Anti-GPC3 CAR T for Recurrent or Refractory Lung Squamous Cell Carcinoma
Primary Purpose
Lung Squamous Cell Carcinoma
Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CAR-GPC3 T Cells
Fludarabine
Cyclophosphamide
Sponsored by
About this trial
This is an interventional treatment trial for Lung Squamous Cell Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Men or women aged 18~70 years old
- Subjects are diagnosed as refractory, recurrent ,metastatic, advanced lung squamous cell carcinoma by histological and cytological methods including specific lesion-targeted brush biopsy, lavage and fine needle aspiration;
- Have at least one new measurable tumor lesion compared with previous irradiated region
- Tumor tissues samples confirmed as GPC3-positive
- Expected survival≥12 weeks
- ECOG scored as 0-1 or KPS grading > 80
- ANC≥1500/nm3
- PLT≥100000/mm3
- Hb≥9.0g/dL
- Serum creatinine≤2.5mg/dL,CCR≥50ml/min (renal malfunction defined as CCR<50ml/min according to Cockroft-Gault formula)
- ALT and AST≤2.5ULN; for liver metastasis,ALT and AST ≤5ULN
- Serum TBiL≤3.0mg/dL, TBiL≤2.5ULN
- PT: INR < 1.7 or extended PT to normal value < 4s
- Adequate venous access for apheresis or venous blood collection, and no other contraindication of blood cell separation
- Patients with willingness to be in this study and able to provide informed consent
- Capable of receiving treatment and follow up, included subjects are required to receive treatment in the enrolled centre
- Women of childbearing age are required to take acceptable measures to minimize the possibility of pregnancy during whole session. Women of childbearing age must have negative results of serum or urine tests within 24 hours prior to infusion. Women subjects must not be in lactation;
Exclusion Criteria:
- CAR-T positive rate < 10%
- pregnant women or women in lactation
- active HBV or HCV infection
- HIV/AIDS infection
- active infection
previously suffered from diseases or concurrent diseases as followed:
- patients confirmed as severe autoimmune diseases in long-term (over 2 months) need of systemic immune inhibitors (steroid) or as immune-mediated symptomatic diseases including ulcerative colitis, Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus (SLE), autoimmune vasculitis (for example, Wegener's granulomatosis)
- subjects with previous diagnosis as motor neurone disease caused by autoimmunity
- subjects previously suffered from toxic epidermal necrolysis (TEN)
- subjects with any mental diseases including dementia, mental status change that may impinge the understanding and performance of informed consent and related questionnaire
- subjects with severe, uncontrollable diseases judged by investigators that may hinder them receiving this treatment
- subjects with previously active malignant tumors including basal or squamous skin cancer, superficial bladder cancer, and in situ breast carcinoma within 5 years who had been completely cured without the need of follow-up treatment are not excluded.
- during ongoing treatment using systemic steroid or steroid inhalants
- previous treatment used gene therapy products
- previous experience of immunotherapies including CIK, DC, DC-CIK, LAK for the treatment of cancer
- allergic to immunotherapies or related drugs
- patients in need of treatment for heart disease with ≥2 NYHA or for poor controlled hypertension
- subjects with unstable or active peptic ulcer or alimentary tract hemorrhage
- subjects with previous organ transplantation or ready for organ transplantation
- subjects in need of anticoagulant therapy treatment (warfarin or heparin)
- subjects judged by investigators as not appropriate for this study
Sites / Locations
- Shanghai Chest Hospital,Shanghai Jiaotong UniversityRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
CAR-GPC3 T cells
Arm Description
Intravenous infusion with escalating dose is adopted in this study. Total dosage: 1 x 10^5 - 2 x 10^9 CAR-GPC3 T cells/kg The next dose and interval depends on the response of the subject to previous dose. Lymphodepletion: Fludarabine: 30 mg/m^2/day x 4 days; Cyclophosphamide: 500 mg/m^2/day x 2 days. Adjustment is in discretion of the investigator based on individual response.
