Inhaled mRNA vaccine for advanced lung cancer and lung metastasis

The Phase I Clinical Study of the Inhaled mRNA Tumor-associated Antigen Dry Powder Vaccine BMD006 in Patients With Advanced Lung Cancer or Metastatic Solid Tumors in the Lungs.

This study is testing a new inhaled vaccine for people with advanced lung cancer to see if it can help them feel better and work well with other treatments.

Quick facts

• Phase: Early Phase 1
• Study type: Interventional
• Enrollment: 83 (estimated)
• Ages: N/A to 99 Years
• Sex: All
• Sponsor: Cancer Institute and Hospital, Chinese Academy of Medical Sciences (Academic / other)
• Drugs / interventions: chemotherapy, immunotherapy, Ivonescimab
• Locations: 1 site (Beijing)
• Trial ID: NCT06928922 on ClinicalTrials.gov

What this trial studies

This trial evaluates BMD006, an inhaled mRNA tumor-associated antigen dry powder vaccine designed for patients with advanced lung cancer and solid tumors that have metastasized to the lungs. It is a single-center, open-label, dose-escalation study that aims to assess the safety, tolerability, and preliminary efficacy of the vaccine, both as a standalone treatment and in combination with PD-1 antibody therapy. Participants will receive varying doses of the vaccine and will be monitored for adverse effects and treatment response over a specified period.

Who should consider this trial

Good fit: Ideal candidates include adults aged 18 to 75 with advanced lung cancer or solid tumors with lung metastasis that have not responded to standard treatments.

Not a fit: Patients with early-stage lung cancer or those who have not yet undergone standard treatment may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a novel therapeutic option for patients with advanced lung cancer and lung metastasis who have exhausted standard treatment options.

How similar studies have performed: While the approach of using inhaled mRNA vaccines is innovative, similar studies have shown promise in other cancer types, suggesting potential for success in this context.

Eligibility criteria

Inclusion Criteria:

* Able to understand and comply with the requirements of the study protocol, voluntarily participate in the trial, and sign a written informed consent form (ICF).
* Must be at least 18 (inclusive) at the time of signing the ICF, and both male and female participants are eligible.
* Histologically or cytologically confirmed as advanced lung cancer (driver gene negative) or advanced solid tumors with lung metastasis, and having failed prior standard treatments or having no standard treatment options.
* Agree to provide fresh tumor tissue samples or archived tumor tissue samples within the past three years.
* Presence of at least one measurable lesion as defined by RECIST V1.1
* Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-1
* Organ function must be adequate at screening (no need for blood transfusion, hematopoietic growth factors, human albumin, or medications for correction within 14 days prior to first treatment), specifically defined as: a) Hematology: Absolute neutrophil count ≥1.5×10\^9/L; platelet count ≥90×10\^9/L; hemoglobin ≥90 g/L (9 g/dL). b) Liver Function: Serum total bilirubin (TBIL) ≤1.5× upper limit of normal (ULN); for patients with liver metastasis or a history/suspected history of Gilbert's syndrome (persistent or recurrent hyperbilirubinemia, primarily unconjugated bilirubin, with no evidence of hemolysis or liver pathology), TBIL ≤3×ULN; for patients without liver metastasis, alanine aminotransferase (ALT) and aspartate aminotransferase (AST); for patients with liver metastasis, ALT or AST ≤5×ULN. c) Renal Function: Creatinine (Cr) ≤1.5×ULN or creatinine clearance (CLcr) ≥60 mL/min (calculated using the Cockcroft-Gault formula, see Attachment 3); urine dipstick test result showing urinary protein \<2+; for patients with baseline urine dipstick showing protein ≥2+, a 24-hour urine collection should be conducted, and the protein content in the 24-hour urine should be \<1 g. d) Cardiac Function: Echocardiography showing left ventricular ejection fraction (LVEF) \>50%. e) Pulmonary Function: Shortness of breath ≤Grade 1 as per the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), and outdoor ambient air oxygen saturation (SpO₂) ≥92%.
* Expected life expectancy ≥12 weeks.
* Female patients of childbearing potential and male patients (and their female partners) must use highly effective contraception from the screening period until at least 6 months after the last dose of the study drug. Patients must not plan to conceive, donate sperm, or donate eggs during this period

Exclusion Criteria:

