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Clinical Study of Granulocyte Infusion for Advanced Cancer

18. Dezember 2019 aktualisiert von: Shanghai East Hospital

Clinical Study of Allogeneic Granulocyte Infusion in the Treatment of Patients With Advanced Cancer

Background & Rationale:

For years, most tumor immunotherapy researches have focused on T cell and natural killer (NK) cell therapies, most of which involve amplification and modification of the patient's immune cells for reinfusion therapy. However, for the treatment of solid tumors, there is currently little breakthrough. Recently, researchers have reported a colony of cancer-resistant mice developed from a single mouse that was immune to multiple lethal cancer cell injections. Further research revealed that such anti-cancer immunity can cause rapid shrinkage or disappearance of the tumors in other cancer-bearing mice. Interestingly, this therapeutic effect is due to the donor granulocytes, instead of T cells or NK cells. Infusion of granulocytes is a classic therapy in treating infection associated with granulocytopenia. Currently, clinical collection of blood components, including isolation of granulocytes, is a mature technique. The infusion of granulocytes is a viable anticancer therapy combining the classic technique and novel anticancer approach. This proposed trial will test whether granulocyte infusions from healthy unrelated donors can be used to treat advanced cancer. In the proposed trial, up to 100 Subjects with advanced cancer can be entered. Each patient will be given a dose of (2.0-5.0)x10^10 granulocytes from a different healthy donor every week over a course of 5 doses. The trial will evaluate the subject's cancer 7, 30, 90 and 180 days after the last infusion.

Studienübersicht

Status

Unbekannt

Intervention / Behandlung

Detaillierte Beschreibung

Granulocyte anti-cancer therapy refers to a method in which healthy donor granulocytes with high cancer-killing activity are collected and infused into a specific cancer patient by matching, to achieve the therapeutic anticancer effect. In this proposed trial, up to 100 Subjects with advanced cancer can be entered. Potentially hundreds of healthy Donor-participants will be recruited. First, granulocyte donors will be identified via in-vitro assay of Cancer Killing Activity (CKA), which screens healthy Donor-participants for those with anticancer activity of more than 80%. Secondly, after donor-recipient blood matching, (2.0-5.0)x10^10 granulocytes will be collected from each donor, accounting for about 1/10 of the human body. Each patient will be given a dose of (2.0-5.0)x10^10 granulocytes from a different donor per week over a course of 5 doses (with an ideal total infusion of 2X10^11 granulocytes). After each infusion, the patients will be monitored carefully for possible adverse events. If adverse events occur, the infusion can be slowed down or stopped until the adverse events can be managed. The trial will observe the subject's cancer 7, 30, 90 and 180 days after the last infusion. Target lesions, non-target lesions, and new lesions will be evaluated via medical imaging and tumor markers. The responses will be compared against the measurements at baseline.

Studientyp

Interventionell

Einschreibung (Voraussichtlich)

100

Phase

  • Phase 2
  • Phase 1

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studieren Sie die Kontaktsicherung

Studienorte

    • Shanghai
      • Shanghai, Shanghai, China, 200123
        • Rekrutierung
        • Department of Oncology, Shanghai East Hospital
        • Kontakt:
          • Yifan Zhang
          • Telefonnummer: +86-021-38804518-22203

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Ja

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria for Subjects:

  • Malignant tumor confirmed by puncture pathology/postoperative pathology;
  • Clinical stage IV;
  • Performance status of ≤2 on the ECOG scale
  • Life expectancy of at least 3 months
  • All patients was diagnosed metastatic tumor by histology and cytology. Cytoreductive surgery can be performed if the patient can endure surgery.
  • Measurable Disease: Lesions that can be accurately measured in at least one dimension (longest diameter recorded) as 20 mm with conventional technique or as 10 mm with spiral CT scan.If the lesion is between 15mm and 20mm, the thickness of the CT layer should be no more than 0.5mm. For multiple lesions, select a representative 10 lesions (maximum 5 in the same organ) and calculate the sum of the longest diameters of all target lesions as the baseline sum diameter.
  • ≥ 4 weeks since prior medical therapy, radiation therapy, and surgery
  • Laboratory tests meet the following criteria:

A. Bone marrow function: Absolute blood neutrophil (ANC) count ≥1*10^9 /L, blood small (PLT) ≥75*10^9 /L.

B. Liver function: serum total bilirubin (STB), combined bilirubin (CB) ≤ upper limit of normal (ULN) * 1.5, alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤ULN*2.5 (in the absence of liver metastases), or ≤ULN*5 (with liver metastases);

C. Renal function: serum creatinine (Cr) ≤ ULN * 1.5, endogenous creatinine clearance (Ccr) ≥ 50 mL / min (calculated using the Cockcroft-Gault formula, see Appendix 2);

  • The anti-neutrophil antibody test result was negative.
  • The patient volunteered and signed an informed consent form.

