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MB-CART20.1 Melanoma

Primary Purpose

Melanoma (Skin)

Status
Unknown status
Phase
Early Phase 1
Locations
Germany
Study Type
Interventional
Intervention
MB-CART20.1
Sponsored by
Miltenyi Biomedicine GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma (Skin)

Eligibility Criteria

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

Inclusion Criteria:

Male or female patients with

  • Histologically confirmed unresectable stage III or stage IV melanoma
  • Willingness to provide a tumor biopsy between the screening visit and prior to administration of the IMP and eight weeks after treatment
  • Progressive disease despite treatment with indicated standard therapies. Time window for decision about progressive disease is to be made depending on the treatment regimen chosen.
  • Measurable lesions according to RECIST1.1
  • ECOG (Eastern cooperative oncology group) performance status of 0-2
  • Negative serological hepatitis B (HBV) test defined as negative tests for HBsAg and HBcAb, unless serology is positive due to recent IVIG therapy, HBcAb positivity will be allowed if HbsAb is present, negative testing of HCVAb, negative human immunodeficiency virus (HIV) 1/2 test within 6 weeks prior to enrollment.
  • Estimated life expectancy of more than 6 months
  • At least 18 years of age
  • WBC ≥ 2500/µL
  • ANC ≥ 1000/µL
  • Platelets ≥ 75 x 103/µL
  • Hemoglobin ≥ 9 g/dL
  • AST ≤ 3 x upper limit of normal (ULN) for patients without liver metastasis
  • AST < 5 x ULN for patients with liver metastasis
  • Total Bilirubin ≤ 2 x ULN
  • patients with Gilbert's Syndrome increase of indirect bilirubin < 6mg/dL
  • No childbearing potential (i.e. postmenopausal, absence of menstrual bleeding for at least 1 year, hysterectomy, bilateral ovariectomy or tubal section/ligation) or negative pregnancy test at screening and before chemotherapy in women with childbearing potential. Sexually active female patients of childbearing potential should use one of the following highly effective methods of contraception (Pearl index < 1%): hormonal contraceptives (oral, injected, implanted, transdermal), intrauterine devices or systems (e.g. hormonal and non-hormonal IUD), or vasectomized sexual partner for at least 1 month before the trial start, during the course of the trial and in the 6 months following dosing. Sexual abstinence is restricted to true abstinence ( in line with the preferred and usual lifestyle of the subject).
  • male patients, unless surgically sterile, must be using two acceptable methods for contraception (e.g. spermicide and condom) during the trial and refrain from fathering a child throughout the trial and for up to 12 months after dosing.
  • Signed and dated informed consent before conduct of any trial-specific procedure.

Exclusion Criteria:

  • Any evidence of brain metastases
  • CNS (central nervous system) disorders and previous strokes, if clinically relevant
  • Patients with epilepsy
  • Clinically relevant autoimmune disorders or history of clinically relevant autoimmune disorders
  • Patients with T-cell lymphoma
  • Treatment with anti-CD20 antibodies or checkpoint blockade inhibitors within 6 weeks before leukapheresis
  • Chemotherapy within 6 weeks prior to leukapheresis
  • History of primary immunodeficiency
  • Creatinine clearance < 50 ml/min calculated according to the modified formula of Cockcroft and Gault
  • concurrent systemic radiotherapy
  • Use of systemic corticosteroids and immunosuppressive medication except prednisone ≤ 10 mg QD or equivalent
  • Patients with severe cardiac disease (e.g. NYHA Functional Class III or IV, myocardial infarction within 6 months before inclusion, ventricular tachyarrhythmia requiring ongoing treatment, unstable angina pectoris)
  • Other investigational treatment within 4 weeks before MB-CART20.1 infusion
  • Hypersensitivity against any drug or its ingredients/impurities that is scheduled or likely to be given during trial participation, e.g. as part of the mandatory lymphodepletion protocol, pre-medication for infusion, rescue medication/salvage therapies for treatment related toxicities
  • Patients in which such medication (likely to be given during trial participation) is contraindicated for other reasons than hypersensitivity, e.g. live vaccines and fludarabine.
  • Severe pulmonary disease (DLCO and/or FEV1 < 65%, dyspnoea at rest)
  • Active systemic fungal, viral or bacterial infection
  • Pregnant or lactating women
  • Patient's lack of accountability, inability to appreciate the nature, meaning and consequence of the trial and to formulate his/her own wishes correspondingly
  • Patients who have a relationship of dependence or employer employee relationship to the sponsor or the investigator
  • Committal to an institution on judicial or official order

Sites / Locations

  • University Hospital of Cologne - Clinic for Internal Medicine IRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Dose Level 1: 1x10e5 MB-CART20.1 cells

Dose Level 2: 1x10e6 MB-CART20.1 cells

Dose Level 3: 1x10e7 MB-CART20.1 cells

Arm Description

3+3 patients will be treated with 1x10e5 MB-CART20.1 cells per kg body weight administered intravenously

