EBV CTLs Expressing CD30 Chimeric Receptors For CD 30+ Lymphoma (CARCD30)
Patients have a type of lymph gland cancer called non-Hodgkin Lymphoma or Hodgkin's Lymphoma.
The body has different ways of fighting infection and disease. No single way seems perfect for fighting cancer. This research study combines two different ways of fighting disease: antibodies and T cells. Antibodies are proteins the protect the body from diseases caused by germs or toxic substances. They work by binding those germs or substances, which stops them from growing and causing bad effects. T cells, also called T lymphocytes, are special infection-fighting blood cells that can kill other cells, including tumor cells or cells that are infected with germs. Both antibodies and T cells have been used to treat patients with cancers: they both have been shown promise, but have not been strong enough to cure most patients. We hope that both will work better together.
We have found from previous research that we can put a new gene into T cells that will make them recognize cancer cells and kill them. We now want to see if we can attach a new gene to T cells that will help them do a better job at recognizing and killing lymphoma cells.
The new gene we will put in T cells makes and antibody called anti-CD30. This antibody sticks to lymphoma cells because of a substance on the outside of the cells called CD30. Anti-CD30 antibodies have been used to treat people with lymphoma, but have not been strong enough to cure most patients.
For this study, the anti-CD30 antibody has been changed so that instead of floating free in the blood it is now joined to the T cells. When an antibody is joined to a T cell in this way it is called a chimeric receptor. These chimeric receptor-T cells seem to kill some of the tumor, but they don't last very long and so their chances of fighting the cancer are unknown.
We have found that T cells that are also trained to recognize the virus that causes infectious mononucleosis can stay in the blood stream for many years. These are called EBV specific Cytotoxic T Lymphocytes. By joining the anti-CD30 antibody to the EBV CTLs, we believe that we will also be able to make a cell that can last a long time in the body and recognize and kill lymphoma cells. We call the final cells CD30 chimeric receptor EBV CTLs. There is also some evidence that patients whose tumors are EBV negative also benefit from this study treatment if their tumor expresses CD30. If we are successful, we hope that these new cells may be able to work longer and target and kill lymphoma cells. However, we do not know that yet.
|Hodgkin's Lymphoma Non-Hodgkin's Lymphoma||Drug: autologous CAR.CD30 EBV specific-CTLs||Phase 1|
|Study Design:||Intervention Model: Single Group Assignment
Masking: No masking
Primary Purpose: Treatment
|Official Title:||Phase I Study of the Administration of EBV CTLs Expressing CD30 Chimeric Receptors for Relapsed CD30+ Hodgkin's Lymphoma and CD30+ Non-Hodgkin's Lymphoma (CAR CD 30)|
- To evaluate the safety of escalating doses of autologous EBV-specific cytotoxic T-lymphocytes (CTLs), [ Time Frame: 6 weeks ]To evaluate the safety of escalating doses of autologous EBV-specific cytotoxic T-lymphocytes (CTLs), genetically modified to express an artificial T-cell receptor (CAR) targeting the CD30 molecule (CAR.CD30), in patients with CD30+ refractory/relapsed Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL)
- To measure the survival of CAR.CD30 transduced EBV-CTLs in vivo. [ Time Frame: 15 years ]To measure the survival of CAR.CD30 transduced EBV-CTLs in vivo.
- To measure the anti-tumor effects of CAR.CD30 transduced CTLs [ Time Frame: 8 weeks ]To measure the anti-tumor effects of CAR.CD30 transduced CTLs in patients with patients with CD30+ refractory/relapsed Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL)
|Actual Study Start Date:||May 10, 2011|
|Estimated Study Completion Date:||October 2033|
|Estimated Primary Completion Date:||October 2018 (Final data collection date for primary outcome measure)|
Experimental: autologous CAR.CD30 EBV specific-CTLs
Group One Dose (CTLs CAR.CD30) at Day 0: 2x10^7 cells/m2
Group Two Dose (CTLs CAR.CD30) at Day 0: 5x10^7 cells/m2
Group Three Dose (CTLs CAR.CD30) at Day 0: 1x10^8 cells/m2
Drug: autologous CAR.CD30 EBV specific-CTLs
Three dose levels will be evaluated. Using the modified continual reassessment method, cohorts of size two will be enrolled at each dose level. Each patient will receive one injection.
Earlier, patients gave us blood to make CD30 chimeric-EBV CTLs in the lab. These cells were grown and frozen for the patient. To get the CD30 antibody to attach to the surface of the T cell, we inserted the antibody gene into the T cell. This is done with a virus called a retrovirus that has been made for this study and will carry the antibody gene into the T cell. Because the patient will have received cells with a new gene in them they will be followed for a total of 15 years to see if there are any long term side effects of gene transfer.
When the patient is enrolled on this study, they will be assigned to one of the following dose levels of CD30 chimeric receptor-EBV CTLs.
- 2×10^7 cells/m2
- 5x10^7 cells/m2
- 1×10^8 cells/m2
The dose level of cells that they will receive will not be based on a medical determination of what is best for them, instead the dose is based on the order in which the patient enrolls on the study relative to other participants. Subjects enrolled earlier in the study will receive a lower dose of cells than those enrolled later in the study. The risks of harm and discomfort from the study treatment may bear some relationship to the dose level. The potential for direct benefit, if any, may also vary with the dose level. To enroll on this study they will need to have recovered from toxic effects of previous chemotherapy for at least one week and not be receiving any other investigational agents. Patients cannot have received any tumor vaccines within the previous six weeks.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01192464
|United States, Texas|
|Houston Methodist Hospital|
|Houston, Texas, United States, 77030|
|Texas Children's Hospital|
|Houston, Texas, United States, 77030|
|Principal Investigator:||Helen E Heslop, MD||Baylor College of Medicine/Center for Cell and Gene Therapy|