NY-ESO-1-Specific T-cells in Treating Patients With Advanced NY-ESO-1-Expressing Sarcomas Receiving Palliative Radiation Therapy
Primary Purpose
Sarcoma
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Autologous NY-ESO-1-specific CD8-positive T Lymphocytes
Laboratory Biomarker Analysis
Palliative Radiation Therapy
Sponsored by

About this trial
This is an interventional treatment trial for Sarcoma
Eligibility Criteria
Inclusion Criteria:
INCLUSION CRITERIA FOR SCREENING:
- Histopathological documentation of sarcoma
- Patients must express NY-ESO-1 in their tumor by immunohistochemistry (IHC) (> 5%) prior to leukapheresis
- For leukapheresis, patients must meet the following criteria (any exceptions to this will require prior approval by the apheresis director and principal investigator [PI]):
- Pulse > 45 or < 120
- Weight >= 45 kg
- Temperature =< 38° Celsius (C) (=< 100.4° Fahrenheit [F])
- White blood cell count (WBC) >= 2,000
- Hematocrit (HCT) >= 30%
- Platelets >= 75,000
INCLUSION CRITERIA FOR TREATMENT:
- A diagnosis of a metastatic or unresectable sarcoma
- Patient must have a biopsy-accessible tumor to be radiated
- Patient must have consulted with a radiation oncologist who is planning radiation; their radiation oncologist should have documented plans to administer a dose of at least 30 Gy in 5 or fewer fractions
- Human leukocyte antigen (HLA) type A0201 or A2402
- Zubrod (Eastern Cooperative Oncology Group [ECOG]) performance status of '0-2'
- All patients must have an electrocardiogram (ECG) within 2 weeks of starting conditioning
- All patients must have an echo or multigated acquisition (MUGA) scan showing ejection fraction (EF) > 50% and normal troponin and creatine kinase MB (CK MB) performed within 90 days of starting treatment
Exclusion Criteria:
EXCLUSION CRITERIA FOR SCREENING:
- Patients who do not meet the above inclusion criteria will not receive leukapheresis
EXCLUSION CRITERIA FOR TREATMENT:
- Patients with a history of proven myocarditis, pericarditis, or endocarditis
- Pregnant women, nursing women, men and women of reproductive ability who are unwilling to use effective contraception or abstinence; women of childbearing potential must have a negative pregnancy test within two weeks prior to study entry
- Inadequate renal function as indicated by serum creatinine >= 1.5 times the upper limit of normal
- Inadequate liver function as indicated by total bilirubin >= 1.5 times the upper limit of normal
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) >= 2.5 times the upper limit of normal
- Active symptomatic congestive heart failure
- Clinically significant hypotension
- Newly diagnosed cardiac arrhythmia; patients with an arrhythmia that has been stable for at least 3 months will be allowed to participate
- Known untreated central nervous system (CNS) metastasis
- Patients with systemic infections requiring antibiotics or chronic maintenance/suppressive therapy
- Patients receiving systemic anticancer therapy (chemotherapy, "biologics", immunotherapy) less than 2 weeks prior to starting radiation
- Clinically significant autoimmune disorders requiring on-going systemic immune-suppression for control
- Patients with acquired immunodeficiency syndrome (AIDS) or who are known to be human immunodeficiency virus (HIV) positive are not eligible for this study; testing may have been done up to 3 months prior to treatment
- Current treatment with steroids
- Known infection with hepatitis B virus (HBV) and hepatitis C virus (HCV); testing may have been done up to 3 months prior to treatment
Sites / Locations
- Fred Hutch/University of Washington Cancer Consortium
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Treatment (radiation and NY-ESO-1-specific T cells)
Arm Description
Patients undergo palliative radiation therapy at the discretion of the treating radiation oncologist. Patients then receive NY-ESO-1-specific T cells IV over 60 minutes 2-3 days after completion of radiation therapy.
