Back to resultsA Clinical Trial to Evaluate the Safety of RP-L102 in Pediatric Subjects With Fanconi Anemia Subtype A
Primary Purpose
Fanconi Anemia Complementation Group A
Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
RP-L102
Sponsored by
About this trial
This is an interventional treatment trial for Fanconi Anemia Complementation Group A focused on measuring FANCA, FA-A, Fanconi Anemia Subtype A
Eligibility Criteria
Inclusion Criteria:
- Fanconi anemia, as diagnosed by chromosomal fragility assay of cultured T-lymphocytes in the presence of DEB or a similar DNA-crosslinking agent.
- Subjects of Fanconi Anemia complementation group A.
- Minimum age: 1 year and a minimum of 8 kg.
- Maximum age: 12 years.
At least one of the following hematologic parameters below lower limits of normal:
- Hemoglobin
- Absolute neutrophils
- Platelets
- At least 30 CD34+ cells/μL are determined in one BM aspiration within 3 months prior to initiation of CD34+ cell collection.
If the number of C34+ cells/ μL in BM is in the range of 10-29, PB parameters should meet two of the three following criteria:
- Hemoglobin: ≥11g/dL
- Neutrophils: ≥900 cells/μL
- Platelets: ≥60,000 cells/μL
- Provide informed consent in accordance with current legislation.
- Women of childbearing age must have a negative urine pregnancy test at the baseline visit and accept the use of an effective contraception method during participation in the trial.
Exclusion Criteria:
- Subjects with an available and medically eligible human leukocyte antigen (HLA)-identical sibling donor.
- Evidence of myelodysplastic syndrome or leukemia, or cytogenetic abnormalities predictive of these conditions in BM aspirate analysis. This assessment should be made by valid studies conducted within the 3 months before the subject commences the stem cell mobilization/collection procedures of the clinical trial.
- Subjects with somatic mosaicism associated with stable or improved counts in all PB cell lineages. (If T-lymphocyte chromosomal fragility analysis indicates potential mosaicism, a medically significant decrease in at least one blood lineage over time must be documented to enable eligibility).
- Lansky performance status ≤60%.
- Any concomitant disease or condition that, in the opinion of the Principal Investigator, renders the subject unfit to participate in the study.
- Pre-existing sensory or motor impairment ≥grade 2 according to the NCI CTCAE v5.0 criteria.
- Pregnant or breastfeeding women.
Hepatic dysfunction as defined by either:
- Bilirubin >3.0 × upper limit of normal (ULN) or
- Alanine aminotransferase (ALT) > 5.0 × ULN or
- Aspartate aminotransferase (AST) > 5.0 × ULN
- Renal dysfunction requiring either hemodialysis or peritoneal dialysis.
Pulmonary dysfunction as defined by either:
- Need for supplemental oxygen during the prior 2 weeks in absence of acute infection.
- Oxygen saturation by pulse oximetry <90%.
- Evidence of active metastatic or locoregionally advanced malignancy for which survival is anticipated to be less than 3 years.
- Subject is receiving androgens (i.e. danazol, oxymethalone).
Sites / Locations
- Stanford University Institute for Stem Cell Biology and Regenerative Medicine Lucille Packard Children's Hospital, Stanford University
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
RP-L102
Arm Description
RP-L102 is a self-inactivating lentiviral vector carrying the therapeutic FANCA gene
Outcomes
Primary Outcome Measures
Number of participants with treatment-related adverse events as assessed by CTCAE v.5.0
Evaluation of safety associated with treatment with RP-L102
Secondary Outcome Measures
Phenotypic correction of T-lymphocytes in peripheral blood after infusion of RP-L102
Assessment of the percentage of peripheral blood T-cells with DEB-induced chromosomal aberrations that decreases from over or equal to 50% at 0-2 months post-infusion to less than 50% during months 6-36 post-infusion (confirmed in at least 2 determinations conducted in each interval).
Phenotypic correction of hematopoietic cells in bone marrow after infusion of RP-L102
During months 6-36 post-infusion, the survival of bone marrow colony forming units to 10nM MMC increases to over or equal to 10% than values determined at 0-2 months post-infusion. (1 determination is considered valid).
