Anti-ESO (Cancer/Test Antigen) mTCR-transduced Autologous Peripheral Blood Lymphocytes and Combination Chemotherapy in Treating Patients With Metastatic Cancer That Expresses NY-ESO-1
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ClinicalTrials.gov Identifier: NCT02774291 |
Recruitment Status : Unknown
Verified March 2020 by Ira Braunschweig, Albert Einstein College of Medicine.
Recruitment status was: Recruiting
First Posted : May 17, 2016
Last Update Posted : March 6, 2020
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Condition or disease | Intervention/treatment | Phase |
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HLA-A2 Positive Cells Present Metastatic Malignant Neoplasm Metastatic Malignant Neoplasm in the Brain | Biological: Aldesleukin Biological: Anti-thyroglobulin mTCR-transduced Autologous Peripheral Blood Lymphocytes Drug: Cyclophosphamide Biological: Filgrastim Drug: Fludarabine Phosphate Other: Laboratory Biomarker Analysis | Early Phase 1 |
PRIMARY OBJECTIVES:
I. To determine the safety and tolerability of the administration of anti-ESO (cancer/test antigen) mTCR (T cell receptor)-engineered peripheral blood lymphocytes (anti-thyroglobulin mTCR-transduced autologous peripheral blood lymphocytes) plus high-dose aldesleukin following a nonmyeloablative lymphoid depleting preparative regimen in human leukocyte antigen (HLA)-A2 positive patients with metastatic cancer expressing the ESO antigen.
SECONDARY OBJECTIVES:
I. Determine the in vivo survival of T-cell receptor (TCR) gene-engineered cells.
II. Determine the objective response rate by Response Evaluation Criteria in Solid Tumors (RECIST) criteria.
OUTLINE:
Patients receive standard cyclophosphamide intravenously (IV) over 1 hour on days -7 to -6 and fludarabine phosphate via intravenous piggy back (IVPB) over 30 minutes on days -5 to -1 followed by anti-ESO (cancer/test antigen) mTCR-transduced autologous peripheral blood lymphocytes IV over 20-30 minutes on day 0 and aldesleukin IV over 15 minutes approximately every 8 hours on days 0-4. Patients also receive filgrastim subcutaneously (SC) on days 1-4.
After completion of study treatment, patients are followed up at 6 weeks, annually for 5 years, and then periodically for 10 years thereafter.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 10 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Pilot Study of Adoptive Cell Transfer for the Treatment of Metastatic Cancer That Expresses NY-ESO-1 Using Lymphodepleting Conditioning Followed by Infusion of Anti-NY ESO-1 Murine TCR-Gene Engineered Lymphocytes |
Study Start Date : | August 2016 |
Estimated Primary Completion Date : | May 2020 |
Estimated Study Completion Date : | May 2020 |

Arm | Intervention/treatment |
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Experimental: Treatment (mTCR, aldesleukin)
Patients receive standard cyclophosphamide IV over 1 hour on days -7 to -6 and fludarabine phosphate via IVPB over 30 minutes on days -5 to -1 followed by anti-ESO (cancer/test antigen) mTCR-transduced autologous peripheral blood lymphocytes IV over 20-30 minutes on day 0 and aldesleukin IV over 15 minutes approximately every 8 hours on days 0-4. Patients also receive filgrastim SC on days 1-4.
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Biological: Aldesleukin
Given IV
Other Names:
Biological: Anti-thyroglobulin mTCR-transduced Autologous Peripheral Blood Lymphocytes Given IV
Other Name: Anti-thyroglobulin mTCR-transduced Autologous PBL Drug: Cyclophosphamide Given IV
Other Names:
Biological: Filgrastim Given SC
Other Names:
Drug: Fludarabine Phosphate Given IVPB
Other Names:
Other: Laboratory Biomarker Analysis Correlative studies |
- Incidence of toxicity, graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 [ Time Frame: Up to 15 years ]
- In vivo survival of TCR gene-engineered cells [ Time Frame: Up to 15 years ]Descriptive statistics will be used to determine the in vivo survival of TCR gene-engineered cells.
- Objective response rate, graded according to RECIST criteria [ Time Frame: Up to 15 years ]Descriptive statistics will be used to determine the objective response rate.

