TMT101 injection as a single-agent treatment for advanced pancreatic cancer or non-small cell lung cancer.

A Single Arm, Open Label, Dose-escalating, Prospective Phase I Clinical Trial Evaluating the Safety, Tolerability and Efficacy of TMT101 Injection Alone in Patients With Advanced Pancreatic Cancer or Non-small Cell Lung Cancer(NSCLC) After Standard Treatment Failure

This trial will test whether weekly intramuscular TMT101 injections are safe and tolerable and might help adults with advanced or metastatic pancreatic cancer or non-small cell lung cancer after standard treatments have failed.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 18 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Peking Union Medical College Hospital (Academic / other)
• Drugs / interventions: chemotherapy, immunotherapy, prednisone
• Locations: 1 site (Beijing, Beijing Municipality)
• Trial ID: NCT06861543 on ClinicalTrials.gov

What this trial studies

This first-in-human, open-label Phase 1 trial uses a 3+3 dose-escalation design to test TMT101 injection alone in adults with unresectable, metastatic, or advanced pancreatic cancer or NSCLC after prior therapies have failed. Three planned dose levels (0.1, 0.2, 0.4 mg) are given once weekly by intramuscular injection for up to nine doses, with dose-limiting toxicities assessed within 21 days of the first dose. Approximately 3–6 patients will be enrolled per dose level and the first tumor assessment is scheduled around week six to inform continued dosing. The primary objective is to define safety, tolerability, and a recommended therapeutic dose for future studies.

Who should consider this trial

Good fit: Adults (≥18 years) with histologically or cytologically confirmed unresectable, metastatic, or advanced pancreatic cancer or NSCLC who have failed the specified prior treatments, have at least one measurable lesion by RECIST 1.1, ECOG ≤1, and estimated life expectancy ≥12 weeks.

Not a fit: Patients with earlier-stage disease, poor performance status (ECOG >1), inadequate organ function, or who have not yet received the required prior therapies are unlikely to benefit or may be ineligible.

Why it matters

Potential benefit: If safe and active, TMT101 could provide a new treatment option and potentially help control tumor growth in patients who have exhausted standard therapies.

How similar studies have performed: mRNA-based cancer therapies are an emerging and largely experimental approach with limited proven benefit to date in late-stage solid tumors.

Eligibility criteria

Inclusion Criteria:

1. Agrees to follow the trial protocol and visit schedule, has signed informed consent;
2. Subjects must be ≥18 years of age at time of informed consent,regardless of gender;
3. Patients with advanced/unresectable or metastatic pancreatic cancer or non-small cell lung cancer that requires histologically and/or cytologically confirmed according to the American Joint Committee on Cancer 8th edition; pancreatic cancer:Previous failure or intolerance of two or more lines of chemotherapy; NSCLC:Previous failure or intolerance of platinum-containing chemotherapy and anti-PD-1/PD-L1 monoclonal antibodies, regardless of combination therapy or sequential therapy, if the previous test for EGFR-sensitive mutations or ALK fusion genes is positive, treatment with a third-generation TKI must be failed or intolerant;
4. At least one evaluable lesion according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1;
5. ECOG≤1;
6. Estimated life expectancy≥12 weeks;
7. Adequate organ function, meet the following laboratory standards:

   1. ANC≥1.5×109/L;PLT≥90×109/L;
   2. Hb≥90 g/L;
   3. TBIL≤1.5×ULN, Patients with Gilbert's syndrome ; without liver metastases, AST and ALT ≤ 2.5×ULN;liver metastases, AST and ALT ≤5×ULN ;
   4. Ccr≥50 mL/min;
   5. INR≤1.5×ULN, APTT≤1.5×ULN;
8. Males of childbearing potential and females of childbearing potential who are willing to use effective contraception since signing the informed consent until 6 months after the last dose of the trial drug. Females of childbearing potential must have a negative pregnancy test result within 7 days prior to the first dose.

