HER2-specific CAR T Cell Locoregional Immunotherapy for HER2-positive Recurrent/Refractory Pediatric CNS Tumors
Central Nervous System Tumor, Pediatric, Glioma, Ependymoma
About this trial
This is an interventional treatment trial for Central Nervous System Tumor, Pediatric focused on measuring CNS, CAR T cell, HER2-positive, brain tumor, pediatric, young adults
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 1 and ≤ 26 years
- Histologically diagnosed HER2-positive Central Nervous System (CNS) tumor
- Evidence of refractory or recurrent CNS disease for which there is no standard therapy
- Able to tolerate apheresis, or has apheresis product available for use in manufacturing
- CNS reservoir catheter, such as an Ommaya or Rickham catheter
- Life expectancy ≥ 8 weeks
- Lansky or Karnofsky score ≥ 60
If patient does not have previously obtained apheresis product, patient must have recovered from acute toxic effects of all prior chemotherapy, immunotherapy, and radiotherapy and discontinue the following prior to enrollment:
- ≥ 7 days post last chemotherapy/biologic administration
- 3 half-lives or 30 days, whichever is shorter post last dose of anti-tumor antibody therapy
- Must be at least 30 days from most recent cell infusion
- All systemically administered corticosteroid treatment therapy must be stable or decreasing within 1 week prior to enrollment with maximum dexamethasone dose of 2.5 mg/m2/day. Corticosteroid physiologic replacement therapy is allowed.
- Adequate organ function
- Adequate laboratory values
- Patients of childbearing/fathering potential must agree to use highly effective contraception
Exclusion Criteria:
- Diagnosis of classic diffuse intrinsic pontine glioma (DIPG)
- Presence of Grade ≥ 3 cardiac dysfunction or symptomatic arrhythmia requiring intervention
- Presence of primary immunodeficiency/bone marrow failure syndrome
- Presence of clinical and/or radiographic evidence of impending herniation
- Presence of active malignancy other than the primary CNS tumor under study
- Presence of active severe infection
- Pregnant or breastfeeding
- Subject and/or authorized legal representative unwilling or unable to provide consent/assent for participation in the 15-year follow up period
- Presence of any condition that, in the opinion of the investigator, would prohibit the patient from undergoing treatment under this protocol
Sites / Locations
- Seattle Children's HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
ARM A (Tumor Cavity Infusion)
ARM B (Ventricular System Infusion)
patients with supratentorial tumors for which CAR T cells will be delivered into the tumor resection cavity Intervention: HER2-specific chimeric antigen receptor (CAR) T cell
patients with either infratentorial tumors or leptomeningeal tumors for which the CAR T cells will be delivered into the fourth ventricle or lateral ventricle, respectively Intervention: HER2-specific chimeric antigen receptor (CAR) T cell