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Bispecific T Cell Engager BRiTE for Patients With Grade IV Malignant Glioma (BRiTE)

Primary Purpose

Malignant Glioma, Glioblastoma

Status
Not yet recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
hEGFRvIII-CD3 (BRiTE)
Sponsored by
Duke University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant Glioma focused on measuring EGFRvIII, Khasraw, BRiTE, Pro00108079

Eligibility Criteria

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

Inclusion Criteria:

  • Age ≥ 18 years old
  • Pathologically documented supratentorial WHO grade IV malignant glioma with an EGFRvIII mutation confirmed by Caris (at most recent diagnosis)

    1. If patient is newly diagnosed, the patient must have completed standard of care radiation therapy (3 or 6 week courses are accepted) with or without temozolomide. i. Patients with methylated MGMT promoter status need to initiate or complete 6 cycles of adjuvant temozolomide to be eligible. ii. Patients with an unmethylated MGMT promoter status do not need to initiate or complete adjuvant temozolomide to be eligible
    2. If patient is at first progression, the patient must have radiographic evidence of progression and completed a standard of care regimen of radiation therapy with or without chemotherapy and initiated adjuvant chemotherapy. Note: Imaging must be completed within 14 days of enrollment.
    3. Patients who progress during XRT or within 4 weeks after completion of XRT are not eligible.
  • Karnofsky Performance Score (KPS) ≥ 70%
  • Absolute neutrophil count (ANC) ≥ 1000/mm3
  • Platelet count ≥ 100,000
  • Hemoglobin ≥ 9.0 g/dL
  • Creatinine ≤ 1.2 x normal range
  • Aspartate aminotransferase (AST) ≤ 2.5 x upper limit of normal (ULN)
  • Alanine aminotransferase (ALT) ≤ 2.5 x ULN
  • Total bilirubin ≤ 2 x ULN (Exception: Patient has known Gilbert's Syndrome or patient has suspected Gilbert's Syndrome, for which additional lab testing of direct and/or indirect bilirubin supports this diagnosis. In these instances, a total bilirubin of ≤ 3.0 x ULN is acceptable.))
  • For women of childbearing potential: negative serum pregnancy test within 1 week of 1st BRiTE injection.

Exclusion Criteria:

  • Women who are pregnant of breastfeeding
  • History or evidence of central nervous system bleeding as defined by stroke or intraocular bleed (including embolic stroke) not associated with any antitumor surgery within 6 months before enrollment
  • Known hypersensitivity to immunoglobulins or to any other component of the BRiTE
  • Prior malignancy (other than in situ cancer) unless treated with curative intent and without evidence of disease for > 2 years before screening
  • Infection requiring intravenous antibiotics that was completed < 1 week of study enrollment (day 1) with the exemption of prophylactic antibiotics for long line insertion or biopsy
  • Known positive test for human immunodeficiency virus (HIV)
  • Known active hepatitis B or C infection
  • Toxicities from prior antitumor therapy have not resolved to CTCAE version 5 grade 1 (with the exception of adverse events reflecting myelosuppression such as neutropenia, anemia, or thrombocytopenia), or to levels dictated in the eligibility criteria. Exceptions include: alopecia or toxicities from prior antitumor therapy that are considered irreversible (defined as having been present and stable for > 2 months) are allowed if they are not otherwise described in the exclusion criteria
  • Patients on corticosteroids ≥ 2 mg dexamethasone daily or equivalent within 14 days of 1st BRiTE injection
  • Females of reproductive potential and males who are unwilling to practice an acceptable method(s) of effective birth control while on study through 1 week (5 half-lives) after receiving the last dose of study drug

Sites / Locations

  • Duke University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

hEGFRvIII-CD3 (BRiTE) infusion

Arm Description

Four escalating doses of BRiTE are planned: #1: 57.0 ng/kg, #2: 570.0 ng/kg, #3: 5700.0 ng/kg, and #4: 57000.0 ng/kg.

Outcomes

Primary Outcome Measures

Dose-limiting toxicity (DLT)
Proportion of patients with DLT within each dose level

Secondary Outcome Measures

Objective response rate (ORR)
ORR per modified Response Assessment in Neuro-Oncology Criteria (RANO)
Pharmacokinetic (PK) of BRiTe observed during the injection of BRiTE
Time for the concentration of BRITE to reach half of the level administered (in minutes)

Full Information

First Posted
May 19, 2021
Last Updated
September 21, 2023
Sponsor
Duke University
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1. Study Identification

Unique Protocol Identification Number
NCT04903795
Brief Title
Bispecific T Cell Engager BRiTE for Patients With Grade IV Malignant Glioma
Acronym
BRiTE
Official Title
A Phase I Study of hEGFRvIII-CD3 Bi-scFv (BRiTE) in Patients With WHO Grade IV Malignant Glioma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
December 2023 (Anticipated)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Duke University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase 1 study will evaluate a novel hEGFRvIII-CD3-biscFv Bispecific T cell engager (BRiTE) in patients diagnosed with pathologically documented World Health Organization (WHO) grade 4 malignant glioma (MG) with an EGFRvIII (epidermal growth factor receptor variant III) mutation (either newly diagnosed or at first progression/recurrence). The primary objective is to evaluate the safety of BRiTE in such patients.
Detailed Description
A maximum of 18 patients with pathologically documented supratentorial WHO grade 4 malignant glioma with an EGFRvIII mutation (either newly diagnosed or at first progression/recurrence) will be treated in this study after undergoing standard of care radiation therapy (XRT) and providing informed consent. After completion of a minimum of 6 cycles of adjuvant temozolomide (TMZ), or at first progression, eligible patients will receive a bolus BRiTE injection followed by a 28-day safety monitoring period. Blood will be drawn to assess the pharmacokinetics (PKs) of BRiTE injection, as well as to investigate the immune system response to BRiTE injection and evaluate for cytokine release syndrome (CRS). Following the 28-day monitoring period, patients will be passively followed as part of their standard of care follow-up.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Glioma, Glioblastoma
Keywords
EGFRvIII, Khasraw, BRiTE, Pro00108079