3+3 patients will be treated with 1x10e6 MB-CART20.1 cells per kg body weight administered intravenously

3+3 patients will be treated with 1x10e7 MB-CART20.1 cells per kg body weight administered intravenously

Outcomes

Primary Outcome Measures

Determination of MTD
MTD is defined as the highest dose level at which < 33% of patients experience dose limiting toxicity (DLT)
Safety and Toxicity Assessment per Adverse Event reporting classified according to CTCAE V5.0
per Adverse Event reporting classified according to CTCAE V5.0

Secondary Outcome Measures

Clinical Response
Number of patients with either Complete Response, Partial Response, Stable Disease or Progressive Disease using RECIST 1.1
Frequency of B-cell aplasia
Circulating B cell numbers in the peripheral blood will be assessed by Flow cytometry
Phenotype and Persistence of infused MB-CART20.1
Blood samples for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed.
Presence and phenotype of MB-CART20.1 and B cells in biopsies
Tumor biopsies for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed
Number of CD20+ tumor cells
Tumor biopsies for determination of number of CD20+ tumor cells
Persistence of T-cell expansion for each dose group
Blood samples for determination MB-CART20.1 levels (transgene copies / genomic DNA)

Full Information

First Posted
March 6, 2019
Last Updated
September 20, 2021
Sponsor
Miltenyi Biomedicine GmbH
Collaborators
DLR German Aerospace Center
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1. Study Identification

Unique Protocol Identification Number
NCT03893019
Brief Title
MB-CART20.1 Melanoma
Official Title
Multicenter Phase I Trial of MB-CART20.1 for the Treatment of Patients With Metastatic Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Unknown status
Study Start Date
March 8, 2019 (Actual)
Primary Completion Date
July 2022 (Anticipated)
Study Completion Date
July 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Miltenyi Biomedicine GmbH
Collaborators
DLR German Aerospace Center

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
This is a phase l multi-centric, single arm, prospective, open, dose-escalation study in patients with unresectable stage III oder IV melanoma. The trial will include 15 adult patients. The trial is a classic 3+3 design with 1 Log dose increments and maximum 3 dose levels of the intravenously administered MB-CART20.1.
Detailed Description
This Phase I trial will be the first trial with CD20 CAR transduced T cells in Europe targeting melanoma. The rationale for the trial is based on the finding that melanoma cancer sustaining cells express CD20 and that targeting CD20+ cells in preclinical model has a strong antitumor effect.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma (Skin)

