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Study of FT516 for the Treatment of COVID-19 in Hospitalized Patients With Hypoxia

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ClinicalTrials.gov Identifier: NCT04363346
Recruitment Status : Recruiting
First Posted : April 27, 2020
Last Update Posted : May 18, 2020
Sponsor:
Information provided by (Responsible Party):
Masonic Cancer Center, University of Minnesota

Brief Summary:
This is a Phase I study with the primary objective of identifying the maximum tolerated dose (MTD) of FT516 using 3 dose-escalation strategies (number of doses and cell dose) for the treatment of coronavirus disease 2019 (COVID-19). This study provides initial estimates of safety and efficacy based on stable respiratory function, as well as, determining the feasibility for full-scale studies designed both for efficacy and safety.

Condition or disease Intervention/treatment Phase
COVID-19 Drug: FT516 Phase 1

Detailed Description:

Given the urgency of COVID-19 and the known anti-viral activity of natural killer (NK) cells, this clinical trial uses immediately available off-the-shelf induced pluripotent stem cell (iPSC) derived NK cells already being used to treat cancer patients.

FT516 is an off-the-shelf cryopreserved NK cell product derived from an iPSC that was transduced with a high affinity, ADAM17 non-cleavable CD16 (Fc receptor) that maintains CD16 on the cell surface, which remains fully functional after NK cell activation. The investigators expect that natural developing anti-COVID IgG (early data suggest that some develop in 7-10 days after diagnosis) will enhance targeting of FT516 to infected cells.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 12 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Intervention Model Description: The study starts with a fast-track design by proceeding in cohorts of one patient until the first DLT is observed. If no DLT is observed, escalation continues by one patient per cohort until Dose Strategy 3 is reached. If the MTD is not yet established by Dose Strategy 3, Dose Strategy 3 is expanded to 6 patients using the final stage of a "3+3" design. An extension of 4 additional patients is planned if FT516 continues to be safe for a total of 10 patients treated at the MTD.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Study of FT516 Safety and Feasibility for the Treatment of Coronavirus Disease 2019 (COVID-19) in Hospitalized Patients With Hypoxia
Actual Study Start Date : May 14, 2020
Estimated Primary Completion Date : January 2022
Estimated Study Completion Date : January 2022

Arm Intervention/treatment
Experimental: Dose Strategy 1

Dose Strategy 1:

Day 1 - FT516 is given at 9x107 cells/dose (low)

Drug: FT516
FT516 is an off-the-shelf cryopreserved NK cell product derived from an iPSC that was transduced with a high affinity, ADAM17 non-cleavable CD16 (Fc receptor) that maintains CD16 on the cell surface, which remains fully functional after NK cell activation.

Experimental: Dose Strategy 2

Dose Strategy 2:

Day 1 - FT516 is given at 9x107 cells/dose (low) + Day 4 - FT516 is given at 3x108 cells/dose (mid)

Drug: FT516
FT516 is an off-the-shelf cryopreserved NK cell product derived from an iPSC that was transduced with a high affinity, ADAM17 non-cleavable CD16 (Fc receptor) that maintains CD16 on the cell surface, which remains fully functional after NK cell activation.

Experimental: Dose Strategy 3

Dose Strategy 3:

Day 1 - FT516 is given at 9x107 cells/dose (low) + Day 4 - FT516 is given at 3x108 cells/dose (mid) + Day 7 - FT516 is given at 9x108 cells/dose (high)

Drug: FT516
FT516 is an off-the-shelf cryopreserved NK cell product derived from an iPSC that was transduced with a high affinity, ADAM17 non-cleavable CD16 (Fc receptor) that maintains CD16 on the cell surface, which remains fully functional after NK cell activation.




Primary Outcome Measures :
  1. Number of participants with Dose Limiting Toxicity Events [ Time Frame: within 7 days after the last dose of FT516 ]

    An accelerated (fast-track) design will continue until first DLT is observed or the maximum Tolerated Dose (MTD) is determined.

