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.
Tutkimuksen yleiskatsaus
Tila
Tila
Ehdot
Ehdot
Interventio / Hoito
Interventio / Hoito
Yksityiskohtainen kuvaus
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
Opintotyyppi
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Ilmoittautuminen
Vaihe
Vaihe
- Vaihe 2
Yhteystiedot ja paikat
Opiskeluyhteys
Opiskeluyhteys
- Nimi: David Einstein, MD
- Puhelinnumero: (617) 667-2100
- Sähköposti: Deinstei@bidmc.harvard.edu
Opiskelupaikat
-
-
Massachusetts
-
Boston, Massachusetts, Yhdysvallat, 02115
- Dana-Farber Cancer Institute
-
Ottaa yhteyttä:
- David Einstein, MD
- Puhelinnumero: (617) 667-2100
- Sähköposti: Deinstei@bidmc.harvard.edu
-
Ottaa yhteyttä:
- Wenxin Xu, MD
- Puhelinnumero: 617-632-3000
- Sähköposti: Wenxin_Xu1@dfci.harvard.edu
-
Boston, Massachusetts, Yhdysvallat, 02115
- Brigham and Women's Hospital
-
Ottaa yhteyttä:
- David Einstein, MD
- Puhelinnumero: (617) 667-2100
- Sähköposti: Deinstei@bidmc.harvard.edu
-
Ottaa yhteyttä:
- Wenxin (Vincent) Xu, MD
- Puhelinnumero: (617) 632-3000
- Sähköposti: Wenxin_Xu1@dfci.harvard.edu
-
Boston, Massachusetts, Yhdysvallat, 02115
- Beth Israel Deaconess Medical Center (BIDMC)
-
Ottaa yhteyttä:
- David Einstein, MD
- Puhelinnumero: (617) 667-2100
- Sähköposti: Deinstei@bidmc.harvard.edu
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
-
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.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Ei käytössä
- Inventiomalli: Yksittäinen ryhmätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseiden lukumäärä
Aseet ja interventiot
Osallistujaryhmä / ArmOsallistujaryhmä / Arm |
Interventio / HoitoInterventio / Hoito |
|---|---|
|
Kokeellinen: 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 |
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Radiographic Objective Response Rate
Aikaikkuna: 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
|
Toissijaiset tulostoimenpiteet
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Radiographic change in target lesions
Aikaikkuna: 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)
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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)
|
Yhteistyökumppanit ja tutkijat
Sponsori
Sponsori
Yhteistyökumppanit
Yhteistyökumppanit
Tutkijat
Tutkijat
- Päätutkija: David Einstein, MD, Beth Israel Deaconess Medical Center
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Arvioitu)
Opiskelun aloitus
Ensisijainen valmistuminen (Arvioitu)
Ensisijainen valmistuminen
Opintojen valmistuminen (Arvioitu)
Opintojen valmistuminen
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Ensimmäinen Lähetetty
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin päivitys julkaistu
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
- Urogenitaaliset sairaudet
- Urogenitaaliset kasvaimet
- Neoplasmat sivustoittain
- Neoplasmat
- Miesten urogenitaaliset sairaudet
- Munuaissairaudet
- Urologiset sairaudet
- Naisten virtsa- ja sukupuolielinten sairaudet
- Naisten virtsa- ja sukupuolielinten sairaudet ja raskauden komplikaatiot
- Neoplasmat histologisen tyypin mukaan
- Kasvaimet, rauhas- ja epiteelikasvaimet
- Adenokarsinooma
- Urologiset kasvaimet
- Karsinooma
- Karsinooma, munuaissolut
- Munuaisten kasvaimet
- Peptidit
- Aminohapot, peptidit ja proteiinit
- Proteiinit
- Orgaaniset kemikaalit
- Kirurgiset toimenpiteet, operatiivinen
- Hiilivety
- Biologiset tekijät
- Fosforamidi -sinapit
- Typpisinappiyhdisteet
- Sinappiyhdisteet
- Hiilivety, halogenoitu
- Fosforamidit
- Organofosforiyhdisteet
- Solunväliset signalointipeptidit ja proteiinit
- Urologiset kirurgiset toimenpiteet
- Urogenitaaliset kirurgiset toimenpiteet
- Sytokiinit
- Interleukiini
- Lymfokiinit
- Syklofosfamidi
- Interleukiini-2
- fludarabiini
- aldesleukin
- Virtsarakon transuretraalinen resektio
Muut tutkimustunnusnumerot
Muut tutkimustunnusnumerot
- 26-686
Yksittäisten osallistujien tietojen suunnitelma (IPD)
Aiotko jakaa yksittäisten osallistujien tietoja (IPD)?
IPD-suunnitelman kuvaus
The Harvard Cancer Consortium encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: [contact information for Sponsor Investigator or designee]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.
IPD-jakamista tukeva tietotyyppi
- STUDY_PROTOCOL
- MAHLA
Lääke- ja laitetiedot, tutkimusasiakirjat
Tutkii yhdysvaltalaista FDA sääntelemää lääkevalmistetta
Tutkii yhdysvaltalaista FDA sääntelemää laitetuotetta
Nämä tiedot haettiin suoraan verkkosivustolta clinicaltrials.gov ilman muutoksia. Jos sinulla on pyyntöjä muuttaa, poistaa tai päivittää tutkimustietojasi, ota yhteyttä register@clinicaltrials.gov. Heti kun muutos on otettu käyttöön osoitteessa clinicaltrials.gov, se päivitetään automaattisesti myös verkkosivustollemme .