Outcomes
Primary Outcome Measures
Incidence of Adverse Events Measured by the National Cancer Institute Common Terminology Criteria for Adverse Events Version (v)4.03
CTCAE v4.03
Secondary Outcome Measures
T Cell Transfer Based on Response Evaluation Criteria In Solid Tumors v1.1
RECIST at 6 weeks after treatment (non-radiated tumors only)
Transferred NY-ESO-1-specific T Cells Based on Flow Cytometry Using Major Histocompatibility Complex Tetramers
Over 5% tet+ cells at 6 weeks? Patients may have detectable NY-ESO-1 specific T cells by MHC tetramers but if they are less than 5% this will be considered negative.
Full Information
NCT ID
NCT02319824
First Posted
November 5, 2014
Last Updated
April 18, 2017
Sponsor
Fred Hutchinson Cancer Center
Collaborators
National Cancer Institute (NCI)
1. Study Identification
Unique Protocol Identification Number
NCT02319824
Brief Title
NY-ESO-1-Specific T-cells in Treating Patients With Advanced NY-ESO-1-Expressing Sarcomas Receiving Palliative Radiation Therapy
Official Title
A Pilot Trial of NY-ESO-1-Specific T Cells in Patients With Metastatic NY-ESO-1-Expressing Sarcomas Receiving Palliative Radiation
Study Type
Interventional
2. Study Status
Record Verification Date
April 2017
Overall Recruitment Status
Completed
Study Start Date
January 2015 (undefined)
Primary Completion Date
June 2015 (Actual)
Study Completion Date
undefined (undefined)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fred Hutchinson Cancer Center
Collaborators
National Cancer Institute (NCI)
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This pilot, phase I trial studies the safety of cancer-testis antigen (NY-ESO-1)-specific T cells (a type of immune cell) in treating patients with NY-ESO-1-expressing sarcomas that have spread to other places in the body and are receiving palliative (relief of symptoms and suffering caused by cancer) radiation therapy. Placing a modified gene for NY-ESO-1 into white blood cells may help the body build an immune response to kill tumor cells that express NY-ESO-1. Palliative radiation therapy may help patients with advanced sarcoma live more comfortably. Giving NY-ESO-1-specific T cells following palliative radiation therapy may be a better treatment for patients with sarcomas.
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate the safety and toxicity of NY-ESO-1-specific T cells when given following high-dose, hypo-fractionated palliative radiation to patients with advanced NY-ESO-1 expressing sarcomas.
SECONDARY OBJECTIVES:
I. To look for preliminary evidence of systemic efficacy of NY-ESO-1-specific T-cell therapy following radiation on non-radiated tumors.
II. To determine whether radiation increases trafficking of adoptively transferred NY-ESO-1-specific T cells by comparing tumor biopsy specimens from radiated and non-radiated tumors.
OUTLINE:
Patients undergo palliative radiation therapy at the discretion of the treating radiation oncologist. Patients then receive NY-ESO-1-specific T cells intravenously (IV) over 60 minutes 2-3 days after completion of radiation therapy.
After completion of study treatment, patients are followed up weekly for 2 weeks, at 4-6, 8, 10, and 12 weeks, and then for up to 6 months.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Treatment (radiation and NY-ESO-1-specific T cells)
Arm Type
Experimental
Arm Description
Patients undergo palliative radiation therapy at the discretion of the treating radiation oncologist. Patients then receive NY-ESO-1-specific T cells IV over 60 minutes 2-3 days after completion of radiation therapy.
