restrictive lung disease, pleural effusion, etc.).
Trial design
Treatments tested in this trial
- [111In]In-DOTA-TCO-trastuzumab
- Small molecule tetrazine trigger component
Treatment groups
Sponsors and collaborators
Radboud University Medical Center
Lead sponsor
Tagworks Pharmaceuticals BV
Collaborator