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GD2/CD56 Bi-specific CAR-T Cell Therapy

25. juni 2022 opdateret af: Shenzhen Geno-Immune Medical Institute

GD2/CD56 Bi-specific CAR-T Cells for Cancer Treatment

The purpose of this clinical trial is to assess the feasibility, safety and efficacy of anti-GD2/CD56 bi-specific CAR-T cell therapy in patients with GD2 and/or CD56 positive cancer. Another goal of the study is to learn more about the function of the anti-GD2/CD56 bi-specific CAR-T cells and their persistency in patients.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Patients with refractory and/or recurrent malignancies have poor prognosis despite complex multimodal therapy; therefore, novel curative approaches are needed. The investigators attempt to use T cells genetically modified to express a 4th generation lentiviral GD2/CD56 bi-specific chimeric antigen receptor (bi-4SCAR-GD2/CD56). The chimeric antigen receptor (CAR) molecules enable the T cells to recognize and kill tumor cells through the recognition of a surface antigen, GD2 or CD56, which is expressed at high levels on tumor cells but not at significant levels on normal tissues.

Disialoganglioside (GD2) is a well-studied tumor associated antigen which is expressed uniformly in nervous system-related tumors but at low levels in normal tissues. Over the past few years, CAR-T therapy against GD2 in tumor has achieved encouraging but modest outcomes. Only a fraction of patients achieved measurable responses. In solid tumors, GD2 CAR-T therapy alone may not be as effective as CAR-T cell therapy in hematological malignancies.

Similar to GD2, the CD56 antigen (NCAM-1) is highly expressed on malignancies with neuronal or neuroendocrine differentiation, including small-cell lung cancer, glioblastoma and neuroblastoma, tumor types for which new therapeutic options are needed. CD56-CAR-T cell therapy has potential for treating patients with aggressive malignancies that are nonresponsive to conventional radiotherapy and chemotherapy, or are unsuitable for hematopoietic stem cell transplantation.

To overcome tumor escape of single target antigen and enhance in vivo CAR-T efficacy, a novel bi-specific GD2/CD56 CAR-T therapy regimen is developed to include booster and consolidation CAR-T applications to target highly-refractory cancer. The aim is to evaluate safety and long term efficacy of the bi-CAR-T therapy strategy in GD2 and/or CD56 positive cancer patients.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

60

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

    • Guangdong
      • Shenzhen, Guangdong, Kina, 518000
        • Rekruttering
        • Shenzhen Geno-immune Medical Institute

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

1 år til 75 år (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Patients with tumors received standard first-line therapy and have been judged to be non-resectable, metastatic, progressive or recurrent.
  2. The expression status of GD2 or CD56 antigens in the tumor tissue will be determined for eligibility. Positive expression is defined by GD2 and CD56 antibody staining results based on immunohistochemistry or flow cytometry analyses.
  3. Body weight greater than or equal to 10 kg.
  4. Age: ≥1 year and ≤ 75 years of age at the time of enrollment.
  5. Life expectancy: at least 8 weeks.
  6. Prior Therapy:

    There is no limit to the number of prior treatment regimens. Any grade 3 or 4 non-hematologic toxicity of any previous therapy must be resolved to grade 2 or less.

  7. Participant must not have received hematopoietic growth factors for at least 1 week prior to mononuclear cells collection.
  8. At least 7 days must have elapsed since the completion of therapy with a biologic agent, selected targeted agent or a metronomic non-myelosuppressive regimen.
  9. At least 4 weeks must have elapsed since prior therapy that included a monoclonal antibody.
  10. At least 1 week since any radiation therapy at the time of study entry.
  11. Karnofsky/jansky score of 60% or greater.
  12. Cardiac function: Left ventricular ejection fraction greater than or equal to 40/55 percent.
  13. Pulse Ox greater than or equal to 90% on room air.
  14. Liver function: defined as alanine transaminase (ALT) <3x upper limit of normal (ULN), aspartate aminotransferase (AST) <3x ULN; serum bilirubin and alkaline phosphatase <2x ULN.
  15. Renal function: Patients must have serum creatinine less than 3 times upper limit of normal.
  16. Marrow function: White blood cell count ≥1000/ul, Absolute neutrophil count ≥500/ul, Absolute lymphocyte count ≥500/ul, Platelet count ≥25,000/ul (not achieved by transfusion).
  17. Patients with known bone marrow metastatic disease will be eligible for study as long as they meet hematologic function criteria, and the marrow disease does not have hematologic toxicity.
  18. For all patients enrolled in this study, themselves or their parents or legal guardians must sign an informed consent and assent.

Exclusion Criteria:

  1. Existing severe illness (e.g. significant cardiac, pulmonary, hepatic diseases, etc.) or major organ dysfunction, or greater than grade 2 hematologic toxicity.
  2. Untreatable central nervous system (CNS) metastasis: Patients with previous CNS tumor involvement that has been treated and is stable for at least 6 weeks following completion of therapy are eligible.
  3. Previous treatment with other genetically engineered GD2 or CD56-specific CAR T cells.
  4. Active HIV, hepatitis B virus (HBV), hepatitis C virus (HCV) infection or uncontrolled infection.
  5. Patients who require systemic corticosteroid or other immunosuppressive therapy.
  6. Evidence of tumor potentially causing airway obstruction.
  7. Inability to comply with protocol requirements.
  8. Insufficient CAR T cells availability.

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: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: bi-4SCAR-GD2/CD56 T Cell Therapy for GD2 and/or CD56 positive tumor
Infusion of bi-4SCAR GD2/CD56 T cells at 10^6 cells/kg body weight via IV

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of patients with adverse events.
Tidsramme: 6 months
Determine the toxicity profile the bi-4SCAR GD2/CD56 cells with Common Toxicity Criteria for Adverse Effects version 4.0
6 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Anti-tumor virkninger
Tidsramme: 1 år
Objektiv komplet respons (CR) vurderes ud fra kriterierne for responsevaluering i solide tumorer (RECIST) v1.1.
1 år
Anti-tumor effects
Tidsramme: 1 year
Objective partial response (PR) are assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria.
1 year
The expansion of bi-4SCAR GD2/CD56 T cells
Tidsramme: 1 year
Scale of CAR copies
1 year
The persistence of bi-4SCAR GD2/CD56 T cells
Tidsramme: 1 year
Scale of tumor burden (for efficacy)
1 year
Survival time of the patients
Tidsramme: 3 years
The progression free survival (PFS) time of the patients treated with the bi-4SCAR GD2/CD56 T cells will be evaluated
3 years
Survival time of the patients
Tidsramme: 3 years
The overall survival (OS) time of the patients treated with the bi-4SCAR GD2/CD56 T cells will be evaluated
3 years

Samarbejdspartnere og efterforskere

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

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 (Forventet)

30. juni 2022

Primær færdiggørelse (Forventet)

31. december 2025

Studieafslutning (Forventet)

30. juni 2026

Datoer for studieregistrering

Først indsendt

21. juni 2022

Først indsendt, der opfyldte QC-kriterier

25. juni 2022

Først opslået (Faktiske)

29. juni 2022

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. juni 2022

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. juni 2022

Sidst verificeret

1. juni 2022

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • GIMI-IRB-22006

Plan for individuelle deltagerdata (IPD)

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Kliniske forsøg med Ondartet sygdom

Kliniske forsøg med bi-4SCAR GD2/CD56 T cells

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