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A Multi-center, Single-arm, Open, Phase I/IIa Clinical Trial to Evaluate the Efficacy and Safety of EBViNT Cell (EBV Specific Autologous CD8+ T Cell) in Patients With Treatment Failed Epstein Barr Virus (EBV)-Positive Malignancies

Primary Purpose

EBV Associated Extranodal NK/T-cell Lymphoma, EBV-Associated GastricCarcinoma or Esophageal AdenoCarcinoma

Status
Recruiting
Phase
Phase 1
Locations
Korea, Republic of
Study Type
Interventional
Intervention
EBViNT Cell
Sponsored by
Eutilex
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for EBV Associated Extranodal NK/T-cell Lymphoma focused on measuring Cytotoxic T cell, Lymphoma, Immuno-oncology, ENKL, EBViNT, Gastric cancer, solid tumor, Esophageal AdenoCarcinoma

Eligibility Criteria

19 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria (Visit 1)

  1. At least 19 years of age
  2. Patients with lymphomas or solid tumors who have been found to be positive for EBV encoded RNA (EBER) by in situ hybridization (ISH) (previous test results may be used as evidence if available)

    1. Part 1: Histologically or cytologically confirmed lymphoma or solid tumor
    2. Part 2: Histologically or cytologically confirmed solid tumor
    3. Part 3: Patients who have been diagnosed with histologically confirmed extranodal NK/T-cell lymphoma (ENKL) according to WHO classification
    4. Parts 4 and 5: Patients with histologically confirmed gastric cancer or esophageal adenocarcinoma
  3. Patients who have given written consent to voluntarily participate in the epitope screening

Exclusion Criteria (Visit 1)

  1. Patients with aggressive NK cell leukemia
  2. Patients with hemophagocytic lymphohistiocytosis (HLH)
  3. Persons who have previously received a solid organ transplant
  4. Persons who have been diagnosed with a malignant tumor other than the target disease in the past 5 years (treated basal cell carcinoma, squamous epithelial cell carcinoma, and non-invasive cervical cancer do not necessitate exclusion)
  5. Patients in whom a tuberculosis infection was confirmed in the 1 year prior to screening for the present study (However, patients who have been determined to be cured after treatment may be enrolled.)
  6. Patients who test positive for anti-HIV antibodies
  7. Patients deemed unsuitable to participate in the clinical trial by an investigator based on active infection (HBV, HCV) test results

Enrollment Criteria (Visit 2)

  1. Persons who have been found to be capable of production in the epitope screening test
  2. Patients who have failed standard treatment or conventional chemotherapy and who meet any one of the following

    1. Patients who have relapsed/progressed after 1 or more chemotherapies, and for whom standard treatment does not exist or cannot be performed
    2. Intolerable patients for whom anticancer treatment cannot be performed or a minimum of one full cycle cannot be completed in a first-line chemotherapy
    3. Patients who are refractory to first-line chemotherapy
  3. Persons with evaluable lesions

    1. Lymphoma: Persons with at least 1 lesion with long axis > 15 mm or 18FDG-PET-CT avid
    2. Solid tumor: Persons with at least 1 measurable lesion based on RECIST 1.1
  4. Persons with appropriate liver, renal, and bone marrow function (two retests are permitted for borderline results, and corrections such as transfusion are permitted)

Exclusion criteria (Visit 2)

  1. Where central nervous system (CNS) lymphoma or uncontrolled CNS metastasis is present (patients with brain metastasis that has been treated and is stable [stable for at least 30 days based on radiology records] may be enrolled)
  2. Persons who have received surgery, radiotherapy, or chemotherapy in the 3 weeks prior to the investigational product administration
  3. Persons who have been administered any other investigational product in the 3 weeks prior to the investigational product administration
  4. Persons who have not recovered from the toxicity of any previous treatment to Grade 1 or lower based on NCI CTCAE v5.0 (however, clinically insignificant toxicities such as alopecia are excluded)
  5. Patients who have received immunosuppressants, including steroids, in the 10 days prior to blood collection (Visit 2) for production of the study drug (however, local steroids and steroids for inhalers are permitted, and steroid equivalent to 20 mg/day of prednisolone may be administered at the investigator's discretion)
  6. Patients with the following (but not limited to) clinically significant cardiovascular comorbidities as determined by the investigator

    : Uncontrolled hypertension (i.e., systolic pressure > 180 mmHg and/or diastolic pressure > 100 mm/Hg), unstable angina, pulmonary embolism, cerebrovascular disease, valvular disease, congestive heart failure (NYHA severity classification Grade III or IV), or myocardial infarction or serious cardiac arrhythmia within the 24 weeks prior to the enrollment visit

  7. Patients with findings of autoimmune or inflammatory disease, whose abnormal results from an autoimmune response test have been deemed clinically significant by an investigator

Sites / Locations

  • Samsung Medical Center
  • National Cancer Center
  • Inje Univ. Hosp
  • Pusan national Univ. Hosp.Recruiting
  • Samsung Medical Center
  • Seoul Asan Medical center
  • Severance hosp.
  • Ajou Univ Hosp.

