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- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT04074746
Células imunes modificadas (AFM13-NK) e um anticorpo monoclonal (AFM13) no tratamento de pacientes com linfomas Hodgkin ou não-Hodgkin CD30 positivos recorrentes ou refratários
NK Engager AFM13 Biespecífico Combinado com Células NK para Pacientes com Linfomas Hodgkin ou Não-Hodgkin Recorrentes de CD30 Refratário Positivo
This phase I/II trial studies the side effects and best dose of modified umbilical cord blood immune cells (natural killer [NK] cells) combined with the antibody AFM13 (AFM13-NK) and AFM13 alone in treating patients with CD30 positive Hodgkin lymphoma or non-Hodgkin lymphoma that has come back (recurrent) or does not respond to treatment (refractory). Immunotherapy with monoclonal antibodies, such as AFM13, may help the body's immune system attack the cancer, and may interfere with the ability of cancer cells to grow and spread. Giving AFM13 loaded with NK cells followed by AFM13 alone may kill more cancer cells and decrease cancer growth in patients with CD30 positive AFM13-NK Hodgkin and Non-Hodgkin lymphomas.
Visão geral do estudo
Status
Condições
- Linfoma não Hodgkin de células B refratário
- Linfoma não Hodgkin recorrente de células B
- Micose Fungóide Recorrente
- Micose Fungóide Refratária
- Linfoma de Hodgkin Clássico Recorrente
- Linfoma de Hodgkin Clássico Refratário
- Linfoma Anaplásico de Células Grandes Refratário
- Linfoma Anaplásico Recorrente de Células Grandes
- Linfoma Refratário de Células T Periféricas, Sem Outra Especificação
- Linfoma Recorrente de Células T Periféricas, Sem Outra Especificação
Descrição detalhada
PRIMARY OBJECTIVE:
I. To establish the safety and recommended phase II dose of umbilical cord blood (CB)-derived natural killer (NK) cells preloaded with the bispecific antibody AFM13 (AFM13-NK), followed by intravenous anti-CD30/CD16A monoclonal antibody AFM13 (AFM13) in patients with refractory/relapsed CD30-positive lymphoid malignancies based on incidence of dose limiting toxicities (DLTs) per dose level. (Phase I) II. To assess the activity of umbilical cord blood (CB)-derived natural killer (NK) cells preloaded with the bispecific antibody AFM13 (AFM13- NK), followed by intravenous AFM13 in patients with refractory/relapsed CD30-positive lymphoid malignancies. based on overall response rate (ORR), complete response (CR) rate and partial response (PR) rate. (Phase II)
SECONDARY OBJECTIVES:
I. To evaluate the duration of response. II. To evaluate the event-free survival (EFS) rate. III. To evaluate the overall survival (OS) time. IV. To quantify the persistence of infused donor CB AFM13-NK cells in the recipient.
V. To conduct comprehensive immune reconstitution studies.
OUTLINE: This is a dose-escalation study of AFM13-NK.
Patients receive standard of care fludarabine intravenously (IV) over 1 hour and standard of care cyclophosphamide IV over 30-60 minutes on days -5 to -3, AFM13-NK IV over 4 hours on day 0, and then AFM13 IV over 4 hours on days 7, 14, and 21.
After completion of study treatment, patients are followed up at 28 days, 8 weeks, 100 and 180 days and then every 3-6 months for 2 years.
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 2
- Fase 1
Contactos e Locais
Locais de estudo
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Texas
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Houston, Texas, Estados Unidos, 77030
- M D Anderson Cancer Center
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
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Patients with a diagnosis of relapsed or refractory classical Hodgkin lymphoma (HL), anaplastic large cell lymphoma (ALCL), peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), mycosis fungoides (MF), or B-cell non-Hodgkin lymphoma with a pre-enrollment tumor biopsy positive for CD30 by immunohistochemistry at >= 1%. Patients with HL, ALCL and MF must be refractory or intolerant to brentuximab vedotin.
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Karnofsky performance status >= 60%.
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Absolute neutrophil count >= 500/mm^3
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Platelet count >= 50,000/mm^3
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Serum creatinine clearance >= 50 ml/min, estimated using the Cockcroft-Gault equation.
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Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) =< 3 x upper limit of normal (ULN).
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Bilirubin =< 2 x ULN.
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Alkaline phosphatase (ALP) =< 2 x ULN.
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Forced expiratory volume in 1 second (FEV1) >= 50%
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Forced vital capacity (FVC) >= 50%
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Carbon monoxide diffusing capability test (DLCO) (corrected for hemoglobin [Hgb]) >= 50%
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Left ventricular ejection fraction >= 40%.
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No uncontrolled arrhythmias or symptomatic cardiac disease.
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If female of child-bearing potential, must not be pregnant or be breastfeeding and required to have a negative urine or serum pregnancy test within 3 days prior to the first dose of study drug.
