Evaluación de la eficacia de las células T con CAR anti-B7-H3 administradas al final de la quimioterapia inicial Map en pacientes con osteosarcoma de alto riesgo recién diagnosticado
Un estudio de fase II que evalúa la eficacia de las células T con CAR B7-H3 administradas al final de la quimioterapia inicial Map en pacientes con osteosarcoma de alto riesgo recién diagnosticado
The purpose of this study is to assess the safety, feasibility, and effectiveness of a consolidative B7-H3 CAR T cell therapy in patients with newly diagnosed high-risk osteosarcoma who have undergone upfront standard chemotherapy.
Primary Objectives:
- To evaluate 1-year RFS from the time of SJCARB7H3-41BBL infusion for patients with newly diagnosed metastatic osteosarcoma who received standard chemotherapy.
Secondary Objectives:
- To evaluate the OS from time of SJCARB7H3-41BBL infusion for patients with newly diagnosed metastatic osteosarcoma who received standard chemotherapy.
- To evaluate the feasibility of delivering SJCARB7H3-41BBL at the end of standard therapy in patients with newly diagnosed metastatic osteosarcoma.
- To describe the safety of autologous SJCARB7H3-41BBL therapy when delivered at the end of standard therapy in patients with newly diagnosed metastatic osteosarcoma.
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
This is a phase 2 study of SJCARB7H3-41BBL for participants with newly diagnosed high-risk metastatic osteosarcoma who received standard chemotherapy.
All participants will receive standard chemotherapy (for example methotrexate, anthracycline, platinum), local control surgery, and pulmonary metastasectomy if applicable, and this is not considered part of protocol therapy. Participants will undergo apheresis prior to standard local control surgery (about 12 weeks after diagnosis) for SJCARB7H3-41BBL manufacture and then resume standard consolidation therapy. A safety run will initiate with Regimen A. For Regimen A, eligible participants with available SJCARB7H3-41BB product will receive lymphodepletion chemotherapy 14-28 days after the completion of standard chemotherapy (31 weeks after diagnosis), followed by SJCARB7H3-41BB infusion. If Regimen A is not cleared, then Regimen B will be evaluated, where lymphodepletion and SJCARB7H3-41BB infusion occur post pulmonary metastasectomy. Following successful clearance of either regimen A or, if necessary, regimen B, then the efficacy cohort will be initiated. Participants will be followed with serial disease evaluations for 2 years from SJCARB7H3-41BB infusion prior to transfer to our institutional long-term follow-up (LTFU) protocol. The total duration from completion of standard therapy, including experimental therapy and follow-up on 3CAR4OS, is approximately 2 years.
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- Fase 2
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Julie Park, MD
- Número de teléfono: 888-226-4343
- Correo electrónico: referralinfo@stjude.org
Copia de seguridad de contactos de estudio
- Nombre: Judith Durrell
- Número de teléfono: 888-226-4343
- Correo electrónico: referralinfo@stjude.org
Ubicaciones de estudio
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Tennessee
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Memphis, Tennessee, Estados Unidos, 38105-2794
- Reclutamiento
- St. Jude Children's Research Hospital
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Investigador principal:
- Julie Park, MD
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Contacto:
- Julie Park, MD
- Número de teléfono: 888-226-4343
- Correo electrónico: referralinfo@stjude.org
-
-
Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
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Participant and/or legally authorized representative has signed the Informed Consent Form for this study
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Prior cancer therapy:
- Regimen A only: Completed all planned cycles of consolidation therapy between 14-28 days prior.
- Regimen B only: has completed all planned cycles of consolidation chemotherapy at least 14 days prior and if clinically indicated, participant has undergone pulmonary metastasectomy. They must have recovered from any surgical complications with no ongoing sequelae of category 2 or higher by the Clavien-Dindo classification system and less than 6 weeks must have passed from time of pulmonary metastasectomy.
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No evidence of progressive disease since enrolled on study
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Lansky performance status score of ≥ 50 for participants <16 years of age or Karnofsky score ≥ 50 for participants ≥ 16 years. Participants who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for purposes of assessing performance status
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Adequate organ function as indicated by:
- Renal: Serum creatinine ≤ 1.5 X the upper limit of normal (ULN) based on enrollment eligibility table.
- Hepatic: Total bilirubin ≤ 3 times ULN for age OR conjugated bilirubin ≤ 2 mg/dL AND ALT (SGPT) ≤ 5 times ULN
- Cardiac: Shortening fraction ≥ 28% OR ejection fraction ≥ 50% as measured by echocardiogram
- Respiratory: Oxygen saturation ≥ 90% on room air without supplemental oxygen or mechanical ventilation
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Laboratory values meet the following criteria:
- Absolute Neutrophil Count (ANC) ≥ 750 cells/uL
- Platelet Count of ≥ 75,000 (can be transfused)
- Hemoglobin ≥ 7 g/dL (can be transfused)
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Participant is ≥ 7 days from receiving supra-physiologic dosing of systemic (IV or PO) corticosteroids. Glucocorticosteroid physiologic replacement therapy for management of adrenal insufficiency is allowed.
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Participant and/or legally authorized representative has signed the Informed Consent Form for the treatment phase of this study.
Exclusion Criteria:
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Major surgical adverse event related to the primary tumor local control defined as Clavien-Dindo category 3 requiring ongoing wound care.
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Evidence of clinically significant encephalopathy/new focal neurologic deficits.
