Clinical trial Recruiting at 26 sites Phase 1 Interventional Ages 18 and up

BL-M14D1 for people with advanced small cell lung cancer and other neuroendocrine tumors.

Official title: A Phase 1 Open-Label Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of BL-M14D1 in Subjects With Locally Advanced or Metastatic Small Cell Lung Cancer and Other Neuroendocrine Neoplasms

Run by SystImmune Inc. · NCT07080242 · Data updated 2026-11-12

This trial will try BL-M14D1 in adults with locally advanced or metastatic small cell lung cancer or other high-grade neuroendocrine tumors to see if it is safe and helps control the cancer after standard treatments have failed.

More Locally Advanced Non-Small Cell Lung Cancer trials

Quick facts

PhasePhase 1
Study typeInterventional
Ages18 Years and up
SexAll
Enrollment120 (estimated)
SponsorSystImmune Inc.
Industry-sponsored
Drugs / interventionsChemotherapy, immunotherapy
Locations31 sites (Huntsville, Alabama and 30 other locations)
StatusRecruiting
StartedApril 28, 2025
Main results expectedDecember 31, 2027
Study endsDecember 31, 2027
Registry record updatedOctober 30, 2026
Trial IDNCT07080242 on ClinicalTrials.gov

Is this trial a fit for you?

Likely a good fit

Adults (≥18 years) with locally advanced or metastatic small cell lung cancer or other poorly differentiated/high-grade neuroendocrine neoplasms, who have failed at least one line of standard therapy and meet safety requirements, are the intended candidates.

Probably not a fit

Patients without DLL3 expression, those who have not yet tried standard therapies, or those with major comorbidities or prior topoisomerase inhibitor–based ADC exposure may not receive benefit from this trial.

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a Phase 1, open-label study testing BL-M14D1 in adults with locally advanced or metastatic small cell lung cancer and other neuroendocrine neoplasms. The trial focuses on safety, tolerability, pharmacokinetics, and preliminary signs of efficacy, using dose-escalation followed by dose-expansion cohorts. Eligible participants must have progressed after at least one line of standard therapy and, in some cohorts, demonstrate DLL3 expression. The study excludes prior treatment with topoisomerase inhibitor–based antibody–drug conjugates and requires regular on-site visits for dosing and monitoring at participating centers.

Why it matters

Potential benefit: If successful, BL-M14D1 could provide a new treatment option that helps control disease and potentially extend survival for patients with DLL3-expressing high-grade neuroendocrine tumors.

How similar studies have gone: Previous DLL3-targeting therapies showed early activity in similar cancers but have had mixed results and safety challenges, so this approach builds on prior work but remains unproven.

Who can join: the full rules

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Documented locally advanced or metastatic SCLC, large cell neuroendocrine cancer of the lung (LCNEC), neuroendocrine prostate cancer (NEPC), poorly differentiated gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) or other extrapulmonary neuroendocrine carcinomas (EP-NECs), Merkel cell carcinoma (MCC), or other poorly differentiated and/or high-grade neuroendocrine neoplasms with evidence of DLL3 expression who have failed at least 1 line of standard therapy in the advanced/metastatic setting or are unable to receive standard treatment

  * Notes: For SCLC, the participant must have failed at least 1 line of platinum therapy in the advanced/metastatic setting.
  * No prior topoisomerase inhibitor-based ADC therapy is permitted.
* In the dose expansion part, Cohort 6 (DLL3-Positive NEN Subgroup): participants will be eligible based on documented positive DLL3 expression.
* At least one measurable lesion based on RECIST (Response Evaluation Criteria in Solid Tumors) v1.1
* Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 to 1
* Toxicity of previous antitumor therapy has returned to Grade ≤1 as defined by National Cancer Institute (NCI) CTCAE v5.0, except for alopecia and endocrinopathies controlled by replacement therapy
* No serious cardiac dysfunction and left ventricular ejection fraction ≥50%
* Adequate organ function

Exclusion Criteria:

