Investigating GNC-038 for treating central nervous system lymphomas

An Open, Multicenter, Phase Ib/II Clinical Study to Evaluate the Safety, Tolerability, Pharmacokinetics/Pharmacodynamics, and Antitumor Activity of Tetra-specific Antibody GNC-038 Injection in Patients With Relapsed or Refractory Primary Central Nervous System Lymphoma (PCNSL) and Relapsed or Refractory Secondary Central Nervous System Lymphoma (SCNSL)

This study is testing a new treatment called GNC-038 to see if it can help people with relapsed or hard-to-treat central nervous system lymphomas feel better and tolerate the medication safely.

Quick facts

• Phase: PHASE1; PHASE2
• Study type: Interventional
• Enrollment: 33 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Sichuan Baili Pharmaceutical Co., Ltd. (industry)
• Drugs / interventions: CAR-T, chemotherapy, methotrexate
• Locations: 4 sites (Beijing, Beijing and 3 other locations)
• Trial ID: NCT05485753 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the safety and preliminary efficacy of GNC-038, a tetra-specific antibody, in patients with relapsed or refractory primary central nervous system lymphoma (PCNSL) and secondary central nervous system lymphoma (SCNSL). The study aims to determine the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of GNC-038, as well as establish the recommended dose for subsequent phase II studies. Participants will be monitored for their response to the treatment and any adverse effects experienced during the trial.

Who should consider this trial

Good fit: Ideal candidates include adults aged 18 and older with confirmed relapsed or refractory PCNSL or SCNSL.

Not a fit: Patients who have not been diagnosed with central nervous system lymphomas or those who are not relapsed or refractory may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new therapeutic option for patients with difficult-to-treat central nervous system lymphomas.

How similar studies have performed: While there have been studies on similar treatments, the specific approach of GNC-038 is novel and has not been extensively tested in this context.

Eligibility criteria

Inclusion Criteria:

* 1. The subject can understand the informed consent, participate in and sign the informed consent voluntarily;
* 2. No gender limitation;
* 3. Age: ≥18;
* 4. Expected survival time ≥3 months;
* 5. Patients with primary CNS lymphoma (PCNSL) and secondary CNS lymphoma (SCNSL) confirmed by histology or cytology;
* 6. A. Patients with recurrent/refractory primary central nervous system lymphoma (PCNSL) and recurrent/refractory secondary central nervous system lymphoma (SCNSL) may be associated with ocular lymphoma;B. Patients with relapsed or refractory primary CNS lymphoma (PCNSL) and relapsed or refractory secondary CNS lymphoma (SCNSL) who were not eligible or intolerant to other therapies were determined by the investigator;Recurrence and refractory are defined as follows: Recurrence refers to the emergence of new lesions after adequate treatment to complete response (CR).Refractory refers to a patient who has experienced at least first-line treatment without disease remission, e.g. induction chemotherapy with methotrexate without CR.
* 7. KPS score ≥60;
* 8. Adverse reactions of previous antitumor therapy returned to CTCAE 5.0 grade ≤1 (except for the indicators that the researchers considered to be related to the disease, such as anemia, and toxicities that the researchers determined to be without safety risk, such as alopecia, grade 2 peripheral neurotoxicity, hypothyroidism stabilized by hormone replacement therapy, etc.);
* 9. Before the first administration, the organ function level should meet the following requirements:

Bone marrow function: In the absence of blood transfusion, G-CSF (long-acting white needle within 2 weeks) and medication correction within 7 days prior to screening:

Absolute neutrophil count (ANC) ≥15×10\^9/L (subjects with bone marrow infiltration should be ≥0.5×10\^9/L);Hemoglobin ≥90 g/L;Platelet count ≥90×10\^9/L; Liver function: Total bilirubin ≤1.5 ULN (Gilbert's syndrome ≤3 ULN), transaminase (AST/ALT) ≤2.5 ULN (≤5.0 ULN for subjects with tumor invasive changes in the liver) without correction with hepatoprotective drugs within 7 days prior to screening; Renal function: Creatinine (Cr) ≤1.5 ULN and creatinine clearance (Ccr) ≥50 mL /min according to the Cockcroft and Gault formula; Routine urine / 24-hour urine protein quantification: qualitative urine protein ≤1+ (if qualitative urine protein ≥2+, 24-hour urine protein \< 1g can be included); Cardiac function: left ventricular ejection fraction ≥50%; Coagulation function: fibrinogen ≥1.5g/L; Activated partial thrombin time (APTT) ≤1.5 ULN; Prothrombin time (PT) ≤1.5 ULN.