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Presence of active severe infection, defined as:
- positive blood culture within 48 hours of enrollment, OR
- fever above 38.2° C, AND clinical signs of infection within 48 hours of enrollment
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Participant has received prior disease-directed therapy other than 1st line therapy with methotrexate, an anthracycline, and a platinum and local control surgery
• Regimen B only - okay to have undergone initial pulmonary metastasectomy
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Pregnant or breastfeeding
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Presence of any condition that, in the opinion of the investigator, would prohibit the participant from undergoing treatment under this protocol
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: N / A
- Modelo Intervencionista: Asignación de un solo grupo
- Enmascaramiento: Ninguno (etiqueta abierta)
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
|---|---|
|
Experimental: 3CAR4OS Treatment
All patients will receive standard of care chemotherapy, which is not considered part of protocol therapy. Eligible patients will undergo apheresis prior to standard local control surgery for CAR T cell manufacture and then resume standard therapy. In the absence of progressive disease, eligible patients with available SJCARB7H3-41BBL product will receive lymphodepletion chemotherapy (fludarabine/cyclophosphamide) after the completion of standard chemotherapy, followed by SJCARB7H3-41BBL infusion. Pulmonary metastasectomy will be performed as indicated according to the standard of care and will be timed after (Regimen A) or before (Regimen B) lymphodepletion and SJCARB7H3-41BBL infusion. Following successful clearance of either regimen A or, if necessary, regimen B, the efficacy cohort will be initiated. |
IV IV IV prior to and again at 3, 6, and 9 hours following each dose of cyclophosphamide. IV collection 1X107 CAR+ T cells/kg |
¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Event-free survival (EFS), defined as time from SJCARB7H3-41BBL infusion to disease relapse, progressive disease, new systemic therapy, secondary malignancy or death
Periodo de tiempo: Time from SJCARB7H3-41BBL infusion to time of first event, followed up to 24-months post-infusion
|
Event-free participants will be censored at the time of last follow-up. This analysis will report the Kaplan-Meier (KM) curve, along with the 12-month EFS estimate and its 80% confidence interval using the arcsine-square root transformation. Evaluable participants are those who complete standard chemotherapy, receive SJCARB7H3-41BBL and are treated on the regimen used for the Efficacy phase. |
Time from SJCARB7H3-41BBL infusion to time of first event, followed up to 24-months post-infusion
|
Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Overall survival (OS), defined as time from SJCARB7H3-41BBL cell infusion to all-cause mortality.
Periodo de tiempo: Time from SJCARB7H3-41BBL infusion to time of death from any cause, followed up to 24-months post-infusion
|
Event-free participants will be censored at the time of last follow-up. OS will be reported similarly to the EFS endpoint on the same participant subset. |
Time from SJCARB7H3-41BBL infusion to time of death from any cause, followed up to 24-months post-infusion
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Number of participants experiencing protocol-specified regimen-related toxicities.
Periodo de tiempo: Time from SJCARB7H3-41BBL infusion up to 28 days post-infusion.
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This outcome measure will be descriptively summarized for the overall participant group and by regimen (if more than 1 regimen is evaluated) for each regimen-related toxicity. Evaluable participants include those who receive SJCARB7H3_41BBL and remain on protocol therapy through at least 28 days post-infusion or experience a related unacceptable toxicity. |
Time from SJCARB7H3-41BBL infusion up to 28 days post-infusion.
|
|
Number of participants with successful manufacture of SJCARB7H3-41BBL cells of sufficient dose and planned product administration
Periodo de tiempo: Time of SJCARB7H3-41BBL infusion
|
This outcome measure will be descriptively summarized for the overall participant group and by regimen (if more than 1 regimen is evaluated) for participants who undergo apheresis and remain on protocol therapy through the end of standard therapy. |
Time of SJCARB7H3-41BBL infusion
|
Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Julie Park, MD, St. Jude Children's Research Hospital
Publicaciones y enlaces útiles
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Neoplasias
- Neoplasias por tipo histológico
- Sarcoma
- Neoplasias De Tejidos Conectivos Y Blandos
- Neoplasias De Tejido Óseo
- Neoplasias Del Tejido Conectivo
- Osteosarcoma
- Compuestos de azufre
- Químicos orgánicos
- Terapéutica
- Hidrocarburos, acíclico
- Hidrocarburos
- Alcanos
- Alcanosulfonatos
- Ácidos alcanosulfónicos
- Ácidos sulfónicos
- Ácidos de azufre
- Mostaza de fosforamida
- Compuestos de mostaza de nitrógeno
- Compuestos de mostaza
- Hidrocarburos, halogenados
- Fosforamidas
- Compuestos organofosforados
- Compuestos de sulfhidrilo
- Ciclofosfamida
- Mesna
- fludarabina
- Extracción de componentes sanguíneos
Otros números de identificación del estudio
Otros números de identificación del estudio
- 3CAR4OS
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Individual participant de-identified datasets containing the variables analyzed in the published article will be made available (related to the study primary or secondary objectives contained in the publication). Supporting documents such as the protocol, statistical analyses plan, and informed consent are available through the CTG website for the specific study. Data used to generate the published article will be made available at the time of article publication. Investigators who seek access to individual level de-identified data will contact the computing team in the Department of Biostatistics (ClinTrialDataRequest@stjude.org) who will respond to the data request.
Marco de tiempo para compartir IPD
Data will be made available at the time of article publication.
Criterios de acceso compartido de IPD
Data will be provided to researchers following a formal request with the following information: full name of requestor, affiliation, data set requested, and timing of when data is needed. As an informational point, the lead statistician and study principal investigator will be informed that primary results datasets have been requested.
Tipo de información de apoyo para compartir IPD
- PROTOCOLO DE ESTUDIO
- SAVIA
- CIF
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .