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Pilot Study of Non-Viral, RNA-Redirected Autologous T Cells in Patients With Refractory or Relapsed Hodgkin Lymphoma

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ClinicalTrials.gov Identifier: NCT02624258
Recruitment Status : Recruiting
First Posted : December 8, 2015
Last Update Posted : October 15, 2018
Sponsor:
Collaborator:
Children's Hospital of Philadelphia
Information provided by (Responsible Party):
University of Pennsylvania

Brief Summary:
Pilot open-label study to estimate the feasibility, safety and efficacy of intravenously administered, RNA electroporated autologous T cells expressing CD19 chimeric antigen receptors expressing tandem TCRζ and 4-1BB (TCRζ /4-1BB) costimulatory domains (referred to as "RNA CART19") in Hodgkin Lymphoma (HL) patients. Subjects will be treated with IV administration of RNA anti-CD19 CAR T cells for a total of six doses over 3 weeks.

Condition or disease Intervention/treatment Phase
Hodgkin Lymphoma Biological: CD19 RNA redirected autologous T-cells (RNA CART19 cells) Early Phase 1

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 10 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Pilot Study of Non-Viral, RNA-Redirected Autologous T Cells Engineered to Contain Anti-CD19 Linked to TCR and 4-1BB Signaling Domains in Patients With Refractory or Relapsed Hodgkin Lymphoma
Study Start Date : November 2015
Estimated Primary Completion Date : July 2019
Estimated Study Completion Date : December 2019


Arm Intervention/treatment
Experimental: RNA CART19 cells
CD19 RNA redirected autologous T-cells (RNA CART19 cells)
Biological: CD19 RNA redirected autologous T-cells (RNA CART19 cells)
Subjects will be treated with IV administration of RNA anti-CD19 CAR T cells for a total of six doses over 3 weeks. The first dose will be administered 1-4 days after infusion of cyclophosphamide 30mg/kg.




Primary Outcome Measures :
  1. Incidence of Treatment-Emergent Adverse Events, defined as NCI CTCAE V4 > Grade 3 [ Time Frame: Month 4 post-CART19 Infusion ]
    Occurrence of study related adverse events, defined as NCI CTCAE V4 > grade 3 signs/symptoms, laboratory toxicities and clinical events that are possible, likely or definitely related to study treatment at any time from the first cyclophosphamide infusion until Month 4.



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Ages Eligible for Study:   18 Years to 24 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female subjects with HL with no available curative treatment options (such as autologous SCT) who have a limited prognosis (several months to < 2 year survival) with currently available therapies will be enrolled.

    • HL with biopsy-proven relapse or refractory disease who are unresponsive to or intolerant of at least one line of standard salvage therapy;
    • Patients must have evaluable disease by radiologic imaging (FDG PET-CT or FDG PET-MRI) within 42 day of enrollment; evaluable includes both assessable and/or measurable disease
  • Age 18 to 24 years. Patients ages 22-24 will only be enrolled if they are currently being treated at CHOP or another pediatric facility/oncologist.
  • Expected survival > 12 weeks at time of screening
  • Adequate organ function defined as:
  • Renal function defined as:

    • Creatinine clearance or radioisotope GFR > 60 mL/min/1.73 m2 OR
    • Serum creatinine: < 1.7mg/dL (male subjects) or < 1.4mg/dL (female subjects)
  • ALT < 5 times the ULN for age
  • Total Bilirubin < 2.0 mg/dl
  • Must have a minimum level of pulmonary reserve defined as ≤ Grade 1 dyspnea and pulse oxygenation > 94% on room air
  • Patients with relapsed disease after prior allogeneic SCT (myeloablative or non-myeloablative) will be eligible if they meet all other inclusion criteria and
  • Have no active GVHD and require no immunosuppression
  • Are more than 6 months from transplant 6) Karnofsky performance status ≥ 50 at screening
  • Left Ventricular Shortening Fraction (LVSF) > 28% confirmed by echocardiogram, or Left Ventricular Ejection Fraction (LVEF) > 45% confirmed by echocardiogram or MUGA
  • Signed written informed consent must be obtained prior to any study procedures
  • Successful T cell test expansion (to be performed as part of inclusion criteria until 3 subjects meet all enrollment criteria)

Exclusion Criteria:

  • Pregnant or lactating women. The safety of this therapy on unborn children is not known. Female study participants of reproductive potential must have a negative serum pregnancy test at enrollment. A urine pregnancy test will be performed within 48 hours before the RNA CART19 infusion.
  • Uncontrolled active infection.
  • Active hepatitis B or hepatitis C infection.
  • Any uncontrolled active medical disorder that would preclude participation as outlined.
  • HIV infection.
  • Patients with known active CNS involvement by malignancy. Patients with prior CNS disease that has been effectively treated will be eligible providing treatment was >4 weeks before enrollment
  • Patients in complete remission with no evidence by radiologic imaging of disease.
  • History of allergy to murine proteins
  • History of allergy or hypersensitivity to study product excipients (human serum albumin, DMSO, and Dextran 40).
  • Anti-CD20 monoclonal antibody therapy within the last 3 months, or absence of circulating B cells
  • Unstable angina and/or myocardial infarction within 6 months prior to screening.

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 ClinicalTrials.gov identifier (NCT number): NCT02624258


Contacts
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Contact: Mia Benson-Smith 267-426-0762 oncointake@email.chop.edu

Locations
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United States, Pennsylvania
Children's Hospital of Philadelphia Recruiting
Philadelphia, Pennsylvania, United States, 19104
Contact: Mia Benson-Smith    267-426-0762    oncointake@email.chop.edu   
Contact: Claire White    267-426-0762    whiteC3@email.chop.edu   
Principal Investigator: Susan Rheingold, MD         
Sponsors and Collaborators
University of Pennsylvania
Children's Hospital of Philadelphia
Investigators
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Principal Investigator: Susan Rheingold, MD Children's Hospital of Philadelphia

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: University of Pennsylvania
ClinicalTrials.gov Identifier: NCT02624258     History of Changes
Other Study ID Numbers: 14BT055, 821157
First Posted: December 8, 2015    Key Record Dates
Last Update Posted: October 15, 2018
Last Verified: October 2018

Additional relevant MeSH terms:
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Lymphoma
Hodgkin Disease
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases