- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02416466
CAR-T Hepatic Artery Infusions and Sir-Spheres for Liver Metastases (HITM-SIR)
March 25, 2019 updated by: Roger Williams Medical Center
Phase Ib Trial of CAR-T Hepatic Artery Infusions Followed by Selective Internal Radiation Therapy (SIRT) With Yttrium-90 Sir-Spheres® for CEA-Expressing Liver Metastases
This is an open label fixed dose phase Ib of anti-CEA CAR-T cells hepatic artery infusions and yttrium-90 SIR-Spheres in patients with CEA-expressing liver metastases.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Patients undergo leukapheresis from which peripheral blood mononuclear cells are purified.
T cells are activated and then re-engineered to express chimeric antigen receptors (CARs) specific for CEA.
Cells are expanded in culture and returned to the patient by percutaneous hepatic artery infusion at specific cell doses.
Prior to the first dose, each patient will undergo diagnostic angiography to verify suitable arterial anatomy.
Three anti-CEA CAR-T doses and one SIR-Sphere dose per patient are planned at 2-week intervals.
Low dose interleukin-2 will be given via an ambulatory infusion pump for 6 weeks.Normal liver and tumor biopsies will be obtained at the time of the initial diagnostic angiogram and during the final infusion session.
Study Type
Interventional
Enrollment (Actual)
8
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Rhode Island
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Providence, Rhode Island, United States, 02908
- Roger Williams Medical Center
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patient with histologically confirmed diagnosis of CEA+ adenocarcinoma and liver metastases. Patient must have either histologic confirmation of the liver metastases or histologic documentation of the primary tumor and definitive radiologic evidence of liver involvement. Measurable disease is required with lesions of > 1.0 cm by CT. Soluble CEA is not acceptable as the sole measure of disease. Limited extrahepatic disease is acceptable if confined to the lungs or peritoneal cavity.
- Tumor must be CEA-expressing as demonstrated by elevated serum CEA levels (≥10ng/ml) or immunohistochemistry on a biopsy specimen. Archived tissue is acceptable for determination of CEA expression.
- Patient must be at least 18 years of age.
- Patient able to understand and sign informed consent.
- Patient with a life expectancy of greater than four months.
- Patient failed at least one line of standard systemic chemotherapy and has unresectable disease.
- Patient with performance status of 0 to 1 (ECOG).
- Patient with adequate organ function as defined in protocol.
- Acceptable hepatic vascular anatomy as determined by CT, MR, or conventional angiography. A nuclear medicine study will be performed to document the absence of a significant hepatic-pulmonary shunt (<20%).
Exclusion Criteria:
- Female patients of childbearing age will be tested for pregnancy. Pregnant patients will be excluded from the study. Males who are actively seeking to have children will be made aware of the unknown risks of this study protocol on human sperm and the need to practice birth control.
- Patients with serious or unstable renal, hepatic, pulmonary, cardiovascular, endocrine, rheumatologic, or allergic disease based on history, physical exam and laboratory tests will be excluded, as outlined in section 5.2.8.
- Patients with active clinical disease caused by CMV, hepatitis B or C, HIV or tuberculosis will be excluded from the study.
- Patients who have had cytotoxic and/or radiation therapy within 4 weeks prior to entry into the trial or 4 weeks prior to infusion will be excluded. Patients with other concurrent malignancies will be excluded.
- Patients requiring systemic steroids will be excluded.
- Patients with unsuitable hepatic vascular anatomy will be excluded from the study.
- Patients with extrahepatic metastatic disease beyond the lungs or abdominal/ retroperitoneal lymph nodes.
- Patients with >50% liver replacement at time of treatment will be excluded.
- Previous external beam radiotherapy to the liver.
- Portal vein thrombosis.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: anti-CEA CAR-T cells + Sir-Spheres
Three infusions of gene-modified anti-CEA T cells over the course of 6 weeks into the hepatic artery via a percutaneous approach along with low dose IL-2.
A single dose of Sir-Spheres will be given 2 weeks following the final T cell dose.
|
Gene modified patient T cells.
Other Names:
SIR-Spheres microspheres are a medical device used in Selective Internal Radiation Therapy (SIRT) for liver tumors.
SIR-Spheres microspheres are a permanent implant and for single use only.
The biocompatible resin microspheres containing yttrium-90 have a median diameter of 32.5 microns (range between 20 and 60 microns).
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety of CAR-T cell hepatic artery infusions in combination with Sir-Spheres as Measured by Number of Participants with Adverse Events
Time Frame: 14 weeks
|
To determine the safety and regimen limiting toxicity (RLT) of a standard of care treatment with Yttrium-90 Sir-Spheres Microspheres when following anti-CEA CAR-T hepatic artery infusions (HAI) for CEA-expressing liver metastases.
|
14 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Treatment response (Liver tumor response by MRI, PET, CEA level, and biopsy)
Time Frame: 14 weeks
|
Liver tumor response by MRI, PET, CEA level, and biopsy
|
14 weeks
|
Serum cytokine levels
Time Frame: 14 weeks
|
Measurement of cytokines as indicators of immune response
|
14 weeks
|
CAR-T detection in liver tumors, normal liver, and extrahepatic sites
Time Frame: 14 weeks
|
Quantification of CAR-T cells in biopsy and blood samples
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14 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Steven C Katz, MD, Roger Williams Medical Center
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
April 1, 2015
Primary Completion (Actual)
November 21, 2016
Study Completion (Actual)
June 1, 2018
Study Registration Dates
First Submitted
March 30, 2015
First Submitted That Met QC Criteria
April 9, 2015
First Posted (Estimate)
April 15, 2015
Study Record Updates
Last Update Posted (Actual)
March 26, 2019
Last Update Submitted That Met QC Criteria
March 25, 2019
Last Verified
March 1, 2019
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 383-74
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
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.
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