Modified Immune Cells (AFM13-NK) and A Monoclonal Antibody (AFM13) in Treating Patients With Recurrent or Refractory CD30 Positive Hodgkin or Non-Hodgkin Lymphomas
Primary Purpose
Recurrent Anaplastic Large Cell Lymphoma, Recurrent B-Cell Non-Hodgkin Lymphoma, Recurrent Classic Hodgkin Lymphoma
Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Anti-CD30/CD16A Monoclonal Antibody AFM13
Cyclophosphamide
Fludarabine
Fludarabine Phosphate
Genetically Engineered Lymphocyte Therapy
Sponsored by
About this trial
This is an interventional treatment trial for Recurrent Anaplastic Large Cell Lymphoma
Eligibility Criteria
Inclusion Criteria:
- Patients with a diagnosis of relapsed or refractory classical Hodgkin lymphoma (HL), anaplastic large cell lymphoma (ALCL), peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), mycosis fungoides (MF), or B-cell non-Hodgkin lymphoma with a pre-enrollment tumor biopsy positive for CD30 by immunohistochemistry at >= 1%. Patients with HL, ALCL and MF must be refractory or intolerant to brentuximab vedotin.
- Karnofsky performance status >= 60%.
- Absolute neutrophil count >= 500/mm^3
- Platelet count >= 50,000/mm^3
- Serum creatinine clearance >= 50 ml/min, estimated using the Cockcroft-Gault equation.
- Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) =< 3 x upper limit of normal (ULN).
- Bilirubin =< 2 x ULN.
- Alkaline phosphatase (ALP) =< 2 x ULN.
- Forced expiratory volume in 1 second (FEV1) >= 50%
- Forced vital capacity (FVC) >= 50%
- Carbon monoxide diffusing capability test (DLCO) (corrected for hemoglobin [Hgb]) >= 50%
- Left ventricular ejection fraction >= 40%.
- No uncontrolled arrhythmias or symptomatic cardiac disease.
If female of child-bearing potential, must not be pregnant or be breastfeeding and required to have a negative urine or serum pregnancy test within 3 days prior to the first dose of study drug.
- Note: Urine pregnancy tests that cannot be confirmed as negative, require a confirmatory negative serum pregnancy test. In addition, females of childbearing potential must agree use of a highly effective method of contraception for the course of the study from 14 days prior to the first dose of study drug until 60 days after the last dose of study drug. Non-childbearing potential is defined as: Postmenopausal: defined as no menses for 12 months without an alternative medical cause. A high follicle-stimulating hormone (FSH) level in the postmenopausal range may be used to confirm post-menopausal state in women not using hormonal contraception or hormonal replacement therapy. In the absence of 12 months of amenorrhea, FSH measurements indicating post-menopausal status must be documented in patient's medical history. Permanently sterile: documented permanent sterilization e.g. hysterectomy, bilateral salpingectomy and bilateral oophorectomy. If male, surgically sterile or agrees to use a highly effective method of contraception, 14 days prior to the first dose of study drug until 60 days after the last dose of study drug.
Exclusion Criteria:
- Major surgery < 4 weeks prior to first dose of study drug.
- Any other severe or uncontrolled disease or condition which might increase the risk associated with study participation.
- Any other malignancy known to be active, with the exception of treated cervical intra-epithelial neoplasia and non-melanoma skin cancer.
- Grade >= 3 non-hematologic toxicity from prior therapy that has not resolved to grade =< 2.
- Active hepatitis B, either active carrier (hepatitis B surface antigen positive [HBsAg +]) or viremic (hepatitis B virus [HBV] deoxyribonucleic acid [DNA] >= 10,000 copies/mL, or >= 2,000 IU/mL), or hepatitis C (detectable viral load by hepatitis C virus [HCV] ribonucleic acid [RNA] polymerase chain reaction [PCR]).
- Active infection requiring parenteral antibiotics.
- Human immunodeficiency virus (HIV) infection.
- Treatment within prior 2 weeks with any anti-cancer agent, investigational or approved.
