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Combination Immunotherapy Targeting Sarcomas

Primary Purpose

Sarcoma, Osteoid Sarcoma, Ewing Sarcoma

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Multiple sarcoma-specific CAR-T cells and sarcoma vaccines
Sponsored by
Shenzhen Geno-Immune Medical Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sarcoma focused on measuring Sarcoma, Chemotherapy, Doxorubicin, CART, Vaccine

Eligibility Criteria

1 Year - 75 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Stage Ⅲ,Ⅳ sarcoma patients or recurrent sarcoma patients;
  2. Age: ≥ 6 months and ≤80 years of age at the time of enrollment;
  3. At least 2 weeks since the last standard chemotherapy or radiotherapy and immunosuppressive therapy such as steroid hormone before enrollment;
  4. Side effects of chemotherapy have been well managed;
  5. Confirmed malignant cell expression of CART target antigens by IHC or flow
  6. Karnofsky /jansky score of 50% or greater;
  7. Expected survival > 8 weeks;
  8. ANC≥ 1×10^6/L,PLT ≥ 1×10^8/L;
  9. Pulse oximetry of≥90% on room air;
  10. Adequate hepatic function, defined as aspartate aminotransferase(AST)< 5 times upper limit of normal(ULN),serum bilirubin < 3 times ULN;
  11. Adequate renal function, defined as serum creatinine less than 2 times ULN, if serum creatinine more than 1.5 times ULN, creatinine clearance rate test is needed;
  12. Patients must have sufficient autologous CART cells at does greater than 0.5x10^6 cells/kg body weight;
  13. Sign an informed consent and assent.

Exclusion Criteria:

  1. The disease is progressing rapidly;
  2. The patient is receiving therapy of other new drugs and under evaluation;
  3. Evidence of tumor potentially causing airway obstruction;
  4. Epilepsy history or other CNS diseases;
  5. Patients who need immunosuppressive drugs;
  6. History of long QT syndrome or severe heart diseases;
  7. Uncontrolled active infection;
  8. Active hepatitis B virus, hepatitis C virus or HIV infection;
  9. Receiving systemic corticosteroid 2 weeks before enrollment except for inhaled steroids;
  10. Previous treatment with any gene therapy;
  11. Creatinine>2.5mg/dl or ALT/AST>3 times normal or bilirubin>2.0 mg/dl;
  12. Patients who have other uncontrolled diseases such as obstruction of lung function would preclude participation as outlined;
  13. Pregnant or lactating women;
  14. Patients previously experienced toxicity from cyclophosphamide and doxorubicin;
  15. Patients who have CNS sarcoma;
  16. In condition that may bring risks to subjects or interference to clinical trials.

Sites / Locations

  • Shenzhen Children's HospitalRecruiting
  • The Seventh Affilliated Hospital, Sun Yat-Sen UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Multiple sarcoma-specific CAR-T cells

Arm Description

Patients who have confirmed surface antigens including GD2, PSMA, Her2, CD276 or other markers

Outcomes

Primary Outcome Measures

Safety of CART cells infusion
Safety of CART cells in patients using CTCAE version 4.0 standard to evaluate the level of adverse events

Secondary Outcome Measures

Overall survival Rate
Percentage of participants with objective response as determined by the investigator based on Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1)
Treatment response rate of sarcomas
Defined as the proportion of patients who achieved complete remission (CR), partial remission (PR), stable disease (SD), or progressive disease (PD) based on CT imaging analysis.

Full Information

First Posted
June 9, 2020
Last Updated
June 12, 2020
Sponsor
Shenzhen Geno-Immune Medical Institute
Collaborators
The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen Children's Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04433221
Brief Title
Combination Immunotherapy Targeting Sarcomas
Official Title
Safety and Efficacy Evaluation of a Combination Immunotherapy Targeting Sarcomas
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Recruiting
Study Start Date
July 1, 2020 (Anticipated)
Primary Completion Date
May 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shenzhen Geno-Immune Medical Institute
Collaborators
The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen Children's Hospital

