Autologous T Cells Expressing Enhanced TCRs Specific for NYESO-1/LAGE in Patients With Ovarian Cancer
This study, will take a subject's "T cells" and "teach" them to be able to recognize and attack the ovarian cancer cells. This is done by putting in a gene or genetic material that will change how a subject's T cells work and hopefully get them to attack and kill ovarian cancer cells. These new T cells are called "engineered T cells" because the new gene is causing them to become directed toward the ovarian cancer cells rather than their usual targets. These are also called "gene-modified T cells". For subjects who have the HLA A2 tissue-type marker, the T cells would be engineered to recognize a substance called "NY ESO 1/LAGE". After putting this new gene in T cells (a procedure called "gene therapy") the investigators will grow the cells in the laboratory and give these cells back to subjects.
|Study Design:||Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Phase I/IIa, Open Label, Clinical Trial Evaluating the Safety and Efficacy of Autologous T Cells Expressing Enhanced TCRs Specific for NY ESO 1/LAGE-1 in Patients With Recurrent or Treatment Refractory Ovarian Cancer|
- NCI CTC V.4 Adverse Events related to study treatment greater than or equal to Grade 3 [ Time Frame: Month: 9 ] [ Designated as safety issue: Yes ]To determine the safety and tolerability of autologous redirected T cell therapy in patients with treatment refractory or resistant Stage III/IV ovarian cancer.
- Tumor Measurements [ Time Frame: Month 9 ] [ Designated as safety issue: No ]Secondary study objectives are: 1) to determine the effect of the treatment on tumor as determined by irRC and progression free survival, 2) to evaluate the persistence of genetically modified cells in the peripheral blood, and as possible at tumor sites, and 3) to evaluate the phenotype and functionality of genetically modified cells isolated from peripheral blood and, as possible, from tumor sites post infusion.
|Study Start Date:||June 2013|
|Estimated Study Completion Date:||January 2019|
|Estimated Primary Completion Date:||July 2014 (Final data collection date for primary outcome measure)|
Experimental: Cohort 1
Subjects who are HLA A201 positive and their tumor expresses NY-ESO-1 and/or LAGE positive.
Biological: T cells
Subjects who are HLA A201 positive and their tumor expresses NY-ESO-1 and/or LAGE positive will undergo apheresis, T cell infusion and frequent follow up for 9 months. Subjects will then undergo long term follow up for up to 15 years.
This is an open label clinical trial. Patients with the HLA-A201 allele and whose tumor expresses the NY-ESO-1 and/or LAGE-1 tumor antigen will be eligible to receive NY ESO 1c259 T. The trial is conducted entirely with outpatient procedures; however, patients may be hospitalized for the cytoreductive chemotherapy at the discretion of the investigator. Upon enrollment, patients will undergo leukapheresis for T cell collection, and their cells will be genetically engineered and expanded ex vivo. Seven days prior to receiving T-cells patients will undergo a cyclophosphamide conditioning regimen to potentiate the immunotherapy. The cell product will be infused as a split infusion (30% Day 0 and 70% Day 1; typically Monday and Tuesday) to mitigate risks associated with unanticipated infusion reactions. Patients will be followed daily for the first week, weekly until 4 weeks, 8 weeks, and 12 weeks and then at 6 months and 9 months. Patients will undergo disease monitoring by MRI/CT scan (as appropriate for disease) at baseline, day 28, 8 weeks and 12 weeks, and months 6, and 9 or until progression, whichever comes first. Optional tumor biopsies will be taken at baseline, at Day 28, and upon progression, if applicable.
In patients who have progressive disease following initial infusion but whose tumors continue to express the appropriate antigen target, these patients will be eligible for a second infusion with redirected T cells.
At 9 months, the interventional portion of the protocol ends and long term follow-up (LTFU) begins at 1 year, in accordance with FDA regulations. LTFU occurs semiannually for up to 5 years post infusion and then annually thereafter for up to 15 years.
|Contact: RPCI Hotlineemail@example.com|
|United States, New York|
|Roswell Park Cancer Institute||Recruiting|
|Buffalo, New York, United States, 14263|
|Contact: Kunle Odunsi, MD, PhD 716-845-3497 Kunle.Odunsi@roswellpark.org|
|Principal Investigator: Kunle Odunsi, MD, PhD|
|Study Chair:||Kunle Odunsi, MD, PhD||Roswell Park Cancer Institute|