- Active central nervous system (CNS) involvement (untreated parenchymal brain metastasis or positive cytology of cerebrospinal fluid).
- Life expectancy =< 6 months.
- Previous treatment with AFM13.
Sites / Locations
- M D Anderson Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Treatment (AFM13-NK, AFM13)
Arm Description
Patients receive standard of care fludarabine IV over 1 hour and standard of care cyclophosphamide IV over 30-60 minutes on days -5 to -3, AFM13-NK IV over 4 hours on day 0, and then AFM13 IV over 4 hours on days 7, 14, and 21.
Outcomes
Primary Outcome Measures
Incidence of adverse events
Adverse events will be summarized by dose.
Secondary Outcome Measures
Overall survival
Distribution will be estimated using Kaplan-Meier method.
Event-free survival
Distribution will be estimated using Kaplan-Meier method.
Overall response rate (ORR)
Will be determined by ratio of responses over number of patients with measurable lesions. Logistic regression will be used to assess the association between ORR and disease and demographic covariates of interest.
Complete response (CR) rate
Will be determined by ratio of CRs over number of patients with measurable lesions.
Partial response (PR) rate
Will be determined by ratio of PRs over number of patients with measurable lesions.
Duration of response
Persistence of infused donor AFM13-NK cells
Will be summarized with descriptive statistics.
Immune reconstitution studies
Will be summarized with descriptive statistics.
Full Information
NCT ID
NCT04074746
First Posted
June 17, 2019
Last Updated
October 5, 2023
Sponsor
M.D. Anderson Cancer Center
1. Study Identification
Unique Protocol Identification Number
NCT04074746
Brief Title
Modified Immune Cells (AFM13-NK) and A Monoclonal Antibody (AFM13) in Treating Patients With Recurrent or Refractory CD30 Positive Hodgkin or Non-Hodgkin Lymphomas
Official Title
Bispecific NK Engager AFM13 Combined With NK Cells for Patients With Recurrent of Refractory CD30 Positive Hodgkin or Non-Hodgkin Lymphomas
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 18, 2020 (Actual)
Primary Completion Date
April 15, 2025 (Anticipated)
Study Completion Date
April 15, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
M.D. Anderson Cancer Center
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This phase I/II trial studies the side effects and best dose of modified umbilical cord blood immune cells (natural killer [NK] cells) combined with the antibody AFM13 (AFM13-NK) and AFM13 alone in treating patients with CD30 positive Hodgkin lymphoma or non-Hodgkin lymphoma that has come back (recurrent) or does not respond to treatment (refractory). Immunotherapy with monoclonal antibodies, such as AFM13, may help the body's immune system attack the cancer, and may interfere with the ability of cancer cells to grow and spread. Giving AFM13 loaded with NK cells followed by AFM13 alone may kill more cancer cells and decrease cancer growth in patients with CD30 positive AFM13-NK Hodgkin and Non-Hodgkin lymphomas.
Detailed Description
PRIMARY OBJECTIVE:
I. To establish the safety and recommended phase II dose of umbilical cord blood (CB)-derived natural killer (NK) cells preloaded with the bispecific antibody AFM13 (AFM13-NK), followed by intravenous anti-CD30/CD16A monoclonal antibody AFM13 (AFM13) in patients with refractory/relapsed CD30-positive lymphoid malignancies based on incidence of dose limiting toxicities (DLTs) per dose level. (Phase I) II. To assess the activity of umbilical cord blood (CB)-derived natural killer (NK) cells preloaded with the bispecific antibody AFM13 (AFM13- NK), followed by intravenous AFM13 in patients with refractory/relapsed CD30-positive lymphoid malignancies. based on overall response rate (ORR), complete response (CR) rate and partial response (PR) rate. (Phase II)
SECONDARY OBJECTIVES:
I. To evaluate the duration of response. II. To evaluate the event-free survival (EFS) rate. III. To evaluate the overall survival (OS) time. IV. To quantify the persistence of infused donor CB AFM13-NK cells in the recipient.
