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NCT06730100 | RECRUITING | Metastatic Mismatch Repair Proficient Colorectal Carcinoma

CBX-12 for the Treatment of Metastatic Chemotherapy-Refractory Microsatellite Stable Colorectal Cancer
Sponsor:

National Cancer Institute (NCI)

Brief Summary:

This phase II trial studies how well CBX-12 works in treating patients with microsatellite stable colorectal cancer that has spread to other parts of the body (metastatic) and is no longer responding to chemotherapy treatment (chemotherapy-refractory). The usual approach to treating colorectal cancer includes treatment with surgery, radiation, or Food and Drug Administration (FDA)-approved drugs such as trifluridine-tipiracil, bevacizumab, regorafenib, or fruquintinib. However, most metastatic colorectal patients progress through all approved treatments and eventually succumb to their disease. CBX-12 is a drug that contains a peptide (a substance that contains many amino acids \[molecules that join together to form proteins\]) called pHLIP, linked to an anticancer substance called exatecan. Upon administration, pHLIP gets inserted into the cellular membrane of tumor cells, delivering exatecan to kill them. Giving CBX-12 may work better than the usual approach in treating patients with metastatic chemotherapy-refractory microsatellite stable colorectal cancer.

Condition or disease

Metastatic Mismatch Repair Proficient Colorectal Carcinoma

Refractory Mismatch Repair Proficient Colorectal Carcinoma

Stage IV Coloresectal Cancer Ajcc v8

Intervention/treatment

Biopsy Procedure

Biospecimen Collection

Computed Tomography

Magnetic Resonance Imaging

pH Low Insertion Peptide-exatecan Conjugate CBX-12

X-Ray Imaging

Phase

PHASE2

Detailed Description:

PRIMARY OBJECTIVE: I. To determine the clinical activity, as determined by response rate, of pH low insertion peptide-exatecan conjugate CBX-12 (CBX-12) in microsatellite stable/mismatch repair proficient (MSS/pMMR) metastatic colorectal cancer (mCRC) patients. SECONDARY OBJECTIVES: I. To evaluate the pharmacodynamics of CBX-12 (DDR3 and apoptosis). II. To determine the effect of CBX-12 on progression-free survival (PFS). EXPLORATORY OBJECTIVES: I. To evaluate the tissue and plasma pharmacokinetics (PK) of CBX-12 and free exatecan. II. To evaluate circulating tumor deoxyribonucleic acid (DNA) (ctDNA) as a predictor for treatment response to CBX-12. III. To evaluate the safety and tolerability of CBX-12 dosed every 21 days. IV. To evaluate biomarkers of response to CBX-12 (DNA damage response, apoptosis, SLFN11 expression, TOP1-DNA complex). OUTLINE: Patients receive CXB-12 intravenously (IV) over 60 minutes on day 1 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo x-rays during screening, and computed tomography (CT), magnetic resonance imaging (MRI), and blood collection throughout the study and patients may undergo biopsy during screening and on study. After completion of study treatment, patients are followed up at 30 days and then every 3 months for 12 months or until death.

Study Type : INTERVENTIONAL
Estimated Enrollment : 35 participants
Masking : NONE
Primary Purpose : TREATMENT
Official Title : Phase 2 Trial of CBX-12 for Metastatic Chemotherapy-Refractory Microsatellite Stable Colorectal Cancer
Actual Study Start Date : 2026-02-17
Estimated Primary Completion Date : 2026-12-01
Estimated Study Completion Date : 2026-12-01

