Phase 3 Randomized Trial for Refractory ADV or CMV Infection With Family Matched CTLs and Standard of Care (SOC) vs SOC Alone
An Open-Label Prospective Randomized Trial of Family Donor-Derived ADV or CMV CTLs Plus Standard of Care (SOC) vs SOC Alone in Children, Adolescents and Young Adults Following Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) With Refractory ADV or CMV Infection/Viremia
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Lauren Harrison, RN
- Phone Number: 617-285-7844
- Email: lauren_harrison@nymc.edu
Study Contact Backup
- Name: Mitchell Cairo, MD
- Phone Number: 914-594-2150
- Email: mitchell_cairo@nymc.edu
Study Locations
-
-
New York
-
Valhalla, New York, United States, 10595
- Recruiting
- New York Medical College
-
Principal Investigator:
- Mitchell S Cairo, MD
-
Contact:
- Lauren Harrison, RN, MSN
- Phone Number: 6172857844
- Email: lauren_harrison@nymc.edu
-
Contact:
- Mitchell S Cairo, MD
- Phone Number: 914-594-2150
- Email: mitchell_cairo@nymc.edu
-
-
Wisconsin
-
Milwaukee, Wisconsin, United States, 53226
- Not yet recruiting
- Medical College of Wisconsin
-
Contact:
- Julie An Talano, MD
- Email: jtalano@mcw.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Description
Patient Eligibility Cohort 1 (ADV) -Patients with ADV viremia (Cohort 1) post AlloHSCT with one or more of the following: Increasing or persistent ADV RT-PCR DNA (> 1000 ADV PCR copies) after 7 days of appropriate anti-viral therapy AND/OR Medical intolerance to anti-viral therapies including one or more of the following: > grade 2 renal insufficiency secondary to cidofovir and/or other > grade 2 toxicities secondary to cidofovir AND/OR Known resistance to cidofovir
Patient Eligibility (Cohort 2) (CMV)
-Patients with CMV viremia with one or more of the following: Increasing or persistent CMV RT-PCR DNA (>1000 copies) after 7 days of appropriate anti-viral therapy AND/OR Medical intolerance to anti-CMV antibiotic therapies: ANC < 500/mm3 secondary to ganciclovir AND/OR > grade 2 renal toxicity secondary to either foscarnet or cidofovir AND/OR Known resistance to ganciclovir and/or foscarnet
- Consent: written informed consent given (by patient or legal representative) prior to any study related procedures
- Performance Status >30% (Lansky < 16 yrs and Karnofsky > 16 years (BOTH COHORTS)
- Age: 0.01 to 30.00 years (BOTH COHORTS)
- Females of childbearing potential with a negative urine pregnancy test at study entry only (BOTH COHORTS)
- Family related donor (> 3 HLA match) that screens positive for ADV5 MACS Peptivator (Cohort 1) or PP65CMV MACS Peptivator (Cohort 2)
Donor Eligibility
- Related donor available with a T-cell response to the ADV MACS PepTivators (Cohort 1) or CMV MACS PepTivator (Cohort 2). As defined in Appendix II, B, 8.2, the donor is considered suitable if the percentage of IFN+ T-cells is >0.01% after stimulation with ADV PepTivators (Cohort 1) or CMV PepTivators (Cohort 2).
- Third-party related allogeneic donor: If original donor is not available or does not have a T-cell response to ADV MCAS PepTivator (Cohort 1) or CMV PepTivator (Cohort 2), third party allogeneic donor (family donor > 3 HLA A, B, DR match to recipient) with a T-cell response at least to the ADV MCAS PepTivator (Cohort 1) or CMV PepTivator (Cohort 2) AND
- Allogeneic donor disease screening is complete similar to hematopoietic stem cell donors (Appendix 1) AND
- Obtained informed consents by donor or donor legally authorized representative prior to donor collection
Patient Exclusion Criteria (Both Cohorts)
- Patient with acute GVHD > grade 2 or moderate or extensive chronic GVHD at the time of CTL infusion.
- Patient receiving steroids (>0.5 mg/kg prednisone equivalent) at the time of CTL infusion.
- Patient treated with donor lymphocyte infusion (DLI) within 4 weeks prior to CTL infusion.
- Patient with poor performance status determined by Karnofksy (patients > 16 yrs) or Lansky (patients < 16 years) score < 30%.
- Concomitant enrollment in another experimental clinical trial investigating the treatment of refractory ADV or CMV infections.
- Any known medical condition which cold compromise participation in the study according to investigators assessment.
- Known AIDS or uncontrolled HIV infection
- Known hypersensitivity to iron dextran
- Encephalitis and/or retinitis
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Standard of Care Medication
Patients will receive standard of care antiviral therapy for CMV or ADV at the discretion of the physician.
|
Standard of Care medications will be selected by the treating physician for either ADV (Cohort 1) or CMV (cohort 2)
|
|
Experimental: Standard of Care Medication plus Cytotoxic T-Lymphocytes (CTLs)
Patients will be randomized to receiving standard of care antiviral therapy plus family matched donor derived CTLs.
|
Standard of Care medications will be selected by the treating physician for either ADV (Cohort 1) or CMV (cohort 2)
ADV or CMV family matched CTLs will be administered with SOC medications one every 2 weeks as needed up to 5 infusions
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Viral PCR to determine resolution of disease
Time Frame: Day 100
|
Patients will be monitored weekly by peripheral blood qtPCR values to monitor viral levels for resolution confirmation.
|
Day 100
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Mitchell Cairo, MD, New York Medical College
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
- NYMC 622
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
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