Safety Study of Zinc Finger Nuclease CCR5-modified Hematopoietic Stem/Progenitor Cells in HIV-1 Infected Patients
This study is currently recruiting participants.
Verified June 2017 by City of Hope Medical Center
Sponsor:
City of Hope Medical Center
Collaborator:
Sangamo Therapeutics
Information provided by (Responsible Party):
City of Hope Medical Center
ClinicalTrials.gov Identifier:
NCT02500849
First received: March 16, 2015
Last updated: June 2, 2017
Last verified: June 2017
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Purpose
The purpose of the study is to evaluate the safety and feasibility of administering SB-728mR-HSPC after conditioning with busulfan.
| Condition | Intervention | Phase |
|---|---|---|
| HIV | Genetic: SB-728mR-HSPC Infusion 3 days following busulfan conditioning | Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: No masking Primary Purpose: Treatment |
| Official Title: | A Pilot Study to Evaluate the Feasibility, Safety and Engraftment of Zinc Finger Nuclease (ZFN) CCR5 Modified CD34+ Hematopoietic Stem/Progenitor Cells (SB-728mR-HSPC) in HIV-1 (R5) Infected Patients |
Resource links provided by NLM:
Further study details as provided by City of Hope Medical Center:
Primary Outcome Measures:
- Toxicity in subjects who received SB-728mR-HSPC after each busulfan dose level [ Time Frame: 18 months ]
Secondary Outcome Measures:
- Number of CD34+ HSPC collected, gene modified, and released throughout the manufacturing process [ Time Frame: Approximately first 1-2 months on study ]
Other Outcome Measures:
- Detection of CCR5 modified HSPC in bone marrow [ Time Frame: Up to Month 12 ]
- Time to hematological recovery as measured by neutrophil and platelet engraftment time [ Time Frame: Up to Year 5 ]
- Changes in CD4+ T-cell percentage after SB-728mR-HSPC infusion [ Time Frame: Up to Year 5 ]
- Changes in CD4+ T-cell number after SB-728mR-HSPC infusion [ Time Frame: Up to Year 5 ]
- Changes in CD4/CD8 ratio after SB-728mR-HSPC infusion [ Time Frame: Up to Year 5 ]
- Detection of CCR5-modified PBMC in blood over time [ Time Frame: Up to Year 5 ]
- HIV-1 RNA levels in plasma during the treatment interruption of antiretroviral medicines [ Time Frame: ATI Day 0 and weeks 2, 4, 6, 8, 10, 12, 14, 16 and 28 ]
- Longitudinal changes of proviral DNA in PBMC [ Time Frame: 18 months ]
- Pharmacokinetic analysis of busulfan (AUC levels) [ Time Frame: pre-busulfan and at 15, 30, 60, 180 and 240 min after end of infusion ]
| Estimated Enrollment: | 12 |
| Study Start Date: | July 2015 |
| Estimated Study Completion Date: | July 2018 |
| Estimated Primary Completion Date: | July 2018 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Cohort 1:
target busulfan AUC levels: 8,000 µM*min (+/- 1,000)
|
Genetic: SB-728mR-HSPC Infusion 3 days following busulfan conditioning
Other Name: busulfan
|
|
Experimental: Cohort 2:
busulfan AUC levels: 12,000 µM*min (+/- 1,000)
|
Genetic: SB-728mR-HSPC Infusion 3 days following busulfan conditioning
Other Name: busulfan
|
Detailed Description:
The objective of the study is to evaluate the safety and feasibility of giving autologous SB-728mR-HSPC to HIV-1 (R5) infected patients who are being treated with cART and have undetectable virus but suboptimal CD4+ cell levels. To strengthen the possibility that CCR5-disrupted HSPCs engraft, patients will receive either a two- or three-day (Cohort 1 or Cohort 2) course of busulfan (dose targeting AUC of 4000 µM/day) before being infused with the genetically modified cells. At 9-12 months after SB-728mR-HSPC infusion, subjects who are aviremic with CD4 cell counts ≥600 cells/µL and have ≥1% CCR5-modified CD4 cells within the peripheral blood detected by pentamer PCR will undergo an ATI.
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years (Adult, Senior) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- Maximum age 75 years for cohort 1 and 65 years for cohort 2.
- HIV-1 R5 seropositive with no evidence of CXCR4-tropic virus.
- On cART with undetectable HIV-1 (<20 gc/ml HIV-1 RNA) for at least 12 months prior to screening evaluations.
- CD4+ T-cell counts ≥200 cells/µL and ≤750 cells/µL.
- No psychosocial conditions that would hinder study compliance and follow-up.
- Absence of clinically significant cardiomyopathy, congestive heart failure.
Secondary Eligibility Criteria (for registration):
- Complete G-CSF/Plerixafor mobilization of HSPC.
- Collect ≥7.5 x 10^6 CD34+ cells/kg in two aphereses.
