A Phase I Trial of Autologous CLL B Cells Transduced to Express Chimeric CD154 (ISF35)
Primary Purpose
Chronic Lymphocytic Leukemia
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ISF35
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Lymphocytic Leukemia focused on measuring Chronic lymphocytic leukemia, CLL, Leukemia, Leukemia, Lymphocytic, Chronic, B-Cell, Leukemia, B-Cell, Immune System Diseases, ISF35, Ad-ISF35, Immunotherapy, Immune therapy, Active immune therapy
Eligibility Criteria
Inclusion Criteria:
Subjects must have a diagnosis of B cell CLL, measurable disease, and an
NCI-WG indication for treatment with one of the following:
- Massive (>6 cm below left costal margin) or progressive splenomegaly;
- Massive (>10 cm longest diameter) lymph nodes, nodal clusters, or progressive lymphadenopathy;
- Progressive anemia;
- Progressive thrombocytopenia;
- Weight loss > 10% body weight over the preceding 6 month period;
- Fatigue attributable to CLL;
- Fever or night sweats without evidence of infection;
- Progressive lymphocytosis.
- Subjects must be age 18 years or older.
- Women of childbearing potential (not postmenopausal for at least one year or not surgically incapable of bearing children) must agree not to become pregnant for the duration of the study. Both men and women participants must agree to use contraception for the duration of the study.
- Subjects must have Zubrod performance status of ≤ 2 (Appendix B).
Subjects must have adequate hematologic, renal, hepatic, and coagulation function:
Adequate hematologic function:
- Platelet count ≥ 50,000/μl; AND
- Hemoglobin ≥ 10 g/dl (may be supported by erythropoietin or transfusion).
Adequate renal function:
- Serum creatinine ≤ 1.5 times upper limit of normal; OR
- Measured creatinine clearance ≥ 40 mL/min/1.73 m^2.
Adequate hepatic function:
- Total bilirubin ≤ 2.5 times upper limit of normal; AND
- ALT ≤ 2.5 times upper limit of normal; AND
Adequate coagulation tests:
- Prothrombin time international normalized ratio (INR) ≤ 2; AND
- Partial thromboplastin time ≤ 1.66 times upper limit of normal
- Subjects must be able to give written informed consent.
Exclusion Criteria:
- Presence of more than 55% prolymphocytes.
- Chemotherapy (e.g., purine analogues, alkylating agents, or corticosteroids), antibody therapy, immunotherapy, radiation therapy, or participation in any investigational drug treatment within 4 weeks of enrollment into protocol or at any time during the study.
- Ongoing toxicity from prior anti-neoplastic therapy.
- Prior gene therapy or allogeneic stem cell transplantation.
- Untreated autoimmune hemolytic anemia or immune thrombocytopenia.
- Active infection requiring parenteral antibiotics.
- Known HIV/HBV/HCV seropositivity.
- Uncompensated hypothyroidism (defined as TSH greater than 4x upper limit of normal not treated with replacement hormone).
Sites / Locations
- University of Texas M.D. Anderson Cancer Center
Outcomes
Primary Outcome Measures
Assess the toxicity, tolerability, and safety of 1x10^8, 3x10^8, and 1x10^9 autologous Ad-ISF35-transduced CLL B cells given as a single intravenous infusion in patients with CLL.
Secondary Outcome Measures
Assess the anti-leukemia activity of a single intravenous dose by evaluating reduction in leukemia count, reduction in adenopathy and splenomegaly, and improvement in bone function.
Assess the quality of life with ISF35 treatment.
Assess pharmacodynamic endpoints including induction of T cell anti-leukemia immune responses, antibody production against autologous CLL B cells, and changes in bystander leukemia cell phenotype.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00779883
Brief Title
A Phase I Trial of Autologous CLL B Cells Transduced to Express Chimeric CD154 (ISF35)
Official Title
A Phase I Trial of Autologous CLL B Cells Transduced to Express Chimeric CD154 (ISF35)
Study Type
Interventional
2. Study Status
Record Verification Date
October 2008
Overall Recruitment Status
Completed
Study Start Date
June 2006 (undefined)
Primary Completion Date
March 2008 (Actual)
Study Completion Date
March 2008 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Memgen, LLC
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The study is a Phase I, dose-escalating, non-randomized, single institution clinical trial assessing the safety and efficacy of autologous Ad-ISF35-transduced CLL B cells administered as a single intravenous infusion in patients with chronic lymphocytic leukemia (CLL).
Detailed Description
Memgen's first TNF family derived product, ISF35, is a gene that encodes a recombinant protein molecule that binds and activates human CD40+ B lymphocytes that are found on a vast majority of malignant leukemias and lymphomas.
In this clinical trial, ISF35 will be introduced into the patients' CLL cells ex vivo using a replication-defective adenovirus Ad5 encoding the ISF35 cDNA transgene. After this ex vivo manipulation, the modified leukemia cells will be extensively washed and the amount of remaining free virus is measured before the cells are reinfused into the patient. Following ex vivo transduction, the CLL cells expressing ISF35 activate a therapeutic immune response directed against the target leukemia cells.
This ascending-dose trial will be divided into three dosing cohorts to determine the existence of a maximum tolerated dose.
Patients will be followed for 12 months after ISF35 administration or until initiation of another treatment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Lymphocytic Leukemia
Keywords
Chronic lymphocytic leukemia, CLL, Leukemia, Leukemia, Lymphocytic, Chronic, B-Cell, Leukemia, B-Cell, Immune System Diseases, ISF35, Ad-ISF35, Immunotherapy, Immune therapy, Active immune therapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
9 (Actual)
8. Arms, Groups, and Interventions
Intervention Type
Biological
Intervention Name(s)
ISF35
Other Intervention Name(s)
Ad-ISF35, AdISF35
Intervention Description
Subjects participating in this study will receive a single dose of 1x10^8, 3x10^8, or 1x10^9 autologous Ad-ISF35-transduced CLL B cells.
Primary Outcome Measure Information:
Title
Assess the toxicity, tolerability, and safety of 1x10^8, 3x10^8, and 1x10^9 autologous Ad-ISF35-transduced CLL B cells given as a single intravenous infusion in patients with CLL.
Time Frame
Duration of the trial
Secondary Outcome Measure Information:
Title
Assess the anti-leukemia activity of a single intravenous dose by evaluating reduction in leukemia count, reduction in adenopathy and splenomegaly, and improvement in bone function.
Time Frame
Duration of the trial
Title
Assess the quality of life with ISF35 treatment.
Time Frame
Two months
Title
Assess pharmacodynamic endpoints including induction of T cell anti-leukemia immune responses, antibody production against autologous CLL B cells, and changes in bystander leukemia cell phenotype.
Time Frame
Two months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects must have a diagnosis of B cell CLL, measurable disease, and an
NCI-WG indication for treatment with one of the following:
Massive (>6 cm below left costal margin) or progressive splenomegaly;
Massive (>10 cm longest diameter) lymph nodes, nodal clusters, or progressive lymphadenopathy;
Progressive anemia;
Progressive thrombocytopenia;
Weight loss > 10% body weight over the preceding 6 month period;
Fatigue attributable to CLL;
Fever or night sweats without evidence of infection;
Progressive lymphocytosis.
Subjects must be age 18 years or older.
Women of childbearing potential (not postmenopausal for at least one year or not surgically incapable of bearing children) must agree not to become pregnant for the duration of the study. Both men and women participants must agree to use contraception for the duration of the study.
Subjects must have Zubrod performance status of ≤ 2 (Appendix B).
Subjects must have adequate hematologic, renal, hepatic, and coagulation function:
Adequate hematologic function:
Platelet count ≥ 50,000/μl; AND
Hemoglobin ≥ 10 g/dl (may be supported by erythropoietin or transfusion).
Adequate renal function:
Serum creatinine ≤ 1.5 times upper limit of normal; OR
Measured creatinine clearance ≥ 40 mL/min/1.73 m^2.
Adequate hepatic function:
Total bilirubin ≤ 2.5 times upper limit of normal; AND
ALT ≤ 2.5 times upper limit of normal; AND
Adequate coagulation tests:
Prothrombin time international normalized ratio (INR) ≤ 2; AND
Partial thromboplastin time ≤ 1.66 times upper limit of normal
Subjects must be able to give written informed consent.
Exclusion Criteria:
Presence of more than 55% prolymphocytes.
Chemotherapy (e.g., purine analogues, alkylating agents, or corticosteroids), antibody therapy, immunotherapy, radiation therapy, or participation in any investigational drug treatment within 4 weeks of enrollment into protocol or at any time during the study.
Ongoing toxicity from prior anti-neoplastic therapy.
Prior gene therapy or allogeneic stem cell transplantation.
Untreated autoimmune hemolytic anemia or immune thrombocytopenia.
Active infection requiring parenteral antibiotics.
Known HIV/HBV/HCV seropositivity.
Uncompensated hypothyroidism (defined as TSH greater than 4x upper limit of normal not treated with replacement hormone).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William G. Wierda, M.D., Ph.D.
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Texas M.D. Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
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A Phase I Trial of Autologous CLL B Cells Transduced to Express Chimeric CD154 (ISF35)
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