- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT06254326
ADAGiO: 재발성 올리고덴드로글리종(OG) 성인 환자의 치료를 위한 입양 세포 요법 (ADAGiO)
This study will enroll 6 DLT evaluable subjects (up to 12 patients total) where we will evaluate feasibility and safety of adoptive cellular therapy combined with IDH1/2 inhibitors in patients with recurrent or progressive oligodendroglioma WHO grade 2 and WHO grade 3.
연구 개요
상태
상세 설명
After screening consent, subjects will undergo standard of care resection or biopsy for confirmatory diagnosis of disease progression and aseptic collection of tumor material for DNA and RNA extraction and sequencing, amplification, and loading of autologous DCs. Following biopsy and confirmatory pathologic diagnosis, eligible patients will be enrolled in treatment.
After surgery, patients will undergo a G-CSF mobilized pheresis to collect PBMCs for DC generation and CD34+ HSCs. Amplified tumor RNA obtained from surgically resected or biopsied specimens will be used to generate total tumor RNA-pulsed DCs (TTRNA-DCs) manufactured while patients initiate salvage chemotherapy regimen after surgery.
Salvage chemotherapy with IDH1/2 inhibitor will initiate 1-2 weeks after G-CSF mobilized leukapheresis for 1-3 cycles after which, treatment cycles will be paused, and the patients will receive 3 priming TTRNA-DCs vaccines every 2 weeks and undergo a non-mobilized leukapheresis to collect vaccine-boosted lymphocytes for ex vivo T cell expansion and generation of additional TTRNA-DC vaccines. Treatment with IDH1/2 inhibitor will resume with monthly TTRNA-DC vaccines for an additional 1-3 cycles until ex vivo expanded T cells are manufactured.
For ACT, patients will undergo non-myeloablative conditioning with cyclophosphamide /fludarabine. The total immunotherapy regimen will consist of up to 9 intradermal DC vaccines (three -bi-weekly (q2 weeks) for priming, monthly for additional 2-3 cycles during T cell expansion, and three bi-weekly during T cell engraftment), a single i.v. infusion of ex vivo expanded tumor-reactive T cells, and a i.v. single infusion of autologous HSCs.
The duration of treatment from enrollment to completion of DLT window is anticipated to be 7 to 9 months.
연구 유형
등록 (추정된)
단계
- 1단계
연락처 및 위치
연구 장소
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Florida
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Gainesville, Florida, 미국, 32610
- University of Florida Health Shands Hospital
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
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Male or female, aged 18 years and above
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Tumor tissue obtained on a screening consent is available.
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Confirmed with recurrent/progressive IDH-mutant 1p/19q co-deleted Oligodendroglioma WHO grade 2 or WHO grade 3 (Patients who received prior radiation must be more than 12 weeks from completion of radiation).
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Karnofsky Performance Status ≥ 60
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Must be a candidate for surgery/biopsy
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Adequate bone marrow and organ function as defined below:
- ANC ≥ 1,000/mcL
- Platelets ≥ 100,000/mcL
- Hemoglobin ≥ 9 g/dL (can be transfused)
- Serum creatinine ≤ 1.5 x IULN OR Creatinine clearance by Cockcroft-Gault ≥ 60 mL/min for patients with serum creatinine > 1.5 x IULN
- Serum total bilirubin ≤ 1.5 x IULN OR Direct bilirubin ≤ IULN for patients with total bilirubin > 1.5 x IULN
- AST (SGOT) and ALT (SGPT) ≤ 3 x IULN
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For females of childbearing potential, negative serum pregnancy test at enrollment
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For women and men of childbearing potential (WOCBP) must be willing to use acceptable contraceptive methods
Exclusion Criteria:
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Prior invasive malignancy (except for non-melanomatous skin cancer) unless disease free for ≥ 3 years.
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Metastases detected below the tentorium or beyond the cranial vault and leptomeningeal involvement.
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Multifocal disease, defined as more than one enhancing lesion separated by noncontiguous T2/FLAIR signal abnormality, as determined by the PI. This exclusion does not apply to patients presenting with a new, separate lesion outside the original tumor site at recurrence, provided the original site of disease remains stable, as determined by the PI.
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Corticosteroids equivalent to ≥ 4mg dexamethasone daily.
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HIV, Hepatitis B, or Hepatitis C seropositive.
