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CAR-T Cells Combined With Peptide Specific Dendritic Cell in Relapsed/Refractory Leukemia/MDS

Primary Purpose

Leukemia, Acute Lymphocytic (ALL), Leukemia, Acute Myelogenous (AML), Myelodysplastic Syndromes

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Chimeric antigen receptor T cells
peptide specific dendritic cell
Sponsored by
Zhujiang Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia, Acute Lymphocytic (ALL)

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Tumor type: Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL) according to the WHO criteria (at least 20% blasts in the marrow). All FAB subtypes except M3. Patients with Myelodysplastic Syndrome, category of Refractory Anemia with Excess Blasts (RAEB): RAEB I (WHO: medullary blast count ≤ 10% and a peripheral blast count ≤ 5%) and RAEB II (WHO: medullary blast count > 10% and/or > 5% peripheral blasts) can be included in the study in absence of other non-experimental treatment modalities.
  2. Positive antigen for any of CD19, CD20, CD22, CD10, CD33, CD38, CD56, CD117, CD123, CD34, or Muc1.Simultaneously ,high expression of EPS8 or WT1 in acute leukemia.
  3. Relapsed/Refractory leukemia patients:

    • Did not achieve complete remission after 2 times of standard plan chemotherapy.
    • Relapsed after first induction chemotherapy.
    • Did not response to chemotherapy before HSCT or relapsed after HSCT.
    • Cannot receive allo-HSCT or refuse to receive allo-HSCT.
    • Relapsed after CAR-T cell infusion.
  4. Age greater than 18 year and less than 80 years.
  5. Objectively assessable parameters of life expectancy: more than 3 months.
  6. Performance status: WHO PS grade 0-1 (ECOG performance status 0 or 1).
  7. Meet the following criteria for apheresis:WBC >= 3,000/L, Hb >= 8.0 g/dL, platelet count >= 80,000/mm3, <= 600,000/mm3.
  8. Pulmonary function: Peripheral blood oxygen saturation greater than 90%; Cardiac function: Left ventricular ejection fraction >60%.
  9. Prior and concomitant associated diseases allowed with the exception of underlying autoimmune disease and positive serology for HIV/HBV/HCV.
  10. No concomitant use of immunosuppressive drugs.
  11. Adequate renal and liver function, i.e. creatinin, bilirubin, and aminotransferase =< 1.2 times the upper limit of normal.
  12. Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial.
  13. Women of child-bearing potential should use adequate contraception prior to study entry and for the duration of study participation.
  14. Written informed consent obtained.

Exclusion Criteria:

  1. Patients with severe complications: cardiovascular disorders, respiratory disorders, renal dysfunction, immunodeficiency, hematological disorders, autoimmune diseases, sever allergy and severe infectious disease.
  2. Patients who should receive systemic administration of steroid or immunosuppressive agents.
  3. Presence of active brain metastases.
  4. Pregnant, lactating, or possibly pregnant women, or willing to be pregnant.
  5. Severe psychiatric disorder.
  6. Active multiple cancers.
  7. Patients have received other genetic therapy products.
  8. Transfection efficiency was less than 30%.
  9. Inappropriate for study entry judged by an attending physician.
  10. patients who have sensitivity to drugs that provide local anesthesia.

Sites / Locations

  • Zhujiang Hospital, Southern Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

CAR-T cells combined with peptide specific dendritic cell

Chimeric antigen receptor T cells

Arm Description

CAR-T cells combined with Eps8 peptide specific dendritic cell,or CAR-T cells combined with WT1 peptide specific dendritic cell

After pretreatment, chimeric antigen receptor T cells will be transfused.

Outcomes

Primary Outcome Measures

Occurrence of study related adverse events, according to NCI CTCAE Version 4.0
Incidence and severity of cytokine release syndrome(CRS): The systemic inflammatory response in patients with significantly increased IL-6 and other cytokines during the observation period is defined as CRS, which is divided into 1-5 grades, 1-2 Grade is mild, grade 3-5 is severe

Secondary Outcome Measures

Progression free survival time
Time from random to the first occurrence of disease progression.
Overall survival time
Time from randomization to death due to any cause
Overall response rate
The proportion of the total number of patients with complete remission and partial remission (CR+PR) after treatment in the total number of evaluable cases
Duration of response
During the observation period, the time between complete remission of bone marrow (the ratio of bone marrow blast cells is less than 5%) to the recurrence of bone marrow (the ratio of bone marrow blast cells is greater than 5%) is the continuous remission time.

Full Information

First Posted
September 20, 2017
Last Updated
August 1, 2021
Sponsor
Zhujiang Hospital
Collaborators
Shenzhen Geno-Immune Medical Institute, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
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1. Study Identification

Unique Protocol Identification Number
NCT03291444
Brief Title
CAR-T Cells Combined With Peptide Specific Dendritic Cell in Relapsed/Refractory Leukemia/MDS
Official Title
A Clinical Study of Chimeric Antigen Receptor T Cells Combined With Eps8 Peptide Specific Dendritic Cell for Patients With Relapsed/Refractory Leukemia and Myelodysplastic Syndromes
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Recruiting
Study Start Date
September 23, 2017 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
June 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zhujiang Hospital
Collaborators
Shenzhen Geno-Immune Medical Institute, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

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
The main purpose of this study is to verify the safety and potential effectiveness of CART cells combined with peptide specific dendritic cell in relapsed/refractory leukemia.
Detailed Description
A prospective study to evaluate the safety and efficacy of Chimeric antigen receptor T cells combined with Eps8 or WT1(Wilms tumor 1) peptide specific dendritic cell for patients with relapsed/refractory leukemia. There are options for CAR-targets: CD19, CD20, CD22 and CD10 for acute lymphoblastic leukemia; CD33, CD38 CD56, CD117, CD123, CD34 and Muc1 for acute myeloid leukemia and Myelodysplastic Syndrome. Progression free survival, overall Survival, overall response rate, and duration of response were monitored.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Acute Lymphocytic (ALL), Leukemia, Acute Myelogenous (AML), Myelodysplastic Syndromes