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Ages Eligible for Study: | 18 Years to 66 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Measurable metastatic cancer that expresses NY ESO-1 as assessed by one of the following methods: reverse transcriptase-polymerase chain reaction (RT-PCR) on tumor tissue, or by immunohistochemistry of resected tissue, or serum antibody reactive with ESO
- Confirmation of diagnosis of metastatic cancer by the Laboratory of Pathology at the Montefiore Medical Center
- Patients must have previously received systemic standard care (or effective salvage chemotherapy regimens) for metastatic disease, if known to be effective for that disease, and have been either non-responders (progressive disease) or have recurred
- 3 or fewer brain metastases; Note: if lesions are symptomatic or greater than or equal to 1 cm each, these lesions must have been treated and stable for 3 months for the patient to be eligible
- More than four weeks must have elapsed since any prior systemic therapy at the time the patient receives the preparative regimen, and patients' toxicities must have recovered to a grade 1 or less (except for toxicities such as alopecia or vitiligo); Note: patients may have undergone minor surgical procedures within the past 3 weeks, as long as all toxicities have recovered to grade 1 or less or as specified in the eligibility criteria
- Eight weeks must have elapsed from the time of any antibody therapy that could affect an anti-cancer immune response, including anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA 4) therapy, at the time the patient receives the preparative regimen to allow antibody levels to decline; Note: patients who have previously received ipilimumab and have documented gastrointestinal (GI) toxicity must have a normal colonoscopy with normal colonic biopsies
- Willing to sign a durable power of attorney
- Able to understand and sign the informed consent document
- Clinical performance status of Eastern Cooperative Oncology Group (ECOG) 0 or 1
- Life expectancy of greater than three months
- Patients must be HLA-A*0201 positive
- Patients of both genders must be willing to practice birth control from the time of enrollment on this study and for up to four months after cells are no longer detected in the blood
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Serology:
- Seronegative for human immunodeficiency virus (HIV) antibody; (the experimental treatment being evaluated in this protocol depends on an intact immune system; patients who are HIV seropositive can have decreased immune-competence and thus be less responsive to the experimental treatment and more susceptible to its toxicities)
- Seronegative for hepatitis B antigen, and seronegative for hepatitis C antibody; if hepatitis C antibody test is positive, then patient must be tested for the presence of antigen by RT-PCR and be hepatitis C virus (HCV) ribonucleic acid (RNA) negative
- Women of child-bearing potential must have a negative pregnancy test because of the potentially dangerous effects of the treatment on the fetus
- Absolute neutrophil count greater than 1000/mm^3 without the support of filgrastim
- White blood cell (WBC) >= 3000/mm^3
- Platelet count >= 100,000/mm^3
- Hemoglobin > 8.0 g/dl
- Serum alanine aminotransferase (ALT)/aspartate aminotransferase (AST) =< to 2.5 times the upper limit of normal
- Serum creatinine =< to 1.6 mg/dl
- Total bilirubin =< to 1.5 mg/dl, except in patients with Gilbert's Syndrome who must have a total bilirubin less than 3.0 mg/dl
Exclusion Criteria:
- Women of child-bearing potential who are pregnant or breastfeeding because of the potentially dangerous effects of the treatment on the fetus or infant
- Any form of primary immunodeficiency (such as severe combined immunodeficiency disease)
- Active systemic infections, coagulation disorders or other major medical illnesses of the cardiovascular, respiratory or immune system, myocardial infarction, cardiac arrhythmias, obstructive or restrictive pulmonary disease
- Concurrent opportunistic infections (the experimental treatment being evaluated in this protocol depends on an intact immune system; patients who have decreased immune competence may be less responsive to the experimental treatment and more susceptible to its toxicities)
- Concurrent systemic steroid therapy
- History of severe immediate hypersensitivity reaction to any of the agents used in this study
- History of coronary revascularization or ischemic symptoms
- History of or active central nervous system (CNS) or peripheral nerve stimulation (PNS) involvement
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Documented left ventricular ejection fraction (LVEF) of less than or equal to 45%; testing is required in patients with:
- Clinically significant atrial and/or ventricular arrhythmias including but not limited to: atrial fibrillation, ventricular tachycardia, second or third degree heart block
- Age >= 60 years old
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Pulmonary function testing in patients with:
- A prolonged history of cigarette smoking (20 pk/yr of smoking within the past two years)
- Symptoms of respiratory dysfunction

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): NCT02774291
United States, New York | |
Albert Einstein College of Medicine | Recruiting |
Bronx, New York, United States, 10461 | |
Contact: Ira Braunschweig 718-920-4826 IBRAUNSC@montefiore.org | |
Principal Investigator: Ira Braunschweig |
Principal Investigator: | Ira Braunschweig | Albert Einstein College of Medicine |
Responsible Party: | Ira Braunschweig, Principal Investigator, Albert Einstein College of Medicine |
ClinicalTrials.gov Identifier: | NCT02774291 |
Other Study ID Numbers: |
2015-5254 NCI-2015-01781 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) 2015-5254 ( Other Identifier: Albert Einstein College of Medicine ) P30CA013330 ( U.S. NIH Grant/Contract ) |
First Posted: | May 17, 2016 Key Record Dates |
Last Update Posted: | March 6, 2020 |
Last Verified: | March 2020 |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Neoplasms Neoplasm Metastasis Neoplasms, Second Primary Neoplastic Processes Pathologic Processes Aldesleukin Cyclophosphamide Fludarabine Fludarabine phosphate Interleukin-2 Lenograstim 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 Antimetabolites Adjuvants, Immunologic Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents |