CD33KO-HSPC Infusion Followed by CART-33 Infusion(s) for Refractory/Relapsed AML (CART33)
Phase 1 Study of Lentivirally Transduced T Cells Engineered to Contain Anti-CD33 Linked to TCRζ And 4-1BB Signaling Domains In Combination With CD33KO-HSPC In Subjects With Refractory Or Relapsed Acute Myeloid Leukemia
The purpose of this study is to provide a new type of treatment for AML. This treatment combines a new type of stem cell transplant along with treatment using chimeric antigen receptor (CAR) T cells that have been engineered to recognize and attack your AML cells.
The first treatment is a modified stem cell transplant, using blood-forming stem cells donated from a healthy donor. From the same donor, we will also make CAR T-cells, which are leukemia fighting cells, which will be given to the patient via an infusion into the vein after the transplanted stem cells have started to grow healthy blood cells. The modification of the stem cell transplant means that the healthy bone marrow cells will be "invisible" to the CAR T-cells that are trying to kill the leukemia cells.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Abramson Cancer Center Clinical Trials Service
- Phone Number: 215-349-8245
- Email: PMCancerResearch@pennmedicine.upenn.edu
Study Locations
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19104
- Recruiting
- University of Pennsylvania
-
Contact:
- Abramson Cancer Center Clinical Trials Service
- Phone Number: 215-349-8245
- Email: PMCancerResearch@pennmedicine.upenn.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female 18 years of age or older
Subjects with AML unlikely to be cured with currently available therapies
- AML that has not achieved a complete remission or morphologic leukemia free state by ELN criteria; partial remission or refractory disease (including primary refractory) are eligible; OR:
- AML relapsed following allogeneic stem cell transplantation (including MDS evolved to AML post-allogeneic stem cell transplantation). Note: morphologic relapse is not required; persistent/recurrent disease-associated molecular, phenotypic or cytogenetic abnormalities (measurable residual disease, MRD) at any time after allogeneic HCT is eligible; OR:
- Subjects with relapsed disease after prior transplant must be off systemic immunosuppression for at least 1 month at the time of enrollment.
- Subjects must have a suitable stem cell donor.
Satisfactory organ function
- Creatinine clearance > 40 ml/min
- ALT/AST must be ≤ 5x upper limit of normal unless related to disease and < 20 x upper limit of normal if related to disease
- Direct bilirubin < 2.0 mg/dl, unless subject has Gilbert's syndrome (≤ 3.0 mg/dL)
- Left ventricular ejection fraction ≥ 40% as confirmed by echocardiogram or MUGA
- DLCO > 45% predicted
- ECOG performance status 0-1
- Written informed consent is given
- Subjects of reproductive potential must agree to use acceptable birth control methods
Exclusion Criteria:
- Pregnant or lactating (nursing) women
- Active hepatitis B or hepatitis C or HIV infection
- Concurrent use of systemic steroids or immunosuppressant medications
- Any uncontrolled active medical disorder that would preclude participation as outlined
- Subjects with signs or symptoms indicative of 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 New York Heart Association Classification
- Subjects with a known history or prior diagnosis of optic neuritis or other immunologic or inflammatory disease affecting the central nervous system, and unrelated to leukemia or previous leukemia treatment.
- Subjects with clinically apparent arrhythmia, or arrhythmias that are not stable on medical management, within 2 weeks of the screening/enrollment visit.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: CD33KO-HSPC followed by CART33
All subjects will receive CD33KO-HSPC, followed by 1-3 CART-33 infusions
|
CD33KO-HSPC: Stem cell transplant (also known as bone marrow transplant) is a common treatment used for patients with blood cancers, but for this transplant we will first modify the cells, in order to make the CAR T-cell treatment safer for when the patient receives them later. The modification is a type of gene editing - this means changing the DNA of the cells, so that a protein that the bone marrow stem cells usually show on their surface is not shown any more. This makes the bone marrow cells "invisible" to the CAR T-cells, and makes this therapy safer for the patient. The protein is called CD33. CART33: Chimeric Antigen Receptor T-cells (CART) are immune cells which are modified by adding a CAR molecule, which makes them much more efficient at finding and killing cancer cells. In this case, the CAR T-cells are programmed to target a protein called CD33, which is found on the surface of leukemia cells, and on healthy bone marrow cells. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Manufacturing feasibility
Time Frame: 1 month
|
Proportion of subjects whose Product 1 (CD33KO-HSPC) meets release criteria.
|
1 month
|
|
Occurrence of dose-limiting toxicities related to CD33KO-HSPC
Time Frame: 3 months
|
Safety of alloHSCT: occurrence of dose-limiting toxicities related to CD33KO-HSPC
|
3 months
|
|
Occurrence of dose-limiting toxicities related to CART-33
Time Frame: 6 months
|
Safety of CART-33: occurrence of dose-limiting toxicities related to CART-33
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Efficacy of CD33KO-HSPC
Time Frame: 1 month
|
Proportion of subjects with hematopoietic engraftment according to standard criteria
|
1 month
|
|
Efficacy of at least 1 dose of CART-33
Time Frame: 6 months
|
Proportion of subjects with residual or recurrent AML before CART-33 infusion who attain a clinical response
|
6 months
|
|
Overall Survival (OS)
Time Frame: 6 months, 12 months
|
Proportion of patients who are alive at 6 months and at 12 months
|
6 months, 12 months
|
|
Progression free survival (PFS)
Time Frame: 6 months, 12 months
|
Proportion of patients who remained in response at 6 and 12 months after attaining a response to the first CART-33 infusion.
Median time to progression of AML from infusion of CART-33.
|
6 months, 12 months
|
|
Duration of Response (DOR)
Time Frame: 15 years
|
Median number of months in remission.
Median time to relapse in patients who receive CART-33 and attain a response.
|
15 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Noelle Frey, MD, University of Pennsylvania
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- IRB # 854325, UPCC # 26423
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Leukemia, Myeloid, Acute
-
NCT03125239CompletedCombination Merestinib and LY2874455 for Patients With Relapsed or Refractory Acute Myeloid LeukemiaRelapsed Adult Acute Myeloid Leukemia | Refractory Adult Acute Myeloid Leukemia
-
NCT06125652RecruitingAcute Myeloid Leukemia, in Relapse | Acute Myeloid Leukemia Refractory
-
NCT02323607CompletedRecurrent Adult Acute Myeloid Leukemia | Secondary Acute Myeloid Leukemia | Untreated Adult Acute Myeloid Leukemia | Therapy-Related Acute Myeloid Leukemia
-
NCT04354025WithdrawnRefractory Acute Myeloid Leukemia | Relapsed Acute Myeloid Leukemia
-
NCT02109627TerminatedAcute Myeloid Leukemia | Refractory Acute Myeloid Leukemia | Relapsed Acute Myeloid Leukemia
-
NCT01961765CompletedRefractory Acute Myeloid Leukemia | Relapsed Acute Myeloid Leukemia
-
NCT05445154RecruitingNewly Diagnosed Acute Myeloid Leukemia (AML)
-
NCT03634228TerminatedAcute Myeloid Leukemia | Recurrent Acute Myeloid Leukemia | Refractory Acute Myeloid Leukemia
-
NCT00003934CompletedUntreated Adult Acute Myeloid Leukemia | Adult Acute Promyelocytic Leukemia (M3) | Childhood Acute Promyelocytic Leukemia (M3) | Adult Acute Myeloid Leukemia With t(15;17)(q22;q12) | Untreated Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies
-
NCT02255162TerminatedAcute Myelogenous Leukemia | Acute Myeloid Leukemia (AML) | Acute Myelocytic Leukemia | Acute Granulocytic Leukemia | Acute Non-Lymphocytic Leukemia
Clinical Trials on CD33KO-HSPC; CART33
-
NCT01864902UnknownRelapsed Adult Myeloid Leukemia | Chemotherapy Refractory Adult Myeloid Leukemia
-
NCT07451054RecruitingHodgkin Lymphoma | T-Cell Non-Hodgkin Lymphoma | Richter's Transformation | B-Cell Non-Hodgkin Lymphoma (NHL)
-
NCT07269041RecruitingEnd Stage Liver Disease | Liver Transplantation | Chimerism | Immune Tolerance | Hematopoietic Stem Cell | Graft Survival | Immunosuppression Disorders | Immune Tolerance/Drug Effects | Immunosuppression After Liver Transplantation
-
NCT01660607CompletedLymphoma, Non-Hodgkin | Acute Myeloid Leukemia | Acute Leukemia | Acute Myelogenous Leukemia | Chronic Myelogenous Leukemia | Myelodysplastic Syndromes (MDS) | Acute Lymphoblastic Leukemia (ALL) | Myeloid Leukemia, Chronic | Myeloproliferative Syndrome
-
NCT01734850CompletedHuman Immunodeficiency Virus
-
NCT02500849Active, not recruiting
-
NCT06272500Recruiting
-
NCT05507827Active, not recruiting
-
NCT05088356Active, not recruitingMyelodysplastic Syndromes | Myeloproliferative Disorders | Acute Leukemia | Chronic Myelogenous Leukemia | Allogeneic Hematopoietic Cell Transplantation (HCT) | Advanced Hematologic Malignancies