KK-LC-1 TCR T Cells for the Treatment of Metastatic Gastric, Lung, Breast, and Cervical Cancers

Inclusion Criteria

• Signed, written informed consent obtained prior to any study procedures
• Age >= 18 years at the time of informed consent
• Metastatic solid tumor with >= 10% of tumor cells positive for KK-LC-1 by immunohistochemistry (IHC) assay. Due to the low frequency of KK-LC-1 expression in most cancers, screening will focus on gastric, non-small cell lung cancer (NSCLC), triple-negative breast cancer (TNBC), and cervix cancers. The IHC test will be performed by the Rutgers Cancer Institute of New Jersey, Department of Biorepository Services
• HLA-A*01:01 allele by human leukocyte antigen (HLA) haplotype test
• Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) criteria version 1.1 at time of enrollment
• Prior treatment with cancer type-specific standard of care systemic cancer therapy is required. Standard treatment options must be considered and declined. Documentation of rationale is required if a subject is deemed unsuitable for standard therapy
• Subjects with =< 3 brain metastases that have been treated with surgery or stereotactic radiosurgery are eligible. Lesions that have been treated with stereotactic radiosurgery must be clinically stable for one month before protocol treatment. Patients with surgically resected brain metastases are eligible
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at screening
• Negative pregnancy test for women under 55 and all women who have had a menstrual period in the last 12 months. A pregnancy tests is not required for women who have had a bilateral oophorectomy or hysterectomy
• Men and women of child-bearing potential must agree to use adequate contraception (i.e., intrauterine device, hormonal barrier method of birth control; abstinence; tubal ligation or vasectomy) prior to study entry and for 12 months after treatment. Should a women become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately
• Leukocytes > 3,000/mcL
• Absolute neutrophil count > 1,500/mcL
• Platelets > 100,000/mcL
• Hemoglobin > 9.0 g/dL
• Total bilirubin within normal institutional limits except in participants with Gilbert’s Syndrome who must have a total bilirubin < 3.0 mg/dL
• Serum aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) < 2.5 x upper limit of normal (ULN)
• Calculated creatinine clearance (CrCl) > 50 mL/min/1.73 m^2 for participants with creatinine levels above institutional normal (by the Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] equation)
• International normalized ratio (INR) or activated partial thromboplastin time (aPTT) =< 1.5 x ULN unless the subject is receiving anticoagulant therapy. Subjects on anticoagulant therapy must have a prothrombin time (PT) or partial thromboplastin time (PTT) within therapeutic range and no history of severe hemorrhage
• Serology: * Human immunodeficiency virus (HIV) antibody negative * Hepatitis B antigen negative * Hepatitis C antibody negative or hepatitis C virus (HCV) ribonucleic acid (RNA) negative (i.e., no current HCV infection)
• More than four weeks must have elapsed since any prior systemic therapy or radiotherapy at the time the patient receives the KK-LC-1 TCR T cells. Adverse events from prior therapy must be resolved to =< grade 1 according to Common Terminology Criteria for Adverse Events (CTCAE) version 5 or have demonstrated clinical stability and meet the eligibility criteria for the protocol
• Participants must agree to participate in protocol Cancer Institute of New Jersey (CINJ) 192103 (Pro2021002307) for gene therapy long term follow up and in protocol CINJ 192002 (Pro2021000281) or National Institutes of Health (NIH) 192202 (Protocol 16C0061) for biospecimen collection study. * Note: Patients may have undergone minor surgical procedures with the past three weeks, as long as all toxicities have recovered to grade 1 or less

Exclusion Criteria

• Current treatment with another investigational agent
• History of severe allergic reactions to compounds of similar chemical or biologic composition to agents in used in study
• History of coronary revascularization or ischemic symptoms unless patient has a normal cardiac stress test
• Documented left ventricular ejection fraction (LVEF) of less than or equal to 45% tested. The following participants will undergo cardiac evaluations: * Clinically significant atrial and/or ventricular arrhythmias including but not limited to: atrial fibrillation, ventricular tachycardia, second or third degree heart block or * Age greater than or equal to 50 years old
• Participants with baseline screening pulse oxygen level of less than or equal to 92% on room air will not be eligible. If the underlying cause of hypoxia improves, then they may be reevaluated
• Uncontrolled intercurrent illness such as active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations at the time of treatment that would limit compliance with study requirements
• Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with KK-LC-1 TCR T cells, breastfeeding should be discontinued if the mother is treated with KK-LC-1 TCR cells. The potential risks may also apply to other agents used in this study
• Participants with a systemic immunodeficiency including acquired deficiency such as HIV or primary immunodeficiency such as severe combined immunodeficiency disease are ineligible. The experimental treatment being evaluated in this protocol depends on an intact immune system. Participants who have decreased immune competence may be less responsive to the treatment
• Participants on immunosuppressive drugs including corticosteroids unless meeting criteria outlined
• Subjects with HLA-A*01:01 damaging mutation or allele loss or other molecular resistance detected by clinical or research genomic profiling will not be eligible
• Participants with potentially severe autoimmune diseases such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, autoimmune hepatitis, autoimmune pancreatitis, or systemic lupus erythematosus are not eligible. Patients with less severe autoimmune diseases such as hypothyroidism, vitiligo, and other minor autoimmune disorders are eligible
• Participants with prior or concurrent malignancy whose natural history or treatment is unlikely to interfere with the safety or efficacy assessments of the investigational regimen are eligible for this trial. Examples include, but are not limited to: * Carcinoma in situ * Cutaneous skin cancers requiring only local excision * Low grade non-muscle invasive bladder cancer * Low grade prostate cancer Participants with prior or concurrent malignancy that do not meet the above criteria are excluded
• Subjects who received a live vaccine within 30 days prior to enrollment are not eligible
• Determination by the principal investigator that participation is not in the best interest of the research subject or may jeopardize the safety of the subject or integrity of the clinical trial data