A First-in-human (FIH), Phase 1 Study of ML261, an Autologous Potency Enhanced Anti-DLL3 CAR T Cell Therapy, in Participants With R/R SCLC or Select NECs (SPECTRAL-1)
A Phase 1 First-In-Human Study to Investigate the Safety, Pharmacokinetics and Preliminary Efficacy of ML261, an Autologous Anti-DLL3 CAR + CARD11-PIK3R3 Fusion T Cell Therapy, in Participants With Relapsed/Refractory Small Cell Lung Cancer or Select Neuroendocrine Carcinomas
Who can join
As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.
- Age
- 18 Years and older
- Sex
- All sexes
- Healthy volunteers
- Not accepted
- Compensation
- Not stated
Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.
What to expect
No one can promise a trial will help you personally — that is what the research is trying to find out.
What participation involves
Not stated in the study description — ask the study team about visits and procedures.
- Compensation
- Not stated
- Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
- Participants are monitored closely by the research team throughout the study.
- Some participants may receive access to an investigational treatment, which is still being studied.
- Your participation helps researchers learn whether this approach could help future patients.
About this study
In plain language
This first study in humans tests ML261, a treatment made from a person's own immune cells that targets DLL3 on cancer cells. It checks safety, how the treatment acts in the body, and early signs that it works. It is for adults with small cell lung cancer or certain neuroendocrine cancers that came back or got worse after treatment.
This is a first-in-human (FIH), open-label, Phase 1 study designed to evaluate the safety, pharmacokinetics (PK), and preliminary efficacy of ML261, an autologous potency enhanced anti-DLL3 CAR T cell therapy, in participants with R/R SCLC or select NECs
Compensation is read from the study's own description and may be missing — always confirm with the study team.
Eligibility
Who can join
- Be at least 18 years old when signing the consent form.
- Have had at least one standard cancer treatment that works throughout the body.
- Scans must show cancer that can be measured and that grew or came back during or after the latest treatment.
- Have advanced or spreading small cell lung cancer, or a qualifying neuroendocrine cancer of the digestive system, pancreas, prostate, or outside the lungs. Neuroendocrine cancers start in cells with nerve-like and hormone-making traits. A tissue test must show DLL3.
- For tumors with mixed cell types, more than 50% must be small cell or neuroendocrine cells. For high-grade prostate cancer, more than 20% must be neuroendocrine cells.
- Be fully active, or able to walk and do light work even if hard physical activity is limited.
- Be expected to live at least 12 weeks.
- Have blood counts and organ function that meet study requirements.
Who can't join
- Cancer that could be cured with surgery, or neuroendocrine cancer of the brain or spinal cord.
- Cancer treatment too close to study treatment; past treatment with DLL3-targeted CAR T cells or other gene-changed T cells; or a past organ or bone marrow transplant from a donor.
- Major surgery within 4 weeks before the first study drug, or major surgery expected during the study. Lasting side effects from earlier cancer treatment may also exclude you, unless they are unlikely to pose a safety risk.
- Fluid buildup in the belly, around the lungs, or around the heart that causes symptoms and needs repeated drainage. Another active cancer may also exclude you, though some removed, treated, or low-risk cancers are allowed.
- Certain serious heart problems, including a heart attack within 6 months, or a new blood clot in a vein. Some clots are allowed if blood flow is stable and blood thinner doses are steady.
- Serious brain or nervous system problems, or active psychosis, which affects contact with reality. Cancer spread to the brain is allowed only if it causes no symptoms and has not needed steroids for at least 2 weeks before study treatment.
- An active disease in which the immune system attacks the body, or a condition needing medicines that weaken the immune system. Recent use of these medicines may also exclude you. Lung scarring or active lung inflammation needing treatment is also excluded.
- An infection needing whole-body treatment within 14 days before immune cells are collected, or an ongoing infection. Uncontrolled health, mental health, or social problems that could prevent safe participation may also exclude you.
Simplified for readability. The official criteria below are what the study team uses.