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

EBViNT Cell

Arm Description

Outcomes

Primary Outcome Measures

Confirmed objective response rate (confirmed ORR) [assessed by IRRC]

Secondary Outcome Measures

Duration of response (DoR) [assessed by IRRC and investigator]
Disease control rate (DCR) [assessed by IRRC and investigator]
Objective response rate (ORR) [assessed by investigator]
Complete response rate (CR rate) [assessed by IRRC and investigator]
Partial response rate (PR rate) [assessed by IRRC and investigator]
Partial response duration (PR duration) [assessed by IRRC and investigator]
Progression-free survival (PFS)
Overall survival (OS)

Full Information

First Posted
December 27, 2018
Last Updated
July 7, 2022
Sponsor
Eutilex
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1. Study Identification

Unique Protocol Identification Number
NCT03789617
Brief Title
A Multi-center, Single-arm, Open, Phase I/IIa Clinical Trial to Evaluate the Efficacy and Safety of EBViNT Cell (EBV Specific Autologous CD8+ T Cell) in Patients With Treatment Failed Epstein Barr Virus (EBV)-Positive Malignancies
Official Title
A Multi-center, Single-arm, Open, Phase I/IIa Clinical Trial to Evaluate the Efficacy and Safety of EBViNT Cell (EBV Specific Autologous CD8+ T Cell) in Patients With Treatment Failed Epstein Barr Virus (EBV)-Positive Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Recruiting
Study Start Date
December 14, 2018 (Actual)
Primary Completion Date
September 2022 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eutilex

