- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT05164666
En undersøgelse af TAK-103 hos voksne med solide tumorer
En åben-label, dosiseskalering, fase 1, første-i-menneske-undersøgelse af TAK-103 hos voksne patienter med mesothelin-udtrykkende avancerede eller metastatiske solide tumorer
I denne undersøgelse vil personer med mesothelin-udtrykkende fremskredne eller metastatiske solide tumorer modtage TAK-103 med deres hvide blodlegemer. Hovedformålet med denne undersøgelse er at undersøge, om deltagerne får bivirkninger ved behandling med TAK-103 og at kontrollere, hvor meget TAK-103 deltagere kan få uden at få bivirkninger af det. Forskere kan derefter beregne den bedste dosis af TAK-103 til at give deltagere i fremtidige undersøgelser.
Ved det første besøg vil undersøgelseslægen tjekke, hvem der kan deltage. For dem, der kan deltage, vil undersøgelsens læger indsamle hvide blodlegemer fra hver deltager. Disse celler sendes til laboratoriet, hvor TAK-103 tilsættes til hver deltagers celler. Dette kan tage op til 4 eller 5 uger. Deltagerne kan modtage specifikke behandlinger, mens deltagerne venter på TAK-103. Derefter vil deltagerne modtage TAK-103 med deres celler langsomt gennem en vene (infusion). 4 forskellige små grupper af deltagere vil modtage lavere til højere doser af TAK-103. Hver deltager får kun 1 dosis. Undersøgelseslægerne vil tjekke for bivirkninger efter hver anden dosis af TAK-103. På denne måde kan forskere finde frem til den bedste dosis af TAK-103 at give deltagere i fremtidige undersøgelser.
Deltagerne vil blive på hospitalet i 28 dage eller længere til deres behandling. Derefter vil deltagerne besøge klinikken til regelmæssig kontrol i op til 3 år.
Studieoversigt
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 1
Kontakter og lokationer
Studiesteder
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Chiba
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Kashiwa, Chiba, Japan
- National Cancer Center Hospital East
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Hyōgo
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Nishinomiya, Hyōgo, Japan
- Hyogo College of Medicine Hospital
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Tokyo
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Chuo-ku, Tokyo, Japan
- National Cancer Center Hospital
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier
- Histologisk eller cytologisk bekræftede fremskredne eller metastatiske solide tumorer, som ikke har nogen mulighed for eller er intolerante over for standardbehandlinger med en dokumenteret klinisk fordel.
- Mesothelin-ekspression (>=50 % positiv på levedygtige tumorceller) skal bestemmes på tumoren lokalt ved immunhistokemi ved hjælp af et valideret assay, scoring og farvning bekræftet af sponsoren. Frisk biopsiprøve skal bruges til egnethedsvurdering, medmindre arkiveret biopsiprøve opnået inden for 6 måneder før leukafereseprocedurer er tilgængelig.
- Forventet levetid >=12 uger.
- Eastern Cooperative Oncology Groups præstationsstatus på 0 eller 1.
Tilstrækkelig organfunktion bekræftet af kliniske laboratorieværdier som specificeret nedenfor:
- Total bilirubin =<1,5 × den øvre grænse for normalområdet (ULN) undtagen hos deltagere med Gilberts syndrom. Deltagere med Gilberts syndrom kan tilmeldes direkte bilirubin =<3 × ULN af det direkte bilirubin. Forhøjet indirekte bilirubin på grund af posttransfusionshæmolyse er tilladt
Alaninaminotransferase (ALT) eller aspartataminotransferase (AST) skal være <3 × ULN.
ASAT og ALAT kan være forhøjet op til 5 × ULN, hvis forhøjelsen med rimelighed kan tilskrives tilstedeværelsen af metastatisk sygdom i leveren.
- Beregnet kreatininclearance >50 ml/min (Cockcroft-Gault formel).
- Hæmoglobin skal være >=9 g/dL.
- Neutrofiltal skal være >1000/mm^3.
- Absolut lymfocyttal skal være >500/mm^3.
- Blodpladetal skal være >75.000/mm^3.
- Deltagerne skal have radiografisk målbar sygdom som defineret af Respons Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST 1.1).
Eksklusionskriterier
- Aktive systemiske infektioner.
- Kendt hepatitis B overfladeantigen (HBsAg) positiv eller kendt eller formodet aktiv hepatitis C virus (HCV) infektion. Deltagere, der har positivt hepatitis B-kerneantistof (HBcAb) eller hepatitis B-overfladeantistof (HBsAb), kan tilmeldes, men skal have en upåviselig hepatitis B-virus (HBV) viral belastning. Deltagere, der har positivt hepatitis C-virus-antistof (HCVAb), skal have en upåviselig HCV-virusbelastning.
- Koagulationsforstyrrelser eller andre større medicinske sygdomme, herunder luftvejs- eller immunsystemsygdomme.
- Deltagere med kendt kardiovaskulær og kardiopulmonær sygdom defineret som ustabil angina, klinisk signifikant arytmi, myokardieinfarkt, kongestiv hjertesvigt, venstre ventrikel ejektionsfraktion (LVEF) <45 %, baseline iltmætning <93 % på rumluft. Et velkontrolleret atrieflimren ville ikke være en udelukkelse, hvorimod ukontrolleret atrieflimren ville være en udelukkelse.
- Deltagere med tegn på lymfom og/eller leukæmi.
- Deltagere, der er diagnosticeret med eller behandlet for en anden malignitet inden for 3 år før leukafereseprocedurer. Deltagere med ikke-melanom hudkræft eller karcinom in situ (f.eks. livmoderhals, blære, bryst) ville blive inkluderet, hvis de blev behandlet tilstrækkeligt.
- Enhver sygdom, der kræver systemisk steroidbehandling.
- Enhver tidligere brug af celle- og genterapi(er).
- Behandling med eventuelle forsøgsprodukter (undtagen celle- eller genterapi) inden for 14 dage før leukafereseprocedurer eller 28 dage før behandling med konditionerende kemoterapi/TAK-103.
- Systemisk kræftbehandling (herunder immunonkologiske terapier) og behandling med strålebehandling inden for 14 dage før leukafereseprocedurer eller behandling med konditionerende kemoterapi/TAK-103.
- Behandling med større operation inden for 28 dage før leukafereseprocedurer eller behandling med konditionerende kemoterapi/TAK-103 (mindre kirurgiske indgreb som kateterplacering er ikke ekskluderende kriterier).
- Tidligere behandling med enhver mesothelin-målrettet terapi.
- Enhver uafklaret toksicitet af grad 3 eller højere fra tidligere anticancerbehandling.
- Deltagere med risiko for blødning som vurderet af investigator.
- Tilstedeværelse af metastaser i centralnervesystemet eller andre væsentlige neurologiske tilstande (Deltager med metastaser i centralnervesystemet, der er blevet effektivt behandlet, hvor det er nødvendigt og stabilt, kan tilmeldes).
- Deltagere med human immundefektvirus (HIV) seropositiv og/eller human T-celle lymfotropisk virus (HTLV) seropositiv.
- Deltagere med en historie med organtransplantation eller afventer organtransplantation.
- Deltagere med alvorlig øjeblikkelig overfølsomhed over for nogen af midlerne, herunder cyclophosphamid, fludarabin eller streptomycin.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Ikke-randomiseret
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Eksperimentel: TAK-103, Dosiseskalering
TAK-103, kimære antigenreceptor (CAR) (+) celler, intravenøs infusion, vil blive administreret med ca. 5 ml/min.
Der er 5 planlagte dosisniveauer: 1x10^6, 3x10^6, 1x10^7, 1x10^8 og 5x10^8 CAR (+) celler/krop.
Dosisniveauet ved dosiseskalering vil blive styret af dosiseskaleringsskema baseret på den observerede dosisbegrænsende toksicitet (DLT) rate ved hvert dosisniveau.
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TAK-103 intravenøs infusion
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Percentage of Participants With Dose-Limiting Toxicities (DLTs)
Tidsramme: Up to 28 days
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DLTs were evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.
