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Clinical Study of CAR-CLD18 T Cells in Patients With Advanced Gastric Adenocarcinoma and Pancreatic Adenocarcinoma

Primary Purpose

Advanced Gastric Adenocarcinoma, Pancreatic Adenocarcinoma

Status
Unknown status
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
CAR-CLD18 T Cells
Sponsored by
Changhai Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Gastric Adenocarcinoma

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients aged 18 - 70 with pathologically confirmed advanced gastric adenocarcinoma and pancreatic adenocarcinoma.
  2. Biopsy confirmation of Claudin18.2 positive.
  3. Patients with advanced gastric adenocarcinoma who have not been cured with second line chemotherapy, and who are not willing to undergo second line chemotherapy after the failure of first line chemotherapy. (1) Failure of treatment is defined as disease progression, recurrence or metastatic disease, or intolerable toxicities occurred after treatment. (2) Each line of treatment during the period of disease progression includes one or more chemotherapy drugs which are administered for not less than one cycle or even longer. Neoadjuvant/adjuvant therapy can be applied at an earlier stage of treatment. If patient has developed recurrence or metastatic disease within 24 weeks of neoadjuvant/adjuvant therapy, it is considered as one line of systemic chemotherapy. (3) Therapies that can be performed at an earlier stage are chemotherapy in conjunction with molecular targeted drugs.
  4. Patients with advanced/metastatic pancreatic adenocarcinoma which has relapsed after surgery or for which there is no surgical indication, who have not been cured with or refused to receive other standard regimens.
  5. Expected survival after first dose of study drug > 12 weeks.
  6. At least one measurable lesion (≥ 10 mm) for imaging assessment.
  7. ECOG scores 0 - 1.
  8. Adequate venous access for apheresis and venous blood sampling, and no other contraindications for leukapheresis.
  9. White blood cells (WBCs) ≥ 2.5×10^9/L Platelets (PLT) ≥ 100×10^9/L Hemoglobin, Blood (Hb) ≥ 9.0 g/dL MID ≥ 1.5×10^9/L Lymphocyte (LY) ≥ 0.47×10^9/L LY% ≥ 15%
  10. Serum albumin (Alb) ≥ 30 g/L
  11. Serum lipase (LPS) and serum amylase < 1.5 ULN
  12. Serum creatinine ≤ 1.5 ULN
  13. Alanine aminotransferase (ALT) ≤ 2.5 ULN Aspartate aminotransferase (AST) ≤ 2.5 ULN If osseous metastasis or liver metastasis is developed and alkaline phosphatase (ALP) > 2.5 ULN, ALT and AST < 1.5 ULN.
  14. Serum total bilirubin (TBIL) ≤ 1.5 ULN
  15. Prothrombin Time (PT): International Normalized Ratio (INR) < 1.7. PT < (ULN + 4) s

All test results should be within their normal ranges, and the patient is not receiving continuous supportive care.

Exclusion Criteria:

  • Patients with any of the following conditions are not eligible for the study.

    1. Pregnant or lactating women.
    2. HIV positive, HCV positive, HBV DNA copies ≥ 10^3.
    3. Uncontrolled active infection.
    4. Concurrent use of systemic steroids. Recent or current use of inhaled steroids is not exclusionary.
    5. Allergic to immunotherapies and related drugs.
    6. Untreated brain metastases or having symptoms of brain metastases.
    7. Metastases to the lung: central tumor or multiple metastases.
    8. Patients with heart disease for which treatment is needed or with poorly controlled hypertension.
    9. Patients with unstable or active peptic ulcer or with alimentary tract hemorrhage.
    10. Patients with previous organ transplantation or in preparation for organ transplantation.
    11. Patients in need of anticoagulant treatment (e.g. warfarin or heparin).
    12. Patients in need of long-term antiplatelet treatment (aspirin, dosage > 300 mg/d; clopidogrel, dosage > 75 mg/d).
    13. Previous treatment with chemoradiotherapy and tumor-targeting drug which were conducted 4 weeks prior to the study (blood collection).
    14. Patients have undertaken major surgeries or have been badly injured 4 weeks before the study (blood collection), or will undertake major surgeries during the study.
    15. The judgment of investigators that the patient is not able to or not willing to follow the instructions of the protocol.

Sites / Locations

  • Changhai HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CAR-CLD18 T cells

Arm Description

Autologous T Cells with a Claudin18.2-redirected Chimeric Antigen Receptor. Route of administration: Intravenous injection. Lymphodepletion conditioning regimen will be applied prior to CAR-CLD18 T cell infusion.