Outcomes
Primary Outcome Measures
Safety and tolerance: Occurrence of study related adverse events
Occurrence of study related adverse events, defined as laboratory toxicities and clinical events that are possibly, likely or definitely related to study treatment at any time from the infusion until week 24. This will include infusive toxicity, and any toxicity possibly related to the CAR-GPC3 T cells.
Secondary Outcome Measures
Engraftment: the DNA vector copies per mL blood of CAR-GPC3 T cells
The DNA vector copies per mL blood of CAR-GPC3 T cells on week 4 after the first infusion by Q-PCR. Q-PCR for CAR-GPC3 vector sequences will also be performed after infusion thereafter until any 2 sequential tests are negative documenting loss of CAR-GPC3 T cells within 2 years.
Full Information
NCT ID
NCT02876978
First Posted
August 9, 2016
Last Updated
August 23, 2016
Sponsor
CARsgen Therapeutics Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT02876978
Brief Title
Anti-GPC3 CAR T for Recurrent or Refractory Lung Squamous Cell Carcinoma
Official Title
Preliminary Clinical Study of Autologous T Cells Modified Chimeric Antigen Receptor (CAR) Targeting GPC3 for the Treatment of Recurrent or Refractory Lung Squamous Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
August 2016
Overall Recruitment Status
Unknown status
Study Start Date
March 2016 (undefined)
Primary Completion Date
October 2017 (Anticipated)
Study Completion Date
April 2019 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CARsgen Therapeutics Co., Ltd.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to observe and confirm the safety, tolerance and cell pharmacokinetics of lentivirus-transduced CAR-GPC3 T cells (CAR-GPC3 T cells targeting GPC3)
Detailed Description
A single-center, open-label pilot study to determine the safety, tolerance and engraftment potential of CAR-GPC3 T cells in subjects with GPC3+ positive lung squamous cell carcinoma.
Primary objectives:
Observe and determine the safety and tolerance in escalating dose infusion of CAR-GPC3 T cells (CAR T cells targeting GPC3) transduced with the lentiviral vector, and the survival of the CAT-GPC3 T cells in vivo, referred to as engraftment potential.
Secondary objectives:
The following indexes are monitored for curative effect of CAR-GPC3 T cells on lung squamous cell carcinoma:
Objective response rate (ORR), is defined as the ratio of patients diagnosed as partial remission (PR) to complete remission (CR) according to RECIST 1.1 criteria.
Progression free survival (PFS), is defined as the duration from baseline to PD (audited and confirmed by independent imaging), or to the day of any death event. The earlier one shall prevail.
Time to tumor progression (TTP), is defined as the duration from baseline to disease starts to get worse or spreads to other parts of the body.
Overall survival (OS), is defined as the time period from the 1st day of treatment to the day of death for any reason. For patients who are still alive at the data analysis day, OS data is subject to the last confirmed time of survival patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Squamous Cell Carcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
CAR-GPC3 T cells
Arm Type
Experimental
Arm Description
Intravenous infusion with escalating dose is adopted in this study.
Total dosage: 1 x 10^5 - 2 x 10^9 CAR-GPC3 T cells/kg
The next dose and interval depends on the response of the subject to previous dose.
Lymphodepletion:
Fludarabine: 30 mg/m^2/day x 4 days; Cyclophosphamide: 500 mg/m^2/day x 2 days. Adjustment is in discretion of the investigator based on individual response.
Intervention Type
Genetic
Intervention Name(s)
CAR-GPC3 T Cells
Other Intervention Name(s)
Anti-GPC3 CAR T, CAR T cells redirected to Glypican-3
Intervention Description
Intravenous infusion of CAR-GPC3 T cells is conducted 1 - 2 days following lymphodepletion.
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Intervention Description
30 mg/m^2/day x 4 days
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
500 mg/m^2/day x 2 days
Primary Outcome Measure Information:
Title
Safety and tolerance: Occurrence of study related adverse events
Description
Occurrence of study related adverse events, defined as laboratory toxicities and clinical events that are possibly, likely or definitely related to study treatment at any time from the infusion until week 24. This will include infusive toxicity, and any toxicity possibly related to the CAR-GPC3 T cells.
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Engraftment: the DNA vector copies per mL blood of CAR-GPC3 T cells
Description
The DNA vector copies per mL blood of CAR-GPC3 T cells on week 4 after the first infusion by Q-PCR. Q-PCR for CAR-GPC3 vector sequences will also be performed after infusion thereafter until any 2 sequential tests are negative documenting loss of CAR-GPC3 T cells within 2 years.
Time Frame
2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Men or women aged 18~70 years old
Subjects are diagnosed as refractory, recurrent ,metastatic, advanced lung squamous cell carcinoma by histological and cytological methods including specific lesion-targeted brush biopsy, lavage and fine needle aspiration;
Have at least one new measurable tumor lesion compared with previous irradiated region
Tumor tissues samples confirmed as GPC3-positive
Expected survival≥12 weeks
ECOG scored as 0-1 or KPS grading > 80
ANC≥1500/nm3
PLT≥100000/mm3
Hb≥9.0g/dL
Serum creatinine≤2.5mg/dL,CCR≥50ml/min (renal malfunction defined as CCR<50ml/min according to Cockroft-Gault formula)
ALT and AST≤2.5ULN; for liver metastasis,ALT and AST ≤5ULN
Serum TBiL≤3.0mg/dL, TBiL≤2.5ULN
PT: INR < 1.7 or extended PT to normal value < 4s
Adequate venous access for apheresis or venous blood collection, and no other contraindication of blood cell separation
Patients with willingness to be in this study and able to provide informed consent
Capable of receiving treatment and follow up, included subjects are required to receive treatment in the enrolled centre
Women of childbearing age are required to take acceptable measures to minimize the possibility of pregnancy during whole session. Women of childbearing age must have negative results of serum or urine tests within 24 hours prior to infusion. Women subjects must not be in lactation;
Exclusion Criteria:
CAR-T positive rate < 10%
pregnant women or women in lactation
active HBV or HCV infection
HIV/AIDS infection
active infection
previously suffered from diseases or concurrent diseases as followed:
patients confirmed as severe autoimmune diseases in long-term (over 2 months) need of systemic immune inhibitors (steroid) or as immune-mediated symptomatic diseases including ulcerative colitis, Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus (SLE), autoimmune vasculitis (for example, Wegener's granulomatosis)
subjects with previous diagnosis as motor neurone disease caused by autoimmunity
subjects previously suffered from toxic epidermal necrolysis (TEN)
subjects with any mental diseases including dementia, mental status change that may impinge the understanding and performance of informed consent and related questionnaire
subjects with severe, uncontrollable diseases judged by investigators that may hinder them receiving this treatment
subjects with previously active malignant tumors including basal or squamous skin cancer, superficial bladder cancer, and in situ breast carcinoma within 5 years who had been completely cured without the need of follow-up treatment are not excluded.
during ongoing treatment using systemic steroid or steroid inhalants
previous treatment used gene therapy products
previous experience of immunotherapies including CIK, DC, DC-CIK, LAK for the treatment of cancer
allergic to immunotherapies or related drugs
patients in need of treatment for heart disease with ≥2 NYHA or for poor controlled hypertension
subjects with unstable or active peptic ulcer or alimentary tract hemorrhage
subjects with previous organ transplantation or ready for organ transplantation
subjects in need of anticoagulant therapy treatment (warfarin or heparin)
subjects judged by investigators as not appropriate for this study
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Li Zonghai, MD
Phone
86-21-54489926
Ext
817
Email
zonghaili@carsgen.com
First Name & Middle Initial & Last Name or Official Title & Degree
Ruan Huaying, bachelor
Phone
86-21-54489926
Ext
806
Email
huayingruan@carsgen.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jiang Liyan, MD
Organizational Affiliation
Shanghai Chest Hospital,Shanghai Jiaotong University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shanghai Chest Hospital,Shanghai Jiaotong University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200030
Country
China
Individual Site Status
Recruiting
12. IPD Sharing Statement
Plan to Share IPD
No
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Anti-GPC3 CAR T for Recurrent or Refractory Lung Squamous Cell Carcinoma
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