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
15 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dose Level 1: 1x10e5 MB-CART20.1 cells
Arm Type
Experimental
Arm Description
3+3 patients will be treated with 1x10e5 MB-CART20.1 cells per kg body weight administered intravenously
Arm Title
Dose Level 2: 1x10e6 MB-CART20.1 cells
Arm Type
Experimental
Arm Description
3+3 patients will be treated with 1x10e6 MB-CART20.1 cells per kg body weight administered intravenously
Arm Title
Dose Level 3: 1x10e7 MB-CART20.1 cells
Arm Type
Experimental
Arm Description
3+3 patients will be treated with 1x10e7 MB-CART20.1 cells per kg body weight administered intravenously
Intervention Type
Biological
Intervention Name(s)
MB-CART20.1
Other Intervention Name(s)
CD20-targeting CAR T cells, anti-CD20 CAR T cells
Intervention Description
MB-CART20.1 consists of autologous CD20 Chimeric Antigen Receptor (CAR) transduced CD4/CD8 enriched T cells targeting CD20.positive tumor cells
Primary Outcome Measure Information:
Title
Determination of MTD
Description
MTD is defined as the highest dose level at which < 33% of patients experience dose limiting toxicity (DLT)
Time Frame
Week 4 after infusion of MB-CART20.1
Title
Safety and Toxicity Assessment per Adverse Event reporting classified according to CTCAE V5.0
Description
per Adverse Event reporting classified according to CTCAE V5.0
Time Frame
until day 28 after infusion of MB-CART20.1
Secondary Outcome Measure Information:
Title
Clinical Response
Description
Number of patients with either Complete Response, Partial Response, Stable Disease or Progressive Disease using RECIST 1.1
Time Frame
1 year after infusion of MB-CART20.1
Title
Frequency of B-cell aplasia
Description
Circulating B cell numbers in the peripheral blood will be assessed by Flow cytometry
Time Frame
1 year after infusion of MB-CART20.1
Title
Phenotype and Persistence of infused MB-CART20.1
Description
Blood samples for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed.
Time Frame
1 year after infusion of MB-CART20.1
Title
Presence and phenotype of MB-CART20.1 and B cells in biopsies
Description
Tumor biopsies for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed
Time Frame
Screening, 8 weeks after infusion of MB-CART20.1
Title
Number of CD20+ tumor cells
Description
Tumor biopsies for determination of number of CD20+ tumor cells
Time Frame
Screening, 8 weeks after infusion of MB-CART20.1
Title
Persistence of T-cell expansion for each dose group
Description
Blood samples for determination MB-CART20.1 levels (transgene copies / genomic DNA)
Time Frame
Day 0 and week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients with Histologically confirmed unresectable stage III or stage IV melanoma Willingness to provide a tumor biopsy between the screening visit and prior to administration of the IMP and eight weeks after treatment Progressive disease despite treatment with indicated standard therapies. Time window for decision about progressive disease is to be made depending on the treatment regimen chosen. Measurable lesions according to RECIST1.1 ECOG (Eastern cooperative oncology group) performance status of 0-2 Negative serological hepatitis B (HBV) test defined as negative tests for HBsAg and HBcAb, unless serology is positive due to recent IVIG therapy, HBcAb positivity will be allowed if HbsAb is present, negative testing of HCVAb, negative human immunodeficiency virus (HIV) 1/2 test within 6 weeks prior to enrollment. Estimated life expectancy of more than 6 months At least 18 years of age WBC ≥ 2500/µL ANC ≥ 1000/µL Platelets ≥ 75 x 103/µL Hemoglobin ≥ 9 g/dL AST ≤ 3 x upper limit of normal (ULN) for patients without liver metastasis AST < 5 x ULN for patients with liver metastasis Total Bilirubin ≤ 2 x ULN patients with Gilbert's Syndrome increase of indirect bilirubin < 6mg/dL No childbearing potential (i.e. postmenopausal, absence of menstrual bleeding for at least 1 year, hysterectomy, bilateral ovariectomy or tubal section/ligation) or negative pregnancy test at screening and before chemotherapy in women with childbearing potential. Sexually active female patients of childbearing potential should use one of the following highly effective methods of contraception (Pearl index < 1%): hormonal contraceptives (oral, injected, implanted, transdermal), intrauterine devices or systems (e.g. hormonal and non-hormonal IUD), or vasectomized sexual partner for at least 1 month before the trial start, during the course of the trial and in the 6 months following dosing. Sexual abstinence is restricted to true abstinence ( in line with the preferred and usual lifestyle of the subject). male patients, unless surgically sterile, must be using two acceptable methods for contraception (e.g. spermicide and condom) during the trial and refrain from fathering a child throughout the trial and for up to 12 months after dosing. Signed and dated informed consent before conduct of any trial-specific procedure. Exclusion Criteria: Any evidence of brain metastases CNS (central nervous system) disorders and previous strokes, if clinically relevant Patients with epilepsy Clinically relevant autoimmune disorders or history of clinically relevant autoimmune disorders Patients with T-cell lymphoma Treatment with anti-CD20 antibodies or checkpoint blockade inhibitors within 6 weeks before leukapheresis Chemotherapy within 6 weeks prior to leukapheresis History of primary immunodeficiency Creatinine clearance < 50 ml/min calculated according to the modified formula of Cockcroft and Gault concurrent systemic radiotherapy Use of systemic corticosteroids and immunosuppressive medication except prednisone ≤ 10 mg QD or equivalent Patients with severe cardiac disease (e.g. NYHA Functional Class III or IV, myocardial infarction within 6 months before inclusion, ventricular tachyarrhythmia requiring ongoing treatment, unstable angina pectoris) Other investigational treatment within 4 weeks before MB-CART20.1 infusion Hypersensitivity against any drug or its ingredients/impurities that is scheduled or likely to be given during trial participation, e.g. as part of the mandatory lymphodepletion protocol, pre-medication for infusion, rescue medication/salvage therapies for treatment related toxicities Patients in which such medication (likely to be given during trial participation) is contraindicated for other reasons than hypersensitivity, e.g. live vaccines and fludarabine. Severe pulmonary disease (DLCO and/or FEV1 < 65%, dyspnoea at rest) Active systemic fungal, viral or bacterial infection Pregnant or lactating women Patient's lack of accountability, inability to appreciate the nature, meaning and consequence of the trial and to formulate his/her own wishes correspondingly Patients who have a relationship of dependence or employer employee relationship to the sponsor or the investigator Committal to an institution on judicial or official order
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Christine Schubert
Phone
+49 2204 8306 6564
Email
christines@miltenyibiotec.de
First Name & Middle Initial & Last Name or Official Title & Degree
Sandra Karitzky, Dr.
Phone
+49 2204 8306 6560
Email
sandrak@miltenyibiotec.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Borchmann, Prof.
Organizational Affiliation
Universitätsklinikum Köln
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital of Cologne - Clinic for Internal Medicine I
City
Cologne
State/Province
NRW
ZIP/Postal Code
50937
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Peter Borchmann, Prof. Dr.
Phone
+49 221 478
Ext
88159
Email
peter.borchmann@uk-koeln.de
First Name & Middle Initial & Last Name & Degree
Udo Holtick, PD Dr.
Phone
+49 221 478 4407
Email
udo.holtick@uk-koeln.de

12. IPD Sharing Statement

Plan to Share IPD
No

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MB-CART20.1 Melanoma

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