Trial record 9 of 31 for:    " November 14, 2012":" December 14, 2012"[FIRST-RECEIVED-DATE]AND HIV[CONDITION]

Safety Study of a Dual Anti-HIV Gene Transfer Construct to Treat HIV-1 Infection

This study is currently recruiting participants. (see Contacts and Locations)
Verified June 2014 by Calimmune, Inc.
Sponsor:
Information provided by (Responsible Party):
Calimmune, Inc.
ClinicalTrials.gov Identifier:
NCT01734850
First received: November 19, 2012
Last updated: June 18, 2014
Last verified: June 2014
  Purpose

This is an early phase research study looking at whether an experimental gene transfer, LVsh5/C46 (also known as Cal-1), is safe and if it can protect the immune system from the effects of HIV without the use of antiretroviral drugs.

Cal-1 is an experimental gene transfer agent designed to inhibit HIV infection through 2 active parts:

  1. Removing a protein named CCR5 from bone marrow and white blood cells
  2. Producing a protein named C46 on bone marrow and white blood cells

Condition Intervention Phase
Human Immunodeficiency Virus
Drug: Busulfan
Biological: Cal-1 modified HSPC
Biological: Cal-1 modified CD4+ T lymphocytes
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Adaptive Phase I/II Study of the Safety of CD4+ T Lymphocytes and CD34+ Hematopoietic Stem/Progenitor Cells Transduced With LVsh5/C46, a Dual Anti-HIV Gene Transfer Construct, With and Without Conditioning With Busulfan in HIV-1 Infected Adults Previously Exposed to ART

Resource links provided by NLM:


Further study details as provided by Calimmune, Inc.:

Primary Outcome Measures:
  • Feasibility and safety of the introduction of Cal-1 into HSPC and CD4+ T lymphocyte cell populations, and the associated delivery procedures. [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]

    Baseline demographic and clinical information, treatment, and duration of follow-up will be summarized by group and overall. Severity of clinical adverse events (AEs) and laboratory safety parameters will be graded according to DAIDS criteria. Numbers of individual AEs, in numbers of subjects, will be summarized by severity and treatment. AEs will also be summarized and aggregated by body system for clinical events. The worst severity of each clinical and laboratory AE, for each subject, will be summarized by treatment.

    All grade 3 and 4 AEs, and any other events that lead to a subject ceasing trial follow-up, will be listed by treatment, with duration and resolution.

    Feasibility measures include the number of manufacturing procedures successfully completed (i.e. complying with all release criteria); number of gene modified cells, as affected by CD4+ and CD34+ purity, transduction efficiency, and viability; and the number of target cells harvested.



Secondary Outcome Measures:
  • The benefit of busulfan conditioning in impacting efficacy of Cal-1 in controlling HIV-1 infection [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]

    Log10 HIV-1 RNA, CD4+ T lymphocyte count, CD4+ %, CD4:CD8 ratio, measures of Cal-1 marking/expression and thymopoiesis will be plotted over time for each individual subject, and will be summarized for each nominal study week.

    Changes in Log10 HIV-1 RNA and CD4+ T lymphocyte count from baseline will be formally compared in all subjects.

    Associations between feasibility and safety measures and secondary outcomes include:

    • Number of gene-modified cells infused and peripheral blood marking, plasma HIV RNA and CD4+ T cell counts
    • Integration profile of the Ttn and HSPCtn products and observations in integration analysis of peripheral blood post infusion
    • HSPCtn methylcellulose colony forming units and peripheral blood subpopulation marking