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
CAR-T cells combined with peptide specific dendritic cell
Arm Type
Experimental
Arm Description
CAR-T cells combined with Eps8 peptide specific dendritic cell,or CAR-T cells combined with WT1 peptide specific dendritic cell
Arm Title
Chimeric antigen receptor T cells
Arm Type
Active Comparator
Arm Description
After pretreatment, chimeric antigen receptor T cells will be transfused.
Intervention Type
Biological
Intervention Name(s)
Chimeric antigen receptor T cells
Other Intervention Name(s)
CAR-T
Intervention Description
After pretreatment, chimeric antigen receptor T cells will be transfused.
Intervention Type
Biological
Intervention Name(s)
peptide specific dendritic cell
Other Intervention Name(s)
WT1 peptide specific dendritic cell, Eps8 peptide specific dendritic cell
Intervention Description
After transfusion of chimeric antigen receptor T cells, Eps8 or WT1 peptide specific dendritic cell were intradermal injected.
Primary Outcome Measure Information:
Title
Occurrence of study related adverse events, according to NCI CTCAE Version 4.0
Description
Incidence and severity of cytokine release syndrome(CRS): The systemic inflammatory response in patients with significantly increased IL-6 and other cytokines during the observation period is defined as CRS, which is divided into 1-5 grades, 1-2 Grade is mild, grade 3-5 is severe
Time Frame
up to 12 months
Secondary Outcome Measure Information:
Title
Progression free survival time
Description
Time from random to the first occurrence of disease progression.
Time Frame
2 years
Title
Overall survival time
Description
Time from randomization to death due to any cause
Time Frame
2 years
Title
Overall response rate
Description
The proportion of the total number of patients with complete remission and partial remission (CR+PR) after treatment in the total number of evaluable cases
Time Frame
2 years
Title
Duration of response
Description
During the observation period, the time between complete remission of bone marrow (the ratio of bone marrow blast cells is less than 5%) to the recurrence of bone marrow (the ratio of bone marrow blast cells is greater than 5%) is the continuous remission time.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Tumor type: Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL) according to the WHO criteria (at least 20% blasts in the marrow). All FAB subtypes except M3. Patients with Myelodysplastic Syndrome, category of Refractory Anemia with Excess Blasts (RAEB): RAEB I (WHO: medullary blast count ≤ 10% and a peripheral blast count ≤ 5%) and RAEB II (WHO: medullary blast count > 10% and/or > 5% peripheral blasts) can be included in the study in absence of other non-experimental treatment modalities. Positive antigen for any of CD19, CD20, CD22, CD10, CD33, CD38, CD56, CD117, CD123, CD34, or Muc1.Simultaneously ,high expression of EPS8 or WT1 in acute leukemia. Relapsed/Refractory leukemia patients: Did not achieve complete remission after 2 times of standard plan chemotherapy. Relapsed after first induction chemotherapy. Did not response to chemotherapy before HSCT or relapsed after HSCT. Cannot receive allo-HSCT or refuse to receive allo-HSCT. Relapsed after CAR-T cell infusion. Age greater than 18 year and less than 80 years. Objectively assessable parameters of life expectancy: more than 3 months. Performance status: WHO PS grade 0-1 (ECOG performance status 0 or 1). Meet the following criteria for apheresis:WBC >= 3,000/L, Hb >= 8.0 g/dL, platelet count >= 80,000/mm3, <= 600,000/mm3. Pulmonary function: Peripheral blood oxygen saturation greater than 90%; Cardiac function: Left ventricular ejection fraction >60%. Prior and concomitant associated diseases allowed with the exception of underlying autoimmune disease and positive serology for HIV/HBV/HCV. No concomitant use of immunosuppressive drugs. Adequate renal and liver function, i.e. creatinin, bilirubin, and aminotransferase =< 1.2 times the upper limit of normal. Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial. Women of child-bearing potential should use adequate contraception prior to study entry and for the duration of study participation. Written informed consent obtained. Exclusion Criteria: Patients with severe complications: cardiovascular disorders, respiratory disorders, renal dysfunction, immunodeficiency, hematological disorders, autoimmune diseases, sever allergy and severe infectious disease. Patients who should receive systemic administration of steroid or immunosuppressive agents. Presence of active brain metastases. Pregnant, lactating, or possibly pregnant women, or willing to be pregnant. Severe psychiatric disorder. Active multiple cancers. Patients have received other genetic therapy products. Transfection efficiency was less than 30%. Inappropriate for study entry judged by an attending physician. patients who have sensitivity to drugs that provide local anesthesia.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sanfang Tu, M.D, Ph.D
Phone
86-20-62782322
Email
doctortutu@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yanjie He, M.D, Ph.D
Phone
86-20-61643190
Email
hyjgzh2006@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yuhua Li, M.D, Ph.D
Organizational Affiliation
Zhujiang Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Zhujiang Hospital, Southern Medical University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510282
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sanfang Tu, M.D, Ph.D
Phone
86-20-62782322
Email
doctortutu@163.com
First Name & Middle Initial & Last Name & Degree
Yanjie He, M.D, Ph.D
Phone
86-20-61643190
Email
hyjgzh2006@163.com
First Name & Middle Initial & Last Name & Degree
Yuhua Li, M.D, Ph.D

12. IPD Sharing Statement

Plan to Share IPD
No

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CAR-T Cells Combined With Peptide Specific Dendritic Cell in Relapsed/Refractory Leukemia/MDS

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