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Chimeric Antigen Receptor T Cells Targeting Glypican-3

Primary Purpose

Hepatocellular Carcinoma

Status
Completed
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CAR-GPC3 T Cells
Sponsored by
CARsgen Therapeutics Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring Hepatocellular Carcinoma, CAR-T

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Aged 18 to 70 years, male or female;
  2. Patients with advanced hepatocellular carcinoma (HCC) diagnosed by histopathology or cytology who are not suitable for surgery or local treatment (including ablation, intervention, and radiotherapy), have developed progressive disease or intolerability after standard systemic therapies (including but not limited to systemic chemotherapy, molecular targeted therapy) and have no effective treatment at the time of enrollment;
  3. According to RECIST 1.1, patients have at least one evaluable target lesion, defined as: the longest diameter of non-lymph node lesion ≥ 10 mm, or the shortest diameter of lymph node lesion ≥ 15 mm); hepatic lesions require arterial phase contrast enhancement;
  4. In tumor tissue samples GPC3 is detected positive by immunohistochemistry (IHC);
  5. According to Barcelona Clinic Liver Cancer staging(BCLC), the patients are classified into Grade C or Grade B unsuitable for local treatment/progressive disease after local treatment;
  6. Expected survival is > 12 weeks;
  7. Cirrhosis status Child-Pugh score: Grade A;
  8. Eastern Cooperative Oncology Group(ECOG) Performance Status score: 0 to 1 point;
  9. Without active hepatitis B and/or Hepatitis C;
  10. Have venous accesses for pheresis;
  11. Acceptable routine blood test showing no contraindication to the lymphodepletion pretreatment;
  12. Adequate liver, renal, cardiovascular, respiratory function;
  13. Subjects of childbearing age must undergo a serum pregnancy test within 14 days before the initiation of the study and the result must be negative. In addition, they should be willing to use a reliable method of contraception during the trial (within 24 months (M24) after cell infusion); male subjects whose spouses are women of childbearing age should undergo sterilization surgery or agree to use a reliable method of contraception during the trial;
  14. Understand and sign informed consent.

Exclusion Criteria:

  1. Pregnant or breast-feeding women;
  2. HCV-RNA(Hepatitis C Virus RNA ), HIV antibodies or Syphilis Serological tests are positive;
  3. HBV(Hepatitis B) and HCV(Hepatitis C virus ) infection exist simultaneously;
  4. Any uncontrollable active infection
  5. Patients who had received systemic steroids or other immunosuppressive agents
  6. Previous or present hepatic encephalopathy;
  7. Current clinically significant ascites;
  8. ≥50% of the liver is replaced by tumor or portal vein main tumor thrombus, or tumor thrombus invasion of mesenteric vein / inferior vena cava;
  9. Metastases to the central nervous system and clinically significant central nervous system diseases;
  10. Patients with existing heart disease in need of treatment or hypertension that be poorly controlled
  11. Patients with known active autoimmune diseases which require to be treated with immunosuppressive agents including biological agents;
  12. Patients with a history of organ transplantation or waiting for organ transplantation (including liver transplantation);
  13. Patients with local treatments such as surgical treatment, interventional therapy, radiotherapy, ablation or systemic chemotherapy were performed for the studied disease within 2 weeks prior to apheresis;Or received immunotherapy (PD-1/ PD-L1 monoclonal antibody, see Section 15) or any Chinese herbal or proprietary medicine for the control of liver cancer within 1 week prior to apheresis;Or received sorafenib, regofenib, ramvastinib and other tyrosine kinase inhibitor targeted drugs within 1 week prior to apheresis;Targeted therapy with anti-angiogenic monoclonal antibodies such as bevacizumab or its analogue 4 weeks prior to apheresis;
  14. Patiens with previous treatment with targeted GPC3, TCR-T or CAR-T;
  15. Patients who previously received anti-PD-1/ PD-L1 monoclonal antibody therapy within 4 weeks prior to apheresis;
  16. Patients who had uncured malignant tumors in the past 5 years or at the same time, excluding in situ cervical cancer and skin basal cell carcinoma;
  17. Other serious illnesses that may limit subjects to participate in the trial (such as poorly controlled diabetes mellitus, severe cardiac insufficiency , myocardial infarction or unstable arrhythmia or unstable angina pectoris within the last 6 months, lung embolism, chronic obstructive pulmonary diseases, interstitial pulmonary diseases,gastric ulcer, a history of gastrointestinal bleeding or a clear tendency to gastrointestinal bleeding;
  18. According to the investigators' evaluation, patients are unable or unwilling to comply with the requirements of the study protocol.