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Known active infection or immunosuppressive disease.
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Autoimmune disease requiring medical management with immunosuppressant.
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Pregnancy or lactation, due to possible adverse effects on the developing fetus or infant.
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Treatment with another investigational drug or other intervention within 30 days prior to projected first dose of study treatment (Priming phase with TTRNA-DC).
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Severe, active co-morbidity, defined as follows:
- Unstable angina and/or congestive heart failure requiring hospitalization.
- Transmural myocardial infarction within the last 6 months.
- Acute bacterial or fungal infection requiring intravenous antibiotics at time of enrollment.
- Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy.
- Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects.
- Acquired Immune Deficiency Syndrome (AIDS) based upon current CDC definition. The need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive.
- Major medical illnesses or psychiatric impairments that, in the investigator's opinion, will prevent administration or completion of protocol therapy.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 해당 없음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
실험적: Adoptive Cellular Therapy
All participants will receive 9 intradermal DC vaccines (three -bi-weekly (q2 weeks) for priming, monthly for additional 2-3 cycles during T cell expansion, and three bi-weekly during T cell engraftment), a single i.v. infusion of ex vivo expanded tumor-reactive T cells, and a i.v. single infusion of autologous HSCs. |
Participants will receive up to 9 intradermal DC vaccines (three -bi-weekly (q2 weeks) for priming, monthly for additional 2-3 cycles during T cell expansion, and three bi-weekly during T cell engraftment Participants will receive a single infusion of autologous CD34+ HSCs Participants will receive a single infusion of ex vivo expanded tumor-reactive T cells All patients will receive a full Td booster IM vaccine 4-24 hours prior to Vaccine #1 and vaccine site pretreatment with a one-fifth dose of Td intradermally, at the site of planned vaccine, 4-24 hours prior to vaccines #3, #5, #7 and #9. |
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Prevalence of enrolled subject who receive qualified immunotherapy investigational product.
기간: enrollment up to 9 months
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Feasibility will be measured by the number of patients who receive autologous dendritic cells, T cells and hematopoietic stem cells that meet the FDA IND defined quality assurance and quality control release criteria. A minimum of 66.7% of enrolled subject must achieve this criterion for feasibility endpoint. |
enrollment up to 9 months
|
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Incidence of investigational treatment related severe toxicity (Dose-limiting toxicity event) assessed during the period beginning with administration of ex vivo expanded TTRNA T cells through 6 weeks post infusion.
기간: enrollment to completion of DLT window; up to 9 months.
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Safety will be defined as < 1 DLT out of six enrolled and treated subjects during the defined period of administration of ex vivo expanded TTRNA T cells through 6 weeks post infusion. Investigational treatment related CTCAE V5.0 adverse events 1) Grade III or greater non-neurologic toxicity; 2) Grade III neurologic toxicity that does not improve to Grade II or better within 5 days; or 3) Grade IV neurologic toxicity will be recorded toward DLT. |
enrollment to completion of DLT window; up to 9 months.
|
공동 작업자 및 조사자
수사관
- 연구 의자: Duane Mitchell, MD, PhD, University of Florida
- 수석 연구원: Ashley Ghiaseddin, MD, University of Florida
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
- 뇌 질환
- 중추신경계 질환
- 신경계 질환
- 부위별 신생물
- 신생물
- 조직학적 유형에 따른 신생물
- 신생물, 선상 및 상피
- 신경교종
- 신생물, 신경상피
- 신경외배엽 종양
- 신생물, 생식 세포 및 배아
- 신생물, 신경 조직
- 신경계 신생물
- 중추신경계 신생물
- 뇌 신생물
- 핍지교종
- 펩타이드
- 아미노산, 펩티드 및 단백질
- 단백질
- 생물학적 요인
- 탄수화물
- 세포 간 신호 전달 펩티드 및 단백질
- 당 단백질
- Glycoconjugates
- 생물학적 제품
- 복잡한 혼합물
- 식민지 자극 요인
- 조혈 세포 성장 인자
- 사이토 카인
- 박테리아 백신
- 백신
- 디프테리아 톡소이드
- 톡소이드
- 파상풍 톡소이드
- 백신, 결합
- 육아 세포-조산 식민지-자극 인자
- 디프테리아-테타니아 백신
기타 연구 ID 번호
- IRB202301855
- OCR44817 (기타 식별자: University of Florida)
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
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