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Safety and Efficacy Evaluation of 4th Generation Safety-engineered CAR T Cells Targeting Sarcomas

Primary Purpose

Sarcoma, Osteoid Sarcoma, Ewing Sarcoma

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Sarcoma-specific CAR-T cells
Sponsored by
Shenzhen Geno-Immune Medical Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sarcoma focused on measuring CART, PD-1, PDL-1, CTLA-4, sarcoma, solid tumor

Eligibility Criteria

1 Year - 75 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Stage Ⅲ,Ⅳ sarcoma patients or recurrent sarcoma patients;
  2. Age: ≥ 18 and ≤65 years of age at the time of enrollment;
  3. At least 4 weeks since any chemotherapy or radiotherapy and at least 1 week since immunosuppressive therapy such as using steroid hormone before enrollment;
  4. Side effects of chemotherapy have been well managed;
  5. Malignant cells are target antigen positive(higher than ++) confirmed by IHC, quantitative PCR or sequencing;
  6. Karnofsky /jansky score of 50% or greater;
  7. Expected survival > 6 weeks;
  8. ANC≥ 1×10^6/L,PLT ≥ 1×10^8/L;
  9. Pulse oximetry of≥90% on room air;
  10. Adequate hepatic function,defined as aspartate aminotransferase(AST)< 5 times upper limit of normal(ULN),serum bilirubin < 3 times ULN;
  11. Adequate renal function,defined as serum creatinine less than 2 times ULN,if serum creatinine more than 1.5 times ULN,creatinine clearance rate test is needed;
  12. Patients must have autologous transduced T cells at levels greater than 15%;
  13. Sign an informed consent and assent.

Exclusion Criteria:

  1. The disease is progresseing rapidly;
  2. The patient is receiving therapy of other new drugs;
  3. Evidence of tumor potentially causing airway obstruction;
  4. Epilepsy history or other CNS diseases;
  5. Patients who need immunosuppressive drugs because of GVAD;
  6. History of long QT syndrome or severe heart diseases;
  7. Uncontrolled active infection;
  8. Active hepatitis B virus,hepatitis C virus and HIV infection;
  9. Receiving systemic corticosteroid 2 weeks before enrollment except for inhaled steroids;
  10. Previous treatment with any gene therapy;
  11. Creatinine>2.5mg/dl or ALT/AST>3 times normal or bilirubin>2.0 mg/dl;
  12. Patients who have other uncontrolled diseases would preclude participation as outlined;
  13. Pregnant or lactating women;
  14. Patients previously experienced toxicity from cyclophosphamide;
  15. Patients who have CNS sarcoma;
  16. In condition that may bring risks to subjects or interference to clinical trials.

Sites / Locations

  • Shenzhen Geno-immune Medical InstituteRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sarcoma-specific CAR-T cells

Arm Description

Peripheral blood mononuclear cells (PBMCs) of patients who have CD133, GD2, Muc1, CD117 or other marker positive sarcoma will be obtained through apheresis, and T cells will be activated and modified to sarcoma-specific CAR-T cells.

Outcomes

Primary Outcome Measures

Safety of CART cells in patients using CTCAE version 4.0 standard to evaluate the level of adverse events
Physiological parameter (measuring cytokine response)

Secondary Outcome Measures

Persistence and proliferation of CART cells in patients
The expansion and functional persistence of CART cells in the peripheral blood of patients will be measured by qPCR on Day 7, 14, 21, 28, 60 and 90 after infusion.

Full Information

First Posted
November 24, 2017
Last Updated
June 10, 2020
Sponsor
Shenzhen Geno-Immune Medical Institute
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1. Study Identification

Unique Protocol Identification Number
NCT03356782
Brief Title
Safety and Efficacy Evaluation of 4th Generation Safety-engineered CAR T Cells Targeting Sarcomas
Official Title
Safety and Efficacy Evaluation of 4th Generation Safety-engineered CAR T Cells Targeting Sarcomas
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Recruiting
Study Start Date
December 1, 2017 (Actual)
Primary Completion Date
November 30, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shenzhen Geno-Immune Medical Institute