V. To conduct comprehensive immune reconstitution studies.
OUTLINE: This is a dose-escalation study of AFM13-NK.
Patients receive standard of care fludarabine intravenously (IV) over 1 hour and standard of care cyclophosphamide IV over 30-60 minutes on days -5 to -3, AFM13-NK IV over 4 hours on day 0, and then AFM13 IV over 4 hours on days 7, 14, and 21.
After completion of study treatment, patients are followed up at 28 days, 8 weeks, 100 and 180 days and then every 3-6 months for 2 years.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Anaplastic Large Cell Lymphoma, Recurrent B-Cell Non-Hodgkin Lymphoma, Recurrent Classic Hodgkin Lymphoma, Recurrent Mycosis Fungoides, Recurrent Peripheral T-Cell Lymphoma, Not Otherwise Specified, Refractory Anaplastic Large Cell Lymphoma, Refractory B-Cell Non-Hodgkin Lymphoma, Refractory Classic Hodgkin Lymphoma, Refractory Mycosis Fungoides, Refractory Peripheral T-Cell Lymphoma, Not Otherwise Specified
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Treatment (AFM13-NK, AFM13)
Arm Type
Experimental
Arm Description
Patients receive standard of care fludarabine IV over 1 hour and standard of care cyclophosphamide IV over 30-60 minutes on days -5 to -3, AFM13-NK IV over 4 hours on day 0, and then AFM13 IV over 4 hours on days 7, 14, and 21.
Intervention Type
Biological
Intervention Name(s)
Anti-CD30/CD16A Monoclonal Antibody AFM13
Other Intervention Name(s)
AFM13
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Other Intervention Name(s)
(-)-Cyclophosphamide, 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate, Carloxan, Ciclofosfamida, Ciclofosfamide, Cicloxal, Clafen, Claphene, CP monohydrate, CTX, CYCLO-cell, Cycloblastin, Cycloblastine, Cyclophospham, Cyclophosphamid monohydrate, Cyclophosphamide Monohydrate, Cyclophosphamidum, Cyclophosphan, Cyclophosphane, Cyclophosphanum, Cyclostin, Cyclostine, Cytophosphan, Cytophosphane, Cytoxan, Fosfaseron, Genoxal, Genuxal, Ledoxina, Mitoxan, Neosar, Revimmune, Syklofosfamid, WR- 138719
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Other Intervention Name(s)
Fluradosa
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Fludarabine Phosphate
Other Intervention Name(s)
2-F-ara-AMP, 9H-Purin-6-amine, 2-fluoro-9-(5-O-phosphono-.beta.-D-arabinofuranosyl)-, Beneflur, Fludara, SH T 586
Intervention Description
Given IV
Intervention Type
Biological
Intervention Name(s)
Genetically Engineered Lymphocyte Therapy
Intervention Description
Given AFM13-NK cells IV
Primary Outcome Measure Information:
Title
Incidence of adverse events
Description
Adverse events will be summarized by dose.
Time Frame
Up to 2 years
Secondary Outcome Measure Information:
Title
Overall survival
Description
Distribution will be estimated using Kaplan-Meier method.
Time Frame
Up to 2 years
Title
Event-free survival
Description
Distribution will be estimated using Kaplan-Meier method.
Time Frame
Up to 2 years
Title
Overall response rate (ORR)
Description
Will be determined by ratio of responses over number of patients with measurable lesions. Logistic regression will be used to assess the association between ORR and disease and demographic covariates of interest.
Time Frame
Up to 2 years
Title
Complete response (CR) rate
Description
Will be determined by ratio of CRs over number of patients with measurable lesions.
Time Frame
Up to 2 years
Title
Partial response (PR) rate
Description
Will be determined by ratio of PRs over number of patients with measurable lesions.
Time Frame
Up to 2 years
Title
Duration of response
Time Frame
Time of initial response to disease relapse/progression, assessed up to 2 years
Title
Persistence of infused donor AFM13-NK cells
Description
Will be summarized with descriptive statistics.