Estimated Enrollment: 12
Study Start Date: April 2013
Estimated Primary Completion Date: June 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: No busulfan pre-conditioning
Cal-1 modified HSPC and Cal-1 modified CD4+ T lymphocytes without busulfan preconditioning
Biological: Cal-1 modified HSPC
Hematopoietic progenitor/stem cells (HSPC) modified with LVsh5/C46 (Cal-1)
Other Name: LVsh5/C46 modified HSPC
Biological: Cal-1 modified CD4+ T lymphocytes
CD4+ T lymphocytes modified with LVsh5/C46 (Cal-1)
Other Name: LVsh5/C46 modified CD4+ T lymphocytes
Experimental: 1 x 4mg/kg busulfan preconditioning
Cal-1 modified HSPC and Cal-1 modified CD4+ T lymphocytes, with single 4mg/kg busulfan dose administered as pre-conditioning for transplant
Drug: Busulfan
Intravenous busulfan
Other Name: Busulfex
Biological: Cal-1 modified HSPC
Hematopoietic progenitor/stem cells (HSPC) modified with LVsh5/C46 (Cal-1)
Other Name: LVsh5/C46 modified HSPC
Biological: Cal-1 modified CD4+ T lymphocytes
CD4+ T lymphocytes modified with LVsh5/C46 (Cal-1)
Other Name: LVsh5/C46 modified CD4+ T lymphocytes
Experimental: 2 x 4mg/kg busulfan pre-conditioning
Cal-1 modified HSPC and Cal-1 modified CD4+ T lymphocytes, with two 4mg/kg busulfan doses administered as pre-conditioning for transplant
Drug: Busulfan
Intravenous busulfan
Other Name: Busulfex
Biological: Cal-1 modified HSPC
Hematopoietic progenitor/stem cells (HSPC) modified with LVsh5/C46 (Cal-1)
Other Name: LVsh5/C46 modified HSPC
Biological: Cal-1 modified CD4+ T lymphocytes
CD4+ T lymphocytes modified with LVsh5/C46 (Cal-1)
Other Name: LVsh5/C46 modified CD4+ T lymphocytes

Detailed Description:

It is estimated that 33 million individuals are currently infected with HIV. HIV/AIDS is a disease that impairs immune function, primarily by decreasing CD4+ T lymphocytes. The progression can be contained by daily dosing with antiretroviral therapy (ART) but there are side effects that can be treatment limiting, and the development of HIV drug resistance can force the physician to modify the ART regimen. There are no effective vaccines currently available for HIV.

LVsh5/C46 (also known as Cal-1) is a dual therapeutic, self-inactivating lentiviral vector that encodes for both a short hairpin RNA against the HIV-1 co-receptor CCR5 (sh5) and a HIV-1 fusion inhibitor, C46 and inhibits two processes required for HIV-1 infection:

  1. Binding of the virus to the cellular CCR5 co-receptor and
  2. Fusion of the virus with the host cell

The rationale is that Cal-1 introduced into hematopoietic progenitor/stem cells (HSPC) and mature CD4+ T lymphocytes will protect these cells and their progeny cells from HIV-1 infection and its pathogenic sequelae. This may provide a continuous means of controlling HIV-1 after a single or infrequent dose(s), thereby decreasing or delaying (partially or completely) the need for antiretroviral drug therapy.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Prior to any study-related procedures, signed informed consent indicating that they understand the purpose, risks and procedures required for the study and are willing to participate in the study
  • Individuals aged 18 to 65 years of age (inclusive) at time of consent
  • Documented HIV-1 infection ≥ 6 months prior to Screening 1
  • Previous treatment with antiretroviral agents that had a demonstrated suppressive effect (defined as plasma HIV RNA ≤ 50 copies/ml)
  • A documented viable ART regimen option, as determined by the Investigator, taking into account prior ART experience and HIV geno/phenotyping analyses
  • Not taking antiretroviral therapy for ≥ 6 weeks prior to Screening 1, for one or more of the following reasons:

    i) Concerns over short-term or long-term toxicities associated with antiretroviral agents, or ii) Treatment fatigue from the daily regimen of life-long therapy

  • Plasma HIV-1 viral RNA ≥ 5,000 copies/mL and ≤ 100,000 copies/ml at Screening 1 and Screening 2
  • CD4+ T lymphocyte count ≥ 500 cells/µl at Screening 1 and Screening 2

Exclusion Criteria:

