Autologous T Cells Expressing MET scFv CAR (RNA CART-cMET)
Primary Purpose
Malignant Melanoma, Breast Cancer
Status
Terminated
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
T cells modified with RNA anti -cMET CAR
Sponsored by
About this trial
This is an interventional treatment trial for Malignant Melanoma
Eligibility Criteria
Inclusion Criteria:
- Unresectable histologically confirmed stage III/IV melanoma or metastatic or locally advanced unresectable ER and PR negative, HER2 neu nonamplified by IHC and/or FISH breast carcinoma
- cMET expression in ≥ 30% tumor cells as demonstrated on immunohistochemistry analysis at the University of Pennsylvania. MET IHC may be performed on tissue from screening biopsy, or archival slides of a metastatic deposit or primary tumor. Punch biopsy or percutaneous core biopsy will be offered to obtain tissue as required for this purpose.
- Patients must have measureable disease as defined by RECIST 1.1 criteria; must have CT scan of chest, abdomen, pelvis within 1 month of enrollment that demonstrates measurable disease by RECIST 1.1 criteria in a tumor other than the one being potentially biopsied and resected for correlative studies
- Failure of at least one prior standard of care therapy for advanced stage disease
- If previously treated with any form of immunotherapy (including agents targeting PD1 or CTLA4, oncolytic viruses) the last administered treatment must be at least 2 weeks prior to enrollment
- Males or female patients age > 18 years old
- Eastern Cooperative Oncology Group (ECOG) Clinical Performance Status 0 or 1
- Adequate hematologic and organ function as defined by:
- WBC > 3.0 and ANC >1500
- Plt > 75,000 (no transfusion permitted within 2 weeks to achieve this goal)
- Hgb > 9 g/dl (transfusions are permitted to achieve this goal)
- serum creatinine ≤ 1.5 times upper limit of normal
- Total bilirubin ≤ 2times upper limit of normal
- ALT and AST ≤ 2 times upper limit of normal
- Cardiac ejection fraction of >40% as measured by resting echocardiogram
- Women of child bearing potential must have a negative serum or urine pregnancy test and agree to use appropriate contraception from enrollment through the duration of the trial. Men must agree to use appropriate contraception from enrollment through the duration of the trial.
- Patients must provide written informed consent.
Exclusion Criteria:
- Known metastatic tumor encasing a great vessel or at risk for imminently causing spinal cord compression
- Known HIV-1/HIV-2 infection
- Known active infection with Hepatitis B virus or Hepatitis C virus
- Received an experimental therapy within 30 days of enrollment
- Pregnant women or lactating women
- History of alcohol abuse or illicit drug use within 12 months of enrollment
- Clinically significant comorbid disease or other underlying condition, including significant active infection, in the opinion of the PI or sub-investigators, would contraindicate study therapy or interfere with interpretation of study results
- Significant psychiatric disorder and/or any other reason in the Investigator's opinion that would jeopardize protocol compliance or compromise the patient's ability to give informed consent.
- Patients with known allergy or hypersensitivity to study product excipients (human serum albumin, DMSO, and Dextran 40).
- Patients with clinically apparent arrhythmia, or arrhythmias that are not stable on medical management within 2 weeks of the Screening/Enrollment visit.
- Having received prior genetically manipulated T-cells in prior clinical trial
- History of autoimmune disease (including but not limited to: systemic lupus erythematosis, Sjogren syndrome, rheumatoid arthritis, psoriasis multiple sclerosis, inflammatory bowel disease etc).
- History of immune related adverse event with previous immunotherapy.