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 aim of this clinical trial is to assess the feasibility, safety and efficacy of a combination low dose chemotherapy and immunotherapy in patients who have sarcoma that is relapsed or late staged. Another goal of the study is to assess the safety and efficacy of the therapy that combines multiple CAR T cells followed by sarcoma vaccines.
Detailed Description
Patients with late staged and/or recurrent sarcoma have poor prognosis despite complex multimodal therapy. Therefore, innovative interventions are needed. Sarcoma is known to express increased levels of surface antigens that can be targeted by CAR-T cells. In addition, studies have shown that low dose chemotherapy such as doxorubicin may modulate surface PD-L1 level and enhance immunotherapy effects. This study will combine multiple CAR T cells with low dose chemotherapy to treat sarcoma, and followed by maintenance sarcoma vaccines. The purpose of this clinical trial will assess the feasibility, safety, efficacy and side effects of this combination therapy in patients who have sarcoma that is relapsed or late staged.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sarcoma, Osteoid Sarcoma, Ewing Sarcoma
Keywords
Sarcoma, Chemotherapy, Doxorubicin, CART, Vaccine

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
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Multiple sarcoma-specific CAR-T cells
Arm Type
Experimental
Arm Description
Patients who have confirmed surface antigens including GD2, PSMA, Her2, CD276 or other markers
Intervention Type
Biological
Intervention Name(s)
Multiple sarcoma-specific CAR-T cells and sarcoma vaccines
Intervention Description
1 infusion, CART 1x10^6~1x10^7 cells/kg via IV and vaccines 1-5x10^6 irradiated cells via subcutaneous injection
Primary Outcome Measure Information:
Title
Safety of CART cells infusion
Description
Safety of CART cells in patients using CTCAE version 4.0 standard to evaluate the level of adverse events
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Overall survival Rate
Description
Percentage of participants with objective response as determined by the investigator based on Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1)
Time Frame
1 year
Title
Treatment response rate of sarcomas
Description
Defined as the proportion of patients who achieved complete remission (CR), partial remission (PR), stable disease (SD), or progressive disease (PD) based on CT imaging analysis.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Stage Ⅲ,Ⅳ sarcoma patients or recurrent sarcoma patients; Age: ≥ 6 months and ≤80 years of age at the time of enrollment; At least 2 weeks since the last standard chemotherapy or radiotherapy and immunosuppressive therapy such as steroid hormone before enrollment; Side effects of chemotherapy have been well managed; Confirmed malignant cell expression of CART target antigens by IHC or flow Karnofsky /jansky score of 50% or greater; Expected survival > 8 weeks; ANC≥ 1×10^6/L,PLT ≥ 1×10^8/L; Pulse oximetry of≥90% on room air; Adequate hepatic function, defined as aspartate aminotransferase(AST)< 5 times upper limit of normal(ULN),serum bilirubin < 3 times ULN; Adequate renal function, defined as serum creatinine less than 2 times ULN, if serum creatinine more than 1.5 times ULN, creatinine clearance rate test is needed; Patients must have sufficient autologous CART cells at does greater than 0.5x10^6 cells/kg body weight; Sign an informed consent and assent. Exclusion Criteria: The disease is progressing rapidly; The patient is receiving therapy of other new drugs and under evaluation; Evidence of tumor potentially causing airway obstruction; Epilepsy history or other CNS diseases; Patients who need immunosuppressive drugs; History of long QT syndrome or severe heart diseases; Uncontrolled active infection; Active hepatitis B virus, hepatitis C virus or HIV infection; Receiving systemic corticosteroid 2 weeks before enrollment except for inhaled steroids; Previous treatment with any gene therapy; Creatinine>2.5mg/dl or ALT/AST>3 times normal or bilirubin>2.0 mg/dl; Patients who have other uncontrolled diseases such as obstruction of lung function would preclude participation as outlined; Pregnant or lactating women; Patients previously experienced toxicity from cyclophosphamide and doxorubicin; Patients who have CNS sarcoma; In condition that may bring risks to subjects or interference to clinical trials.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lung-Ji Chang, MD
Phone
86-(0755)86725195
Email
c@szgimi.org
Facility Information:
Facility Name
Shenzhen Children's Hospital
City
Shenzhen
State/Province
Guangdong
ZIP/Postal Code
518000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiuli Yuan, MD
Phone
86-18938690212
Email
18938690212@163.com
Facility Name
The Seventh Affilliated Hospital, Sun Yat-Sen University
City
Shenzhen
State/Province
Guangdong
ZIP/Postal Code
518107
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bo Wang, MD
Phone
86-0755-23242570
Email
wangb68377@sina.com

12. IPD Sharing Statement

Plan to Share IPD
No

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Combination Immunotherapy Targeting Sarcomas

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