Re-directed T Cells for the Treatment (FAP)-Positive Malignant Pleural Mesothelioma

This study is not yet open for participant recruitment. (see Contacts and Locations)
Verified November 2012 by University of Zurich
Sponsor:
Information provided by (Responsible Party):
University of Zurich
ClinicalTrials.gov Identifier:
NCT01722149
First received: October 31, 2012
Last updated: November 2, 2012
Last verified: November 2012
  Purpose

MPM patients not eligible for surgical procedures like decortication or pleuro-pneumectomy have a median survival of 12 months with palliative chemotherapy. Therefore, new therapeutic approaches are of crucial need in this clinical situation. This is a phase I trial for patients with malignant pleural mesothelioma with pleural effusion testing the safety of a fixed single dose of 1x10e6 adoptively transferred FAP-specific re-directed T cells given directly in the pleural effusion. Lymphocytes will be taken 21 days before transfer from peripheral blood. CD8 positive T cells will be isolated and re-programmed by retroviral transfer of a chimeric antigen receptor (CAR) recognizing FAP which serves as target structure in MPM.

  • Trial with immunomodulatory product / biological

Condition Intervention Phase
Malignant Pleural Mesothelioma
Genetic: Adoptive Transfer of re-directed T cells
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase I Study for the Adoptive Transfer of Re-directed FAP-specific T Cells in the Pleural Effusion of Patients With Malignant Pleural Mesothelioma.

Resource links provided by NLM:


Further study details as provided by University of Zurich:

Primary Outcome Measures:
  • Safety [ Time Frame: until 35 days after transfer of re-directed T cells ] [ Designated as safety issue: Yes ]
    Incidence and severity of treatment-related laboratory abnormalities, graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version v4.03 criteria as grade III-IV. In the case of one AE grade III/IV or one SAE the safety monitoring board will judge whether the case is treatment related and whether it have to be counted as DLT.


Estimated Enrollment: 6
Study Start Date: April 2013
Estimated Study Completion Date: October 2014
Estimated Primary Completion Date: October 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Adoptive Transfer of re-directed T cells
Adoptive Transfer of re-directed FAP specific T cells in the pleural effusion
Genetic: Adoptive Transfer of re-directed T cells
Adoptive Transfer of 10e6 re-directed T cells in the pleural effusion

Detailed Description:

This is a phase I trial for patients with malignant pleural mesothelioma. A fixed single dose of adoptively transferred FAP-specific CD8 positive re-directed T cells will be given in the pleural effusion.

Three patients who are at the time point of screening not operable will be treated with re-directed T cells administered into the pleural effusion after completion of 3 cycles of palliative chemotherapy. In the case of one AE grade III/IV or one SAE - and the occurrence of DLT both judged to be treatment related by an independent safety monitoring board - the patient number will be expanded to 6 patients. The study will be stopped if one additional DLT occurs also judged to be treatment related.

Patients will be treated with 1x10e6 re-directed FAP-specific T cells injected in the pleural effusion. The study ends 35 days after adoptive T cell transfer. Re-directed FAP-specific T cells will be administered at day 0 (day 14 of the third cycle of palliative chemotherapy). The study is designed to demonstrate safety of 1x10e6 re-directed FAP-specific T cells. The next patient will be enrolled earliest, when the previous patient completed day +14 and the safety monitoring board has not declared any DLTs. The palliative chemotherapy is not part of the study protocol.

  Eligibility

Ages Eligible for Study:   18 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria:

  • Histologically or cytologically confirmed and documented malignant pleural mesothelioma with pleural effusion,
  • Signed Informed Consent after being informed,
  • Patients medically and/or functionally at screening not accessible for surgical treatment with planned third cycle of palliative chemotherapy in 21 days,
  • Bone marrow function: hemoglobin = 100 g/L; white blood cell count (WBC) = 3.0 x 109/L; absolute neutrophile count (ANC) = 1.5 x 109/L; platelet count = 100 x 109/L,
  • Hepatic: aspartate transaminase (AST) and alanine transaminase (ALT) = 2.5 times upper limit of normal (ULN)); bilirubin = 1.5 x ULN,
  • Renal: creatinine = 2 mg/dL and creatinine clearance = 45 mL/min,
  • No concomitant treatment with systemic corticosteroids, or any other immunosuppressive agents,
  • The patient has received no major organ allograft,
  • HIV-negative,
  • HBV and HCV negative,
  • No uncontrolled bleeding disorder,
  • Patients of child-producing potential must agree to use contraception while enrolled in the study and for 24 months after the adoptive transfer.

Exclusion criteria:

  • Contra-indications to the class of TpP, e.g. known hypersensitivity or allergy to the investigational product,
  • Contra-indications on ethical grounds,
  • Women who are pregnant or breast feeding,
  • Intention to become pregnant during the course of the study,
  • Lack of safe contraception: Safe contraception is defined as follows:Female and male subjects of childbearing potential, using and willing to continue using a medically reliable method of double barrier contraception for the entire study duration and the next 2 years, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices in combination with preservatives. Or subjects who are using any other method considered sufficiently reliable by the investigator in individual cases.Subjects who are surgically sterilized/hysterectomized or post-menopausal for longer than 2 years are not considered as being of child bearing potential.
  • Known or suspected non-compliance,
  • drug or alcohol abuse,
  • Patients with medical history of coronary heart disease (CHD), stroke or peripheral vascular disease (PVD),
  • Patients with medical history of autoimmune disease such as multiple sclerosis, lupus, rheumatoid arthritis, inflammatory bowel disease or small vessel vasculitis,
  • Regular intake of immune-modulating drugs,
  • Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia or confusional state of the subject,
  • Participation in another study with investigational drug within the 30 days preceding and during the present study,
  • Previous enrolment into the current study,
  • Enrolment of the investigator, his/her family members, employees and other dependent persons.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01722149

Contacts
Contact: Ulf Petrausch, MD ulf.petrausch@usz.ch
Contact: Christoph Renner, Prof MD christoph.renner@usz.ch

Locations
Switzerland
University Hospital Zurich, Division of Immunology Not yet recruiting
Zurich, ZH, Switzerland, 8091
Sponsors and Collaborators
University of Zurich
Investigators
Principal Investigator: Christoph Renner, Prof MD University Hospital Zurich, Division of Immunology
  More Information

No publications provided by University of Zurich

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: University of Zurich
ClinicalTrials.gov Identifier: NCT01722149     History of Changes
Other Study ID Numbers: FAPME-1
Study First Received: October 31, 2012
Last Updated: November 2, 2012
Health Authority: Switzerland: Swissmedic

Keywords provided by University of Zurich:
malignant pleural mesothelioma
re-directed T cells
FAP
fibroblast activation protein
CD8 positive T cells
pleural effusion

Additional relevant MeSH terms:
Mesothelioma
Neoplasms, Mesothelial
Pleural Effusion
Adenoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Pleural Diseases
Respiratory Tract Diseases

ClinicalTrials.gov processed this record on September 18, 2014