Intervention Type
Biological
Intervention Name(s)
Autologous NY-ESO-1-specific CD8-positive T Lymphocytes
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Intervention Type
Radiation
Intervention Name(s)
Palliative Radiation Therapy
Intervention Description
Undergo palliative radiation therapy
Primary Outcome Measure Information:
Title
Incidence of Adverse Events Measured by the National Cancer Institute Common Terminology Criteria for Adverse Events Version (v)4.03
Description
CTCAE v4.03
Time Frame
Up to 12 weeks post-treatment
Secondary Outcome Measure Information:
Title
T Cell Transfer Based on Response Evaluation Criteria In Solid Tumors v1.1
Description
RECIST at 6 weeks after treatment (non-radiated tumors only)
Time Frame
At 6 weeks post-treatment
Title
Transferred NY-ESO-1-specific T Cells Based on Flow Cytometry Using Major Histocompatibility Complex Tetramers
Description
Over 5% tet+ cells at 6 weeks? Patients may have detectable NY-ESO-1 specific T cells by MHC tetramers but if they are less than 5% this will be considered negative.
Time Frame
Up to 6 weeks post-treatment
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
INCLUSION CRITERIA FOR SCREENING:
Histopathological documentation of sarcoma
Patients must express NY-ESO-1 in their tumor by immunohistochemistry (IHC) (> 5%) prior to leukapheresis
For leukapheresis, patients must meet the following criteria (any exceptions to this will require prior approval by the apheresis director and principal investigator [PI]):
Pulse > 45 or < 120
Weight >= 45 kg
Temperature =< 38° Celsius (C) (=< 100.4° Fahrenheit [F])
White blood cell count (WBC) >= 2,000
Hematocrit (HCT) >= 30%
Platelets >= 75,000
INCLUSION CRITERIA FOR TREATMENT:
A diagnosis of a metastatic or unresectable sarcoma
Patient must have a biopsy-accessible tumor to be radiated
Patient must have consulted with a radiation oncologist who is planning radiation; their radiation oncologist should have documented plans to administer a dose of at least 30 Gy in 5 or fewer fractions
Human leukocyte antigen (HLA) type A0201 or A2402
Zubrod (Eastern Cooperative Oncology Group [ECOG]) performance status of '0-2'
All patients must have an electrocardiogram (ECG) within 2 weeks of starting conditioning
All patients must have an echo or multigated acquisition (MUGA) scan showing ejection fraction (EF) > 50% and normal troponin and creatine kinase MB (CK MB) performed within 90 days of starting treatment
Exclusion Criteria:
EXCLUSION CRITERIA FOR SCREENING:
Patients who do not meet the above inclusion criteria will not receive leukapheresis
EXCLUSION CRITERIA FOR TREATMENT:
Patients with a history of proven myocarditis, pericarditis, or endocarditis
Pregnant women, nursing women, men and women of reproductive ability who are unwilling to use effective contraception or abstinence; women of childbearing potential must have a negative pregnancy test within two weeks prior to study entry
Inadequate renal function as indicated by serum creatinine >= 1.5 times the upper limit of normal
Inadequate liver function as indicated by total bilirubin >= 1.5 times the upper limit of normal
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) >= 2.5 times the upper limit of normal
Active symptomatic congestive heart failure
Clinically significant hypotension
Newly diagnosed cardiac arrhythmia; patients with an arrhythmia that has been stable for at least 3 months will be allowed to participate
Known untreated central nervous system (CNS) metastasis
Patients with systemic infections requiring antibiotics or chronic maintenance/suppressive therapy
Patients receiving systemic anticancer therapy (chemotherapy, "biologics", immunotherapy) less than 2 weeks prior to starting radiation
Clinically significant autoimmune disorders requiring on-going systemic immune-suppression for control
Patients with acquired immunodeficiency syndrome (AIDS) or who are known to be human immunodeficiency virus (HIV) positive are not eligible for this study; testing may have been done up to 3 months prior to treatment
Current treatment with steroids
Known infection with hepatitis B virus (HBV) and hepatitis C virus (HCV); testing may have been done up to 3 months prior to treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Seth Pollack
Organizational Affiliation
Fred Hutch/University of Washington Cancer Consortium
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fred Hutch/University of Washington Cancer Consortium
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States
12. IPD Sharing Statement
Learn more about this trial
NY-ESO-1-Specific T-cells in Treating Patients With Advanced NY-ESO-1-Expressing Sarcomas Receiving Palliative Radiation Therapy
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