Exclusion Criteria:

1. Allergic to TMT101 Injection or any of the components in the prescription;
2. Uncontrolled illness including, but not limited to, active infection requiring systemic therapy, uncontrolled hypertensionuncontrolled hyperglycemia, decompensated congestive heart failure , unstable angina, arrhythmias that require clinical intervention; ascites or uncontrolled pleural effusion (CTCAE 5.0≥grade 2), thrombosis (such as pulmonary embolism, cerebral infarction, myocardial infarction) or history of stroke, active autoimmune disease, psychiatric disease, active peptic ulcer disease, active bleeding disorder, which would limit compliance with study requirements or impair the patient's ability to sign informed consent in writing;
3. Patients who used immunosuppressive drugs within 3 weeks prior to the first dose, or patients who have achieved immunosuppressive intent (dose \> 10 mg/day prednisone or other equivalent hormones and the duration of use is at least 7 days ) on systemic hormonal therapy or absorbable topical hormonal therapy, with the exception of physiologic doses of intranasal and inhaled corticosteroids;
4. Within 4 weeks prior to the first administration, received major surgery, radiotherapy (except palliative radiotherapy for bone metastasis), or treatment for surgical wounds that were not healed, ulcerated, or fractured; within 4 weeks prior to the first administration or within 5 half-lives (whichever is shorter) received anti-tumor treatments such as chemotherapy, biological therapy, endocrine therapy, targeted therapy, or immunotherapy.
5. Patients with prior or concurrent occurrence of other malignancies, with the following exceptions: a) Carcinoma in situ of the cervix or breast, curatively treated with no signs of recurrence for at least 3 years prior to the study; b) The primary malignancy was completely resected and in complete remission for ≥ 5 years;
6. History of interstitial lung disease or current interstitial lung disease or suspected of such disease by imaging during screening. and pneumonitis that previously required systemic corticosteroid treatment;
7. Treponema pallidum antibody or human immunodeficiency virus (HIV) antibody positive, positive for hepatitis C virus antibody and hepatitis C virus (HCV) RNA, or active hepatitis B (positive for hepatitis B surface antigen and HBV DNA ≥ upper limit of normal);
8. Received live vaccines within 4 weeks before the first dose or planned to receive live vaccines during the study period and within 4 weeks after the last dose, including but not limited to: measles, mumps, rubella, chickenpox, yellow fever, rabies, BCG and typhoid vaccines;
9. History of allogeneic organ transplantation and allogeneic hematopoietic stem cell transplantation;
10. Interventional therapy in other clinical trials 3 weeks before the first dose, and it is judged by the investigator and medical monitor to be unsuitable for inclusion in the study;
11. Patients who have had a previous ≥grade 3 immune-related adverse event or immunotherapy-related serious adverse event (SAE) leading to permanent discontinuation;
12. Pregnant or lactating females;
13. In the opinion of the investigator, the subject has other conditions that may affect compliance or are not suitable for participation in this study;
14. Patient has active central nervous system metastases (with or without treatment), including symptomatic brain metastases or meningeal metastases or spinal cord compression, but asymptomatic brain metastases except;
15. Within 4 weeks prior to the first dose, all toxicities from prior antineoplastic therapy have not recovered to grade 1 or less, with the following exceptions: a. alopecia, b. long-term toxicity caused by radiotherapy, c. other toxicities that cannot be recovered in the judgment of the investigator but have no effect on the subject's administration
16. Major surgery within 4 weeks prior to the first dose;
17. Transsplenectomy which is not suitable is judged by the investigator.

Where this trial is running

Beijing, Beijing Municipality

• Peking Union Medical College Hospital — Beijing, Beijing Municipality, China (Recruiting)

Study contacts

• Principal investigator: Wenming Wu, PhD — Peking Union Medical College Hospital
• Study coordinator: Wenming Wu, PhD

Conditions Non-small Cell Lung Cancer; TMT101 Injection; mRNA; advanced pancreatic cancer or NSCLC