Exclusion Criteria of Subjects:

  • Arrhythmia, congestive heart failure, or severe coronary artery disease;
  • Pregnant or nursing women;
  • Patients with severe autoimmune diseases;
  • Patients who have been using or are using immunosuppressive agents for a long time;
  • Those with coagulopathy;
  • Cases that the investigator considered inappropriate for inclusion.

Inclusion Criteria for Granulocyte Donors:

  • Must have signed Donor-participant Informed Consent Form
  • Must be able to provide granulocytes in local blood donation center, and transport collected granulocytes to the hospital blood bank or clinical application within 24 hours;
  • Must score >80% in Cancer Killing Assay (CKA), a score of 60-80% would be considered when there are insufficient donors;
  • Must have CMV negative or positive sero-testing completed; only seronegative donors are accepted for a seronegative recipient;
  • Must have compatible ABO and RH typing with the recipient;
  • Must be qualified for blood donation: aged 18-35, male >50kg or female >45kg, normal cardiopulmonary function, specific gravity of blood male≥1.052 or female≥1.051, HbsAg, anti-HCV, anti-HIV, or syphilis tests.

Exclusion Criteria for Granulocyte Donors:

  • Dental or other minor surgery within preceding 15 days;
  • Arrhythmia, congestive heart failure, or severe coronary artery disease;
  • Major surgery within preceding 6 months;
  • Appendectomy, hernia repair, or tonsillectomy within preceding 3 months;
  • Females 3 days before or after menstruation, ≤6 months since prior pregnancy or abortion, ≤ 1 year since delivery/breastfeeding;
  • Recovery from flu or acute gastroenteritis within preceding week, acute renal infection within preceding month, pneumonia within preceding 3 months;
  • Recovery from infectious diseases such as dysentery within preceding 6 months, typhoid fever within preceding year, brucellosis within preceding 2 years, or malaria within preceding 3 years;
  • Recovery from localized dermatitis within preceding week, extensive inflammation within preceding 2 weeks;
  • Receiving whole blood or blood components within preceding 5 years;
  • Allergic to G-CSF mobilizer.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: N / A
  • Interventionsmodell: Einzelgruppenzuweisung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Granulocytes infusion only
Fresh, non-irradiated granulocytes from ABO, Rh, CMV compatible, unrelated donors; bioactivity of anti-cancer ability meets the criteria.
Granulocytes cross-matched for ABO-Rh and CMV; bioactivity of anti-cancer ability meets the criteria.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Progression free survival (PFS)
Zeitfenster: 90 days post treatment
The trial will observe the subject's progression free survival for 3 months after the granulocyte infusions are completed.
90 days post treatment

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
median Overall Survival (mOS)
Zeitfenster: 180 days post treatment
The patients will be followed 1 week, 1 month, 3 months and 6 months after the last treatment. Median Overall Survival will be measured as the length of time from the date of inclusion that half of the patients are still alive.
180 days post treatment
Objective Response Rate (ORR )
Zeitfenster: 180 days post treatment
Objective Response Rate will be evaluated based on the Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1. If a response is achieved in a patient, the evaluation will be repeated 4-6 weeks after the first evaluation to confirm the response.
180 days post treatment
Disease Control Rate (DCR)
Zeitfenster: 180 days post treatment
Disease Control Rate will be measured as the percentage of patients achieved complete response (CR), partial response (PR) and stable disease (SD) to the treatment (evaluated based on RECIST 1.1).
180 days post treatment
Quality of life measured in ECOG
Zeitfenster: 180 days post treatment
ECOG Scale of Performance Status will be evaluated for patients after treatment to reflect impact on quality of life.
180 days post treatment
Treatment-related adverse events
Zeitfenster: 5 weeks of treatment and 1 month post treatment
Incidence of treatment-related adverse events as assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.
5 weeks of treatment and 1 month post treatment

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Ermittler

  • Hauptermittler: Zhongming Liu, MD/Ph.D, Shanghai East Hospital, Shanghai Tongji University

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. Dezember 2019

Primärer Abschluss (Voraussichtlich)

30. September 2022

Studienabschluss (Voraussichtlich)

30. September 2022

Studienanmeldedaten

Zuerst eingereicht

10. September 2019

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

10. Oktober 2019

Zuerst gepostet (Tatsächlich)

11. Oktober 2019

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

19. Dezember 2019

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

18. Dezember 2019

Zuletzt verifiziert

1. Dezember 2019

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • KY2019-01

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Produkt, das in den USA hergestellt und aus den USA exportiert wird

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .

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