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Dose-escalating Trial With UniCAR02-T Cells and PSMA Target Module (TMpPSMA) in Patients With Progressive Disease After Standard Systemic Therapy in Cancers With Positive PSMA Marker

Primary Purpose

Prostate Cancer

Status
Recruiting
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
Cyclophosphamide (Non-IMP)
Fludarabine (Non-IMP)
UniCAR02-T-pPSMA
UniCAR02-T (IMP)
Sponsored by
AvenCell Europe GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥ 18 years
  2. Patients diagnosed with progressive castration-resistant prostate cancer refractory to standard treatments and with no other available standard or curative treatment
  3. Measurable or non-measurable disease based on immune-related Response Evaluation Criteria in Solid Tumors (irRECIST) and positivity in PSMA Positron Emission Tomography (PET)
  4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1
  5. Life expectancy of at least 3 months
  6. Adequate renal and hepatic laboratory assessments
  7. Adequate cardiac function, i.e. left ventricular ejection fraction (LVEF)
  8. Permanent venous access existing (e.g. port-system) resp. acceptance of implantation of a device
  9. Able to give written informed consent
  10. Weight ≥ 45kg
  11. Using a highly effective method of birth control

Exclusion Criteria:

  1. Central nervous system metastasis or meningeosis carcinomatosa
  2. Cardiac disease: i.e. heart failure (NYHA III or IV); unstable coronary artery disease, myocardial infarction or serious cardiac ventricular arrhythmias requiring anti-arrhythmic therapy within the last 6 months prior to study entry
  3. Patients undergoing renal dialysis
  4. Pulmonary disease with clinical relevant hypoxia (need for oxygen inhalation)
  5. Parkinson, epilepsy and stroke or presence or history of seizures, paresis, aphasia, central nervous system (CNS) or intracranial hemorrhage
  6. History or presence of disseminated intravascular coagulation (DIC) or thromboembolism
  7. Multiple sclerosis
  8. Hemolytic anemia
  9. Eye diseases with neovascularization
  10. Active infectious disease considered by investigator to be incompatible with protocol or being contraindications for lymphodepletion therapy
  11. Presence of urotoxicity from previous chemo- or radiotherapy or urinary outflow obstruction
  12. Vaccination with live viruses less than 2 weeks prior lymphodepletion therapy
  13. Any disease requiring immunosuppressive therapy
  14. Major surgery within 28 days (prior start of TMpPSMA infusion)
  15. Other malignancy requiring active therapy but adjuvant endocrine therapy is allowed
  16. Treatment with any investigational drug substance or experimental therapy within 4 weeks or 5 half-lives of the substance (whatever is shorter) prior to administration of TMpPSMA
  17. Prior treatment with gene therapy products
  18. Use of checkpoint inhibitors within 5 half-lives of the respective substance prior to administration of TMpPSMA
  19. Autoimmune diseases requiring systemic steroids or other systemic immunosuppressants (note that physiologic steroid replacement not exceeding 10 mg prednisolone equivalent per day is allowed)
  20. Psychologic disorders, drug and/or significant active alcohol abuse
  21. Known history of human immunodeficiency virus (HIV) or active/chronic infection with hepatitis C virus (HCV) or hepatitis B virus (HBV)
  22. Presence of autoantibodies against La/SS-B or presence or history of autoimmune diseases (e.g. systemic lupus erythematosus, SS/SLE overlap syndrome, subacute cutaneous lupus erythematosus, neonatal lupus, primary biliary cirrhosis, Sjögren's syndrome)
  23. Known hypersensitivity to cellular component (UniCAR02-T) and/or targeting peptide module (TMpPSMA) excipients and/or contraindication to compounds of the lymphodepletion therapy (cyclophosphamide and fludarabine), and tocilizumab or corticosteroids as specified in the respective IB/SmPC
  24. Evidence suggesting that the patient is not likely to follow the study protocol (e.g. lacking compliance)
  25. Incapability of understanding purpose and possible consequences of the trial
  26. Patients who should not be included according to the opinion of the investigator

Sites / Locations

  • Universitätsklinikum UlmRecruiting
  • Universitätsklinikum WürzburgRecruiting
  • Universitätsklinikum Dresden
  • Universitätsklinikum Hamburg-EppendorfRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

UniCAR02-T-pPSMA

Arm Description

Preconditioning (lymphodepletion) with cyclophosphamide and fludarabine, followed by combination treatment of genetically modified T-cells carrying universal chimeric antigen receptors (UniCAR02-T) with the peptide TMpPSMA.

Outcomes

Primary Outcome Measures

Safety and tolerability
Incidence and intensity of adverse events graded according to CTCAE V5.0 with the exception of CRS and ICANS graded according to Lee et al. 2014 and Lee et al. 2019 respectively
Incidence of dose limiting toxicity (DLT)
DLT is defined as any adverse event at least possible related to TMpPSMA and/or UniCAR02-T
Maximum tolerated dose (MTD)
The dose for which the isotonic estimate of the DLT probability is closest to the target DLT probability of 0.2.

