Redirected MazF‐CD4 Autologous T Cells for HIV Gene Therapy

This study is currently recruiting participants.
Verified December 2013 by University of Pennsylvania
Sponsor:
Information provided by (Responsible Party):
University of Pennsylvania
ClinicalTrials.gov Identifier:
NCT01787994
First received: January 31, 2013
Last updated: December 17, 2013
Last verified: December 2013
  Purpose

This is an open label, dual cohort study evaluating safety, tolerability and immunogenicity of redirected CD4+ T cells in HIV subjects.


Condition Intervention Phase
HIV
Genetic: Autologous CD4+ T cells genetically modified with a retroviral vector expressing the MazF endoribonuclease gene (MazF‐T), given via intravenous infusion.
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I, Open Label, Dual Cohort, Single Center Study to Evaluate the Safety, Tolerability and Immunogenicity of Autologous CD4 T Cells Modified With a Retroviral Vector Expressing the MazF Endoribonuclease Gene in Patients With HIV

Resource links provided by NLM:


Further study details as provided by University of Pennsylvania:

Primary Outcome Measures:
  • The number of subjects with adverse events following a single dose of MazF transduced cells. Safety will be assessed by reviewing adverse events at 24 hours, 72 hours and 7, 14, 21 days, 4 weeks and 2, 3 and 6 months post infusion. [ Time Frame: 3 years ] [ Designated as safety issue: Yes ]
  • Feasibility will be assessed by counting the number of manufacturing failures. [ Time Frame: Day 0 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Antiviral effects will be monitored in veremic subjects of Cohort 2. The anti-viral effect of infusion will be determined by comparing the viral loads pre-infusion and post-infusion [ Time Frame: 3 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 12
Study Start Date: December 2012
Estimated Study Completion Date: December 2016
Estimated Primary Completion Date: December 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Cohort 1

Cohort 1: HIV‐1‐positive women and men ≥18 years with a CD4 count > 350 cells/mm3, HIV‐1‐RNA levels undetectable by ultrasensitive HIV PCR Abbott assay. Subjects with HIV‐1 RNA < 400 copies/mL are also eligible; however, the HIV‐1 RNA must be < 50 copies/mL within 60 days prior to study entry based on the Abbott assay. Subjects with intermittent isolated episodes of detectable low level viremia (> 50 but <1,000 copies RNA/mL; blips) will be eligible.

There should be at least 2 documented HIV‐1 RNA assays, one drawn >3 months before study entry, one drawn <3 months before study entry. Subjects should be on HAART (no changes to treatment within 4 weeks of study entry) for at least 3 months.

Cohort 1 subjects will receive a single dose of MazF-T cells.

Genetic: Autologous CD4+ T cells genetically modified with a retroviral vector expressing the MazF endoribonuclease gene (MazF‐T), given via intravenous infusion.
Experimental: Cohort 2

Cohort 2: HIV‐1‐positive men and women ≥18 years with detectable viremia (1,000‐ 10,000 copies/ml) and who are off HAART for at least 3 months. The subjects should have a CD4 counts ≥500 cells/mm3 at screening.

Cohort 2 subjects will receive a single dose of MazF-T cells.

Genetic: Autologous CD4+ T cells genetically modified with a retroviral vector expressing the MazF endoribonuclease gene (MazF‐T), given via intravenous infusion.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Subjects with chronic HIV‐1 infection, as documented by ELISA and confirmed by Western blot at any time prior to study entry. HIV‐1 culture, HIV‐1 antigen, plasma HIV‐1 RNA, or a second antibody test by a method other than ELISA is acceptable as an alternative confirmatory test.
  2. Antiretroviral medication

    • Cohort 1: Subjects on HAART (no changes to treatment within 4 weeks of study entry) for at least 3 months.
    • Cohort 2: Subjects off any anti‐retroviral therapy for at least 12 weeks. These subjects can be treatment naïve or patients who interrupted ART for various reasons for at least 12 weeks before the screening visit.
  3. Plasma HIV viremia

    • Cohort 1: HIV‐1‐positive men and women >18 years of age with HIV‐1‐RNA levels undetectable by ultrasensitive HIV PCR Abbott assay at screening. Also eligible are subjects with HIV‐1 RNA < 400 copies/mL; however, the HIV‐1 RNA must be < 50 copies/mL within 60 days prior to study entry based on the Abbott assay. Subjects with intermittent isolated episodes of detectable low level viremia (> 50 but <1,000 copies RNA/mL; blips) will be eligible. There should be at least 2 documented HIV‐1 RNA assays, one drawn >3 months before study entry, one drawn <3 months before study entry.
    • Cohort 2: HIV‐1‐positive men and women >18 years of age with detectable viremia (1,000‐10,000 copies/ml) and who are off HAART for at least 3 months.
  4. CD4 counts

    • Cohort 1: Subjects with CD4 counts >200 cells/mm3.
    • Cohort 2: Subjects with CD4 counts of at least 500 cells/mm3 at screening. CD4+ T cell counts should have been obtained within 60 days prior to study entry.
  5. Adequate venous access and no other contraindications for leukapheresis.
  6. Laboratory values obtained within 60 days prior to entry.