Sites / Locations

  • Nanfang Hospital of Southern Medical University
  • The First Affiliated Hospital of Zhengzhou University
  • The 81st Hospital of Chinese PLA
  • Renji Hospital Shang Hai Jiaotong Unversity of Medicine
  • Zhongshan Hospital of Fudan University
  • The First Affiliated Hospital Zhejiang University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CAR-GPC3 T Cells

Arm Description

The subjects are enrolled into 2 dose levels cohorts in sequence

Outcomes

Primary Outcome Measures

Dose-limiting toxicity (DLT)
Safety
Maximum tolerated dose (MTD)
tolerability

Secondary Outcome Measures

Pharmacokinetics (the copies of cells in vivo)
Pharmacokinetics is the"Implantation endpoint" which is defined as the number of copies of CAR-GPC3 DNA in peripheral blood at each visit after infusion until any two consecutive test results are negative or below the detection limit. It aims to calculate the Peak Plasma Concentration (Cmax)
Pharmacokinetics ( the duration of survival of cells in vivo)
Duration of CAR-GPC3 T cell persistence is the period from the day of infusion to the first negative test result or result lower than the detection limit.It aims to calculate the area under the plasma concentration versus time curve (AUC)
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Adverse events up to 24 months of follow-up visit judged by the investigator to be associated with CAR-GPC3T cell infusion, such as abnormalities or changes in laboratory examinations, physical examinations, vital signs, etc.
Antitumor efficacy-Progression-free survival (PFS)
The period from the day when the subject receives the infusion of cells to the first recorded tumor progression (whether treated or not) or death of any cause, which occurs first.
Antitumor efficacy-Duration of response (DOR)
The period from the first evaluation of CR or PR to the first evaluation of PD(Progressive Disease) or death of any cause.
Antitumor efficacy-Duration of disease control (DDC)
The period from the first evaluation of CR, PR, or SD to the first evaluation of PD or any cause of death.
Antitumor efficacy-Overall survival (OS)
The period from the first infusion to any cause of death
Antitumor efficacy-Objective response rate (ORR);
The number of cases in which tumor size is reduced to PR or CR / the total number of evaluable cases (%). In the event of PR or CR, the subjects should confirm it no less than 4 weeks after the first evaluation
Antitumor efficacy-Disease control rate (DCR)
The number of cases in which response (PR + CR) and stable disease (SD) are achieved from the start of cell infusion/the total number of evaluable cases (%).

Full Information

First Posted
February 25, 2019
Last Updated
February 8, 2022
Sponsor
CARsgen Therapeutics Co., Ltd.
Collaborators
NanJing PLA 81 Hospital, First Affiliated Hospital of Zhejiang University, RenJi Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03884751
Brief Title
Chimeric Antigen Receptor T Cells Targeting Glypican-3
Official Title
A Phase I Clinical Study of Chimeric Antigen Receptor T Cells Targeting Glypican-3 (CAR-GPC3 T Cells) in Patients With Advanced Hepatocellular Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Completed
Study Start Date
August 15, 2019 (Actual)
Primary Completion Date
May 28, 2021 (Actual)
Study Completion Date
December 3, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CARsgen Therapeutics Co., Ltd.
Collaborators
NanJing PLA 81 Hospital, First Affiliated Hospital of Zhejiang University, RenJi Hospital