Secondary Outcome Measures

Recommended phase 2 dose (RP2D)
The RP2D will be determined based on MTD, all available efficacy data, and all available safety data, including information derived from additional treatment cycles.
Antitumor activity
Antitumor activity of UniCAR02-T-pPSMA at any time point according to irRECIST (immune-related) Response Evaluation Criteria in Solid Tumors): Complete remission (CR) and partial remission (PR), Objective response rate (ORR), Disease control rate (DCR), Best response rate, Duration of response (DOR),Progression free survival (PFS)
Prostate specific antigen (PSA) response
Overall Survival (OS)
Influence on Circulating tumor cells (CTC)

Full Information

First Posted
November 11, 2020
Last Updated
August 22, 2023
Sponsor
AvenCell Europe GmbH
Collaborators
PHARMALOG Institut für klinische Forschung GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT04633148
Brief Title
Dose-escalating Trial With UniCAR02-T Cells and PSMA Target Module (TMpPSMA) in Patients With Progressive Disease After Standard Systemic Therapy in Cancers With Positive PSMA Marker
Official Title
Multicenter, Open-label, Adaptive Design Phase I Trial With Genetically Modified T-cells Carrying Universal Chimeric Antigen Receptors (UniCAR02-T) in Combination With PSMA Peptide Target Module (TMpPSMA) for the Treatment of Patients With Progressive Disease After Standard Systemic Therapy in Cancers With Positive PSMA Marker
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 23, 2020 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
July 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AvenCell Europe GmbH
Collaborators
PHARMALOG Institut für klinische Forschung GmbH

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 dose-escalating phase I trial assesses for the first time the safety, the side effects and the harmlessness, as well as the therapeutical benefit of the new study drug UniCAR02-T-pPSMA in patients with progressive disease after standard systemic therapy in castration-resistant prostate cancers with positive PSMA marker. The UniCAR02-T-pPSMA drug is a combination of a cellular component (UniCAR02-T) with a recombinant antibody derivative (TMpPSMA) which together forms the active drug.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Initial dose escalation followed an adaptive design. Further dose escalation includes 2 additional TMpPSMA dose levels and follows a 3+3 design.
Masking
None (Open Label)
Allocation
N/A
Enrollment
51 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
UniCAR02-T-pPSMA
Arm Type
Experimental
Arm Description
Preconditioning (lymphodepletion) with cyclophosphamide and fludarabine, followed by combination treatment of genetically modified T-cells carrying universal chimeric antigen receptors (UniCAR02-T) with the peptide TMpPSMA.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide (Non-IMP)
Intervention Description
Intravenous infusion for 3 days
Intervention Type
Drug
Intervention Name(s)
Fludarabine (Non-IMP)
Intervention Description
Intravenous infusion for 3 days
Intervention Type
Drug
Intervention Name(s)
UniCAR02-T-pPSMA
Intervention Description
Intravenous Infusion for 21 days
Intervention Type
Drug
Intervention Name(s)
UniCAR02-T (IMP)
Intervention Description
Intravenous infusion of single dose
Primary Outcome Measure Information:
Title
Safety and tolerability
Description
Incidence and intensity of adverse events graded according to CTCAE V5.0 with the exception of CRS and ICANS graded according to Lee et al. 2014 and Lee et al. 2019 respectively
Time Frame
DLT period (infusion period of TMpPSMA + 7 days or + 14 days in patients with with myelosuppression)
Title
Incidence of dose limiting toxicity (DLT)
Description
DLT is defined as any adverse event at least possible related to TMpPSMA and/or UniCAR02-T
Time Frame
DLT period (infusion period of TMpPSMA + 7 days or + 14 days in patients with with myelosuppression)
Title
Maximum tolerated dose (MTD)
Description
The dose for which the isotonic estimate of the DLT probability is closest to the target DLT probability of 0.2.
Time Frame
DLT period (infusion period of TMpPSMA + 7 days or + 14 days in patients with with myelosuppression)
Secondary Outcome Measure Information:
Title
Recommended phase 2 dose (RP2D)
Description
The RP2D will be determined based on MTD, all available efficacy data, and all available safety data, including information derived from additional treatment cycles.
Time Frame
DLT period (infusion period of TMpPSMA + 7 days or + 14 days in patients with with myelosuppression)
Title
Antitumor activity
Description
Antitumor activity of UniCAR02-T-pPSMA at any time point according to irRECIST (immune-related) Response Evaluation Criteria in Solid Tumors): Complete remission (CR) and partial remission (PR), Objective response rate (ORR), Disease control rate (DCR), Best response rate, Duration of response (DOR),Progression free survival (PFS)
Time Frame
DLT period (infusion period of TMpPSMA + 7 days or + 14 days in patients with with myelosuppression)
Title
Prostate specific antigen (PSA) response
Time Frame
DLT period (infusion period of TMpPSMA + 7 days or + 14 days in patients with with myelosuppression)
Title
Overall Survival (OS)
Time Frame
Until fifteen years after last UniCAR02-T administration
Title
Influence on Circulating tumor cells (CTC)
Time Frame
Before start of lymphodepletion therapy until 6 resp. 12 months after start of last TMpPSMA application