    • Hemoglobin: ≥ 10.0 (males); ≥ 9.5 (females) g/dL
    • Absolute neutrophil count (ANC): ≥ 1000/mm3
    • Platelet count: ≥ 75,000/mm3
    • Serum creatinine: ≤ 1.5 mg/dL (133μ mol/L)
    • Aspartate aminotransferase (AST) or alanine aminotransferase (ALT): ≤ 2.5 times the upper limit of normal (ULN).
  7. Subjects must be willing to comply with study‐mandated evaluations. Rectal biopsy procedures are optional.
  8. Be male or female, 18 years of age and older.
  9. Ability and willingness of subject to provide informed consent.
  10. Have a Karnofsky Performance Score of 70 or higher.

Exclusion Criteria:

  1. Current or prior AIDS diagnosis.
  2. Concomitant acute or chronic hepatitis B (surface antigen positive) or hepatitis C infection. If HCV antibody test is positive, an HCV RNA test will be performed. If both HCV tests (antibody and RNA) are positive, the subjects will be excluded from study. If HCV antibody test is positive, but HCV RNA test is negative, subject can enroll.
  3. History of cancer or malignancy, with the exception of successfully treated basal cell or squamous cell carcinoma of the skin.
  4. History or any features on physical examination indicative of active or unstable cardiac disease or hemodynamic instability. NOTE: subjects with a history of cardiac disease may participate with a physician's approval.
  5. History or any features on physical examination indicative of a bleeding diathesis.
  6. Have been previously treated with any HIV experimental vaccine within 6 months prior to screening, or any previous gene therapy using an integrating vector.
  7. Use of chronic corticosteroids, hydroxyurea, or immunomodulating agents (e.g., interleukin‐2, interferon‐alpha or ‐gamma, granulocyte colony stimulating factors, etc.) within 30 days prior to study entry.

    NOTE: Recent or current use of inhaled steroids is not exclusionary. If subjects are prescribed a brief course of oral corticosteroids, the use should be limited to less than 7 days.

  8. Use of steroids before apheresis and immune assessment blood draws should be discouraged as it will affect white blood cell function.
  9. Breast‐feeding, pregnant, or unwilling to use acceptable methods of birth control.
  10. Use of aspirin, dipyrdamole, warfarin or any other medication that is likely to affect platelet function or other aspects of blood coagulation during the 2‐week period prior to leukapheresis.
  11. Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
  12. Serious illness requiring systemic treatment and/or hospitalization within 30 days prior to study entry.
  13. Asymptomatic baseline serum chemistry elevations in total or indirect bilirubin in subjects receiving atazanavir or indinavir is not exclusionary. Asymptomatic baseline serum chemistry elevations in LFTs, lipase and creatinine due to HAART medication are not exclusionary, when in the opinion of the investigator, the abnormalities are not attributable to intrinsic hepatorenal disease. Such elevations must be due to HAART.
  14. Receipt of a vaccination within 30 days prior to study entry. NOTE: It is recommended that subjects enrolling into this study should have completed their routine vaccinations (hepatitis A, hepatitis B, pneumococcus, and tetanus diphtheria booster) at least 30 days prior to screening for the study.
  15. Have an allergy or hypersensitivity to study product excipients (human serum albumin, DMSO and Dextran 40).
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01787994

Contacts
Contact: Meghan Metz, MS 267.507.6769 Meghan.Metz@DrexelMed.edu

Locations
United States, Pennsylvania
Division of Infectious Diseases & HIV Medicine at Drexel University College of Medicine Recruiting
Philadelphia, Pennsylvania, United States, 19102
Contact: Meghan Metz, MS         
Principal Investigator: Jeffrey Jacobson, MD         
Sponsors and Collaborators
University of Pennsylvania
  More Information

No publications provided

Responsible Party: University of Pennsylvania
ClinicalTrials.gov Identifier: NCT01787994     History of Changes
Other Study ID Numbers: 815441
Study First Received: January 31, 2013
Last Updated: December 17, 2013
Health Authority: United States: Food and Drug Administration

ClinicalTrials.gov processed this record on April 17, 2014