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NKX101, Intravenous Allogeneic CAR NK Cells, in Adults With AML or MDS

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ClinicalTrials.gov Identifier: NCT04623944
Recruitment Status : Recruiting
First Posted : November 10, 2020
Last Update Posted : April 15, 2022
Information provided by (Responsible Party):
Nkarta Inc.

Brief Summary:
This is a single arm, open-label, multi-center, Phase 1 study to determine safety and tolerability of an experimental therapy called NKX101 (allogeneic CAR NK cells targeting NKG2D ligands) in patients with relapsed/refractory AML or intermediate, high and very high risk relapsed/refractory MDS

Condition or disease Intervention/treatment Phase
Relapsed/Refractory AML AML, Adult MDS Refractory Myelodysplastic Syndromes Biological: NKX101 - CAR NK cell therapy Phase 1

Detailed Description:

This is a dose-finding study of NKX101 and will be conducted in 2 parts:

Part 1: dose finding with two dosing regimens, utilizing modified "3+3" enrollment schema.

Part 2: dose expansion to further evaluate safety and tolerability, cellular kinetics, pharmacodynamics and anti-tumor response in expansion cohorts of patients with either AML or MDS.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 90 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1 Study of NKX101, an Activating Chimeric Receptor Natural Killer Cell Therapy, in Subjects With Hematological Malignancies or Dysplasias
Actual Study Start Date : September 21, 2020
Estimated Primary Completion Date : July 2023
Estimated Study Completion Date : July 2038

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: NKX101 - CAR NK cell therapy

All subjects in Part 1 will receive fludarabine/cyclophosphamide lymphodepletion followed by 3 or 2 (Regimen A or B, respectively) weekly doses of NKX101.

Subjects in Part 2 will receive either fludarabine/cyclophosphamide lymphodepletion or, if an AML combination arm is opened, fludarabine/cytarabine (ara-C), followed by 3 or 2 weekly doses of NKX101 depending on specific expansion cohort.

Regimen A will have 3 doses of NKX101 on Day 0, 7, and 14 of a 28-day cycle. Regimen B will have 2 doses of NKX101 on Day 0 and 7 of a 28-day cycle.

Part 1 and 2: either haplo-matched related donor derived or unrelated off-the-shelf donor derived NKX101 will be used.

Biological: NKX101 - CAR NK cell therapy
NKX101 is an investigational allogeneic CAR NK product targeting NKG2D ligands on cancer cells. The starting dose of NKX101 in Part 1/Regimen A is 1 × 10^8 NK cells (2 × 10^6/kg for patients < 50 kg) administered as 3 weekly doses. The starting dose of NKX101 in Part 1/Regimen B is 1.5 × 10^8 NK cells (3 × 10^6/kg for patients < 50 kg) administered as 2 weekly doses. Part 2 will use the maximum tolerated dose (MTD) or recommended Phase 2 dose (RP2D) of NKX101 as determined in Part 1.
Other Names:
  • Cyclophosphamide
  • Fludarabine
  • Cytarabine (ara-C)

Primary Outcome Measures :
  1. Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] [ Time Frame: 30 days after last dose of NKX101 ]
    Incidence, nature, and severity of treatment related adverse events will be evaluated. An adverse event is any unfavorable and unintended sign including clinically significant abnormal laboratory findings, symptom or disease.

  2. Proportion of subjects experiencing dose-limiting toxicities of NKX101 [ Time Frame: 28 days from first dose of NKX101 ]
    DLTs are defined as adverse events attributable to NKX101 treatment that occur during Cycle 1 and meet protocol-specified criteria

  3. Response rate to NKX101 (for Part 2) [ Time Frame: 28 days from first dose of NKX101 ]
    Responses will be assessed per modified ELN criteria and will include complete and partial remission with and without varying degrees of hematologic recovery

Secondary Outcome Measures :
  1. Assessment of NKX101 half-life [ Time Frame: 28 days from first dose of NKX101 ]
    Time required for 50% reduction from maximum amount of circulating NKX101

  2. NKX101 duration of persistence [ Time Frame: Followed up to 2 years after last dose of NKX101 ]
    Testing NKX101 in peripheral blood every 3 months after dosing to determine persistence

  3. Evaluation of host immune response against NKX101 [ Time Frame: Followed up to 2 years after last dose of NKX101 ]
    Serum samples will be measured for antibodies against NKX101

  4. Response rate to NKX101 [ Time Frame: Primary assessment: 28 days after first dose of NKX101 followed up to 2 years after last dose of NKX101 ]
    Time-to-first response, time-to-best response, duration of response, transfusion independent rate, bridge-to-transplant rate, event-free survival, progression-free survival (PFS), overall survival (OS) (for all subjects), and hematologic improvement rates (for subjects with myelodysplastic syndrome [MDS])

