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Adapt NK for High Risk Myeloid Diseases as Bridge to Allo HSCT

Safety and Efficacy of Expanded KIR-HLA Mismatched Natural Killer Cell Immunotherapy (AdaptNK) for High-Risk Myeloid Diseases as Bridge to Allogeneic Hematopoietic Stem Cell Transplantation

This is a multi-institutional Phase I/II study of an allogeneic KIR-HLA mismatched NK cell infusion (AdaptNK) and a short course of subcutaneous interleukin-2 (IL-2) administered after lymphodepleting chemotherapy [cyclophosphamide (CY)/fludarabine (FLU)] in patients with relapsed or refractory acute myelogenous leukemia (AML). AdaptNK is a natural killer (NK) cell product that is enriched for NK cells with an "adaptive", or human cytomegalovirus (CMV)-induced, phenotype.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

18

Fase

  • Fase 2
  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Minnesota
      • Minneapolis, Minnesota, Forenede Stater, 55455
        • Rekruttering
        • Mark Juckett, MD
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • 18-74 years with Karnofsky score ≥ 70%
  • 75 years and older: KPS ≥ 70%, HCT-CI < 5 (excluding history of solid tumor), AND not frail by Fried frailty criteria (see Appendix III)
  • HLA type C1/C1 or C2/C2

Note: For easy determination, the definition of HLA-C ligand group assigments is included below:

HLA-C1 group alleles are defined as HLA-C01, C03, C07, C08, C12, C14, C16 HLA-C2 group alleles are defined as HLA-C02, C04, C05, C06, C15, C17, C18

  • adequate liver, renal, pulmonary and cardiac function
  • ability to be off glucocorticoids and other immunosuppressive medications indicated for acute or chronic GVHD for at least 28 days prior to the AdaptNK cell infusion
  • There must be sufficient time between the most recent therapy and the screening bone marrow as delineated below:
  • anti-leukemic systemic cytotoxic chemotherapy - 2 weeks
  • Targeted anti-leukemic agents (FLT-3, IDH, menin inhibitors) - 3 half-lives of the medication
  • Radiotherapy - 1 week
  • donor lymphocyte infusions - 6 weeks
  • hematopoietic growth factors (filgrastim, TPO agonists, EPO) - 1 week
  • biologic therapy (monoclonal antibodies, T-cell engagers) - 2 weeks
  • Immune effector cellular therapy - 4 weeks
  • Intrathecal chemotherapy for treatment of active CNS leukemia - there must be at least two CSF samples negative for leukemia separated by one week before enrollment.
  • WBC shall be < 25,000 before infusion. Hydroxyurea is permitted until day -3 to control excess blast proliferation. No other systemic treatment is allowed after the screening bone marrow is performed for inclusion in protocol
  • All prior treatment related toxicities should have resolved to ≤ grade 1 prior to study enrollment
  • agrees to use of adequate contraception from study enrollment to 4 months after cell infusion
  • voluntary written consent

Exclusion Criteria:

  • Myeloid neoplasms with known or strongly suspected germline background, except DDX41, TP53, or RUNX1.
  • Acute promyelocytic leukemia (APL)
  • myocardial infarction (MI) within previous 6 months of study enrollment
  • pregnant or breastfeeding
  • Active CNS involvement with AML
  • new or progressive pulmonary infiltrates
  • active autoimmune disease requiring immunosuppressive therapy
  • Preexisting inflammatory disease requiring immunosuppressive therapy
  • history of severe asthma and currently on chronic systemic medications
  • HIV-1/2 positivity or hepatitis C/B
  • active systemic infections requiring anti-infective treatment
  • received any investigational agent within the 14 days before the start of study treatment (1st dose of fludarabine)
  • Patients with second malignancies are excluded if they have required systemic cytotoxic chemotherapy within 1 year or if they are not in remission
  • Exception: patients that are on stable dosing of hormonal therapy (e.g. aromatase inhibitor or antiandrogen therapy) for active breast or prostate cancer for 1 year are eligible.
  • Patients with excised basal cell or squamous cell carcinoma of the skin are eligible.
  • Patients with excised carcinoma in situ of the cervix or breast are eligible.
  • Patients with untreated T1a or T1b prostate cancer are eligible.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Sekventiel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Dose Level Cohort -1
Safety dose level. < 1 x 10^8 Total Nucleated Cells (TNC) of AdaptNK product administered intravenously (IV).

The NK cell product is comprised of peripheral blood (PB) leukocytes sourced from a cryopreserved pool.

of third-party donors that are seropositive for cytomegalovirus (CMV+), have NK cells expressing >20% NKG2C and >30% single-self KIR and depleted from CD3+ (T-lymphocytes) and CD19+ (B-lymphocytes) cells.