- Chronic use of therapeutic anti-coagulants such as coumadin, heparin, or lovenox
- Symptomatic or untreated CNS metastases. Pts with previously treated CNS metastases are eligible if lesions are radiographically/clinically stable without requirement of steroids within 4 weeks prior to treatment
Sites / Locations
- University of Pennsylvania
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Melanoma
Breast
Arm Description
Intravenous infusion 1x10^8 total T cells modified with RNA anti-cMET CAR
Intravenous infusion 1x10^8 total T cells modified with RNA anti-cMET CAR
Outcomes
Primary Outcome Measures
Number of participants with treatment-related adverse events as assessed by CTCAE v4.03 in melanoma and breast cancer subjects
Secondary Outcome Measures
Objective overall response rate by clinical exam for visible cutaneous tumors
Objective overall response rate by radiologic imaging using RECIST 1.1
Estimate the activity of RNA CART-cMET in subjects who receive at least 1 dose of cells by objective response rate using RECIST 1.1 criteria
Estimate the activity of RNA CART-cMET in subjects who receive at least 1 dose of cells by objective response rate using pathological evaluation of resected or biopsied tissue
Full Information
NCT ID
NCT03060356
First Posted
February 7, 2017
Last Updated
June 20, 2023
Sponsor
University of Pennsylvania
1. Study Identification
Unique Protocol Identification Number
NCT03060356
Brief Title
Autologous T Cells Expressing MET scFv CAR (RNA CART-cMET)
Official Title
Clinical Trial of Autologous cMET Redirected T Cells Administered Intravenously in Patients With Melanoma & Breast Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Terminated
Why Stopped
Halt in funding
Study Start Date
December 21, 2016 (Actual)
Primary Completion Date
March 27, 2020 (Actual)
Study Completion Date
March 27, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Pennsylvania
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
This is a pilot study to evaluate feasibility, safety, and preliminary evidence of efficacy for intravenously administered, RNA electroporated autologous T cells expressing MET chimeric antigen receptors with tandem TCRζ and 4-1BB (TCRζ /4-1BB) co-stimulatory domains (referred to as "RNA CART-cMET") in patients with advanced melanoma or breast carcinoma.
Detailed Description
This is a pilot study to evaluate feasibility, safety, and preliminary evidence of efficacy for intravenously administered, RNA electroporated autologous T cells expressing MET chimeric antigen receptors with tandem TCRζ and 4-1BB (TCRζ /4-1BB) co-stimulatory domains (referred to as "RNA CART-cMET") in patients with advanced melanoma or breast carcinoma. Subjects will be treated with IV administration of the RNA transduced anti-cMET CAR T cells for a total of up to six doses over a 2 week period.
Each dose is 1x108 total T cells modified with RNA anti-cMET CAR. All subjects in both the melanoma and breast carcinoma arms will receive up to 6 doses of RNA CART-cMET cells, with no lymphodepleting chemotherapy administered prior to cell infusion Cell numbers are based on total cells with a portion of them having CAR expression depending on transduction efficiency and determined by flow cytometry Based on the product release criteria, at least 20% of the total cells will express the anti-cMET CAR. Treatment limiting toxicity (TLT). Adverse event reporting will begin at the start of the first dose of RNA CART-cMET and will continue until 4 months after the first infusion, or until another alternative therapy is initiated, whichever occurs earlier. Subjects will be continually reassessed for evidence of acute and cumulative toxicity.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Melanoma, Breast Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
77 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Melanoma
Arm Type
Active Comparator
Arm Description
Intravenous infusion 1x10^8 total T cells modified with RNA anti-cMET CAR
Arm Title
Breast
Arm Type
Active Comparator
Arm Description
Intravenous infusion 1x10^8 total T cells modified with RNA anti-cMET CAR
Intervention Type
Biological
Intervention Name(s)
T cells modified with RNA anti -cMET CAR
Intervention Description
Intravenously administered, RNA electroporated autologous T cells expressing MET chimeric antigen receptors with tandem TCRζ and 4-1BB (TCRζ /4-1BB) co-stimulatory domains
Primary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.03 in melanoma and breast cancer subjects
Time Frame
from day 0 - month 4
Secondary Outcome Measure Information:
Title
Objective overall response rate by clinical exam for visible cutaneous tumors
Time Frame
day 25 and month 4
Title
Objective overall response rate by radiologic imaging using RECIST 1.1
Time Frame
day 25 and month 4
Title
Estimate the activity of RNA CART-cMET in subjects who receive at least 1 dose of cells by objective response rate using RECIST 1.1 criteria
Time Frame
day -7 and day 11
Title
Estimate the activity of RNA CART-cMET in subjects who receive at least 1 dose of cells by objective response rate using pathological evaluation of resected or biopsied tissue
Time Frame
day -7 and day 11
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Unresectable histologically confirmed stage III/IV melanoma or metastatic or locally advanced unresectable ER and PR negative, HER2 neu nonamplified by IHC and/or FISH breast carcinoma
cMET expression in ≥ 30% tumor cells as demonstrated on immunohistochemistry analysis at the University of Pennsylvania. MET IHC may be performed on tissue from screening biopsy, or archival slides of a metastatic deposit or primary tumor. Punch biopsy or percutaneous core biopsy will be offered to obtain tissue as required for this purpose.