4. Oversight

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

5. Study Description

Brief Summary
The aim of this clinical trial is to assess the feasibility, safety and efficacy of CAR T cells immunotherapy in patients who have sarcoma that is relapsed or late staged. Another goal of the study is to assess the safety and efficacy of the therapy that combines CAR T cells and IgT cells to treat sarcoma.
Detailed Description
Patients with late staged and/or recurrent sarcoma have poor prognosis despite complex multimodal therapy. Therefore, novel curative approaches are needed.This study will combine two different ways to fight sarcoma: antibodies and CAR-T cells. Several immune checkpoint antibodies have been examined on various tumors with good outcomes. Sarcoma is known to express increased levels of surface antigens that can be targeted by CAR-T cells. Thus, in this study, the 4SCAR-IgT cells targeting sarcoma surface antigens will be infused in dose escalation cohorts.This study will assess the feasibility, safety, efficacy and side effects of CAR T cells immunotherapy in patients who have sarcoma that is relapsed or late staged.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma, Osteoid Sarcoma, Ewing Sarcoma
Keywords
CART, PD-1, PDL-1, CTLA-4, sarcoma, solid tumor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Sarcoma-specific CAR-T cells
Arm Type
Experimental
Arm Description
Peripheral blood mononuclear cells (PBMCs) of patients who have CD133, GD2, Muc1, CD117 or other marker positive sarcoma will be obtained through apheresis, and T cells will be activated and modified to sarcoma-specific CAR-T cells.
Intervention Type
Biological
Intervention Name(s)
Sarcoma-specific CAR-T cells
Intervention Description
1 infusion, for 1x10^6~1x10^7 cells/kg via IV
Primary Outcome Measure Information:
Title
Safety of CART cells in patients using CTCAE version 4.0 standard to evaluate the level of adverse events
Description
Physiological parameter (measuring cytokine response)
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Persistence and proliferation of CART cells in patients
Description
The expansion and functional persistence of CART cells in the peripheral blood of patients will be measured by qPCR on Day 7, 14, 21, 28, 60 and 90 after infusion.
Time Frame
3 months
Other Pre-specified Outcome Measures:
Title
Anti-tumor effects
Description
Objective response, such as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) will be assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Stage Ⅲ,Ⅳ sarcoma patients or recurrent sarcoma patients; Age: ≥ 18 and ≤65 years of age at the time of enrollment; At least 4 weeks since any chemotherapy or radiotherapy and at least 1 week since immunosuppressive therapy such as using steroid hormone before enrollment; Side effects of chemotherapy have been well managed; Malignant cells are target antigen positive(higher than ++) confirmed by IHC, quantitative PCR or sequencing; Karnofsky /jansky score of 50% or greater; Expected survival > 6 weeks; ANC≥ 1×10^6/L,PLT ≥ 1×10^8/L; Pulse oximetry of≥90% on room air; Adequate hepatic function,defined as aspartate aminotransferase(AST)< 5 times upper limit of normal(ULN),serum bilirubin < 3 times ULN; Adequate renal function,defined as serum creatinine less than 2 times ULN,if serum creatinine more than 1.5 times ULN,creatinine clearance rate test is needed; Patients must have autologous transduced T cells at levels greater than 15%; Sign an informed consent and assent. Exclusion Criteria: The disease is progresseing rapidly; The patient is receiving therapy of other new drugs; Evidence of tumor potentially causing airway obstruction; Epilepsy history or other CNS diseases; Patients who need immunosuppressive drugs because of GVAD; History of long QT syndrome or severe heart diseases; Uncontrolled active infection; Active hepatitis B virus,hepatitis C virus and HIV infection; Receiving systemic corticosteroid 2 weeks before enrollment except for inhaled steroids; Previous treatment with any gene therapy; Creatinine>2.5mg/dl or ALT/AST>3 times normal or bilirubin>2.0 mg/dl; Patients who have other uncontrolled diseases would preclude participation as outlined; Pregnant or lactating women; Patients previously experienced toxicity from cyclophosphamide; Patients who have CNS sarcoma; In condition that may bring risks to subjects or interference to clinical trials.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lung-Ji Chang, PhD
Phone
86-075586725195
Email
c@szgimi.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lung-Ji Chang, PhD
Organizational Affiliation
Shenzhen Geno-Immune Medical Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shenzhen Geno-immune Medical Institute
City
Shenzhen
State/Province
Guangdong
ZIP/Postal Code
518000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lung-Ji Chang, PhD
Phone
86-075586725195
Email
c@szgimi.org

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
31401903
Citation
Hattinger CM, Patrizio MP, Magagnoli F, Luppi S, Serra M. An update on emerging drugs in osteosarcoma: towards tailored therapies? Expert Opin Emerg Drugs. 2019 Sep;24(3):153-171. doi: 10.1080/14728214.2019.1654455. Epub 2019 Aug 14.
Results Reference
derived

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Safety and Efficacy Evaluation of 4th Generation Safety-engineered CAR T Cells Targeting Sarcomas

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