A Phase 2 Study Evaluating the Efficacy of Anti-CD38 Antibody in Combination With KRAS Vaccine and Anti-PD-1 Antibody in Subjects With Pancreatic Ductal Adenocarcinoma and Refractory Non-Small Cell Lung Cancer

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Trial Details

Sponsor: Georgetown University (other)

Phase: 2

Start date: Jan. 31, 2024

Planned enrollment: 54

Trial ID: NCT06015724
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More trial details at ClinicalTrials.gov More info

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Goal: Evaluate the anti-tumor activity and safety of adding the anti-CD38 antibody daratumumab to a KRAS-targeted vaccine (TG01 with Stimulon QS-21) plus the anti–PD-1 antibody nivolumab in advanced PDAC and NSCLC after prior standard therapy, with the aim of improving response, disease control, and survival after PD-1/PD-L1 failure (NSCLC) or after one prior line (PDAC).

Patients: Adults ≥18 years with measurable disease by irRECIST. Two cohorts: refractory advanced NSCLC with progression on frontline PD-1/PD-L1–containing therapy (excluding rapid progressors) and PDAC after one prior regimen. Tumors must harbor mutant KRAS at codon 12 (G12A/C/D/R/S/V) or 13 (G13D). Prior KRAS G12C inhibitor exposure is allowed with a 1-week washout. ECOG 0–2 and adequate organ function required. Key exclusions include prior anti-CD38 therapy, active autoimmune disease requiring systemic therapy, uncontrolled comorbidities, significant pulmonary disease, active CNS disease not meeting protocol criteria, active infections including uncontrolled HBV/HCV or HIV, and recent major therapy within protocol-defined washouts.

Design: Phase 2, non-randomized, open-label, two-arm study enrolling approximately 54 participants across PDAC and refractory NSCLC cohorts. Primary purpose is treatment. Efficacy assessed every 8 weeks using irRECIST.

Treatments: Daratumumab (anti-CD38 monoclonal antibody) plus nivolumab (anti–PD-1) in combination with the TG01 KRAS vaccine formulated with the Stimulon QS-21 adjuvant. Daratumumab targets CD38, a surface glycoprotein expressed on plasma cells and some immunosuppressive myeloid and lymphoid subsets; it mediates cell killing via complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity/phagocytosis, and can modulate the tumor immune microenvironment. Nivolumab is a standard anti–PD-1 checkpoint inhibitor to restore T-cell activity. TG01 is a peptide-based vaccine comprising mutated KRAS peptides intended to elicit KRAS-specific T-cell responses; QS-21 is a saponin adjuvant that enhances antigen-specific immunity. TG01 has shown immunogenicity against KRAS-mutant peptides in early clinical studies, with detectable vaccine-specific T-cell responses; definitive efficacy in PDAC or NSCLC remains unproven. The combination seeks to augment KRAS-specific immunity while relieving checkpoint inhibition and reducing CD38-mediated immunosuppression.

Outcomes: Primary endpoint: objective response rate (CR+PR) by irRECIST. Secondary endpoints: incidence of treatment-emergent adverse events, progression-free survival at 6 and 9 months, duration of response, clinical benefit rate (≥SD), and overall survival. Imaging assessments occur approximately every 8 weeks; survival and response durability followed up to 2–3 years.

Burden on patient: Moderate. Participants will receive combination IV immunotherapy with a vaccine schedule plus protocol-mandated safety labs and serial imaging every 8 weeks. Mandatory blood and tissue collections for correlative research add procedures beyond standard care; the tissue requirement may necessitate a new biopsy depending on archival availability. Visit frequency is higher early in treatment due to infusion schedules and vaccine administrations, increasing travel and time in clinic. There are no intensive pharmacokinetic draws typical of phase 1 studies, but ongoing safety assessments and correlative sampling contribute to cumulative burden over a multi-month treatment period.

Last updated: Oct 2025

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Sites (2)

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Georgetown Lombardi Comprehensive Cancer Center

Washington D.C., District of Columbia, 20007, United States

[email protected] / 202-784-5097

Status: Recruiting

John Theurer Cancer Center at Hackensack University Medical Center

Hackensack, New Jersey, 07601, United States

[email protected] / 551-996-1777

Status: Recruiting

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