Outcomes

Primary Outcome Measures

Safety and tolerance
During the trial conduction, especially within the 24 weeks of treatment phase when CAR-CLD18 T cell administered, all adverse events (including laboratory abnormality and clinical events) will be closely monitored, and all ≥ grade 3 adverse events per CTCAE (v 3.0) will be recorded, including but not limited to the toxicities potentially suspected to relate to infusion procedures and/or CAR-CLD18 T cell therapy as listed below: Fever Chills Nausea, vomiting and other gastrointestinal symptoms Fatigue Hypotension Respiratory distress Tumor lysis syndrome Cytokine release syndrome Neutropenia, thrombocytopenia Liver and kidney dysfunction

Secondary Outcome Measures

Engraftment
Duration of in vivo survival of CAR-CLD18 T cells is defined as "engraftment". The primary engraftment endpoint is the number of DNA vector copies per mL blood of CAR-CLD18 T cells at regular intervals through week 4 following the initial infusion. Q-PCR for CAR-CLD18 T vector sequences will be performed until any 2 sequential tests are negative, documented as engraftment and persistence of CAR-CLD18 T cells.

Full Information

First Posted
May 11, 2017
Last Updated
March 8, 2018
Sponsor
Changhai Hospital
Collaborators
CARsgen Therapeutics Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03159819
Brief Title
Clinical Study of CAR-CLD18 T Cells in Patients With Advanced Gastric Adenocarcinoma and Pancreatic Adenocarcinoma
Official Title
Clinical Study of Redirected Autologous T Cells With a Claudin18.2-targeted Chimeric Antigen Receptor in Patients With Advanced Gastric Adenocarcinoma and Pancreatic Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Unknown status
Study Start Date
April 1, 2017 (Actual)
Primary Completion Date
December 31, 2019 (Anticipated)
Study Completion Date
December 31, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Changhai Hospital
Collaborators
CARsgen Therapeutics Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A single arm, open-label pilot study is designed to determine the safety, tolerability and engraftment of CAR-CLD18 T cells in patients with advanced gastric adenocarcinoma and pancreatic adenocarcinoma.
Detailed Description
For patients with gastric adenocarcinoma who have not been cured with first line chemotherapy, and who are not willing to undergo second line chemotherapy after the failure of first line chemotherapy while there are no effective therapies for their unmet medical needs known at this time, and for patients with advanced/metastatic pancreatic adenocarcinoma which has relapsed after surgery or for which there is no surgical indication, who have not been cured with or refused to receive other standard regimens, single or multiple doses of CAR-CLD18 T cells will be given to observe safety and efficacy of CAR-CLD18 T cells. Primary objectives: Determine the safety, tolerability and cytokinetics of the autologous T cells transduced with anti-Claudin18.2 lentiviral vector in patients with gastric adenocarcinoma and pancreatic adenocarcinoma. Secondary objectives: Make a preliminary evaluation on the efficacy of CAR-CLD18 T cells in patients with gastric adenocarcinoma and pancreatic adenocarcinoma with the following parameters: Time of tumor progression (TTP); Disease Control Rate (DCR); Objective Remission Rate (ORR); Overall Survival (OS).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Gastric Adenocarcinoma, Pancreatic Adenocarcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
CAR-CLD18 T cells
Arm Type
Experimental
Arm Description
Autologous T Cells with a Claudin18.2-redirected Chimeric Antigen Receptor. Route of administration: Intravenous injection. Lymphodepletion conditioning regimen will be applied prior to CAR-CLD18 T cell infusion.
Intervention Type
Genetic
Intervention Name(s)
CAR-CLD18 T Cells
Other Intervention Name(s)
Claudin18.2-redirected Autologous Cells
Intervention Description
Dose escalation will be applied in this study.
Primary Outcome Measure Information:
Title
Safety and tolerance
Description
During the trial conduction, especially within the 24 weeks of treatment phase when CAR-CLD18 T cell administered, all adverse events (including laboratory abnormality and clinical events) will be closely monitored, and all ≥ grade 3 adverse events per CTCAE (v 3.0) will be recorded, including but not limited to the toxicities potentially suspected to relate to infusion procedures and/or CAR-CLD18 T cell therapy as listed below: Fever Chills Nausea, vomiting and other gastrointestinal symptoms Fatigue Hypotension Respiratory distress Tumor lysis syndrome Cytokine release syndrome Neutropenia, thrombocytopenia Liver and kidney dysfunction
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Engraftment
Description
Duration of in vivo survival of CAR-CLD18 T cells is defined as "engraftment". The primary engraftment endpoint is the number of DNA vector copies per mL blood of CAR-CLD18 T cells at regular intervals through week 4 following the initial infusion. Q-PCR for CAR-CLD18 T vector sequences will be performed until any 2 sequential tests are negative, documented as engraftment and persistence of CAR-CLD18 T cells.