* Patients with lung cancer who have concurrent other types of malignant tumors or are diagnosed with multiple primary malignancies, except for the following: completely resected basal cell carcinoma and squamous cell carcinoma of the skin, completely resected any type of carcinoma in situ.
* Symptomatic central nervous system metastasis; for patients with asymptomatic brain metastasis or those whose symptoms have been stable for ≥2 weeks after treatment of brain metastasis, they may participate in this study if they meet all the following criteria: measurable lesions in the lungs; cessation of steroid treatment 14 days prior to the first trial product dose.
* Patients with chronic obstructive pulmonary disease (COPD), asthma, or allergies to pollen or dust.
* Patients suspected of having active or latent tuberculosis infection, based on interferon-γ release assay results, clinical symptoms, and/or chest imaging findings (patients with evidence of adequately treated prior active tuberculosis infection may be enrolled after assessment by the investigator; for latent tuberculosis, patients must have completed at least 4 weeks of anti-tuberculosis treatment, with no liver function impairment \[ALT ≤3×ULN, AST ≤3×ULN\], and after the investigator assesses that the risk is manageable, they may be considered for continued screening or enrollment).
* History of interstitial lung disease (e.g., idiopathic pulmonary fibrosis or organizing pneumonia), or active, non-infectious pneumonia requiring immunosuppressive treatment such as corticosteroids.
* Patients with active autoimmune diseases requiring therapeutic intervention.
* History of serious bleeding disorders; or those with coagulation dysfunction (as indicated by laboratory tests or medical history) who are deemed by the investigator to be unsuitable for the trial treatment.
* History or current diagnosis of cardiovascular disease, including any of the following: a) Recent myocardial infarction or coronary artery bypass grafting (CABG) within the past 6 months; b) Uncontrolled congestive heart failure; c) Unstable angina (within the past 6 months); d) Clinically significant (symptomatic) arrhythmias (e.g., sustained ventricular tachycardia, clinically significant second- or third-degree atrioventricular block without a pacemaker).
* Clinically uncontrolled third-space fluid accumulation (e.g., pleural effusion/pericardial effusion; patients with effusions that do not require drainage or those whose effusions have not increased significantly after stopping drainage for 3 days may be included).
* Severe infection requiring intravenous antibiotic treatment or hospitalization at screening, or any uncontrolled active infection within 4 weeks prior to the first dose of the trial product.
* History of severe allergic reactions, or known allergy to any active or inactive component of BMD006 or PD-1 inhibitors.
* Any other metabolic, hematological, renal, hepatic, pulmonary, neurological, endocrine, cardiac, or gastrointestinal disease that, in the investigator's opinion, may present unacceptable risks to the patient during treatment.
* Presence of unresolved toxicity from prior anti-tumor treatments before the first dose of the study product, which has not recovered to Grade 0 or 1 (excluding alopecia) (severity assessed according to NCI CTCAE v5.0).
* Positive test results for hepatitis B at screening \[defined as: ① Hepatitis B surface antigen (HBsAg) positive; ② HBsAg negative but hepatitis B core antibody (HbcAb) positive (further testing through hepatitis B virus deoxyribonucleic acid \[HBV DNA\] is required, and patients with HBV DNA levels exceeding the normal limit for the test method must be excluded)\], positive hepatitis C antibody (HCV Ab) \[further testing through hepatitis C virus ribonucleic acid (HCV RNA) is required, and patients with HCV RNA levels exceeding the normal limit for the test method must be excluded\], or positive human immunodeficiency virus antibody (HIV Ab).
* Underwent major surgery within 4 weeks prior to the first dose of the trial product (cranial, thoracic, or abdominal surgery) or has an unresolved wound, ulcer, or fracture. Note: Thoracoscopic surgery and mediastinoscopy will not be considered major surgery. Patients who are ≥2 weeks post-surgery or who are deemed eligible by the investigator may be included in the study.
* Previously received similar products or treatments.
* Received other anti-tumor treatments (radiotherapy, chemotherapy, endocrine therapy, targeted therapy, immunotherapy, etc.) within 4 weeks or 5 half-lives (whichever is longer) prior to the first dose of the trial product.
* Received systemic immunosuppressive agents (e.g., systemic corticosteroids) within 3 months prior to the first dose of the trial product.
* Received or planned to receive live or attenuated live vaccines within 3 months prior to the first dose of the trial product or during the study.
* Pregnant or breastfeeding women.
* Participated in any clinical drug trial (defined as being randomized and receiving trial product treatment) within 3 months or 5 half-lives (whichever is longer) prior to screening.
* Any other condition deemed by the investigator to make the patient unsuitable for participation in the trial.

Where this trial is running

Beijing

• Cancer Institute and Hospital, Chinese Academy of Medical Sciences — Beijing, China (Recruiting)

Study contacts

• Principal investigator: Ning Li, Doctor — Cancer Institute and Hospital, Chinese Academy of Medical Sciences
• Study coordinator: Shuhang Wang, Doctor

Conditions Advanced Lung Cancer; Lung Metastasis; inhaled mRNA tumor-associated antigen dry powder vaccine; advanced lung cancer; solid tumors with lung metastasis; mRNA vaccine combination with PD-1 or PD-1/VEGF antibody