* Chemotherapy, biological therapy, immunotherapy, , targeted therapy (including small molecule inhibitor of tyrosine kinase), and other antitumor therapy within 4 weeks or 5 half-lives (whichever is shorter) prior to the first administration; radical radiotherapy, major surgery within 4 weeks prior to the first administration; mitomycin and nitrosoureas treatment within 6 weeks prior to the first administration; oral fluorouracil drugs such as tegafur, capecitabine, or palliative radiotherapy within 2 weeks prior to initial administration.
* Participants who have received prior topoisomerase inhibitor-based ADC therapy
* Participants with other prior or concurrent malignancies except for basal cell carcinoma of the skin, squamous cell carcinoma of the skin and/or carcinoma in situ after adequate resection, or other malignancy treated with curative intent with a disease-free interval of at least 3 years
* Participants with advanced/ clinically significant lung diseases, such as poorly controlled chronic obstructive pulmonary disease (COPD) and asthma, restrictive lung disease, pulmonary hypertension etc.
* Participants with primary neoplasms in the central nervous system (CNS), active or untreated CNS metastases, spinal cord compression, or carcinomatous meningitis should be excluded. Active brain metastases are defined as untreated symptomatic brain metastases or untreated brain metastases requiring systemic corticosteroids and/or anticonvulsants to control CNS-related symptoms. Patients with brain metastases are eligible if they meet any of the following criteria:

  1. untreated, asymptomatic brain metastases
  2. previously treated brain metastases may participate provided they are clinically stable with local therapy (eg, surgery or radiotherapy, currently asymptomatic, no longer requiring corticosteroid treatment, and recovered from all local therapy-related adverse events, as determined by the investigator
* Participated in another clinical trial within 4 weeks prior to first dose of study treatment
* Participants who are pregnant or breastfeeding, or planning to become pregnant during the study
* Other conditions that the Investigator or Sponsor believes are not suitable for participating in this clinical trial

Where it's running

  • Clearview Cancer Institute
    Huntsville, Alabama, United States
    Recruiting
  • OPN Healthcare
    Glendale, California, United States
    Recruiting
  • MemorialCare Long Beach Medical Center
    Long Beach, California, United States
    Recruiting
  • Valkyrie Clinical Trials
    Los Angeles, California, United States
    Recruiting
  • UCLA
    Los Angeles, California, United States
    Recruiting
  • UCSF- San Francisco (Helen Diller Family Comprehensive Cancer Center)
    San Francisco, California, United States
    Recruiting
Show 25 more locations
  • University of Colorado - Anschutz Cancer Pavilion
    Aurora, Colorado, United States
    Recruiting
  • Yale Cancer Center
    New Haven, Connecticut, United States
    Recruiting
  • Emory Winship
    Atlanta, Georgia, United States
    Recruiting
  • Tulane School of Medicine
    New Orleans, Louisiana, United States
    Recruiting
  • START - New Jersey
    East Brunswick, New Jersey, United States
    Recruiting
  • John Theurer Cancer Center-Hackensack
    Hackensack, New Jersey, United States
    Recruiting
  • Rutgers Cancer Institute
    New Brunswick, New Jersey, United States
    Recruiting
  • Icahn School of Medicine at Mount Sinai
    New York, New York, United States
    Recruiting
  • Ohio State University
    Columbus, Ohio, United States
    Recruiting
  • Providence Cancer Institute
    Portland, Oregon, United States
    Recruiting
  • Prisma Health Cancer Institute
    Greenville, South Carolina, United States
    Recruiting
  • NEXT Dallas
    Dallas, Texas, United States
    Recruiting
  • START Dallas- Fort Worth
    Dallas, Texas, United States
    Recruiting
  • MD Anderson Cancer Center
    Houston, Texas, United States
    Recruiting
  • NEXT Houston
    Houston, Texas, United States
    Recruiting
  • START- San Antonio
    San Antonio, Texas, United States
    Recruiting
  • NEXT Oncology Virginia
    Fairfax, Virginia, United States
    Recruiting
  • University of Washington/Fred Hutchinson Cancer Center
    Seattle, Washington, United States
    Recruiting
  • LTD "Pineo Medical Ecosystem"
    Tbilisi, Georgia
    Recruiting
  • LLC "Caucasus Medical Centre"
    Tbilisi, Georgia
    Recruiting
  • LTD "High Technology Hospital Medcenter"
    Batumi, Georgia
    Not yet recruiting
  • JSC "Vian"
    Kutaisi, Georgia
    Not yet recruiting
  • LTD "New Hospitals"
    Tbilisi, Georgia
    Not yet recruiting
  • Regional Municipal Nonprofit Enterprise "Bukovinian clinical oncology center" of the Chernivtsi Regional Council
    Chernivtsi, Ukraine
    Not yet recruiting
  • "The Municipal Enterprise "Volyn Regional Clinical Hospital" of the Volyn Regional Council, Regional Medical Oncology Centre"
    Lutsk, Ukraine
    Not yet recruiting

Study contacts

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How to take part

  1. Review the eligibility criteria above with your treating physician.
  2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
  3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.
Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.