- Note: Urine pregnancy tests that cannot be confirmed as negative, require a confirmatory negative serum pregnancy test. In addition, females of childbearing potential must agree use of a highly effective method of contraception for the course of the study from 14 days prior to the first dose of study drug until 60 days after the last dose of study drug. Non-childbearing potential is defined as: Postmenopausal: defined as no menses for 12 months without an alternative medical cause. A high follicle-stimulating hormone (FSH) level in the postmenopausal range may be used to confirm post-menopausal state in women not using hormonal contraception or hormonal replacement therapy. In the absence of 12 months of amenorrhea, FSH measurements indicating post-menopausal status must be documented in patient's medical history. Permanently sterile: documented permanent sterilization e.g. hysterectomy, bilateral salpingectomy and bilateral oophorectomy. If male, surgically sterile or agrees to use a highly effective method of contraception, 14 days prior to the first dose of study drug until 60 days after the last dose of study drug.
Exclusion Criteria:
- Major surgery < 4 weeks prior to first dose of study drug.
- Any other severe or uncontrolled disease or condition which might increase the risk associated with study participation.
- Any other malignancy known to be active, with the exception of treated cervical intra-epithelial neoplasia and non-melanoma skin cancer.
- Grade >= 3 non-hematologic toxicity from prior therapy that has not resolved to grade =< 2.
- Active hepatitis B, either active carrier (hepatitis B surface antigen positive [HBsAg +]) or viremic (hepatitis B virus [HBV] deoxyribonucleic acid [DNA] >= 10,000 copies/mL, or >= 2,000 IU/mL), or hepatitis C (detectable viral load by hepatitis C virus [HCV] ribonucleic acid [RNA] polymerase chain reaction [PCR]).
- Active infection requiring parenteral antibiotics.
- Human immunodeficiency virus (HIV) infection.
- Treatment within prior 2 weeks with any anti-cancer agent, investigational or approved.
- Active central nervous system (CNS) involvement (untreated parenchymal brain metastasis or positive cytology of cerebrospinal fluid).
- Life expectancy =< 6 months.
- Previous treatment with AFM13.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: Treatment (AFM13-NK, AFM13)
Patients receive standard of care fludarabine IV over 1 hour and standard of care cyclophosphamide IV over 30-60 minutes on days -5 to -3, AFM13-NK IV over 4 hours on day 0, and then AFM13 IV over 4 hours on days 7, 14, and 21. |
Given IV
Outros nomes:
Given IV
Outros nomes:
Given IV
Outros nomes:
Given IV
Outros nomes:
Given AFM13-NK cells IV |
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Maximum Tolerate Dose of AFM13 Umbilical Cord Blood(UCB) Derived Natural Killer(NK) Cells Infused on D=0,D+7,D+14,D+21 for Each Cohort (1x10^6,1x10^7,1x10^8).
Prazo: 28 days post AFM13-NK cells on D=0 for each Cohort.
|
Number of Participants who have experienced Dose-limiting toxicity (DLT) during AFM13-NK cell infusions. DLT will be defined as any related grade 3 or greater non- hematologic toxicity that occurs within 28 days of AFM13-NK infusion |
28 days post AFM13-NK cells on D=0 for each Cohort.
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Number of Participants That Achieved Complete Response (CR) Post AFM13-NK Cell Infusions.
Prazo: Time Frame: 1 year post AFM13-NK cells on D=0
|
Complete Remission requires all of the following: Complete metabolic response by PET-CT: Score 1-3. Score 1 (no uptake above the background), Score 2 (uptake is less than or equal to the mediastinal blood pool), or Score 3 (uptake is greater than the mediastinal blood pool but less than or equal to the normal liver) with or without a residual mass on 5 point scale or on CT, target nodes/nodal masses must regress to ≤ 1.5 cm in Di. Lyric Response Criteria (Appendix 2): Complete Response (CR): PET-CT Scores 1-3 Partial Response (PR): PET-CT Scores 4-5 with reduced uptake compared with baseline. Progression Disease (PD): PET-CT Scores 4-5 with an increased uptake compared to baseline or new and/or regrowth of measurable lesions. |
Time Frame: 1 year post AFM13-NK cells on D=0
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Yago L Nieto, M.D. Anderson Cancer Center
Publicações e links úteis
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Neoplasias
- Doenças do sistema imunológico
- Neoplasias por Tipo Histológico
- Doenças Linfáticas
- Distúrbios Linfoproliferativos
- Distúrbios imunoproliferativos
- Linfoma Não-Hodgkin
- Linfoma
- Linfoma de Células T Cutâneo
- Doenças hemic e linfáticas
- Linfoma de Células B
- Linfoma de Células T
- Linfoma de Células Grandes Anaplásico
- Micose Fungóide
- Produtos químicos orgânicos
- Hidrocarbonetos
- Mustarazas de fosforamida
- Compostos de mostarda de nitrogênio
- Compostos de mostarda
- Hidrocarbonetos, halogenados
- Fosforamidas
- Compostos organofosforos
- Ciclofosfamida
- fludarabina
- fosfato de fludarabina
- AFM13
Outros números de identificação do estudo
- 2018-1092
- 2018-1092 (Outro identificador: M D Anderson Cancer Center)
- NCI-2019-03536 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
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