* 10. Fertile female subjects or male subjects with fertile partners must use highly effective contraception beginning 7 days before the first dose and up to 12 weeks after the last dose. Fertile female subjects must have a negative serum/urine pregnancy test within 7 days prior to initial dosing;
* 11. The subject is able and willing to follow the visits, treatment plans, laboratory tests, and other study-related procedures specified in the study protocol.

Exclusion Criteria:

* 1. Lung disease defined as grade ≥3 according to NCI-CTCAE V5.0; Patients with current interstitial lung disease (ILD) (except those who have recovered from previous interstitial pneumonia);
* 2. Active infections requiring systemic treatment, such as severe pneumonia, bacteremia, sepsis, etc.;
* 3. Active tuberculosis;
* 4. Brain stem tumor infiltration or only eye lesions;
* 5. Patients with active autoimmune diseases, such as: Systemic lupus erythematosus, systemic treatment of psoriasis, rheumatoid arthritis, inflammatory bowel disease, and hashimoto's thyroiditis, etc., with the exception of type I diabetes, only replacement therapy can control the hypothyroidism, no systemic treatment of skin disease (e.g., vitiligo, psoriasis), B cells caused by autoimmune disease;
* 6. Non-melanoma skin cancer in situ, superficial bladder cancer, cervical cancer in situ, gastrointestinal intramucosal cancer, breast cancer, localized prostate cancer and other cancers that have been cured and have not recurred within 5 years prior to the first administration are excluded;
* 7. HBsAg positive or HBcAb positive, and HBV-DNA test ≥ the upper limit of normal; HCV antibody positive and HCV-RNA≥ the upper limit of normal value; HIV antibody positive;
* 8. Poorly controlled hypertension (systolic blood pressure \>150 mmHg or diastolic blood pressure \>100 mmHg);
* 9. Have a history of serious cardiovascular and cerebrovascular diseases, including but not limited to: Severe cardiac rhythm or conduction abnormalities, such as ventricular arrhythmias and degree ⅲ ATrioventricular block requiring clinical intervention; Longer QT interval at rest (QTc \> 450 msec for men or 470 msec for women); Acute coronary syndrome, congestive heart failure, aortic dissection, stroke, or other grade 3 or higher cardiovascular and cerebrovascular events occurred within 6 months prior to first administration; Heart failure with the New York Heart Association (NYHA) Heart function rating ≥II; 10. Patients with a history of allergy to recombinant humanized antibodies or to any excipient ingredient of GNC-038;
* 11. Pregnant or breastfeeding women;
* 12. Patients who cannot tolerate MRI examination;
* 13. Patients who underwent major surgery within 28 days prior to administration of the drug in this study, or who planned to undergo major surgery during the study period (except for puncture or biopsy surgery);
* 14. Prior organ transplantation or allogeneic hematopoietic stem cell transplantation (ALLO-HSCT);
* 15. Autologous hematopoietic stem cell transplantation (AUTO-HSCT) within 12 weeks prior to initiation of GNC-038 therapy;
* 16. Immunosuppressants are being used, including but not limited to: Cyclosporine, tacrolimus, etc. within 2 weeks prior to gnC-038 treatment; Gnc-038 received a high dose of glucocorticoid for 2 weeks prior to treatment (longer than 14 days, a steady dose of dexamethasone \>5mg per day or equivalent dose of other glucocorticoids);
* 17. Received radiotherapy within 4 weeks prior to initiation of GNC-038 treatment;
* 18. Received anti-CD20 or anti-CD79B treatment within 4 weeks prior to initiation of GNC-038 and still responded;
* 19. Received chemotherapy and small molecule targeted therapy within 2 weeks prior to treatment;
* 20. Received CAR-T therapy within 12 weeks prior to initiation of GNC-038;
* 21. Participated in any other clinical trials within 4 weeks prior to administration of this trial;
* 22. Past or present central nervous system disease, including, but not limited to, stroke (imaging)
* 23. Medical examination indicated "lacunar cerebral infarction" except those requiring no treatment), severe brain injury, Senile dementia, Parkinson's disease, organic brain syndrome, psychosis;
* 24. Other conditions that the investigator considers inappropriate for participation in this clinical trial.

Where this trial is running

Beijing, Beijing and 3 other locations

• Beijing Tiantan Hospital, Capital Medical University — Beijing, Beijing, China (RECRUITING)
• Beijing GoBroad Boren Hospital — Beijing, Beijing, China (RECRUITING)
• Guangdong Provincial People's Hospital — Guangzhou, Guangdong, China (RECRUITING)
• The First Affiliated Hospital of Zhengzhou University — Zhengzhou, Henan, China (RECRUITING)

Study contacts

• Principal investigator: Wenbin Li — Beijing Tiantan Hospital
• Study coordinator: Sa Xiao, PHD

Conditions: Primary Central Nervous System Lymphoma, Secondary Central Nervous System Lymphoma