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NY-ESO-1-Specific T-cells in Treating Patients With Advanced NY-ESO-1-Expressing Sarcomas Receiving Palliative Radiation Therapy

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ClinicalTrials.gov Identifier: NCT02319824
Recruitment Status : Completed
First Posted : December 18, 2014
Results First Posted : July 5, 2017
Last Update Posted : July 5, 2017
Sponsor:
Collaborator:
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Seth Pollack, Fred Hutchinson Cancer Center

Study Description
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Brief Summary:
This pilot, phase I trial studies the safety of cancer-testis antigen (NY-ESO-1)-specific T cells (a type of immune cell) in treating patients with NY-ESO-1-expressing sarcomas that have spread to other places in the body and are receiving palliative (relief of symptoms and suffering caused by cancer) radiation therapy. Placing a modified gene for NY-ESO-1 into white blood cells may help the body build an immune response to kill tumor cells that express NY-ESO-1. Palliative radiation therapy may help patients with advanced sarcoma live more comfortably. Giving NY-ESO-1-specific T cells following palliative radiation therapy may be a better treatment for patients with sarcomas.

Condition or disease Intervention/treatment Phase
Sarcoma Biological: Autologous NY-ESO-1-specific CD8-positive T Lymphocytes Other: Laboratory Biomarker Analysis Radiation: Palliative Radiation Therapy Phase 1

Detailed Description:

PRIMARY OBJECTIVES:

I. To evaluate the safety and toxicity of NY-ESO-1-specific T cells when given following high-dose, hypo-fractionated palliative radiation to patients with advanced NY-ESO-1 expressing sarcomas.

SECONDARY OBJECTIVES:

I. To look for preliminary evidence of systemic efficacy of NY-ESO-1-specific T-cell therapy following radiation on non-radiated tumors.

II. To determine whether radiation increases trafficking of adoptively transferred NY-ESO-1-specific T cells by comparing tumor biopsy specimens from radiated and non-radiated tumors.

OUTLINE:

Patients undergo palliative radiation therapy at the discretion of the treating radiation oncologist. Patients then receive NY-ESO-1-specific T cells intravenously (IV) over 60 minutes 2-3 days after completion of radiation therapy.

After completion of study treatment, patients are followed up weekly for 2 weeks, at 4-6, 8, 10, and 12 weeks, and then for up to 6 months.

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 2 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Pilot Trial of NY-ESO-1-Specific T Cells in Patients With Metastatic NY-ESO-1-Expressing Sarcomas Receiving Palliative Radiation
Study Start Date : January 2015
Actual Primary Completion Date : June 2015

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: Treatment (radiation and NY-ESO-1-specific T cells)
Patients undergo palliative radiation therapy at the discretion of the treating radiation oncologist. Patients then receive NY-ESO-1-specific T cells IV over 60 minutes 2-3 days after completion of radiation therapy.
 Biological: Autologous NY-ESO-1-specific CD8-positive T Lymphocytes
Given IV

Other: Laboratory Biomarker Analysis
Correlative studies

Radiation: Palliative Radiation Therapy
Undergo palliative radiation therapy


Outcome Measures
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Primary Outcome Measures :
  1. Incidence of Adverse Events Measured by the National Cancer Institute Common Terminology Criteria for Adverse Events Version (v)4.03 [ Time Frame: Up to 12 weeks post-treatment ]
    CTCAE v4.03


Secondary Outcome Measures :
  1. T Cell Transfer Based on Response Evaluation Criteria In Solid Tumors v1.1 [ Time Frame: At 6 weeks post-treatment ]
    RECIST at 6 weeks after treatment (non-radiated tumors only)

  2. Transferred NY-ESO-1-specific T Cells Based on Flow Cytometry Using Major Histocompatibility Complex Tetramers [ Time Frame: Up to 6 weeks post-treatment ]
    Over 5% tet+ cells at 6 weeks? Patients may have detectable NY-ESO-1 specific T cells by MHC tetramers but if they are less than 5% this will be considered negative.


Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

INCLUSION CRITERIA FOR SCREENING:

  • Histopathological documentation of sarcoma
  • Patients must express NY-ESO-1 in their tumor by immunohistochemistry (IHC) (> 5%) prior to leukapheresis
  • For leukapheresis, patients must meet the following criteria (any exceptions to this will require prior approval by the apheresis director and principal investigator [PI]):
  • Pulse > 45 or < 120
  • Weight >= 45 kg
  • Temperature =< 38° Celsius (C) (=< 100.4° Fahrenheit [F])
  • White blood cell count (WBC) >= 2,000
  • Hematocrit (HCT) >= 30%
  • Platelets >= 75,000

INCLUSION CRITERIA FOR TREATMENT:

  • A diagnosis of a metastatic or unresectable sarcoma
  • Patient must have a biopsy-accessible tumor to be radiated
  • Patient must have consulted with a radiation oncologist who is planning radiation; their radiation oncologist should have documented plans to administer a dose of at least 30 Gy in 5 or fewer fractions
  • Human leukocyte antigen (HLA) type A0201 or A2402
  • Zubrod (Eastern Cooperative Oncology Group [ECOG]) performance status of '0-2'
  • All patients must have an electrocardiogram (ECG) within 2 weeks of starting conditioning
  • All patients must have an echo or multigated acquisition (MUGA) scan showing ejection fraction (EF) > 50% and normal troponin and creatine kinase MB (CK MB) performed within 90 days of starting treatment

Exclusion Criteria:

EXCLUSION CRITERIA FOR SCREENING:

  • Patients who do not meet the above inclusion criteria will not receive leukapheresis

EXCLUSION CRITERIA FOR TREATMENT:

  • Patients with a history of proven myocarditis, pericarditis, or endocarditis
  • Pregnant women, nursing women, men and women of reproductive ability who are unwilling to use effective contraception or abstinence; women of childbearing potential must have a negative pregnancy test within two weeks prior to study entry
  • Inadequate renal function as indicated by serum creatinine >= 1.5 times the upper limit of normal
  • Inadequate liver function as indicated by total bilirubin >= 1.5 times the upper limit of normal
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) >= 2.5 times the upper limit of normal
  • Active symptomatic congestive heart failure
  • Clinically significant hypotension
  • Newly diagnosed cardiac arrhythmia; patients with an arrhythmia that has been stable for at least 3 months will be allowed to participate
  • Known untreated central nervous system (CNS) metastasis
  • Patients with systemic infections requiring antibiotics or chronic maintenance/suppressive therapy
  • Patients receiving systemic anticancer therapy (chemotherapy, "biologics", immunotherapy) less than 2 weeks prior to starting radiation
  • Clinically significant autoimmune disorders requiring on-going systemic immune-suppression for control
  • Patients with acquired immunodeficiency syndrome (AIDS) or who are known to be human immunodeficiency virus (HIV) positive are not eligible for this study; testing may have been done up to 3 months prior to treatment
  • Current treatment with steroids
  • Known infection with hepatitis B virus (HBV) and hepatitis C virus (HCV); testing may have been done up to 3 months prior to treatment
Contacts and Locations
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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): NCT02319824


Locations
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United States, Washington
Fred Hutch/University of Washington Cancer Consortium
Seattle, Washington, United States, 98109
Sponsors and Collaborators
Fred Hutchinson Cancer Center
National Cancer Institute (NCI)
Investigators
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Principal Investigator: Seth Pollack Fred Hutch/University of Washington Cancer Consortium
More Information
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Responsible Party: Seth Pollack, Responsible Party, Fred Hutchinson Cancer Center
ClinicalTrials.gov Identifier: NCT02319824    
Other Study ID Numbers: 2721.00
NCI-2014-02154 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
2721
2721.00 ( Other Identifier: Fred Hutch/University of Washington Cancer Consortium )
K23CA175167 ( U.S. NIH Grant/Contract )
P30CA015704 ( U.S. NIH Grant/Contract )
First Posted: December 18, 2014    Key Record Dates
Results First Posted: July 5, 2017
Last Update Posted: July 5, 2017
Last Verified: April 2017
Additional relevant MeSH terms:
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Sarcoma
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Neoplasms