  • Abnormal hematology at Screening 1: Absolute neutrophil count (ANC) < 1.5 x 109/L, Platelet count < 100 x 109/L, Hemoglobin < 10 g/dL
  • Abnormal biochemistry at Screening 1: Alanine aminotransferase (ALT) > 2.5 x Upper Limit of Normal (ULN), Total bilirubin > 1.5 x ULN, Serum creatinine > 1.5 x ULN
  • Detection of any CXCR4-tropic HIV-1 at Screening 1
  • Evidence of co-infection with hepatitis B virus, hepatitis C virus, West Nile Virus, or HTLV-1 as detected at Screening 2
  • Evidence of active TB infection determined by positive QuantiFERON®-TB Gold/IGRA test result and clinical confirmation at Screening 2
  • ART or other antiretroviral therapy within 6 weeks of Screening 1 or any time during the pre-infusion period
  • Documented history of CD4+ T lymphocyte count < 250 cells/µl
  • Any previous or current AIDS-defining illnesses (CDC Category C), including AIDS-related dementia, with the exception of Kaposi's sarcoma confined to the skin
  • History of malignancy or systemic chemotherapy within the last 5 years (i.e., subjects with prior malignancy must be disease-free for 5 years), except curatively-treated basal cell carcinoma, cutaneous squamous cell carcinoma, or cervical or anal intra-epithelial neoplasia
  • History of steroid-dependent asthma in the past 5 years
  • History of seizure
  • Any clinical history of hematologic diseases including leukemia, myelodysplasia, myeloproliferative disease, thromboembolic disease, sickle cell disorder, thrombocytopenia or leukopenia
  • Class II-IV heart failure, according to the New York Heart Association classification
  • Inadequate venous access for apheresis, as assessed at Screening 1
  • Current or planned systemic immunosuppressive or immunomodulatory medication
  • Taking warfarin, aspirin or any medication that is likely to affect platelet function or other aspects of blood coagulation, and unable to safely cease this medication for a period of 1 week prior, during, and 1 week after administration of G-CSF (a total period of 19 days)
  • Participation in any study involving any investigational drug or medical device within 30 days prior to Screening 1
  • Receipt of a vaccine for HIV-1 or any gene transfer product at any time
  • Prior treatment with recombinant G-CSF or busulfan or other stem-cell mobilizing or modulating agent within the previous 12 months
  • Known hypersensitivity to busulfan, G-CSF (Neupogen™) or E. coli-derived proteins
  • Subjects who will not accept transfusions of blood products
  • Pregnant or breast-feeding at any time between Screening 1 and Baseline (infusion)
  • History of alcohol or drug abuse within the 12 months prior to Screening 1
  • Inability to understand and provide informed consent
  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: NCT01734850

Locations
United States, California
UCLA CARE Center Recruiting
Los Angeles, California, United States, 90035
Contact: Maricela Gonzalez    310-557-3729    mmgonzalez@mednet.ucla.edu   
Principal Investigator: Ronald Mitsuyasu, M.D.         
Quest Clinical Research Recruiting
San Francisco, California, United States, 94115
Contact: Grace Gonzaga    415-353-0212    grace@questclinical.com   
Principal Investigator: Jacob Lalezari, M.D.         
Sponsors and Collaborators
Calimmune, Inc.
Investigators
Principal Investigator: Ronald Mitsuyasu, M.D. University of California, Los Angeles
  More Information

No publications provided

Responsible Party: Calimmune, Inc.
ClinicalTrials.gov Identifier: NCT01734850     History of Changes
Other Study ID Numbers: CAL-USA-11
Study First Received: November 19, 2012
Last Updated: June 18, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by Calimmune, Inc.:
HIV-1

Additional relevant MeSH terms:
Acquired Immunodeficiency Syndrome
HIV Infections
Immunologic Deficiency Syndromes
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Slow Virus Diseases
Immune System Diseases
Busulfan
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antineoplastic Agents, Alkylating
Antineoplastic Agents
Therapeutic Uses
Myeloablative Agonists

ClinicalTrials.gov processed this record on September 14, 2014