    DLT is defined as any treatment emergent toxicity within 7 days after the last dose of FT516 meeting one of the following criteria based on CTCAE v5:

    • Grade 3 or greater infusion related reaction following FT516 infusion
    • Any new or worsening Grade 3 and any Grade 4 adverse events with the exception of the following known complications of COVID-19:

      • Grade 3 gastrointestinal disorders (diarrhea)
      • Grade 3 hepatic investigations (ALT increased, AST increased)
      • Grade 3 leukopenia/lymphopenia
    • Respiratory deterioration between the 1st dose and 7 days after the last dose of FT516 defined as the need for any type of assisted ventilation (invasive or non-invasive including BiPAP) or oxygen delivery device intended to deliver ≥60% FiO2 (including non-rebreather mask or >10L by simple facemask) to maintain an SpO2 >88%.


Secondary Outcome Measures :
  1. The time in days from the 1st FT516 infusion to the elimination of viral shedding in nasal pharyngeal and stool samples [ Time Frame: 36 days ]
  2. The time in days from the 1st FT516 infusion to discontinued need for supplemental oxygen [ Time Frame: 36 Days ]
  3. The time in days from the 1st FT516 infusion to hospital discharge [ Time Frame: 36 Days ]


Information from the National Library of Medicine

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, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 76 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Has laboratory-confirmed novel coronavirus (SARS-CoV-2) infection as determined by polymerase chain reaction (PCR), or other commercial or public health assay.
  • Requires hospitalization and meets the following:

    • Radiographic infiltrates by imaging (chest x-ray, CT scan)
    • Able to maintain Sp02 ≥ 93% oxygen supplementation to a maximum 4L by low flow O2-delivery device at rest
    • IL-6 level ≥40 pg/ml but <150 pg/mL OR CRP ≥40 mg/L (4 mg/dL) but <150 mg/L (15 mg/dL)
    • Ferritin < 1000 ng/mL
    • HCT-CI score of 4 or less - For this score, if PFTs results are not available, any patient requiring oxygen prior to COVID-19 illness is not eligible
  • Report of usual daily activity level (before COVID-19 illness) of Karnofsky ≥70%
  • ≥ 18 years of age, but < 76 years at time of consent signing
  • Females of child-bearing potential and males with partners of child-bearing potential must agree to use highly effective contraception from the time of consent and for at least 3 months after the last dose of FT516
  • Agrees to and signs the separate consent for up to 15 years of follow-up on a separate LTFU companion study (IDIM-2020-28770)
  • Voluntary written consent prior to the performance of any research related procedures

Exclusion Criteria:

  • Any medical condition or clinical laboratory abnormality that per Investigator judgement precludes safe participation in and completion of the study, or which could affect compliance with protocol conduct or interpretation of results.
  • Need for higher-percentage oxygen delivery device (face mask, oxymizer, nonrebreather, venti-mask or pressure support with CPAP/BiPAP)
  • Patients with adequate oxygenation on room air
  • Receiving concomitant COVID-19 directed therapy (drugs may be stopped to make patients eligible)
  • Known allergy to the following FT516 components: albumin (human) or DMSO
  • Any known condition that requires systemic immunosuppressive therapy (> 5mg prednisone daily or equivalent) topical and inhale steroids are permitted
  • Active autoimmune disease requiring systemic immunosuppressive therapy
  • History of severe asthma and currently on chronic systemic medications (mild asthma requiring inhaled steroids only is eligible)
  • Known history of HIV positivity
  • Pregnant or breast feeding

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): NCT04363346


Contacts
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Contact: Dr.Joshua Rhein, MD 612-624-3898 rhei0005@umn.edu

Locations
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United States, Minnesota
University of Minnesota Recruiting
Minneapolis, Minnesota, United States, 55455
Sub-Investigator: Timothy Schacker, MD         
Sub-Investigator: Mahsa Abassi, DO,MPH         
Sub-Investigator: Meghan Rothenberger, MD         
Sponsors and Collaborators
Masonic Cancer Center, University of Minnesota
Investigators
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Principal Investigator: Dr.Joshua Rhein, MD Department of Medicine, University of Minnesota
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Responsible Party: Masonic Cancer Center, University of Minnesota
ClinicalTrials.gov Identifier: NCT04363346    
Other Study ID Numbers: IDIM-2020-28708
2020LS083 ( Other Identifier: University of Minnesota Masonic Cancer Center )
First Posted: April 27, 2020    Key Record Dates
Last Update Posted: May 18, 2020
Last Verified: May 2020

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Masonic Cancer Center, University of Minnesota:
COVID-19
Corona Virus
SARS-COV-2
Additional relevant MeSH terms:
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Hypoxia
Signs and Symptoms, Respiratory
Signs and Symptoms