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:

  • General:

    • ECOG performance status ≤2
    • Haplo-matched related subjects require a suitable haplo-matched related donor, who is able and willing to undergo leukapheresis
  • Disease related:

    • For AML subjects:

      • Previously treated relapsed/refractory AML, including subjects with MRD+ disease
      • Received at least 1 and at most 2 lines of previous standard anti-leukemia therapy
      • For subjects with fms-like tyrosine kinase 3 (FLT3)-mutated or isocitrate dehydrogenase (IDH)1/2 mutated disease, subjects must have received at least 1 prior respective targeted therapy and may receive up to 3 lines of prior therapy
      • White blood cell count of ≤25 × 10^9/L
    • For MDS subjects:

      • Intermediate-, high-, or very high-risk MDS
      • Previously treated relapsed/refractory MDS
      • Received at least 1 and at most 2 lines of previous standard anti-MDS therapy
  • Adequate Organ Function
  • Platelet count ≥30,000/uL (platelet transfusions acceptable)
  • Other:

    • Signed informed consent
    • Agree to use an effective barrier method of birth control

Exclusion Criteria:

  • Disease related:

    • Acute promyelocytic leukemia with t(15;17) (q22;q12); or abnormal promyelocytic leukemia/retinoic acid receptor alpha (APML-RARA)
    • Evidence of leukemic meningitis or known active central nervous system disease
    • Peripheral leukocytosis with ≥ 20,000 blasts/μL or other evidence of rapidly progressive disease that would preclude subject from completing at least 1 cycle of treatment
    • Use of any anti-AML/MDS chemotherapeutic or targeted small molecule drug within protocol specified window prior to the first dose of NKX101
    • Presence of residual non-hematologic toxicity from prior therapies that has not resolved to ≤ Grade 1
    • Any hematopoietic cell transplantation within 16 weeks
  • Other comorbid conditions and concomitant medications prohibited as per study protocol
  • Other:

    • Pregnant or lactating female

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): NCT04623944

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Contact: David Shook, MD +1 415-651-5080 medmonitor@nkartatx.com
Contact: Cornell Chang +1 415-651-5060 clinops@nkartatx.com

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United States, Colorado
Colorado Blood Cancer Institute Recruiting
Denver, Colorado, United States, 80218
Contact: Marcello Rotta    844-482-4812    asksarah@sarahcannon.com   
Principal Investigator: Marcello Rotta, MD         
United States, Georgia
Winship Cancer Institute, Emory University Recruiting
Atlanta, Georgia, United States, 30322
Contact: Corey Williams    404-251-2014    corey.williams2@emory.edu   
Principal Investigator: William Blum, MD         
United States, Illinois
University of Chicago Medical Center Recruiting
Chicago, Illinois, United States, 60637
Contact: Hongtao Liu, MD, PhD    773-834-0589    hliu2@medicine.bsd.uchicago.edu   
Principal Investigator: Hongtao Liu, MD, PhD         
United States, Ohio
The Cleveland Clinic - Taussig Cancer Institute Recruiting
Cleveland, Ohio, United States, 44195
Contact: Betty Hamilton, MD       hamiltb2@ccf.org   
Principal Investigator: Betty Hamilton, MD         
United States, Tennessee
Sarah Cannon at TriStar Bone Marrow Transplant Center Recruiting
Nashville, Tennessee, United States, 37203
Contact: Jeremy Pantin    844-482-4812    asksarah@sarahcannon.com   
Principal Investigator: Jeremy Pantin, MD         
United States, Texas
MD Anderson Cancer Center, University of Texas Recruiting
Houston, Texas, United States, 77030
Contact: Carol Bivins    713-794-4460    cbibins@mdanderson.org   
Principal Investigator: Gautam Borthakur, MD         
Methodist Healthcare System of San Antonio Recruiting
San Antonio, Texas, United States, 78229
Contact: Sherri Shade, RN, CCRC    210-575-4238    sherri.shade@mhshealth.com   
Principal Investigator: Carlos Bachier, MD         
Sponsors and Collaborators
Nkarta Inc.
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Study Director: David Shook, MD Nkarta Inc.
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Responsible Party: Nkarta Inc.
ClinicalTrials.gov Identifier: NCT04623944    
Other Study ID Numbers: NKX101-101
First Posted: November 10, 2020    Key Record Dates
Last Update Posted: April 15, 2022
Last Verified: April 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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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 Nkarta Inc.:
Natural killer
Interleukin 15
NK cell
Cell Therapy
Adoptive cell therapy
r/r AML
Additional relevant MeSH terms:
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Myelodysplastic Syndromes
Bone Marrow Diseases
Hematologic Diseases
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Myeloablative Agonists
Antimetabolites, Antineoplastic
Antiviral Agents
Anti-Infective Agents