Information not available for Arms and Intervention/treatment

Ages Eligible for Study: 18 Years
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
Criteria
Inclusion Criteria
  • * Patients must have histologically or cytologically confirmed metastatic colorectal cancer (mCRC) that is mismatch repair proficient (pMMR) based on local testing performed in a Clinical Laboratory Improvement Act (CLIA) lab
  • * Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as \>= 20 mm (\>= 2 cm) by chest x-ray or as \>= 10 mm (\>= 1 cm) with CT scan, MRI, or calipers by clinical exam
  • * Potential trial participants should have recovered from clinically significant adverse events of their most recent therapy/intervention prior to enrollment, with no Common Terminology Criteria for Adverse Events (CTCAE) version (v)5.0 toxicity of grade 3 or higher at the time of enrollment
  • * Availability of archival tumor tissue at the time of patient enrollment for molecular profiling studies
  • * Patients must have progressed on or been intolerant to at least 2 lines of prior therapies
    • * Have progressed on or intolerant of standard therapies, including a fluoropyrimidine (5-fluorouracil or capecitabine), oxaliplatin, irinotecan, and VEGF inhibitor (bevacizumab or biosimilar).
    • * If left-sided primary and RAS/RAF wild-type, then have progressed on or intolerant of EGFR inhibitor (cetuximab or panitumumab).
    • * If BRAF V600 mutation, then have progressed on or intolerant of BRAF inhibitor (encorafenib).
    • * Age \>= 18 years. Because no dosing or adverse event data are currently available on the use of CBX-12 in patients \<18 years of age, children are excluded from this study
    • * Eastern Cooperative Oncology Group (ECOG) performance status =\< 1 (Karnofsky \>= 70%)
    • * Absolute neutrophil count \>= 1,000/mcL
    • * Platelets \>= 100,000/mcL
    • * Hemoglobin \>= 8.0 g/dL
    • * Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN)
    • * Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase \[SGOT\])/ alanine aminotransferase (ALT)(serum glutamic pyruvic transaminase \[SGPT\]) =\< 3 × institutional ULN
    • * Glomerular filtration rate (GFR) \>= 60 mL/min/1.73 m\^2
    • * Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
    • * For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
    • * Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
    • * Patients with treated brain metastases are eligible if follow-up brain imaging after central nervous system (CNS)-directed therapy shows no evidence of progression for at least 4 weeks
    • * Patients with new or progressive brain metastases (active brain metastases) or leptomeningeal disease are eligible if the treating physician determines that immediate CNS specific treatment is not required and is unlikely to be required during the first cycle of therapy
    • * Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
    • * Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class II or better
    • * Patients are willing and able to undergo pre- and on-treatment biopsies (first 10 patients in stage 1 only)
    • * The effects of CBX-12 on the developing human fetus are unknown. For this reason and because topoisomerase 1 inhibitors are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and 6 months after the last dose of study medication. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 4 months after completion of CBX-12 administration
    • * Ability to understand and the willingness to sign a written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants
    Exclusion Criteria
    • * Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities \> grade 1) with the exception of alopecia
    • * Patients who are receiving any other investigational agents
    • * History of allergic reactions attributed to compounds of similar chemical or biologic composition to CBX-12
    • * Patients with concurrent administration of medication expected to cause drug interactions with CBX-12, including strong inducers and strong inhibitors of CYP3A4/1A2 isoenzymes or sensitive substrates of CYP3A4/2B6, OATP1B1, OATP1B3, OAT1, and MATE-2k
    • * Patients with uncontrolled intercurrent illness or any other significant condition(s) that would make participation in this protocol unreasonably hazardous
    • * Pregnant women are excluded from this study because CBX-12 is a topoisomerase 1 inhibitors agent with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with CBX-12, breastfeeding should be discontinued if the mother during treatment with CBX-12 and for at least 4 months after the last dose of CBX-12. Male patients treated with CBX-12 should use effective contraception and avoid fathering a child during and up to 4 months after treatment
CBX-12 for the Treatment of Metastatic Chemotherapy-Refractory Microsatellite Stable Colorectal Cancer

Location Details

NCT06730100

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How to Participate

Want to participate in this study, select a site at your convenience, send yourself email to get contact details and prescreening steps.

Locations

RECRUITING

United States, California

UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care

Irvine, California, United States, 92612

RECRUITING

United States, California

USC / Norris Comprehensive Cancer Center

Los Angeles, California, United States, 90033

RECRUITING

United States, California

UC Irvine Health/Chao Family Comprehensive Cancer Center

Orange, California, United States, 92868

RECRUITING

United States, Illinois

Northwestern University

Chicago, Illinois, United States, 60611

RECRUITING

United States, Maryland

Johns Hopkins University/Sidney Kimmel Cancer Center

Baltimore, Maryland, United States, 21287

RECRUITING

United States, New York

Montefiore Medical Center-Einstein Campus

The Bronx, New York, United States, 10461

RECRUITING

United States, Ohio

University of Cincinnati Cancer Center-UC Medical Center

Cincinnati, Ohio, United States, 45219

RECRUITING

United States, Ohio

University of Cincinnati Cancer Center-West Chester

West Chester, Ohio, United States, 45069

RECRUITING

United States, Pennsylvania

University of Pittsburgh Cancer Institute (UPCI)

Pittsburgh, Pennsylvania, United States, 15232

RECRUITING

United States, Texas

M D Anderson Cancer Center

Houston, Texas, United States, 77030

RECRUITING

United States, Wisconsin

University of Wisconsin Carbone Cancer Center - Eastpark Medical Center

Madison, Wisconsin, United States, 53718

RECRUITING

United States, Wisconsin

University of Wisconsin Carbone Cancer Center - University Hospital

Madison, Wisconsin, United States, 53792