Any Grade 3 or higher toxicities that were considered by the investigator to be at least possibly related to therapy with TAK-103 during the 28 days immediately after infusion of TAK-103 and, any adverse events (AEs) requiring endotracheal intubation or tracheostomy were considered as DLTs.
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Up to 28 days
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Percentage of Participants With Treatment-emergent Adverse Events (TEAEs)
Tidsramme: From first dose of study drug administration up to 24 months
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An AE was defined as any untoward medical occurrence in a clinical investigation participant administered a drug.
An AE can be any unfavourable and unintended sign (including physical examinations, vital signs, electrocardiogram (ECG), laboratory assessment findings), symptom, or disease temporally associated with the use of a drug whether or not it is considered related to the drug.
TEAEs were defined as AEs that newly occurred or worsened on or after the start of study product administration.
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From first dose of study drug administration up to 24 months
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Percentage of Participants With Adverse Events of Clinical Interest (AECIs)
Tidsramme: From first dose of study drug administration up to 24 months
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In this study, immune effector cell-associated neurotoxicity syndrome (ICANS), cytokine release syndrome (CRS), hemophagocytic lymphohistiocytosis (HLH), macrophage activation syndrome (MAS), and tumor lysis syndrome (TLS) were predefined as AECIs.
CRS and ICANS were evaluated according to American Society for Transplantation and Cellular Therapy (ASTCT) consensus.
For management of HLH and MAS, CARTOX (CAR-T-cell-therapy-associated TOXicity) recommendations were used.
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From first dose of study drug administration up to 24 months
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Overall Response Rate (ORR) Assessed by Investigator According to RECIST 1.1
Tidsramme: Up to 24 months
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ORR was defined as the percentage of participants whose best overall response was complete response (CR) or partial response (PR) as determined by the investigator per Response Evaluation Criteria in Solid Tumor (RECIST) version 1.1.
Complete Response (CR): Disappearance of all target lesions (TL) and non-target lesions and normalization of tumor marker level.
Partial response (PR): At least a 30 percent (%) decrease in the sum of the longest diameter (LD) of TL, taking as reference the baseline sum LD.
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Up to 24 months
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ORR Assessed by Investigator According to Immune RECIST (iRECIST)
Tidsramme: Up to 24 months
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ORR was defined as the percentage of participants whose best overall response was immune complete response (iCR) or immune partial response (iPR) as determined by the investigator per iRECIST.
Immune Complete Response (iCR): Disappearance of all TL and Non-TL.
All lymph nodes must be non-pathological in size (less than [<]10 millimeters [mm] in short axis diameter [SAD]).
Immune Partial Response (iPR): Tumor load of the TL is reduced by less than or equal to (=<) 30% compared to the baseline, or in the case of complete remission of the TL, when one or more, non-TL can still be distinguished.
Immune Stable Disease (iSD), which is to be determined if the criteria of iCR or iPR are not met and no tumor progression is present.
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Up to 24 months
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Disease Control Rate (DCR) Assessed by Investigator According to RECIST 1.1
Tidsramme: Up to 24 months
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DCR was defined as the percentage of participants whose best overall response was CR, PR and stable disease (SD) or better as determined by the investigator per RECIST version 1.1.
CR: Disappearance of all TL and Non-TL.
All lymph nodes must be non-pathological in size (< 10 mm in SAD).
PR: Tumor load of the TL is reduced by =<30% compared to the baseline, or in the case of complete remission of the TL, when one or more, Non-TL can still be distinguished.SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for Progressive Disease (PD), taking as reference the smallest sum LD since the treatment started.
SD have to be maintained for at least 24 days (around 4 weeks) after the TAK-103 infusion.
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Up to 24 months
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DCR Assessed by Investigator According to iRECIST
Tidsramme: Up to 24 months
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DCR was defined as the percentage of participants whose best overall response was iCR, iPR and iSD or better as determined by the investigator per iRECIST.
iCR: Disappearance of all TL and Non-TL.
