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.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
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
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- フェーズ2
連絡先と場所
研究連絡先
研究連絡先
- 名前:David Einstein, MD
- 電話番号:(617) 667-2100
- メール:Deinstei@bidmc.harvard.edu
研究場所
-
-
Massachusetts
-
Boston、Massachusetts、アメリカ、02115
- Dana-Farber Cancer Institute
-
コンタクト:
- David Einstein, MD
- 電話番号:(617) 667-2100
- メール:Deinstei@bidmc.harvard.edu
-
コンタクト:
- Wenxin Xu, MD
- 電話番号:617-632-3000
- メール:Wenxin_Xu1@dfci.harvard.edu
-
Boston、Massachusetts、アメリカ、02115
- Brigham and Women's Hospital
-
コンタクト:
- David Einstein, MD
- 電話番号:(617) 667-2100
- メール:Deinstei@bidmc.harvard.edu
-
コンタクト:
- Wenxin (Vincent) Xu, MD
- 電話番号:(617) 632-3000
- メール:Wenxin_Xu1@dfci.harvard.edu
-
Boston、Massachusetts、アメリカ、02115
- Beth Israel Deaconess Medical Center (BIDMC)
-
コンタクト:
- David Einstein, MD
- 電話番号:(617) 667-2100
- メール:Deinstei@bidmc.harvard.edu
-
-
参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的: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 |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Radiographic Objective Response Rate
時間枠: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
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Radiographic change in target lesions
時間枠: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)
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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)
|
協力者と研究者
協力者
協力者
捜査官
捜査官
- 主任研究者:David Einstein, MD、Beth Israel Deaconess Medical Center
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
- 泌尿生殖器疾患
- 泌尿生殖器腫瘍
- 部位別新生物
- 新生物
- 男性の泌尿生殖器疾患
- 腎臓病
- 泌尿器疾患
- 女性の泌尿生殖器疾患
- 女性の泌尿生殖器疾患と妊娠合併症
- 組織型別の新生物
- 新生物、腺および上皮
- 腺癌
- 泌尿器科の新生物
- がん
- がん、腎細胞
- 腎腫瘍
- ペプチド
- アミノ酸、ペプチド、およびタンパク質
- タンパク質
- 有機化学物質
- 外科的処置、手術
- 炭化水素
- 生物学的要因
- ホスホルアミドマスタード
- 窒素マスタード化合物
- マスタード化合物
- 炭化水素、ハロゲン化
- ホスホラミド
- 有機リン化合物
- 細胞間シグナル伝達ペプチドとタンパク質
- 泌尿器科学的処置
- 泌尿生殖器外科手術
- サイトカイン
- インターロイキン
- リンフォカイン
- シクロホスファミド
- インターロイキン-2
- フルダラビン
- アルデスルキン
- 膀胱の経尿道切除
その他の研究ID番号
その他の研究ID番号
- 26-686
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
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 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。