Engraftment of gene-corrected hematopoietic cells after infusion of RP-L102
The level of gene marking of the FANCA-LV provirus in total peripheral blood cells is at least 0.1 vector copy number/nucleated cell during months 6-36 post-infusion. (This should be confirmed in at least 2 determinations conducted at different intervals). An increase in the vector copy number/peripheral blood cell is observed from 0-2 months post-infusion to the 3rd year post-infusion. (This should be confirmed in at least 2 determinations conducted in each interval periods).
Prevention or rescue of bone marrow failure after infusion of RP-L102
Assessment of the need for treatment of bone marrow failure 6-36 months post-infusion. During the 3rd year post-infusion, peripheral blood parameters: hemoglobin levels, neutrophils, and platelets will be assessed and considered stable if they remain at over or equal to 80% of values determined at pre-treatment evaluation visit or immediately prior to mobilization before the administration of granulocyte-colony stimulating factor.
Full Information
NCT ID
NCT03814408
First Posted
January 14, 2019
Last Updated
November 23, 2020
Sponsor
Rocket Pharmaceuticals Inc.
1. Study Identification
Unique Protocol Identification Number
NCT03814408
Brief Title
A Clinical Trial to Evaluate the Safety of RP-L102 in Pediatric Subjects With Fanconi Anemia Subtype A
Official Title
A Phase I Clinical Trial to Evaluate the Safety of the Infusion of Autologous CD34+ Cells Transduced With a Lentiviral Vector Carrying the FANCA Gene in Pediatric Subjects With Fanconi Anemia Subtype A
Study Type
Interventional
2. Study Status
Record Verification Date
November 2020
Overall Recruitment Status
Unknown status
Study Start Date
January 11, 2019 (Actual)
Primary Completion Date
December 2020 (Anticipated)
Study Completion Date
March 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Rocket Pharmaceuticals Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The objective of this study is to assess the therapeutic safety and preliminary efficacy of a hematopoietic cell-based gene therapy consisting of autologous CD34+ enriched cells transduced with a lentiviral vector carrying the FANCA gene in subjects with Fanconi anemia subtype A (FA-A).
Detailed Description
This is a pediatric open-label Phase 1 clinical trial and will include a safety evaluation and preliminary assessment of the efficacy of hematopoietic gene therapy consisting of autologous CD34+ enriched cells transduced with a lentiviral vector carrying the FANCA gene in subjects with FA-A. CD34+ cells will be transduced ex vivo with the therapeutic lentiviral vector and infused following transduction, without any prior conditioning. After transduction, product quality control evaluations will be carried out in aliquots of the transduced population. Investigational product will be infused via intravenous infusion with no upper or lower limit; a dose of ≥5 x 105 CD34+ cells/kg body weight will be considered optimal.
The active agent is a self-inactivating lentiviral vector carrying the therapeutic FANCA gene and the therapeutic product is subject's autologous HSCs that have been transduced with the lentiviral vector. The vector contains the functional FANCA gene.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fanconi Anemia Complementation Group A
Keywords
FANCA, FA-A, Fanconi Anemia Subtype A
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
RP-L102
Arm Type
Experimental
Arm Description
RP-L102 is a self-inactivating lentiviral vector carrying the therapeutic FANCA gene
Intervention Type
Biological
Intervention Name(s)
RP-L102
Intervention Description
CD34+ enriched cells from subjects with Fanconi anemia subtype A transduced ex vivo with lentiviral vector carrying the FANCA gene, PGK-FANCA-WPRE
Primary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v.5.0
Description
Evaluation of safety associated with treatment with RP-L102
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Phenotypic correction of T-lymphocytes in peripheral blood after infusion of RP-L102
Description
Assessment of the percentage of peripheral blood T-cells with DEB-induced chromosomal aberrations that decreases from over or equal to 50% at 0-2 months post-infusion to less than 50% during months 6-36 post-infusion (confirmed in at least 2 determinations conducted in each interval).
Time Frame
3 years
Title
Phenotypic correction of hematopoietic cells in bone marrow after infusion of RP-L102
Description
During months 6-36 post-infusion, the survival of bone marrow colony forming units to 10nM MMC increases to over or equal to 10% than values determined at 0-2 months post-infusion. (1 determination is considered valid).
Time Frame
3 years
Title
Engraftment of gene-corrected hematopoietic cells after infusion of RP-L102
Description
The level of gene marking of the FANCA-LV provirus in total peripheral blood cells is at least 0.1 vector copy number/nucleated cell during months 6-36 post-infusion. (This should be confirmed in at least 2 determinations conducted at different intervals). An increase in the vector copy number/peripheral blood cell is observed from 0-2 months post-infusion to the 3rd year post-infusion. (This should be confirmed in at least 2 determinations conducted in each interval periods).
Time Frame
3 years
Title
Prevention or rescue of bone marrow failure after infusion of RP-L102
Description
Assessment of the need for treatment of bone marrow failure 6-36 months post-infusion. During the 3rd year post-infusion, peripheral blood parameters: hemoglobin levels, neutrophils, and platelets will be assessed and considered stable if they remain at over or equal to 80% of values determined at pre-treatment evaluation visit or immediately prior to mobilization before the administration of granulocyte-colony stimulating factor.
Time Frame
3 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Fanconi anemia, as diagnosed by chromosomal fragility assay of cultured T-lymphocytes in the presence of DEB or a similar DNA-crosslinking agent.
Subjects of Fanconi Anemia complementation group A.
Minimum age: 1 year and a minimum of 8 kg.
Maximum age: 12 years.
At least one of the following hematologic parameters below lower limits of normal:
Hemoglobin
Absolute neutrophils
Platelets
At least 30 CD34+ cells/μL are determined in one BM aspiration within 3 months prior to initiation of CD34+ cell collection.
If the number of C34+ cells/ μL in BM is in the range of 10-29, PB parameters should meet two of the three following criteria:
Hemoglobin: ≥11g/dL
Neutrophils: ≥900 cells/μL
Platelets: ≥60,000 cells/μL
Provide informed consent in accordance with current legislation.
Women of childbearing age must have a negative urine pregnancy test at the baseline visit and accept the use of an effective contraception method during participation in the trial.
Exclusion Criteria:
Subjects with an available and medically eligible human leukocyte antigen (HLA)-identical sibling donor.
Evidence of myelodysplastic syndrome or leukemia, or cytogenetic abnormalities predictive of these conditions in BM aspirate analysis. This assessment should be made by valid studies conducted within the 3 months before the subject commences the stem cell mobilization/collection procedures of the clinical trial.
Subjects with somatic mosaicism associated with stable or improved counts in all PB cell lineages. (If T-lymphocyte chromosomal fragility analysis indicates potential mosaicism, a medically significant decrease in at least one blood lineage over time must be documented to enable eligibility).
Lansky performance status ≤60%.
Any concomitant disease or condition that, in the opinion of the Principal Investigator, renders the subject unfit to participate in the study.
Pre-existing sensory or motor impairment ≥grade 2 according to the NCI CTCAE v5.0 criteria.
Pregnant or breastfeeding women.
Hepatic dysfunction as defined by either:
Bilirubin >3.0 × upper limit of normal (ULN) or
Alanine aminotransferase (ALT) > 5.0 × ULN or
Aspartate aminotransferase (AST) > 5.0 × ULN
Renal dysfunction requiring either hemodialysis or peritoneal dialysis.
Pulmonary dysfunction as defined by either:
Need for supplemental oxygen during the prior 2 weeks in absence of acute infection.
Oxygen saturation by pulse oximetry <90%.
Evidence of active metastatic or locoregionally advanced malignancy for which survival is anticipated to be less than 3 years.
Subject is receiving androgens (i.e. danazol, oxymethalone).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Agnieszka Czechowicz, MD
Organizational Affiliation
Stanford University, Stem Cell Transplantation and Regenerative Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University Institute for Stem Cell Biology and Regenerative Medicine Lucille Packard Children's Hospital, Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94304
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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A Clinical Trial to Evaluate the Safety of RP-L102 in Pediatric Subjects With Fanconi Anemia Subtype A
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