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 present study is a multi-center, single-arm, open, phase I/IIa clinical trial to evaluate the efficacy and safety of EBViNT Cell when administered to patients with Epstein-Barr (EBV) positive malignancies The present study investigates with 5 parts; Part1-phase I: IP single therapy on ENKL and solid tumors Part2-phase I: IP + lymphodepletion on solid tumors Part 3&5- Phase IIa: IP single therapy on each ENKL and solid tumors Part 4- Phase IIa: IP + lymphodepletion on solid tumors
Detailed Description
The present study is a multi-center, single-arm, open, phase I/IIa clinical trial to evaluate the efficacy and safety of EBViNT Cell when administered to patients with Epstein-Barr (EBV) positive tumors After proving the safety through Part 1 and part 2, the efficacy and safety would be studied through part 3~5. If CTCAE grade 3 or higher adverse drug events (ADR) do not occur in the three subjects: Begin enrollment for phase IIa If a CTCAE grade 3 or higher ADR occurs in one of the three subjects: Enroll three more subjects (up to six subjects in total) and assess whether any CTCAE grade 3 or higher ADR occurs If a CTCAE grade 3 or higher ADR does not occur in the three additional subjects (1/6): Begin enrollment for phase IIa If a CTCAE grade 3 or higher ADR occurs in at least one of the three additional subjects (more than 2/6): Begin enrollment for phase IIa at 7.0x10^8 cells, the maximum dose from phase I If a CTCAE grade 3 or higher ADR occurs in two of the three subjects: Begin enrollment for phase IIa at 7.0x10^8 cells, the maximum dose from phase I Subjects participating in the present study will undergo 1) an EBV epitope screening test followed by 2) an eligibility assessment for clinical trial enrollment. Subjects who are administered with the investigational product will be monitored until progressive disease (PD) is confirmed or for 24 weeks (main observation period of 4 weeks + monitoring for 20 weeks) to evaluate the product's safety and efficacy, and will undergo immunological assessment. Radiological tests for tumor assessment will be conducted at the enrollment visit, 4 weeks, 8 weeks, 16 weeks, and 24 weeks and assessed by the Independent Radiology Review Committee (IRRC) using the Lugano criteria. To eliminate pseudo-progression, progressive disease (PD) will be determined by considering immunological tests, a quantitative EBV DNA assay, and intermediate response (IR) under LYRIC. Biopsies may be performed to achieve this.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
EBV Associated Extranodal NK/T-cell Lymphoma, EBV-Associated GastricCarcinoma or Esophageal AdenoCarcinoma
Keywords
Cytotoxic T cell, Lymphoma, Immuno-oncology, ENKL, EBViNT, Gastric cancer, solid tumor, Esophageal AdenoCarcinoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
EBViNT Cell
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
EBViNT Cell
Other Intervention Name(s)
Eutil autologous blood-derived T lymphocytes
Intervention Description
Dosage: 1 bag containing 1.4x10^9 cells/100mL Administration: Inject intravenously over 30 minutes Dosing schedule: Single dose
Primary Outcome Measure Information:
Title
Confirmed objective response rate (confirmed ORR) [assessed by IRRC]
Time Frame
up to 6 month from LPI
Secondary Outcome Measure Information:
Title
Duration of response (DoR) [assessed by IRRC and investigator]
Time Frame
up to 6 month from LPI
Title
Disease control rate (DCR) [assessed by IRRC and investigator]
Time Frame
up to 6 month from LPI
Title
Objective response rate (ORR) [assessed by investigator]
Time Frame
up to 6 month from LPI
Title
Complete response rate (CR rate) [assessed by IRRC and investigator]
Time Frame
up to 6 month from LPI
Title
Partial response rate (PR rate) [assessed by IRRC and investigator]
Time Frame
up to 6 month from LPI
Title
Partial response duration (PR duration) [assessed by IRRC and investigator]
Time Frame
up to 6 month from LPI
Title
Progression-free survival (PFS)
Time Frame
up to 6 month from LPI
Title
Overall survival (OS)
Time Frame
up to 6 month from LPI
Other Pre-specified Outcome Measures:
Title
Immunological assessment
Description
Plasma cytokine analysis (IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, TNF, IFN-γ, IL-17a) EBV LMP2a-specific cytokine production (IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, TNF, IFN-γ, IL-17a) Phenotypical analysis of CD8 T cells
Time Frame
up to 6 month
Title
Quantitative EBV DNA assay
Time Frame
up to 6 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria (Visit 1) At least 19 years of age Patients with lymphomas or solid tumors who have been found to be positive for EBV encoded RNA (EBER) by in situ hybridization (ISH) (previous test results may be used as evidence if available) Part 1: Histologically or cytologically confirmed lymphoma or solid tumor Part 2: Histologically or cytologically confirmed solid tumor Part 3: Patients who have been diagnosed with histologically confirmed extranodal NK/T-cell lymphoma (ENKL) according to WHO classification Parts 4 and 5: Patients with histologically confirmed gastric cancer or esophageal adenocarcinoma Patients who have given written consent to voluntarily participate in the epitope screening Exclusion Criteria (Visit 1) Patients with aggressive NK cell leukemia Patients with hemophagocytic lymphohistiocytosis (HLH) Persons who have previously received a solid organ transplant Persons who have been diagnosed with a malignant tumor other than the target disease in the past 5 years (treated basal cell carcinoma, squamous epithelial cell carcinoma, and non-invasive cervical cancer do not necessitate exclusion) Patients in whom a tuberculosis infection was confirmed in the 1 year prior to screening for the present study (However, patients who have been determined to be cured after treatment may be enrolled.) Patients who test positive for anti-HIV antibodies Patients deemed unsuitable to participate in the clinical trial by an investigator based on active infection (HBV, HCV) test results Enrollment Criteria (Visit 2) Persons who have been found to be capable of production in the epitope screening test Patients who have failed standard treatment or conventional chemotherapy and who meet any one of the following Patients who have relapsed/progressed after 1 or more chemotherapies, and for whom standard treatment does not exist or cannot be performed Intolerable patients for whom anticancer treatment cannot be performed or a minimum of one full cycle cannot be completed in a first-line chemotherapy Patients who are refractory to first-line chemotherapy Persons with evaluable lesions Lymphoma: Persons with at least 1 lesion with long axis > 15 mm or 18FDG-PET-CT avid Solid tumor: Persons with at least 1 measurable lesion based on RECIST 1.1 Persons with appropriate liver, renal, and bone marrow function (two retests are permitted for borderline results, and corrections such as transfusion are permitted) Exclusion criteria (Visit 2) Where central nervous system (CNS) lymphoma or uncontrolled CNS metastasis is present (patients with brain metastasis that has been treated and is stable [stable for at least 30 days based on radiology records] may be enrolled) Persons who have received surgery, radiotherapy, or chemotherapy in the 3 weeks prior to the investigational product administration Persons who have been administered any other investigational product in the 3 weeks prior to the investigational product administration Persons who have not recovered from the toxicity of any previous treatment to Grade 1 or lower based on NCI CTCAE v5.0 (however, clinically insignificant toxicities such as alopecia are excluded) Patients who have received immunosuppressants, including steroids, in the 10 days prior to blood collection (Visit 2) for production of the study drug (however, local steroids and steroids for inhalers are permitted, and steroid equivalent to 20 mg/day of prednisolone may be administered at the investigator's discretion) Patients with the following (but not limited to) clinically significant cardiovascular comorbidities as determined by the investigator : Uncontrolled hypertension (i.e., systolic pressure > 180 mmHg and/or diastolic pressure > 100 mm/Hg), unstable angina, pulmonary embolism, cerebrovascular disease, valvular disease, congestive heart failure (NYHA severity classification Grade III or IV), or myocardial infarction or serious cardiac arrhythmia within the 24 weeks prior to the enrollment visit Patients with findings of autoimmune or inflammatory disease, whose abnormal results from an autoimmune response test have been deemed clinically significant by an investigator
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sehee Hwang
Phone
+82-2-2071-3310
Email
hsh0820@eutilex.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hyeon Seok Eom, MD
Organizational Affiliation
National Cancer Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Won Seog Kim, MD
Organizational Affiliation
Samsung Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Ho Jin Shin, MD
Organizational Affiliation
Pusan National University Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Min-hee Ryu, MD
Organizational Affiliation
Asan Medical Cente
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Won Sik Lee, MD
Organizational Affiliation
Inje University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Minsuk Kwon, MD
Organizational Affiliation
Ajou Univ. Hosp.
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Hyo song Kim, MD
Organizational Affiliation
Severance Hosp
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jeeyun Lee, MD
Organizational Affiliation
Samsung Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Samsung Medical Center
City
Seoul
State/Province
Gangnam-gu
ZIP/Postal Code
06351
Country
Korea, Republic of
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Won Seog Kim, Dr
Phone
82221487390
Facility Name
National Cancer Center
City
Goyang-si
State/Province
Gyeonggi-do
ZIP/Postal Code
10408
Country
Korea, Republic of
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hyeon Seok Eom, Dr
Phone
82319201165
Facility Name
Inje Univ. Hosp
City
Pusan
Country
Korea, Republic of
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Won Sik Lee, MD, PhD
Facility Name
Pusan national Univ. Hosp.
City
Pusan
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ho Jin Shin, MD, PhD
Facility Name
Samsung Medical Center
City
Seoul
Country
Korea, Republic of
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jeeyun Lee, MD, PhD
Facility Name
Seoul Asan Medical center
City
Seoul
Country
Korea, Republic of
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Min-hee Ryu, MD, PhD
Facility Name
Severance hosp.
City
Seoul
Country
Korea, Republic of
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hyo Song Kim, MD, PhD
Facility Name
Ajou Univ Hosp.
City
Suwon
Country
Korea, Republic of
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Minsuk Kwon, MD, PhD

