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Study of ProTmune for Allogeneic HCT in Adult Patients With Hematologic Malignancies

Primary Purpose

Hematologic Malignancies, Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ProTmune
Control Arm
Sponsored by
Fate Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Hematologic Malignancies focused on measuring Cell Transplants, Hematopoietic Cell Transplant, HCT, Hematologic Malignancies, Hematologic Malignancy, Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, ALL, AML, Myelodysplastic Syndrome, MDS, Allogeneic, CML, Stem Cell Transplant, Transplant, aGvHD, Acute graft-versus-host Disease, cGvHD, Chronic graft-versus-host Disease

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  1. Male and female patients aged 18 years and older, inclusive;
  2. Patients must have a hematologic malignancy for which allogeneic hematopoietic peripheral blood cell transplantation is deemed clinically appropriate.

    Eligible diseases and stages include the following:

    1. Acute myeloid leukemia
    2. Acute lymphoblastic leukemia, including T lymphoblastic lymphoma with a history of marrow involvement
    3. Myelodysplatic Syndrome
    4. Chronic Myelogenous leukemia
  3. Availability of a suitable 8/8 HLA-A, -B, -C, and -DRB1-matched unrelated mPB donor;
  4. mBP donor collection that meets protocol specifications;
  5. Adequate performance status, defined as Karnofsky score greater than 70%;
  6. For female patients of childbearing potential, all of the following criteria must be met:

    • They are not pregnant (i.e., female patients must have a negative serum pregnancy test at screening);
    • They are not breastfeeding;
    • They do not plan to become pregnant during the study; and
    • They are using an effective method of contraception from screening to the end of the study, unless their sexual partner is surgically sterile
  7. For male patients, agreement to use condoms with spermicide during sexual intercourse from screening to the end of study; and
  8. Willingness and ability to sign an IRB/IEC approved ICF before performance of any study specific procedures or tests and to comply with protocol visits, and study procedures.

Key Exclusion Criteria:

  1. Phase 1 only: known bone marrow fibrosis; Phase 2 only: Bone marrow fibrosis grade 3 (severe) or greater;
  2. Positive serology for human immunodeficiency virus (HIV) or human T-cell lymphotropic virus (HTLV) at any time prior to enrollment;
  3. Currently uncontrolled bacterial, viral, or fungal infection (progression of clinical symptoms despite therapy);
  4. Prior autologous or allogeneic HCT;
  5. Active malignancy, other than the one for which the allogeneic mPB transplant is being performed, within 12 months of enrollment, excluding superficial basal cell and carcinoma in situ cervical cancer;
  6. Pulmonary disease, renal dysfunction, hepatic disease, cardiac disease, neurologic disease;
  7. Participation in another clinical trial involving an investigational product within 30 days prior to screening; or
  8. Any condition or therapy, which, in the opinion of the Investigator, might pose a risk to the patient or make participation in the study not in the best interest of the patient.

Sites / Locations

  • University of Alabama
  • City of Hope
  • University of California, San Diego (UCSD) Moores Cancer Center
  • University of Chicago
  • Indiana Blood and Marrow Transplant
  • Dana Farber Cancer Institute
  • Barbara Ann Karmanos Cancer Institute
  • Weill Cornell Medicine
  • Jewish Hospital
  • The Ohio State University
  • Oregon Health & Science University
  • Sarah Cannon Research Institute
  • Texas Transplant Institute
  • Huntsman Cancer Institute (University of Utah)
  • Virginia Commonwealth University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

ProTmune

Control Arm

Arm Description

Conditioning regimen consisting of one of the following five preparative regimens: fludarabine and busulfan (FluBu4); busulfan (Bu) and cyclophosphamide (Cy); Cy and >or=12 Gy total body irradiation (TBI); TBI and etoposide; or fludarabine and melphalan (FluMel 140). Subjects will receive mPB cells from an available 8/8 HLA-A, -B, -C, and -DRB1-matched unrelated peripheral blood cell donor that were programmed ex vivo with ProTmune.

Conditioning regimen consisting of one of the following five preparative regimens: fludarabine and busulfan (FluBu4); busulfan (Bu) and cyclophosphamide (Cy); Cy and >or=12 Gy total body irradiation (TBI); TBI and etoposide; or fludarabine and melphalan (FluMel 140). Subjects will receive unmanipulated mPB cells from an available 8/8 HLA-A, -B, -C, and -DRB1-matched unrelated peripheral blood cell donor.

Outcomes

Primary Outcome Measures

Percentage of Participants With Cumulative Incidence of Grade II to IV aGvHD Through Day +100 Based on Investigator Assessment
Acute GvHD (aGvHD) is assessed by assigning the clinical stage for the target organs (skin, liver, and gut) along with assigning an overall grade based on the minimum degree of organ involvement required to confer that grade. Grade II is defined as Stage 1 skin, Stage 1 liver, or Stage 1 GI; Grade III is defined as any Stage 1-3 skin, and Stage 2-3 liver, or Stage 2-4 GI; Grade IV is defined as Stage 4 skin, or Stage 4 liver and any Stage GI. A higher overall grade indicates a more severe outcome. The cumulative incidence of CIBMTR Grade II to IV aGVHD through approximately 100 days following HCT is measured by the percentage of participants who experienced grade II to IV aGVHD. The cumulative incidence and the associated 95% confidence interval are estimated using a competing risk analysis with death and relapse without grade II-IV aGvHD as a competing risk.

Secondary Outcome Measures

1-year GvHD-free, Relapse-free Survival (GRFS)
1-year GvHD-free, relapse-free survival (GRFS) is a composite endpoint in which events included Grade III to IV aGvHD, cGvHD requiring systemic immunosuppressive therapy, relapse, or death from any cause. GRFS is defined as the time from HCT to the earlier of the dates of the first documented CIBMTR Grade III-IV aGvHD, first use of systemic immunosuppressive therapy for cGvHD, first documented relapse of the underlying malignancy, or death from any cause. Subjects who are alive with no documented events for Grade III-IV aGvHD, use of systemic immunosuppressive therapy for cGvHD, relapse, or death at the data cutoff will be censored at their last visit date or follow-up on or prior to the date of one-year study completion/early discontinuation. The Kaplan-Meier estimate of the median GRFS and the 95% CI are presented
Percentage of Subjects Alive Without Relapse and Without Moderate or Severe cGvHD at Day +365 - mITT Population
Percentage of subjects alive without relapse and without moderate or severe cGvHD per NIH Consensus Criteria at Day +365

Full Information

First Posted
February 9, 2016
Last Updated
January 12, 2023
Sponsor
Fate Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT02743351
Brief Title
Study of ProTmune for Allogeneic HCT in Adult Patients With Hematologic Malignancies
Official Title
A Phase 1, Non-Randomized, Open-Label/Phase 2, Randomized, Blinded Study of ProTmune™ (ex Vivo Programmed Mobilized Peripheral Blood Cells) Versus Non-Programmed Mobilized Peripheral Blood Cells for Allogeneic Hematopoietic Cell Transplantation in Adult Subjects With Hematologic Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
December 20, 2016 (Actual)
Primary Completion Date
December 4, 2020 (Actual)
Study Completion Date
November 5, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fate Therapeutics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is a Phase 1, non-randomized, open-label/Phase 2 randomized, blinded study of ProTmune (ex vivo programmed mobilized peripheral blood cells) versus non-programmed mobilized peripheral blood cells for allogeneic hematopoietic cell transplantation (HCT) in adult subjects aged 18 years and older with hematologic malignancies. A total of 88 study subjects were treated in the trial at approximately 15 centers in the US.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hematologic Malignancies, Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, Myelodysplastic Syndromes, Chronic Myelogenous Leukemia, Acute Graft-versus-host Disease
Keywords
Cell Transplants, Hematopoietic Cell Transplant, HCT, Hematologic Malignancies, Hematologic Malignancy, Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, ALL, AML, Myelodysplastic Syndrome, MDS, Allogeneic, CML, Stem Cell Transplant, Transplant, aGvHD, Acute graft-versus-host Disease, cGvHD, Chronic graft-versus-host Disease