Official eligibility criteria
Inclusion Criteria * ≥18 years of age at the time of signing the ICF * Have been previously treated with at least one line of systemic standard of care (SOC) anti-cancer therapy for their respective cancer indication. Participants with locally advanced disease who are eligible for curative resection will be excluded. * Have documented radiological disease progression/relapse during or after their most recent line of anti-cancer therapy with measurable disease on imaging, as assessed by RECIST v1.1 * Have histologically and/or cytologically confirmed diagnosis of select advanced or metastatic R/R solid tumor malignancy in one of the following: R/R SCLC, R/R GEP-NEC, R/R high-grade NEPC, R/R epNEC with biopsy-documented DLL3 expression on archival tissue or fresh biopsy by local or central assessment. CNS NEC is excluded. Participants with mixed histologies for any of these indications qualify if the small cell/neuroendocrine tumor cell percentage is \> 50%, except for high-grade NEPC where neuroendocrine component must be \> 20%. * Eastern Cooperative Oncology Group (ECOG) Performance Score (PS) 0 or 1 * Life expectancy ≥12 weeks * Have adequate hematologic and end-organ function Exclusion Criteria: * Previous systemic anti-cancer therapies within the timeframes, as specified in the protocol. * Prior exposure/treatment with DLL3-targeted CAR T therapy or any other genetically engineered adoptive T cell therapy. * Prior allogeneic organ transplant (including allogeneic bone marrow transplant). * Major surgical procedure within 4 weeks of the first dose of any study drug administration or anticipated to be in need of a major surgical procedure during the course of study. * Participants with toxicities (as a result of prior anti-cancer therapy) which have not recovered to baseline or CTCAE v5.0 \<Grade 2, except for adverse events (AEs) not considered a likely safety risk: (e.g., alopecia, neuropathy, non-clinically relevant laboratory abnormalities). * Symptomatic ascites or effusions (pleural or pericardial) requiring intermittent drainage. * History of any other malignancy known to be active, with the exception of completely removed in situ cervical intra-epithelial neoplasia, non-melanoma skin cancer, ductal carcinoma in situ, early-stage prostate cancer that has been adequately treated, and other cancers from which the participant has been disease free for 3 years or longer or does not require treatment and in the opinion of investigator after discussion with the medical monitor are not likely to impact the patient's life expectancy. * One or more of the following cardiac criteria: Unstable angina, Myocardial infarction within 6 months prior to Screening, New York Heart Association Class III to IV heart failure, clinically important abnormalities in rhythm, conduction, or morphology of resting ECG (e.g., complete left bundle branch block or third-degree heart block) * Acute venous thromboembolism (VTE). VTEs without hemodynamic compromise, treated with stable doses of anticoagulants are allowed. * Presence of clinically significant CNS pathology: * seizure disorder, aphasia, stroke, severe brain injuries, dementia, Parkinson's disease, or cerebellar disease. History of these disorders requires discussion with the medical monitor. * Presence of clinically active psychosis. * Known brain metastases unless asymptomatic and not requiring steroids for at least 2 weeks prior to the first dose of any study drug administration. * Active systemic autoimmune disease or any other condition that requires, or is anticipated to require, systemic treatment with steroids or other systemic immunosuppressive agents, or participants who have received such agents within 4 weeks of leukapheresis and ML261 administration (further details provided in protocol body). * Evidence of interstitial lung disease (such as idiopathic pulmonary fibrosis) or active pneumonitis of any etiology requiring treatment. * Any active infection (defined as symptoms, signs, or radiographic) of bacterial, viral, or fungal or unknown etiology requiring systemic therapy within 14 days of leukapheresis. Participants with clinical and/or laboratory evidence of persistent infection will be excluded. * Uncontrolled medical, psychological/psychiatric, or social condition that would interfere with the participant's participation or compromise the objectives of the study in the opinion of the Investigator and/or the Sponsor.
Study sites (7)
MO
- Washington University Medicine · St Louis, MO 63130Amberly Scott · Study contact · 314-273-5116 · amberly@wustl.eduJeff Ward, MD · Principal investigatorMore trials in St Louis
NJ
- Hackensack University Medical Center · Hackensack, NJ 07601Oncology Clinical Research Referral Office · Study contact · 551-996-1777 · OncologyResearchReferral@hmhn.orgMartin Gutierrez, MD · Principal investigatorMore trials in Hackensack
NY
- NYU Langone Health · New York, NY 10016Phase 1 Screening · Study contact · DL_Phase1Screening@nyulangone.orgSalman Punekar, MD · Principal investigatorMore trials in New York
TN
- Sarah Cannon Research Institute (SCRI) · Nashville, TN 37203AskSarah · Study contact · 844-482-4812Melissa Johnson, MD · Principal investigatorMore trials in Nashville
TX
- UT Southwestern Medical Center · Dallas, TX 75235Silviya Meletath · Study contact · 909-560-9597 · Silviya.Meletath@UTSouthwestern.eduBen Drapkin, MD · Principal investigatorMore trials in Dallas
- MD Anderson Cancer Center · Houston, TX 77030 · Study contact · 713-792-3934 · eeileana@mdanderson.orgEcaterina Dumbrava, MD · Principal investigatorMore trials in Houston
WA
- Fred Hutch Cancer Center · Seattle, WA 98109Fred Hutch Intake · Study contact · 206-606-1024 · hutchdoc@fredhutch.orgSylvia Lee, MD · Principal investigatorMore trials in Seattle