All lymph nodes must be non-pathological in size (< 10 mm in SAD).
iPR: Tumor load of the TL is reduced by =<30% compared to the baseline, or in the case of complete remission of the TL, when one or more, non-TL can still be distinguished.
iSD: Determined if the criteria of iCR or iPR are not met and no tumor progression is present.
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Up to 24 months
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Duration of Response (DOR) Assessed by Investigator With RECIST 1.1
Tidsramme: Up to 24 months
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DOR was defined as the time from the date of first documentation of a PR or better to the date of first documentation of PD per RECIST version 1.1.
PR: At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD.
PD: At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
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Up to 24 months
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DOR Assessed by Investigator With iRECIST
Tidsramme: Up to 24 months
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DOR was defined as the time from the date of first documentation of an iPR or better to the date of first documentation of disease progression per iRECIST.
iPR: Tumor load of the TL is reduced by =<30% compared to the baseline, or in the case of complete remission of the TL, when one or more, non-TL can still be distinguished.
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Up to 24 months
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Time to Progression (TTP) Assessed by Investigator With RECIST 1.1
Tidsramme: Up to 24 months
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TTP was defined as the time from the TAK-103 infusion date to the date of first documented disease progression by the investigator per RECIST version 1.1.
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Up to 24 months
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TTP Assessed by Investigator With iRECIST
Tidsramme: Up to 24 months
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TTP was defined as the time from the TAK-103 infusion date to the date of first documented disease progression by the investigator per iRECIST.
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Up to 24 months
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Progression-Free Survival (PFS) Assessed by Investigator With RECIST 1.1
Tidsramme: Up to 24 months
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PFS was defined as the time from the TAK-103 infusion date to the date of disease progression per RECIST version 1.1 or death from any cause, whichever occurred first.
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Up to 24 months
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PFS Assessed by Investigator With iRECIST
Tidsramme: Up to 24 months
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PFS was defined as the time from the TAK-103 infusion date to the date of disease progression per iRECIST or death from any cause, whichever occurred first.
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Up to 24 months
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Overall Survival (OS)
Tidsramme: Up to 24 months
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OS was defined as the time from the TAK-103 infusion date to the date of death from any cause.
Participants who did not die were censored at the last known survival follow-up.
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Up to 24 months
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Cmax- Maximum Observed in Peripheral Blood Drug Concentration After Single Dose Administration by CAR Copy Number of TAK-103
Tidsramme: At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18, 22, 29, Months 3, 4, 5, 7, 10, and 13) post-dose
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At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18, 22, 29, Months 3, 4, 5, 7, 10, and 13) post-dose
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Tmax- Time of First Occurrence of Maximum Observed Peripheral Blood Concentration by CAR Copy Number of TAK-103
Tidsramme: At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18, 22, 29, Months 3, 4, 5, 7, 10, and 13) post-dose
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At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18, 22, 29, Months 3, 4, 5, 7, 10, and 13) post-dose
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Clast- Last Observed Quantifiable Concentration in Peripheral Blood by CAR Copy Number of TAK-103
Tidsramme: At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18 and 22) post-dose
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At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18 and 22) post-dose
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Tlast- Persistence: Time of Last Observed Quantifiable Concentration in Peripheral Blood (Days) by CAR Copy Number of TAK-103
Tidsramme: At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18 and 22) post-dose
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At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18 and 22) post-dose
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AUC- Area Under the Blood Concentration-Time Curve by CAR Copy Number of TAK-103
Tidsramme: At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18, 22, and 29) post-dose
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At Pre-dose and multiple time points (Day 1, 2, 4, 8, 11, 15, 18, 22, and 29) post-dose
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Number of Participants With Replication Competent Retrovirus (RCR)-Positive Test Results
Tidsramme: Up to 24 months
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Number of participants with RCR-Positive test results were reported.
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Up to 24 months
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Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Studieleder: Study Director, Takeda
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- TAK-103-1001
- jRCT2033210463 (Registry Identifier: jRCT)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
IPD-delingsadgangskriterier
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
- SAP
- ICF
- CSR
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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