A Phase I Trial of Autologous CLL B Cells Transduced to Express Chimeric CD154 (ISF35)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00779883
Recruitment Status : Completed
First Posted : October 24, 2008
Last Update Posted : October 24, 2008
Information provided by:
Memgen, LLC

Brief Summary:
The study is a Phase I, dose-escalating, non-randomized, single institution clinical trial assessing the safety and efficacy of autologous Ad-ISF35-transduced CLL B cells administered as a single intravenous infusion in patients with chronic lymphocytic leukemia (CLL).

Condition or disease Intervention/treatment Phase
Chronic Lymphocytic Leukemia Biological: ISF35 Phase 1

Detailed Description:

Memgen's first TNF family derived product, ISF35, is a gene that encodes a recombinant protein molecule that binds and activates human CD40+ B lymphocytes that are found on a vast majority of malignant leukemias and lymphomas.

In this clinical trial, ISF35 will be introduced into the patients' CLL cells ex vivo using a replication-defective adenovirus Ad5 encoding the ISF35 cDNA transgene. After this ex vivo manipulation, the modified leukemia cells will be extensively washed and the amount of remaining free virus is measured before the cells are reinfused into the patient. Following ex vivo transduction, the CLL cells expressing ISF35 activate a therapeutic immune response directed against the target leukemia cells.

This ascending-dose trial will be divided into three dosing cohorts to determine the existence of a maximum tolerated dose.

Patients will be followed for 12 months after ISF35 administration or until initiation of another treatment.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 9 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I Trial of Autologous CLL B Cells Transduced to Express Chimeric CD154 (ISF35)
Study Start Date : June 2006
Actual Primary Completion Date : March 2008
Actual Study Completion Date : March 2008

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Leukemia

Intervention Details:
  • Biological: ISF35
    Subjects participating in this study will receive a single dose of 1x10^8, 3x10^8, or 1x10^9 autologous Ad-ISF35-transduced CLL B cells.
    Other Names:
    • Ad-ISF35
    • AdISF35

Primary Outcome Measures :
  1. Assess the toxicity, tolerability, and safety of 1x10^8, 3x10^8, and 1x10^9 autologous Ad-ISF35-transduced CLL B cells given as a single intravenous infusion in patients with CLL. [ Time Frame: Duration of the trial ]

Secondary Outcome Measures :
  1. Assess the anti-leukemia activity of a single intravenous dose by evaluating reduction in leukemia count, reduction in adenopathy and splenomegaly, and improvement in bone function. [ Time Frame: Duration of the trial ]
  2. Assess the quality of life with ISF35 treatment. [ Time Frame: Two months ]
  3. Assess pharmacodynamic endpoints including induction of T cell anti-leukemia immune responses, antibody production against autologous CLL B cells, and changes in bystander leukemia cell phenotype. [ Time Frame: Two months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Subjects must have a diagnosis of B cell CLL, measurable disease, and an

    NCI-WG indication for treatment with one of the following:

    • Massive (>6 cm below left costal margin) or progressive splenomegaly;
    • Massive (>10 cm longest diameter) lymph nodes, nodal clusters, or progressive lymphadenopathy;
    • Progressive anemia;
    • Progressive thrombocytopenia;
    • Weight loss > 10% body weight over the preceding 6 month period;
    • Fatigue attributable to CLL;
    • Fever or night sweats without evidence of infection;
    • Progressive lymphocytosis.
  2. Subjects must be age 18 years or older.
  3. Women of childbearing potential (not postmenopausal for at least one year or not surgically incapable of bearing children) must agree not to become pregnant for the duration of the study. Both men and women participants must agree to use contraception for the duration of the study.
  4. Subjects must have Zubrod performance status of ≤ 2 (Appendix B).
  5. Subjects must have adequate hematologic, renal, hepatic, and coagulation function:

    • Adequate hematologic function:

      • Platelet count ≥ 50,000/μl; AND
      • Hemoglobin ≥ 10 g/dl (may be supported by erythropoietin or transfusion).
    • Adequate renal function:

      • Serum creatinine ≤ 1.5 times upper limit of normal; OR
      • Measured creatinine clearance ≥ 40 mL/min/1.73 m^2.
    • Adequate hepatic function:

      • Total bilirubin ≤ 2.5 times upper limit of normal; AND
      • ALT ≤ 2.5 times upper limit of normal; AND
    • Adequate coagulation tests:

      • Prothrombin time international normalized ratio (INR) ≤ 2; AND
      • Partial thromboplastin time ≤ 1.66 times upper limit of normal
  6. Subjects must be able to give written informed consent.

Exclusion Criteria:

  1. Presence of more than 55% prolymphocytes.
  2. Chemotherapy (e.g., purine analogues, alkylating agents, or corticosteroids), antibody therapy, immunotherapy, radiation therapy, or participation in any investigational drug treatment within 4 weeks of enrollment into protocol or at any time during the study.
  3. Ongoing toxicity from prior anti-neoplastic therapy.
  4. Prior gene therapy or allogeneic stem cell transplantation.
  5. Untreated autoimmune hemolytic anemia or immune thrombocytopenia.
  6. Active infection requiring parenteral antibiotics.
  7. Known HIV/HBV/HCV seropositivity.
  8. Uncompensated hypothyroidism (defined as TSH greater than 4x upper limit of normal not treated with replacement hormone).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00779883

United States, Texas
University of Texas M.D. Anderson Cancer Center
Houston, Texas, United States, 77030
Sponsors and Collaborators
Memgen, LLC
Principal Investigator: William G. Wierda, M.D., Ph.D. M.D. Anderson Cancer Center

Publications of Results:
Other Publications:
Castro JE, Cantwell MJ, Prusak CE, Bole J, Wierda WG, Kipps TJ. long-term followup of chronic lymphocytic leukemia patients treated with CD40-ligand (CD154) gene therapy. Blood 2003; 102(11):491a (Abstract #1790).
Saville W, Kipps TJ, Cantwell MJ, et al. A phase II trial of immune therapy for chronic lymphocytic leukemia. Blood. 2003; 102(11 ):437a (Abstract #1592).

Responsible Party: William G. Wierda, M.D., Ph.D., M.D. Anderson Cancer Center Identifier: NCT00779883     History of Changes
Other Study ID Numbers: CLL-35-101
First Posted: October 24, 2008    Key Record Dates
Last Update Posted: October 24, 2008
Last Verified: October 2008

Keywords provided by Memgen, LLC:
Chronic lymphocytic leukemia
Leukemia, Lymphocytic, Chronic, B-Cell
Leukemia, B-Cell
Immune System Diseases
Immune therapy
Active immune therapy

Additional relevant MeSH terms:
Leukemia, Lymphoid
Leukemia, Lymphocytic, Chronic, B-Cell
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Leukemia, B-Cell