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
A Phase I Clinical Study of Chimeric Antigen Receptor T Cells Targeting Glypican-3 (CAR-GPC3 T Cells) in Patients with Advanced Hepatocellular Carcinoma
Detailed Description
This is a phase I open-label, single-arm, multicenter clinical trial designed to observe and evaluate the safety, cell metabolokinetics, and efficacy of CAR-GPC3 T cells infused intravenously at single escalating doses in patients with advanced hepatocellular carcinoma. Primary objectives: - To evaluate the safety and tolerability of CAR-GPC3 T cells infused intravenously at escalating doses in patients with advanced hepatocellular carcinoma. Secondary objectives: To evaluate the metabolic kinetics of single infusion of CAR-GPC3 T cells To evaluate the overall safety and tolerability of infusion of CAR-GPC3 T cells To observe the efficacy of CAR-GPC3 T cells in the treatment of advanced hepatocellular carcinoma

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma
Keywords
Hepatocellular Carcinoma, CAR-T

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CAR-GPC3 T Cells
Arm Type
Experimental
Arm Description
The subjects are enrolled into 2 dose levels cohorts in sequence
Intervention Type
Biological
Intervention Name(s)
CAR-GPC3 T Cells
Other Intervention Name(s)
Chimeric Antigen Receptor T Cells Targeting Glypican-3
Intervention Description
CAR-GPC3 T Cells injection
Primary Outcome Measure Information:
Title
Dose-limiting toxicity (DLT)
Description
Safety
Time Frame
After 28 days of single infusion
Title
Maximum tolerated dose (MTD)
Description
tolerability
Time Frame
After 28 days of single infusion
Secondary Outcome Measure Information:
Title
Pharmacokinetics (the copies of cells in vivo)
Description
Pharmacokinetics is the"Implantation endpoint" which is defined as the number of copies of CAR-GPC3 DNA in peripheral blood at each visit after infusion until any two consecutive test results are negative or below the detection limit. It aims to calculate the Peak Plasma Concentration (Cmax)
Time Frame
Day0~Week 26
Title
Pharmacokinetics ( the duration of survival of cells in vivo)
Description
Duration of CAR-GPC3 T cell persistence is the period from the day of infusion to the first negative test result or result lower than the detection limit.It aims to calculate the area under the plasma concentration versus time curve (AUC)
Time Frame
Day0~Week 26
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Description
Adverse events up to 24 months of follow-up visit judged by the investigator to be associated with CAR-GPC3T cell infusion, such as abnormalities or changes in laboratory examinations, physical examinations, vital signs, etc.
Time Frame
Month 24
Title
Antitumor efficacy-Progression-free survival (PFS)
Description
The period from the day when the subject receives the infusion of cells to the first recorded tumor progression (whether treated or not) or death of any cause, which occurs first.
Time Frame
Month 24
Title
Antitumor efficacy-Duration of response (DOR)
Description
The period from the first evaluation of CR or PR to the first evaluation of PD(Progressive Disease) or death of any cause.
Time Frame
Month 24
Title
Antitumor efficacy-Duration of disease control (DDC)
Description
The period from the first evaluation of CR, PR, or SD to the first evaluation of PD or any cause of death.
Time Frame
Month 24
Title
Antitumor efficacy-Overall survival (OS)
Description
The period from the first infusion to any cause of death
Time Frame
Month 24
Title
Antitumor efficacy-Objective response rate (ORR);
Description
The number of cases in which tumor size is reduced to PR or CR / the total number of evaluable cases (%). In the event of PR or CR, the subjects should confirm it no less than 4 weeks after the first evaluation
Time Frame
Month 24
Title
Antitumor efficacy-Disease control rate (DCR)
Description
The number of cases in which response (PR + CR) and stable disease (SD) are achieved from the start of cell infusion/the total number of evaluable cases (%).
Time Frame
Month 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged 18 to 70 years, male or female; Patients with advanced hepatocellular carcinoma (HCC) diagnosed by histopathology or cytology who are not suitable for surgery or local treatment (including ablation, intervention, and radiotherapy), have developed progressive disease or intolerability after standard systemic therapies (including but not limited to systemic chemotherapy, molecular targeted therapy) and have no effective treatment at the time of enrollment; According to RECIST 1.1, patients have at least one evaluable target lesion, defined as: the longest diameter of non-lymph node lesion ≥ 10 mm, or the shortest diameter of lymph node lesion ≥ 15 mm); hepatic lesions require arterial phase contrast enhancement; In tumor tissue samples GPC3 is detected positive