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
26938947
Citation
Eom HS, Choi BK, Lee Y, Lee H, Yun T, Kim YH, Lee JJ, Kwon BS. Phase I Clinical Trial of 4-1BB-based Adoptive T-Cell Therapy for Epstein-Barr Virus (EBV)-positive Tumors. J Immunother. 2016 Apr;39(3):140-8. doi: 10.1097/CJI.0000000000000113.
Results Reference
background
PubMed Identifier
24714356
Citation
Choi BK, Lee SC, Lee MJ, Kim YH, Kim YW, Ryu KW, Lee JH, Shin SM, Lee SH, Suzuki S, Oh HS, Kim CH, Lee DG, Hwang SH, Yu EM, Lee IO, Kwon BS. 4-1BB-based isolation and expansion of CD8+ T cells specific for self-tumor and non-self-tumor antigens for adoptive T-cell therapy. J Immunother. 2014 May;37(4):225-36. doi: 10.1097/CJI.0000000000000027.
Results Reference
background
Links:
URL
http://www.eutilex.com/en/
Description
Web address

Learn more about this trial

A Multi-center, Single-arm, Open, Phase I/IIa Clinical Trial to Evaluate the Efficacy and Safety of EBViNT Cell (EBV Specific Autologous CD8+ T Cell) in Patients With Treatment Failed Epstein Barr Virus (EBV)-Positive Malignancies

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