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
96 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ProTmune
Arm Type
Experimental
Arm Description
Conditioning regimen consisting of one of the following five preparative regimens: fludarabine and busulfan (FluBu4); busulfan (Bu) and cyclophosphamide (Cy); Cy and >or=12 Gy total body irradiation (TBI); TBI and etoposide; or fludarabine and melphalan (FluMel 140). Subjects will receive mPB cells from an available 8/8 HLA-A, -B, -C, and -DRB1-matched unrelated peripheral blood cell donor that were programmed ex vivo with ProTmune.
Arm Title
Control Arm
Arm Type
Active Comparator
Arm Description
Conditioning regimen consisting of one of the following five preparative regimens: fludarabine and busulfan (FluBu4); busulfan (Bu) and cyclophosphamide (Cy); Cy and >or=12 Gy total body irradiation (TBI); TBI and etoposide; or fludarabine and melphalan (FluMel 140). Subjects will receive unmanipulated mPB cells from an available 8/8 HLA-A, -B, -C, and -DRB1-matched unrelated peripheral blood cell donor.
Intervention Type
Biological
Intervention Name(s)
ProTmune
Intervention Description
Ex-vivo, programmed mobilized peripheral blood (mPB) cells
Intervention Type
Biological
Intervention Name(s)
Control Arm
Intervention Description
Untreated mobilized peripheral blood (mPB) cells
Primary Outcome Measure Information:
Title
Percentage of Participants With Cumulative Incidence of Grade II to IV aGvHD Through Day +100 Based on Investigator Assessment
Description
Acute GvHD (aGvHD) is assessed by assigning the clinical stage for the target organs (skin, liver, and gut) along with assigning an overall grade based on the minimum degree of organ involvement required to confer that grade. Grade II is defined as Stage 1 skin, Stage 1 liver, or Stage 1 GI; Grade III is defined as any Stage 1-3 skin, and Stage 2-3 liver, or Stage 2-4 GI; Grade IV is defined as Stage 4 skin, or Stage 4 liver and any Stage GI. A higher overall grade indicates a more severe outcome. The cumulative incidence of CIBMTR Grade II to IV aGVHD through approximately 100 days following HCT is measured by the percentage of participants who experienced grade II to IV aGVHD. The cumulative incidence and the associated 95% confidence interval are estimated using a competing risk analysis with death and relapse without grade II-IV aGvHD as a competing risk.
Time Frame
100 days post-HCT
Secondary Outcome Measure Information:
Title
1-year GvHD-free, Relapse-free Survival (GRFS)
Description
1-year GvHD-free, relapse-free survival (GRFS) is a composite endpoint in which events included Grade III to IV aGvHD, cGvHD requiring systemic immunosuppressive therapy, relapse, or death from any cause. GRFS is defined as the time from HCT to the earlier of the dates of the first documented CIBMTR Grade III-IV aGvHD, first use of systemic immunosuppressive therapy for cGvHD, first documented relapse of the underlying malignancy, or death from any cause. Subjects who are alive with no documented events for Grade III-IV aGvHD, use of systemic immunosuppressive therapy for cGvHD, relapse, or death at the data cutoff will be censored at their last visit date or follow-up on or prior to the date of one-year study completion/early discontinuation. The Kaplan-Meier estimate of the median GRFS and the 95% CI are presented
Time Frame
365 days post-HCT
Title
Percentage of Subjects Alive Without Relapse and Without Moderate or Severe cGvHD at Day +365 - mITT Population
Description
Percentage of subjects alive without relapse and without moderate or severe cGvHD per NIH Consensus Criteria at Day +365
Time Frame
365 days post-HCT

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Male and female patients aged 18 years and older, inclusive; Patients must have a hematologic malignancy for which allogeneic hematopoietic peripheral blood cell transplantation is deemed clinically appropriate. Eligible diseases and stages include the following: Acute myeloid leukemia Acute lymphoblastic leukemia, including T lymphoblastic lymphoma with a history of marrow involvement Myelodysplastic Syndrome Chronic myelogenous leukemia Availability of a suitable 8/8 HLA-A, -B, -C, and -DRB1-matched unrelated mPB donor; mBP donor collection that meets protocol specifications; Adequate performance status, defined as Karnofsky score greater than or equal to 70%; For female patients of childbearing potential, all of the following criteria must be met: They are not pregnant (i.e., female patients must have a negative serum pregnancy test at screening); They are not breastfeeding; They do not plan to become pregnant during the study; and They are using an effective method of contraception from screening to the end of the study, unless their sexual partner is surgically sterile. For male patients, agreement to use condoms with spermicide during sexual intercourse from screening to the end of study; and Willingness and ability to sign an IRB/IEC-approved ICF before performance of any study-specific procedures or tests and to comply with protocol visits, and study procedures. Key Exclusion Criteria: Phase 1 only: Known bone marrow fibrosis; Phase 2 only: Bone marrow fibrosis grade 3 (severe) or greater; Positive serology for human immunodeficiency virus (HIV) or human T-cell lymphotropic virus (HTLV) at any time prior to enrollment; Currently uncontrolled bacterial, viral, or fungal infection (progression of clinical symptoms despite therapy); Prior autologous or allogeneic HCT; Active malignancy, other than the one for which the allogeneic mPB transplant is being performed, within 12 months of enrollment, excluding superficial basal cell and carcinoma in situ cervical cancer; Pulmonary disease, renal dysfunction, hepatic disease, cardiac disease, neurologic disease; Participation in another clinical trial involving an investigational product within 30 days prior to screening; or Any condition or therapy, which, in the opinion of the Investigator, might pose a risk to the patient or make participation in the study not in the best interest of the patient.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sarah Cooley, MD
Organizational Affiliation
Fate Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama
City
Birmingham
State/Province
Alabama
Country
United States
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
University of California, San Diego (UCSD) Moores Cancer Center
City
San Diego
State/Province
California
Country
United States
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
Country
United States
Facility Name
Indiana Blood and Marrow Transplant
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46237
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Barbara Ann Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
Weill Cornell Medicine
City
New York
State/Province
New York
Country
United States
Facility Name
Jewish Hospital
City
Cincinnati
State/Province
Ohio
Country
United States
Facility Name
The Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
Country
United States
Facility Name
Sarah Cannon Research Institute
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Texas Transplant Institute
City
San Antonio
State/Province
Texas
Country
United States
Facility Name
Huntsman Cancer Institute (University of Utah)
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84103
Country
United States
Facility Name
Virginia Commonwealth University
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Study of ProTmune for Allogeneic HCT in Adult Patients With Hematologic Malignancies

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