by immunohistochemistry (IHC); According to Barcelona Clinic Liver Cancer staging(BCLC), the patients are classified into Grade C or Grade B unsuitable for local treatment/progressive disease after local treatment; Expected survival is > 12 weeks; Cirrhosis status Child-Pugh score: Grade A; Eastern Cooperative Oncology Group(ECOG) Performance Status score: 0 to 1 point; Without active hepatitis B and/or Hepatitis C; Have venous accesses for pheresis; Acceptable routine blood test showing no contraindication to the lymphodepletion pretreatment; Adequate liver, renal, cardiovascular, respiratory function; Subjects of childbearing age must undergo a serum pregnancy test within 14 days before the initiation of the study and the result must be negative. In addition, they should be willing to use a reliable method of contraception during the trial (within 24 months (M24) after cell infusion); male subjects whose spouses are women of childbearing age should undergo sterilization surgery or agree to use a reliable method of contraception during the trial; Understand and sign informed consent. Exclusion Criteria: Pregnant or breast-feeding women; HCV-RNA(Hepatitis C Virus RNA ), HIV antibodies or Syphilis Serological tests are positive; HBV(Hepatitis B) and HCV(Hepatitis C virus ) infection exist simultaneously; Any uncontrollable active infection Patients who had received systemic steroids or other immunosuppressive agents Previous or present hepatic encephalopathy; Current clinically significant ascites; ≥50% of the liver is replaced by tumor or portal vein main tumor thrombus, or tumor thrombus invasion of mesenteric vein / inferior vena cava; Metastases to the central nervous system and clinically significant central nervous system diseases; Patients with existing heart disease in need of treatment or hypertension that be poorly controlled Patients with known active autoimmune diseases which require to be treated with immunosuppressive agents including biological agents; Patients with a history of organ transplantation or waiting for organ transplantation (including liver transplantation); Patients with local treatments such as surgical treatment, interventional therapy, radiotherapy, ablation or systemic chemotherapy were performed for the studied disease within 2 weeks prior to apheresis;Or received immunotherapy (PD-1/ PD-L1 monoclonal antibody, see Section 15) or any Chinese herbal or proprietary medicine for the control of liver cancer within 1 week prior to apheresis;Or received sorafenib, regofenib, ramvastinib and other tyrosine kinase inhibitor targeted drugs within 1 week prior to apheresis;Targeted therapy with anti-angiogenic monoclonal antibodies such as bevacizumab or its analogue 4 weeks prior to apheresis; Patiens with previous treatment with targeted GPC3, TCR-T or CAR-T; Patients who previously received anti-PD-1/ PD-L1 monoclonal antibody therapy within 4 weeks prior to apheresis; Patients who had uncured malignant tumors in the past 5 years or at the same time, excluding in situ cervical cancer and skin basal cell carcinoma; Other serious illnesses that may limit subjects to participate in the trial (such as poorly controlled diabetes mellitus, severe cardiac insufficiency , myocardial infarction or unstable arrhythmia or unstable angina pectoris within the last 6 months, lung embolism, chronic obstructive pulmonary diseases, interstitial pulmonary diseases,gastric ulcer, a history of gastrointestinal bleeding or a clear tendency to gastrointestinal bleeding; According to the investigators' evaluation, patients are unable or unwilling to comply with the requirements of the study protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Qin shukui, Pro
Organizational Affiliation
The 81st Hospital of PLA
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Zhai bo, Pro
Organizational Affiliation
RenJi Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Nanfang Hospital of Southern Medical University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510000
Country
China
Facility Name
The First Affiliated Hospital of Zhengzhou University
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450000
Country
China
Facility Name
The 81st Hospital of Chinese PLA
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210002
Country
China
Facility Name
Renji Hospital Shang Hai Jiaotong Unversity of Medicine
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200001
Country
China
Facility Name
Zhongshan Hospital of Fudan University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200001
Country
China
Facility Name
The First Affiliated Hospital Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310006
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

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Chimeric Antigen Receptor T Cells Targeting Glypican-3

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