Patients must have measureable disease as defined by RECIST 1.1 criteria; must have CT scan of chest, abdomen, pelvis within 1 month of enrollment that demonstrates measurable disease by RECIST 1.1 criteria in a tumor other than the one being potentially biopsied and resected for correlative studies
Failure of at least one prior standard of care therapy for advanced stage disease
If previously treated with any form of immunotherapy (including agents targeting PD1 or CTLA4, oncolytic viruses) the last administered treatment must be at least 2 weeks prior to enrollment
Males or female patients age > 18 years old
Eastern Cooperative Oncology Group (ECOG) Clinical Performance Status 0 or 1
Adequate hematologic and organ function as defined by:
WBC > 3.0 and ANC >1500
Plt > 75,000 (no transfusion permitted within 2 weeks to achieve this goal)
Hgb > 9 g/dl (transfusions are permitted to achieve this goal)
serum creatinine ≤ 1.5 times upper limit of normal
Total bilirubin ≤ 2times upper limit of normal
ALT and AST ≤ 2 times upper limit of normal
Cardiac ejection fraction of >40% as measured by resting echocardiogram
Women of child bearing potential must have a negative serum or urine pregnancy test and agree to use appropriate contraception from enrollment through the duration of the trial. Men must agree to use appropriate contraception from enrollment through the duration of the trial.
Patients must provide written informed consent.
Exclusion Criteria:
Known metastatic tumor encasing a great vessel or at risk for imminently causing spinal cord compression
Known HIV-1/HIV-2 infection
Known active infection with Hepatitis B virus or Hepatitis C virus
Received an experimental therapy within 30 days of enrollment
Pregnant women or lactating women
History of alcohol abuse or illicit drug use within 12 months of enrollment
Clinically significant comorbid disease or other underlying condition, including significant active infection, in the opinion of the PI or sub-investigators, would contraindicate study therapy or interfere with interpretation of study results
Significant psychiatric disorder and/or any other reason in the Investigator's opinion that would jeopardize protocol compliance or compromise the patient's ability to give informed consent.
Patients with known allergy or hypersensitivity to study product excipients (human serum albumin, DMSO, and Dextran 40).
Patients with clinically apparent arrhythmia, or arrhythmias that are not stable on medical management within 2 weeks of the Screening/Enrollment visit.
Having received prior genetically manipulated T-cells in prior clinical trial
History of autoimmune disease (including but not limited to: systemic lupus erythematosis, Sjogren syndrome, rheumatoid arthritis, psoriasis multiple sclerosis, inflammatory bowel disease etc).
History of immune related adverse event with previous immunotherapy.
Chronic use of therapeutic anti-coagulants such as coumadin, heparin, or lovenox
Symptomatic or untreated CNS metastases. Pts with previously treated CNS metastases are eligible if lesions are radiographically/clinically stable without requirement of steroids within 4 weeks prior to treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tara C. Mitchell, MD
Organizational Affiliation
University of Pennaylvania
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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Autologous T Cells Expressing MET scFv CAR (RNA CART-cMET)
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