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CD123 Redirected Autologous T Cells for AML

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ClinicalTrials.gov Identifier: NCT02623582
Recruitment Status : Terminated (This study was terminated due to lack of funding.)
First Posted : December 7, 2015
Last Update Posted : October 17, 2017
Sponsor:
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 anti-CD123 chimeric antigen receptors expressing tandem TCR and 4-1BB (TCR /4-1BB) costimulatory domains (referred to as RNA CART123) in Acute Myeloid Leukemia (AML) subjects.

Condition or disease Intervention/treatment Phase
Relapsed or Refractory Acute Myeloid Leukemia Biological: Autologous Anti-CD 123 CAR TCR/4-1BB-expressing T-lymphocytes Drug: Cyclophosphamide Early Phase 1

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 7 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Pilot Study of RNA-Redirected Autologous T Cells Engineered to Contain Anti-CD123 Linked to TCR and 4-1BB Signaling Domains in Patients With Refractory or Relapsed Acute Myeloid Leukemia
Study Start Date : December 2015
Actual Primary Completion Date : August 26, 2016
Actual Study Completion Date : November 18, 2016


Arm Intervention/treatment
Experimental: Cohort 1
The first 3 subjects to receive RNA CART123 cells will receive up to 3 doses of RNA CART123 cells, with no lymphodepleting chemotherapy prior to infusion.
Biological: Autologous Anti-CD 123 CAR TCR/4-1BB-expressing T-lymphocytes
Given IV

Experimental: Cohort 2

The remaining 12 subjects of the study will receive up to six IV doses of RNA CART123 cells.

Subjects in Cohort 2 may be given lymphodepleting chemotherapy 4 days (+/- 1 day) prior to the first CART123 cell infusion (if ALC> 500/uL).

Lymphodepleting chemotherapy may be repeated before the fourth dose of RNA CART123 cells (if ALC> 500/uL).

Lymphodepleting chemotherapy includes a single dose of cyclophosphamide (1g/m2) Weight used for dosing will be the weight obtained prior to the apheresis procedure Cell numbers are based on CAR+ cells with CAR expression determined by flow cytometry Based on the product release criteria, at least 20% of the total cells will be RNA CART123 cells.

Dosing will not be changed for changes in subject weight The indicated doses are +/- 20% to account for manufacturing variability.

Biological: Autologous Anti-CD 123 CAR TCR/4-1BB-expressing T-lymphocytes
Given IV

Drug: Cyclophosphamide
Given IV




Primary Outcome Measures :
  1. Number of Adverse Events [ Time Frame: 2 years ]


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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:

  • Male or female subjects 18 years of age or older with AML with no available curative treatment options using currently available therapies
  • Subjects must have a suitable stem cell donor available who may donate cells if the subject needs to undergo allogeneic HCT. Donor may be matched or mismatched and must be found to be suitable according to the institution's standard criteria.
  • Subjects with second or subsequent relapse, any relapse refractory to salvage, or with persistent disease after at least two lines of therapy.

    a. Subjects with relapsed disease after prior allogeneic HCT (myeloablative or non-myeloablative) will be eligible if they meet all other inclusion criteria and i. Have experienced graft rejection (no evidence of donor cells by STR analysis on 2 occasions separated by at least 1 month), OR: ii. Donor cells are present but there is no active GVHD, subject does not require immunosuppression and is more than 6 months from transplant

  • Subjects must have evaluable disease defined as >5% blasts on marrow aspirate or biopsy, extramedullary disease (CNS involvement is prohibited), or at least 20% blasts in the peripheral blood within 2 weeks prior to enrollment. Note: subjects with second or subsequent relapse are considered to have evaluable disease even without meeting the above morphologic criteria if they are found to have persistent recurrent disease-associated molecular or cytogenetic abnormalities.
  • Creatinine < 1.6 mg/dl
  • ALT/AST must be < 5 x upper limit of normal unless related to disease
  • Bilirubin < 2.0 mg/dl, unless subject has Gilbert's syndrome (≤3.0 mg/dL);
  • ECOG Performance status 0-2.
  • Left ventricular ejection fraction > 40% as confirmed by ECHO/MUGA
  • Written informed consent is given.
  • Subjects of reproductive potential must agree to use acceptable birth control methods.

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 infusion.
  • HIV infection.
  • Active hepatitis B or hepatitis C infection.
  • Concurrent use of systemic steroids or immunosuppressant medications. Recent or current use of inhaled steroids or physiologic replacement with hydrocortisone is not exclusionary.
  • Absolute lymphocyte count <500/uL
  • Any uncontrolled active medical disorder that would preclude participation as outlined.
  • Subjects with signs or symptoms indicative of CNS involvement. A CNS evaluation should be performed as clinically appropriate to rule out CNS involvement.
  • Known history of allergy or hypersensitivity to study product excipients (human serum albumin, DMSO, and Dextran 40).
  • Class III/IV cardiovascular disability according to the New York Heart Association Classification.
  • Patients with a known history or prior diagnosis of optic neuritis or other immunologic or inflammatory disease affecting the central nervous system
  • Subjects with clinically apparent arrhythmia, or arrhythmias that are not stable on medical management, within 2 weeks of the Screening/Enrollment visit.

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): NCT02623582


Locations
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United States, Pennsylvania
Abramson Cancer Center of the University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
Sponsors and Collaborators
University of Pennsylvania
Investigators
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Principal Investigator: Saar Gill, MD, PhD Abramson Cancer Center of the University of Pennsylvania

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Responsible Party: University of Pennsylvania
ClinicalTrials.gov Identifier: NCT02623582     History of Changes
Other Study ID Numbers: 823175 - UPCC 04415
First Posted: December 7, 2015    Key Record Dates
Last Update Posted: October 17, 2017
Last Verified: October 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes

Additional relevant MeSH terms:
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Leukemia
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Neoplasms by Histologic Type
Neoplasms
Cyclophosphamide
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Myeloablative Agonists