Lifileucel (TIL) Therapy After PD-1 Blockade Failure in Kidney Cancer
A Phase II Trial of Autologous Ex Vivo Expanded Tumor-Infiltrating Lymphocyte (TIL) Therapy With Lifileucel After Failure of PD-1 Blockade in Kidney Cancer.
This study aims to evaluate autologous ex vivo expanded tumor-infiltrating lymphocyte therapy (lifileucel/LN-145) for kidney cancer after failure of PD-1 blockade.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This is a Phase II single-arm trial of tumor-infiltrating lymphocyte (TIL) therapy in kidney cancer. Briefly, participants who meet eligibility criteria undergo surgical removal of a metastasis or primary tumor to provide material for generation of the TIL product in a lab, which involves growing and expanding the immune cells contained in the tumor before infusing the TIL product into the patient.
Baseline evaluations occur before tumor harvest, and participants who proceed on study undergo tumor resection so tissue can be shipped to a manufacturing facility to create the autologous TIL product LN-145/lifileucel. The treatment plan includes 5 days of lymphodepleting chemotherapy before TIL infusion, using cyclophosphamide and fludarabine, followed by LN-145 infusion on Day 0 and IL-2 (aldesleukin) afterward. The study calendar includes post-treatment visits around Day 14, Day 28, Weeks 8, 12, and 18, then every 3 months starting at Month 6, with long-term follow-up by telephone continuing until study end or withdrawal, up to Month 36. Participants undergo screening and tumor resection to obtain tissue for manufacture of the TIL product. If treatment proceeds, participants receive lymphodepleting chemotherapy with cyclophosphamide and fludarabine, followed by LN-145 infusion and IL-2 (aldesleukin). Participants complete scheduled clinic-based assessments and longer-term follow-up, including telephone follow-up approximately every 3 months for up to about 3 years
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: David Einstein, MD
- Phone Number: (617) 667-2100
- Email: Deinstei@bidmc.harvard.edu
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02115
- Dana-Farber Cancer Institute
-
Contact:
- David Einstein, MD
- Phone Number: (617) 667-2100
- Email: Deinstei@bidmc.harvard.edu
-
Contact:
- Wenxin Xu, MD
- Phone Number: 617-632-3000
- Email: Wenxin_Xu1@dfci.harvard.edu
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Boston, Massachusetts, United States, 02115
- Brigham and Women's Hospital
-
Contact:
- David Einstein, MD
- Phone Number: (617) 667-2100
- Email: Deinstei@bidmc.harvard.edu
-
Contact:
- Wenxin (Vincent) Xu, MD
- Phone Number: (617) 632-3000
- Email: Wenxin_Xu1@dfci.harvard.edu
-
Boston, Massachusetts, United States, 02115
- Beth Israel Deaconess Medical Center (BIDMC)
-
Contact:
- David Einstein, MD
- Phone Number: (617) 667-2100
- Email: Deinstei@bidmc.harvard.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
-
Histologically or cytologically confirmed, advanced or metastatic renal cell carcinoma with clear cell, papillary, sarcomatoid (with or without other subtypes present), or unclassified histology. Other non-clear cell subtypes are also eligible if the patient has had a prior documented response to immune checkpoint inhibitor therapy.
- Participants must have measurable disease with at least two malignant lesions, one for disease monitoring as response to therapy and one for TIL harvest.
- Age ≥18 years
- Received one of the following regimens:
- Anti-PD-(L)1 immune checkpoint inhibitor (ICI) with or without an anti-CTLA-4 ICI or VEGF tyrosine kinase inhibitor (TKI) for treatment of advanced/metastatic disease, and experienced either (1) radiographic progression of disease while on treatment or (2) best response of stable disease after at least 6 months
- Adjuvant anti-PD-(L)1 ICI after nephrectomy for localized disease and had either (1) disease recurrence while receiving adjuvant ICI or (2) disease recurrence within 6 months of the final dose of any amount of adjuvant ICI
- Prior HIF2α inhibitor exposure in the adjuvant or advanced/metastatic setting is allowed but not required
- Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 and an estimated life expectancy of ≥ 3 months in the opinion of the Investigator.
- Participants must have adequate organ and marrow function as defined in the protocol.
- Patients with definitively treated brain metastases may be considered for enrollment if the patient is clinically stable for ≥ 14 days, with no lesions on follow-up imaging and no requirement for ongoing steroid treatment.
- Participants must have a washout period from any anticancer therapy prior to tumor harvest. The protocol contains provisions for optional use of "bridging" TKI between tumor harvest and lymphodepleting chemotherapy.
- Palliative radiation therapy is permitted as long as it does not involve lesions being selected for resection for TIL manufacturing, or being assessed radiographically as target lesions.
- Participants must have recovered from all prior anti-cancer therapy-related adverse events (AEs), as defined in the protocol.
- Participants of childbearing potential or those with partners of childbearing potential must be willing to practice an approved method of highly effective birth control.
- Previous surgical procedure(s) is/are permitted provided that wound healing has occurred, all complications have resolved, and at least 14 days have elapsed (for major operative procedures) prior to the tumor resection.