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Patients diagnosed with progressive castration-resistant prostate cancer refractory to standard treatments and with no other available standard or curative treatment Measurable or non-measurable disease based on immune-related Response Evaluation Criteria in Solid Tumors (irRECIST) and positivity in PSMA Positron Emission Tomography (PET) Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 Life expectancy of at least 3 months Adequate renal and hepatic laboratory assessments Adequate cardiac function, i.e. left ventricular ejection fraction (LVEF) Permanent venous access existing (e.g. port-system) resp. acceptance of implantation of a device Able to give written informed consent Weight ≥ 45kg Using a highly effective method of birth control Exclusion Criteria: Central nervous system metastasis or meningeosis carcinomatosa Cardiac disease: i.e. heart failure (NYHA III or IV); unstable coronary artery disease, myocardial infarction or serious cardiac ventricular arrhythmias requiring anti-arrhythmic therapy within the last 6 months prior to study entry Patients undergoing renal dialysis Pulmonary disease with clinical relevant hypoxia (need for oxygen inhalation) Parkinson, epilepsy and stroke or presence or history of seizures, paresis, aphasia, central nervous system (CNS) or intracranial hemorrhage History or presence of disseminated intravascular coagulation (DIC) or thromboembolism within the last three months Multiple sclerosis Hemolytic anemia Eye diseases with neovascularization Active infectious disease considered by investigator to be incompatible with protocol or being contraindications for lymphodepletion therapy Presence of urotoxicity from previous chemo- or radiotherapy or urinary outflow obstruction Vaccination with live viruses less than 2 weeks prior lymphodepletion therapy Any disease requiring immunosuppressive therapy Major surgery within 28 days (prior start of TMpPSMA infusion) Other malignancy requiring active therapy but adjuvant endocrine therapy is allowed Treatment with any investigational drug substance or experimental therapy within 4 weeks or 5 half-lives of the substance (whatever is shorter) prior to administration of TMpPSMA Prior treatment with gene therapy products Use of checkpoint inhibitors within 5 half-lives of the respective substance prior to administration of TMpPSMA Autoimmune diseases requiring systemic steroids or other systemic immunosuppressants (note that physiologic steroid replacement not exceeding 10 mg prednisolone equivalent per day is allowed) Psychologic disorders, drug and/or significant active alcohol abuse Known history of human immunodeficiency virus (HIV) or active/chronic infection with hepatitis C virus (HCV) or hepatitis B virus (HBV) Presence of autoantibodies against La/SS-B or presence or history of autoimmune diseases (e.g. systemic lupus erythematosus, SS/SLE overlap syndrome, subacute cutaneous lupus erythematosus, neonatal lupus, primary biliary cirrhosis, Sjögren's syndrome) Known hypersensitivity to cellular component (UniCAR02-T) and/or targeting peptide module (TMpPSMA) excipients and/or contraindication to compounds of the lymphodepletion therapy (cyclophosphamide and fludarabine), and tocilizumab or corticosteroids as specified in the respective IB/SmPC Evidence suggesting that the patient is not likely to follow the study protocol (e.g. lacking compliance) Incapability of understanding purpose and possible consequences of the trial Patients who should not be included according to the opinion of the investigator
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Antje Warth, Dr.
Phone
+493514466450
Ext
0
Email
UC02-PSMA-01@avencell.com
First Name & Middle Initial & Last Name or Official Title & Degree
Martin Lorkowski, Dr.
Phone
+493514466450
Ext
0
Email
UC02-PSMA-01@avencell.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ralf Bargou, Prof.
Organizational Affiliation
Wuerzburg University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsklinikum Ulm
City
Ulm
State/Province
Baden-Württemberg
ZIP/Postal Code
89081
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Andreas Viardot, Prof.
Email
andreas.viardot@uniklinik-ulm.de
Facility Name
Universitätsklinikum Würzburg
City
Würzburg
State/Province
Bayern
ZIP/Postal Code
97080
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ralf Bargou, Prof.
Email
Bargou_R@ukw.de
Facility Name
Universitätsklinikum Dresden
City
Dresden
State/Province
Sachsen
ZIP/Postal Code
01307
Country
Germany
Individual Site Status
Terminated
Facility Name
Universitätsklinikum Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gunhild von Amsberg, Prof.
Email
g.von-amsberg@uke.de

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Dose-escalating Trial With UniCAR02-T Cells and PSMA Target Module (TMpPSMA) in Patients With Progressive Disease After Standard Systemic Therapy in Cancers With Positive PSMA Marker

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