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.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
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
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Phase 2
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: David Einstein, MD
- Telefonnummer: (617) 667-2100
- E-Mail: Deinstei@bidmc.harvard.edu
Studienorte
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Massachusetts
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Boston, Massachusetts, Vereinigte Staaten, 02115
- Dana-Farber Cancer Institute
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Kontakt:
- David Einstein, MD
- Telefonnummer: (617) 667-2100
- E-Mail: Deinstei@bidmc.harvard.edu
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Kontakt:
- Wenxin Xu, MD
- Telefonnummer: 617-632-3000
- E-Mail: Wenxin_Xu1@dfci.harvard.edu
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Boston, Massachusetts, Vereinigte Staaten, 02115
- Brigham and Women's Hospital
-
Kontakt:
- David Einstein, MD
- Telefonnummer: (617) 667-2100
- E-Mail: Deinstei@bidmc.harvard.edu
-
Kontakt:
- Wenxin (Vincent) Xu, MD
- Telefonnummer: (617) 632-3000
- E-Mail: Wenxin_Xu1@dfci.harvard.edu
-
Boston, Massachusetts, Vereinigte Staaten, 02115
- Beth Israel Deaconess Medical Center (BIDMC)
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Kontakt:
- David Einstein, MD
- Telefonnummer: (617) 667-2100
- E-Mail: Deinstei@bidmc.harvard.edu
-
-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
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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.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
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 |
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Radiographic Objective Response Rate
Zeitfenster: 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
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Radiographic change in target lesions
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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)
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Hauptermittler: David Einstein, MD, Beth Israel Deaconess Medical Center
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Urogenitale Erkrankungen
- Urogenitale Neoplasmen
- Neubildungen nach Standort
- Neubildungen
- Männliche Urogenitalerkrankungen
- Nierenerkrankungen
- Urologische Erkrankungen
- Weibliche Urogenitalerkrankungen
- Weibliche Urogenitalerkrankungen und Schwangerschaftskomplikationen
- Neubildungen nach histologischem Typ
- Neubildungen, Drüsen und Epithelien
- Adenokarzinom
- Urologische Neubildungen
- Karzinom
- Karzinom, Nierenzelle
- Nierentumoren
- Peptide
- Aminosäuren, Peptide und Proteine
- Proteine
- Organische Chemikalien
- Chirurgische Eingriffe, operativ
- Kohlenwasserstoffe
- Biologische Faktoren
- Phosphoramid -Senf
- Stickstoffsenfverbindungen
- Senfverbindungen
- Kohlenwasserstoffe, halogeniert
- Phosphoramide
- Organophosphorverbindungen
- Interzelluläre Signalpeptide und Proteine
- Urologische chirurgische Verfahren
- Urogenitale chirurgische Eingriffe
- Zytokine
- Interleukins
- Lymphokine
- Cyclophosphamid
- Interleukin-2
- Fludarabine
- Aldesleukin
- Transurethrale Resektion der Blase
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- 26-686
Plan für individuelle Teilnehmerdaten (IPD)
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Art der unterstützenden IPD-Freigabeinformationen
- STUDIENPROTOKOLL
- SAFT
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Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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