Time Frame
2 years
Other Pre-specified Outcome Measures:
Title
Anti-tumor responses to CAR-CLD18 T cell infusions
Description
Disease Control Rate (DCR)
Time Frame
2 years
Title
Anti-tumor responses to CAR-CLD18 T cell infusions
Description
Progression-free Survival (PFS)
Time Frame
2 years
Title
Anti-tumor responses to CAR-CLD18 T cell infusions
Description
Time of Tumor Progression (TTP)
Time Frame
2 years
Title
Anti-tumor responses to CAR-CLD18 T cell infusions
Description
Overall Survival (OS)
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: Patients aged 18 - 70 with pathologically confirmed advanced gastric adenocarcinoma and pancreatic adenocarcinoma. Biopsy confirmation of Claudin18.2 positive. Patients with advanced gastric adenocarcinoma who have not been cured with second line chemotherapy, and who are not willing to undergo second line chemotherapy after the failure of first line chemotherapy. (1) Failure of treatment is defined as disease progression, recurrence or metastatic disease, or intolerable toxicities occurred after treatment. (2) Each line of treatment during the period of disease progression includes one or more chemotherapy drugs which are administered for not less than one cycle or even longer. Neoadjuvant/adjuvant therapy can be applied at an earlier stage of treatment. If patient has developed recurrence or metastatic disease within 24 weeks of neoadjuvant/adjuvant therapy, it is considered as one line of systemic chemotherapy. (3) Therapies that can be performed at an earlier stage are chemotherapy in conjunction with molecular targeted drugs. Patients with advanced/metastatic pancreatic adenocarcinoma which has relapsed after surgery or for which there is no surgical indication, who have not been cured with or refused to receive other standard regimens. Expected survival after first dose of study drug > 12 weeks. At least one measurable lesion (≥ 10 mm) for imaging assessment. ECOG scores 0 - 1. Adequate venous access for apheresis and venous blood sampling, and no other contraindications for leukapheresis. White blood cells (WBCs) ≥ 2.5×10^9/L Platelets (PLT) ≥ 100×10^9/L Hemoglobin, Blood (Hb) ≥ 9.0 g/dL MID ≥ 1.5×10^9/L Lymphocyte (LY) ≥ 0.47×10^9/L LY% ≥ 15% Serum albumin (Alb) ≥ 30 g/L Serum lipase (LPS) and serum amylase < 1.5 ULN Serum creatinine ≤ 1.5 ULN Alanine aminotransferase (ALT) ≤ 2.5 ULN Aspartate aminotransferase (AST) ≤ 2.5 ULN If osseous metastasis or liver metastasis is developed and alkaline phosphatase (ALP) > 2.5 ULN, ALT and AST < 1.5 ULN. Serum total bilirubin (TBIL) ≤ 1.5 ULN Prothrombin Time (PT): International Normalized Ratio (INR) < 1.7. PT < (ULN + 4) s All test results should be within their normal ranges, and the patient is not receiving continuous supportive care. Exclusion Criteria: Patients with any of the following conditions are not eligible for the study. Pregnant or lactating women. HIV positive, HCV positive, HBV DNA copies ≥ 10^3. Uncontrolled active infection. Concurrent use of systemic steroids. Recent or current use of inhaled steroids is not exclusionary. Allergic to immunotherapies and related drugs. Untreated brain metastases or having symptoms of brain metastases. Metastases to the lung: central tumor or multiple metastases. Patients with heart disease for which treatment is needed or with poorly controlled hypertension. Patients with unstable or active peptic ulcer or with alimentary tract hemorrhage. Patients with previous organ transplantation or in preparation for organ transplantation. Patients in need of anticoagulant treatment (e.g. warfarin or heparin). Patients in need of long-term antiplatelet treatment (aspirin, dosage > 300 mg/d; clopidogrel, dosage > 75 mg/d). Previous treatment with chemoradiotherapy and tumor-targeting drug which were conducted 4 weeks prior to the study (blood collection). Patients have undertaken major surgeries or have been badly injured 4 weeks before the study (blood collection), or will undertake major surgeries during the study. The judgment of investigators that the patient is not able to or not willing to follow the instructions of the protocol.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xianbao Zhan, M.D.
Phone
86-021-31161441
Email
zhanxianbao@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xianbao Zhan, M.D.
Organizational Affiliation
Changhai Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Changhai Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200433
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bin Wang, Dr.
Phone
86-021-31161448
Email
qcwangb@163.com
First Name & Middle Initial & Last Name & Degree
Xianbao Zhan, M.D.
First Name & Middle Initial & Last Name & Degree
Bin Wang, M.D.

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Clinical Study of CAR-CLD18 T Cells in Patients With Advanced Gastric Adenocarcinoma and Pancreatic Adenocarcinoma

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