Time Frame
Up to 2 years
Title
Immune reconstitution studies
Description
Will be summarized with descriptive statistics.
Time Frame
Up to 2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
15 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with a diagnosis of relapsed or refractory classical Hodgkin lymphoma (HL), anaplastic large cell lymphoma (ALCL), peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), mycosis fungoides (MF), or B-cell non-Hodgkin lymphoma with a pre-enrollment tumor biopsy positive for CD30 by immunohistochemistry at >= 1%. Patients with HL, ALCL and MF must be refractory or intolerant to brentuximab vedotin.
Karnofsky performance status >= 60%.
Absolute neutrophil count >= 500/mm^3
Platelet count >= 50,000/mm^3
Serum creatinine clearance >= 50 ml/min, estimated using the Cockcroft-Gault equation.
Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) =< 3 x upper limit of normal (ULN).
Bilirubin =< 2 x ULN.
Alkaline phosphatase (ALP) =< 2 x ULN.
Forced expiratory volume in 1 second (FEV1) >= 50%
Forced vital capacity (FVC) >= 50%
Carbon monoxide diffusing capability test (DLCO) (corrected for hemoglobin [Hgb]) >= 50%
Left ventricular ejection fraction >= 40%.
No uncontrolled arrhythmias or symptomatic cardiac disease.
If female of child-bearing potential, must not be pregnant or be breastfeeding and required to have a negative urine or serum pregnancy test within 3 days prior to the first dose of study drug.
Note: Urine pregnancy tests that cannot be confirmed as negative, require a confirmatory negative serum pregnancy test. In addition, females of childbearing potential must agree use of a highly effective method of contraception for the course of the study from 14 days prior to the first dose of study drug until 60 days after the last dose of study drug. Non-childbearing potential is defined as: Postmenopausal: defined as no menses for 12 months without an alternative medical cause. A high follicle-stimulating hormone (FSH) level in the postmenopausal range may be used to confirm post-menopausal state in women not using hormonal contraception or hormonal replacement therapy. In the absence of 12 months of amenorrhea, FSH measurements indicating post-menopausal status must be documented in patient's medical history. Permanently sterile: documented permanent sterilization e.g. hysterectomy, bilateral salpingectomy and bilateral oophorectomy. If male, surgically sterile or agrees to use a highly effective method of contraception, 14 days prior to the first dose of study drug until 60 days after the last dose of study drug.
Exclusion Criteria:
Major surgery < 4 weeks prior to first dose of study drug.
Any other severe or uncontrolled disease or condition which might increase the risk associated with study participation.
Any other malignancy known to be active, with the exception of treated cervical intra-epithelial neoplasia and non-melanoma skin cancer.
Grade >= 3 non-hematologic toxicity from prior therapy that has not resolved to grade =< 2.
Active hepatitis B, either active carrier (hepatitis B surface antigen positive [HBsAg +]) or viremic (hepatitis B virus [HBV] deoxyribonucleic acid [DNA] >= 10,000 copies/mL, or >= 2,000 IU/mL), or hepatitis C (detectable viral load by hepatitis C virus [HCV] ribonucleic acid [RNA] polymerase chain reaction [PCR]).
Active infection requiring parenteral antibiotics.
Human immunodeficiency virus (HIV) infection.
Treatment within prior 2 weeks with any anti-cancer agent, investigational or approved.
Active central nervous system (CNS) involvement (untreated parenchymal brain metastasis or positive cytology of cerebrospinal fluid).
Life expectancy =< 6 months.
Previous treatment with AFM13.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yago L Nieto
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
M D Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
12. IPD Sharing Statement
Links:
URL
http://www.mdanderson.org
Description
University of Texas MD Anderson Cancer Center Website
Learn more about this trial
Modified Immune Cells (AFM13-NK) and A Monoclonal Antibody (AFM13) in Treating Patients With Recurrent or Refractory CD30 Positive Hodgkin or Non-Hodgkin Lymphomas
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