- The SB-728mR-HSPC product passed all release testing
Exclusion Criteria:
- Use of AZT or maraviroc in the cART regimen.
- History of significant hematologic diseases such as leukemia, myelodysplasia, coagulopathy, and thromboembolism.
- Any AIDS-related opportunistic infection occurring within the past year such as tuberculosis, cryptococcosis and for which treatment has been unsuccessful as determined by the Principal Investigator.
- AIDS-related syndromes, infectious or otherwise, if perceived to cause excessive risk for morbidity post-HSPC infusion, as determined by the Principal Investigator.
- Patients with active HBV or HCV infection, i.e., HBV DNA and HCV RNA in blood, are excluded. Those with inactive, but past infection with HBV (positive HBV surface antigen or HBV surface antibody) or inactive HCV (positive HCV antibody), must have no cirrhosis, as determined by abdominal ultrasound with elastography.
- Active CMV retinitis or other active CMV-related organ dysfunction.
- CXCR4-tropic virus.
- Pregnant or nursing women.
- Any history of HIV-associated encephalopathy; dementia of any kind; seizures in the past 12 months; any perceived inability to directly provide informed consent.
- Participants may not be receiving any other investigational agents, or concurrent biological, chemotherapy, or radiation therapy. Participation in prior investigational drug or medical device study within the previous 45 days.
- Current or history of immunomodulatory agent or steroid use.
- Prior therapy with HIV vaccine or gene therapy product.
- History of alcohol or substance abuse for the previous 12 months.
- Participants with active malignancies. However, participants with skin cancers, namely basal cell or squamous cell carcinoma, and malignancies treated with curative intent having no known active disease present for ≥2 years, may be eligible.
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: NCT02500849
Please refer to this study by its ClinicalTrials.gov identifier: NCT02500849
Contacts
| Contact: Rodica Stan, PhD | 626-218-8330 | rstan@coh.org |
Locations
| United States, California | |
| City of Hope Medical Center | Not yet recruiting |
| Duarte, California, United States, 91010 | |
| Contact: Rodica Stan, PhD 626-218-8330 rstan@coh.org | |
| Principal Investigator: Amrita Y. Krishnan, MD | |
| UCLA CARE Center | Recruiting |
| Los Angeles, California, United States, 90035 | |
| Contact: Maricella Gonzalez 310-557-3729 mmgonzalez@mednet.ucla.edu | |
| Principal Investigator: Ronald Mitsuyasu, MD | |
| Mills Clinical Research | Recruiting |
| Los Angeles, California, United States, 90069 | |
| Contact: Sandro Antunes 310-550-2271 Sandro.Antunes@millsclinicalresearch.com | |
| Principal Investigator: Anthony Mills, MD | |
| Palmtree Clinical Research, Inc. | Recruiting |
| Palm Springs, California, United States, 92262 | |
| Contact: Erik Hernandez 760-902-9615 ehernandez@palmtreeclinical.com | |
| Principal Investigator: Richard A. Loftus, MD | |
| Quest Clinical Research | Recruiting |
| San Francisco, California, United States, 94115 | |
| Contact 415-353-0800 | |
| Principal Investigator: Sandra S. Win, MD | |
| United States, Connecticut | |
| Circle CARE Center, LLC | Recruiting |
| Norwalk, Connecticut, United States, 06850 | |
| Contact: Greg Ulrich, RN 203-852-9525 gulrich@whcccc.org | |
| Contact: Patricia R Garton, APRN 203-852-9525 tgarton@whcccc.org | |
| Principal Investigator: David Rubin, MD | |
| United States, Florida | |
| Gary J. Richmond, MD, PA | Recruiting |
| Fort Lauderdale, Florida, United States, 33316 | |
| Contact: Vernon F. Appleby, RN 954-524-2250 ext 211 vfappleby@earthlink.net | |
| Principal Investigator: Gary J. Richmond, MD | |
Sponsors and Collaborators
City of Hope Medical Center
Sangamo Therapeutics
Investigators
| Principal Investigator: | Amrita Y. Krishnan, MD | City of Hope Medical Center |
More Information
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | City of Hope Medical Center |
| ClinicalTrials.gov Identifier: | NCT02500849 History of Changes |
| Other Study ID Numbers: |
14017 |
| Study First Received: | March 16, 2015 |
| Last Updated: | June 2, 2017 |
Keywords provided by City of Hope Medical Center:
|
Gene therapy Acquired Immunodeficiency Syndrome HIV Infections Retroviridae Infections RNA Virus Infections Virus Diseases |
Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases Busulfan Pharmacologic Actions |
Additional relevant MeSH terms:
|
Busulfan Alkylating Agents Molecular Mechanisms of Pharmacological Action Immunosuppressive Agents Immunologic Factors |
Physiological Effects of Drugs Antineoplastic Agents, Alkylating Antineoplastic Agents Myeloablative Agonists |
ClinicalTrials.gov processed this record on July 17, 2017


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