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
hEGFRvIII-CD3 (BRiTE) infusion
Arm Type
Experimental
Arm Description
Four escalating doses of BRiTE are planned: #1: 57.0 ng/kg, #2: 570.0 ng/kg, #3: 5700.0 ng/kg, and #4: 57000.0 ng/kg.
Intervention Type
Drug
Intervention Name(s)
hEGFRvIII-CD3 (BRiTE)
Other Intervention Name(s)
BRiTE
Intervention Description
Bispecific T cell engager possessing one effector binding arm specific for the epsilon subunit of CD3 (a signaling molecule complex associated with the T cell receptor on T cells) while the opposing target-binding arm is directed against the hEGFRvIII epitope that is differentially expressed on the surface of tumor cells
Primary Outcome Measure Information:
Title
Dose-limiting toxicity (DLT)
Description
Proportion of patients with DLT within each dose level
Time Frame
Begins with the injection of BRiTE and goes through 28 days after the injection
Secondary Outcome Measure Information:
Title
Objective response rate (ORR)
Description
ORR per modified Response Assessment in Neuro-Oncology Criteria (RANO)
Time Frame
7 weeks
Title
Pharmacokinetic (PK) of BRiTe observed during the injection of BRiTE
Description
Time for the concentration of BRITE to reach half of the level administered (in minutes)
Time Frame
96 hours post BRiTE injection

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years old Pathologically documented supratentorial WHO grade IV malignant glioma with an EGFRvIII mutation confirmed by Caris (at most recent diagnosis) If patient is newly diagnosed, the patient must have completed standard of care radiation therapy (3 or 6 week courses are accepted) with or without temozolomide: Patients with methylated MGMT promoter status need to initiate or complete 6 cycles of adjuvant temozolomide to be eligible. Patients with an unmethylated MGMT promoter status do not need to initiate or complete adjuvant temozolomide to be eligible If patient is at first progression, the patient must have radiographic evidence of progression and completed a standard of care regimen of radiation therapy with or without chemotherapy and initiated adjuvant chemotherapy. Note: Imaging must be completed within 14 days of enrollment. Patients who progress during XRT or within 4 weeks after completion of XRT are not eligible. Karnofsky Performance Score (KPS) ≥ 70% Absolute neutrophil count (ANC) ≥ 1000/mm3 Platelet count ≥ 100,000 Hemoglobin ≥ 9.0 g/dL Creatinine ≤ 1.2 x normal range Aspartate aminotransferase (AST) ≤ 2.5 x upper limit of normal (ULN) Alanine aminotransferase (ALT) ≤ 2.5 x ULN Total bilirubin ≤ 2 x ULN (Exception: Patient has known Gilbert's Syndrome or patient has suspected Gilbert's Syndrome, for which additional lab testing of direct and/or indirect bilirubin supports this diagnosis. In these instances, a total bilirubin of ≤ 3.0 x ULN is acceptable.)) For women of childbearing potential: negative serum pregnancy test within 1 week of 1st BRiTE injection. Exclusion Criteria: Women who are pregnant of breastfeeding History or evidence of central nervous system bleeding as defined by stroke or intraocular bleed (including embolic stroke) not associated with any antitumor surgery within 6 months before enrollment Known hypersensitivity to immunoglobulins or to any other component of the BRiTE Prior malignancy (other than in situ cancer) unless treated with curative intent and without evidence of disease for > 2 years before screening Infection requiring intravenous antibiotics that was completed < 1 week of study enrollment (day 1) with the exemption of prophylactic antibiotics for long line insertion or biopsy Known positive test for human immunodeficiency virus (HIV) Known active hepatitis B or C infection Toxicities from prior antitumor therapy have not resolved to CTCAE version 5 grade 1 (with the exception of adverse events reflecting myelosuppression such as neutropenia, anemia, or thrombocytopenia), or to levels dictated in the eligibility criteria. Exceptions include: alopecia or toxicities from prior antitumor therapy that are considered irreversible (defined as having been present and stable for > 2 months) are allowed if they are not otherwise described in the exclusion criteria Patients on corticosteroids ≥ 2 mg dexamethasone daily or equivalent within 14 days of 1st BRiTE injection Females of reproductive potential and males who are unwilling to practice an acceptable method(s) of effective birth control while on study through 1 week (5 half-lives) after receiving the last dose of study drug
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mustafa Khasraw, MBChB, MD, FRCP, FRACP
Phone
9196845301
Email
dukebrain1@dm.duke.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Stevie Threatt, BA
Phone
9196845301
Email
dukebrain1@dm.duke.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mustafa Khasraw, MBChB, MD, FRCP, FRACP
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mustafa Khasraw, MBChB, MD, FRCP, FRACP
Phone
9196845301
Email
dukebrain1@dm.duke.edu
First Name & Middle Initial & Last Name & Degree
Stevie Threatt, BA
Phone
9196845301
Email
dukebrain1@dm.duke.edu
First Name & Middle Initial & Last Name & Degree
Mustafa Khasraw, MBChB, MD, FRCP, FRACP

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://tischbraintumorcenter.duke.edu/
Description
The Preston Robert Tisch Brain Tumor Center at Duke
URL
https://www.dukehealth.org/clinical-trials
Description
Duke Health

Learn more about this trial

Bispecific T Cell Engager BRiTE for Patients With Grade IV Malignant Glioma

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