25 mg/kg administered on days -6, -5, -4, -3 and -2. Part of Lymphodepleting conditioning chemotherapy regimen.
60 mg/kg administered on days -5 and -4. Part of Lymphodepleting conditioning chemotherapy regimen.
IL-2 at 6 million IU subcutaneously (SC) every other day (EOD) for 3 doses with Dose 1 on Day 0 (no sooner than 4 hours post cell infusion) with the last dose no later than Day +8.
Eksperimentel: Dose Level Cohort 1
2.4 - 3 x 10^8 Total Nucleated Cells (TNC) of AdaptNK product administered intravenously (IV).

The NK cell product is comprised of peripheral blood (PB) leukocytes sourced from a cryopreserved pool.

of third-party donors that are seropositive for cytomegalovirus (CMV+), have NK cells expressing >20% NKG2C and >30% single-self KIR and depleted from CD3+ (T-lymphocytes) and CD19+ (B-lymphocytes) cells.

25 mg/kg administered on days -6, -5, -4, -3 and -2. Part of Lymphodepleting conditioning chemotherapy regimen.
60 mg/kg administered on days -5 and -4. Part of Lymphodepleting conditioning chemotherapy regimen.
IL-2 at 6 million IU subcutaneously (SC) every other day (EOD) for 3 doses with Dose 1 on Day 0 (no sooner than 4 hours post cell infusion) with the last dose no later than Day +8.
Eksperimentel: Dose Level Cohort 2
0.8 - 1 x 10^9 Total Nucleated Cells (TNC) of AdaptNK product administered intravenously (IV).

The NK cell product is comprised of peripheral blood (PB) leukocytes sourced from a cryopreserved pool.

of third-party donors that are seropositive for cytomegalovirus (CMV+), have NK cells expressing >20% NKG2C and >30% single-self KIR and depleted from CD3+ (T-lymphocytes) and CD19+ (B-lymphocytes) cells.

25 mg/kg administered on days -6, -5, -4, -3 and -2. Part of Lymphodepleting conditioning chemotherapy regimen.
60 mg/kg administered on days -5 and -4. Part of Lymphodepleting conditioning chemotherapy regimen.
IL-2 at 6 million IU subcutaneously (SC) every other day (EOD) for 3 doses with Dose 1 on Day 0 (no sooner than 4 hours post cell infusion) with the last dose no later than Day +8.
Eksperimentel: Dose Level Cohort 3
2.4 - 3 x 10^9 Total Nucleated Cells (TNC) of AdaptNK product administered intravenously (IV).

The NK cell product is comprised of peripheral blood (PB) leukocytes sourced from a cryopreserved pool.

of third-party donors that are seropositive for cytomegalovirus (CMV+), have NK cells expressing >20% NKG2C and >30% single-self KIR and depleted from CD3+ (T-lymphocytes) and CD19+ (B-lymphocytes) cells.

25 mg/kg administered on days -6, -5, -4, -3 and -2. Part of Lymphodepleting conditioning chemotherapy regimen.
60 mg/kg administered on days -5 and -4. Part of Lymphodepleting conditioning chemotherapy regimen.
IL-2 at 6 million IU subcutaneously (SC) every other day (EOD) for 3 doses with Dose 1 on Day 0 (no sooner than 4 hours post cell infusion) with the last dose no later than Day +8.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Maximum tolerated dose (MTD)
Tidsramme: 1 year
The primary objective of the study is to assess the safety and determine the maximum tolerated dose (MTD) of AdaptNK administered as a single infusion intravenously (IV) to KIR-HLA mismatched patients with relapsed or refractory AML.
1 year

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Objective response (OR)
Tidsramme: Day 42
includes complete remission with or without hematologic recovery (CR or CRi) or partial remission (PR)
Day 42
Safety of AdaptNK
Tidsramme: Day 42
measured by rate of treatment related mortality (TRM)
Day 42

Andre resultatmål

Resultatmål
Tidsramme
Samlet overlevelse
Tidsramme: 1 år
1 år
Samlet overlevelse
Tidsramme: 2 år
2 år
Leukemia free survival (LFS)
Tidsramme: 1 year
1 year
Leukemia free survival (LFS)
Tidsramme: 2 year
2 year

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

8. maj 2026

Primær færdiggørelse (Anslået)

1. marts 2030

Studieafslutning (Anslået)

1. marts 2035

Datoer for studieregistrering

Først indsendt

11. maj 2026

Først indsendt, der opfyldte QC-kriterier

11. maj 2026

Først opslået (Faktiske)

18. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

19. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

15. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 2023LS005

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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