Exclusion Criteria:
- Patients who have received an organ allograft or prior cell transfer therapy within the past 20 years that included a non-myeloablative or myeloablative chemotherapy regimen.
- Patients who have a history of hypersensitivity to any component of the study intervention.
- Patients with rapidly progressive disease or symptomatic disease requiring urgent treatment per investigator discretion.
- Patients with symptomatic and/or untreated brain metastases.
- Patients who are on chronic systemic steroid therapy except for those requiring steroid therapy for management of adrenal insufficiency.
- Patients who are pregnant or breastfeeding.
- Patients who have any form of primary immunodeficiency (such as severe combined immunodeficiency disease [SCID] and acquired immunodeficiency syndrome [AIDS]).
- Patients with any other primary malignancy that is radiographically visible or is expected to require treatment within the next three years.
- Patients who are hypoxemic (oxygen saturation <90%) on room air at baseline or who require supplemental oxygen.
Other protocol-defined inclusion/exclusion criteria may apply.
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: Lifileucel (LN-145) TIL regimen
Participants undergo tumor resection for TIL manufacturing, then receive lymphodepleting cyclophosphamide and fludarabine, followed byLN-145/lifileucel infusion and IL-2 (aldesleukin), with scheduled post-treatment clinic visits and long-term follow-up |
Part of the lymphodepleting chemotherapy given before LN-145 infusion Part of the lymphodepleting chemotherapy given before LN-145 infusion. Administered after LN-145 infusion as part of the treatment regimen. Surgical removal of tumor tissue for TIL production/manufacture |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Radiographic Objective Response Rate
Time Frame: Participants will be followed thought out the course of the trial for 3 years
|
HCC-centrally assessed Objective Response Rate per RECIST 1.1 of the efficacy evaluable population Primary analysis is performed on patients who receive TIL. |
Participants will be followed thought out the course of the trial for 3 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Radiographic change in target lesions
Time Frame: Participants will be followed thought out the course of the trial for 3 years
|
Longitudinal and best change in target lesion measurements. Target lesions are measured at baseline and followed per RECIST 1.1 |
Participants will be followed thought out the course of the trial for 3 years
|
|
Radiographic Disease Control Rate (SD + PR + CR)
Time Frame: Participants will be followed thought out the course of the trial for 3 years
|
Disease control rate is listed as a secondary endpoint and will be summarized in the efficacy cohort. |
Participants will be followed thought out the course of the trial for 3 years
|
|
Duration of response
Time Frame: Participants will be followed thought out the course of the trial for 3 years
|
Duration of overall response is measured from the first time CR or PR criteria are met until the first date recurrent or progressive disease is objectively documented, or death due to any cause |
Participants will be followed thought out the course of the trial for 3 years
|
|
Progression-free survival
Time Frame: Participants will be followed thought out the course of the trial for 3 years
|
Progression-free survival is a listed secondary endpoint for both the efficacy evaluable population and the total population. Time-to-event variables are calculated from TIL infusion; PFS is also calculated for the total population from trial enrollment. |
Participants will be followed thought out the course of the trial for 3 years
|
|
Toxicity per CTCAE v6.0
Time Frame: Participants will be followed thought out the course of the trial for 3 years
|
Adverse events are graded using NCI Common Terminology Criteria for Adverse Events version 6.0. |
Participants will be followed thought out the course of the trial for 3 years
|
|
Feasibility
Time Frame: Assessed at time of TIL infusion (D0)
|
Feasibility is defined as the proportion of patients who successfully undergo tumor harvest, ex vivo TIL expansion, lymphodepletion, and TIL infusion, regardless of number of IL-2 doses given post-TIL. |
Assessed at time of TIL infusion (D0)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: David Einstein, MD, Beth Israel Deaconess Medical Center
Study record dates
Study Major Dates
Study Start (Estimated)
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
- Urogenital Diseases
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Male Urogenital Diseases
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Neoplasms by Histologic Type
- Neoplasms, Glandular and Epithelial
- Adenocarcinoma
- Urologic Neoplasms
- Carcinoma
- Carcinoma, Renal Cell
- Kidney Neoplasms
- Peptides
- Amino Acids, Peptides, and Proteins
- Proteins
- Organic Chemicals
- Surgical Procedures, Operative
- Hydrocarbons
- Biological Factors
- Phosphoramide Mustards
- Nitrogen Mustard Compounds
- Mustard Compounds
- Hydrocarbons, Halogenated
- Phosphoramides
- Organophosphorus Compounds
- Intercellular Signaling Peptides and Proteins
- Urologic Surgical Procedures
- Urogenital Surgical Procedures
- Cytokines
- Interleukins
- Lymphokines
- Cyclophosphamide
- Interleukin-2
- fludarabine
- aldesleukin
- Transurethral Resection of Bladder
Other Study ID Numbers
Other Study ID Numbers
- 26-686
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
The Harvard Cancer Consortium encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: [contact information for Sponsor Investigator or designee]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
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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