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Clinical Study of DC-AML Cells in the Treatment of Acute Myeloid Leukemia

Primary Purpose

Acute Myeloid Leukemia

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
DC vaccine
Sponsored by
Affiliated Hospital to Academy of Military Medical Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of acute myeloid leukemia (AML) according to the 2008 criteria of the World Health Organization (WHO).
  • Patients completed induction and consolidation chemotherapy and have achieved complete remission (CR) by bone marrow biopsy criteria but with persistent MRD (defined by upregulated WT1 level and less than 5% of blast cells in bone marrow biopsy) and are not eligible for stem cell transplant
  • Patients have MRD molecular relapse (defined by upregulated WT1 level and less than 5% of blast cells in bone marrow biopsy) after achieved CR following induction and consolidation chemotherapy.
  • Patients with molecular relapse (define by upregulated WT1 level and less than 5% of blast cells in bone marrow biopsy) after allogeneic stem cell transplant
  • Leukemic cells express at least one of the following antigens: WT1, hTERT or survivin detected by qRT-PCR and/or flow cytometry or immunohistochemistry
  • Karnofsky PS ≥60% or ECOG PS≤2.
  • Patients must have organ and marrow function as defined below:

    • leukocytes >=3,000/mcL
    • absolute neutrophil count >=1,500/mcL
    • platelets >=100,000/mcL
    • hemoglobin >=9.0 g/dL
    • total bilirubin within normal institutional limits except in patients with Gilberts Syndrome who must have a total bilirubin < 3.0 mg/dL
    • AST(SGOT)/ALT(SGPT) Serum ALT/AST < 2.5X ULN
    • creatinine clearance Calculated creatinine clearance (CrCl) >=50 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal (by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation)
    • Adequate cardiac function: LVEF ≥50% by MUGA
  • Ability of subject to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • Participation in any other interventional clinical trial during the study period.
  • History or concomitant presence of any other malignancy, except for any other effectively treated malignancy that has been in remission for >5 years or that is highly likely to be cured at the time of enrollment.
  • Patients with a second invasive malignancy requiring treatment within the last 2 years are not eligible.
  • Patients with any form of systemic immunodeficiency, including AIDS or primary immunodeficiency such as Severe Combined Immunodeficiency Disease, are ineligible. The experimental treatment being evaluated in this protocol depends on an intact immune system. Patients who have decreased immune competence may be less responsive to the treatment.
  • Active hepatitis B, C infection
  • Patients on immunosuppressive drugs including corticosteroids.
  • Patients with autoimmune diseases such as Crohn s disease, ulcerative colitis, rheumatoid arthritis, autoimmune hepatitis, autoimmune pancreatitis, or systemic lupus erythematosus.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations at the time of treatment that would limit compliance with study requirements.
  • Allergic to human albumin or IL-2. History of severe allergic reactions attributed to compounds of similar chemical or biologic composition to agents used in study.
  • Pregnant or breast-feeding.

Sites / Locations

  • Department of hematologyRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

DC vaccine

Arm Description

Vaccination with autologous or HLA-matched donors' WT1/TERT/survivin loaded DCs plus follow-up care.

Outcomes

Primary Outcome Measures

the Incidence of Treatment Adverse Events
To determine the safety of autologous/or HLA-matched DCs loaded with WT1/TERT/Survivin. The primary objective of this single-arm phase I clinical study is to determine the safety and feasibility of WT1/TERT/survivin-targeted DC vaccination in adult AML patients with MRD at very high risk of relapse.

Secondary Outcome Measures

OS
Overall survival
Complete MRD response rate
To determine the Complete MRD response rate
Relapse rate
(time frame: at study completion, an average of 5 year)
Relapse-free survival
(time frame: at study completion, an average of 5 year)
Change in WT1 mRNA levels from peripheral blood samples and/or bone marrow biopsy samples.
Efficacy assessment will also be performed on a molecular level. Bone marrow biopsy samples obtained from participants will be examined, and part of samples will be analyzed by qRT-PCR for WT1 expression.

Full Information

First Posted
July 13, 2021
Last Updated
August 16, 2021
Sponsor
Affiliated Hospital to Academy of Military Medical Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT05000801
Brief Title
Clinical Study of DC-AML Cells in the Treatment of Acute Myeloid Leukemia
Official Title
Safety and Feasibility Study of Dendritic Cell (DC) Vaccination Expressing WT1/hTERT/Survivin in AML Patients With Minimal Residual Disease (MRD)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Recruiting
Study Start Date
July 1, 2021 (Actual)
Primary Completion Date
July 1, 2026 (Anticipated)
Study Completion Date
July 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Affiliated Hospital to Academy of Military Medical Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The primary aim of this innovative immunotherapy using WT1/hTERT/Survivin-loaded DCs is to determine whether this novel DC vaccination is safe and can significantly prevent clinical relapse and increase survival of acute myeloid leukemia (AML) patients by eradicating minimal residual disease, while maintaining its safety profile in this phase I trial.
Detailed Description
we will conduct a single-arm phase I clinical study in 20 patients with acute myeloid leukemia (AML) at the stage of minimal residual disease (MRD) following standard chemotherapy, and these patients are not the subjects of stem cell transplantation. Adult patients between18 and 70 years old with AML who have entered morphological remission after induction, consolidation or intensive chemotherapy with molecular signature of increased WT1 molecule levels and pathological characteristics of bone marrow biopsy, together with fulfilling all other eligibility criteria, will be vaccinated with dendritic cells loaded with tri-antigens (WT1/TERT/survivin) in the absence of any additional therapeutic measurements. The primary aim of this innovative immunotherapy study is to determine whether the anti-leukemic effects seen in our preclinical study can be confirmed in patients and whether such DC vaccination can significantly prevent relapse and increase survival of AML patients by eradicating minimal residual disease. Patients will be recruited at 307 Hospital in Beijing. Recruitment will start in the second half of 2021 and will last for two years or until 20 safety and efficacy-evaluable AML patients are included. This is a single-arm trial. The patients who present MRD after complete chemotherapy will receive a conditioning regimen of cyclophosphamide, followed by six infusions of autologous or HLA-matched donor-derived DCs loaded with tri-antigens including WT1/TERT/survivin. The dendritic cell therapy product will be administered in the stem cell transplantation center at 307 Hospital headed by Dr. Liang-Ding Hu. After inclusion of 20 safety/feasibility-evaluable patients, relapse rate, relapse-free survival and overall survival analysis will be performed. Tumor marker levels and immune signature molecules will also be monitored at molecular and immunological levels, and general and disease-specific quality of life will be evaluated using quality of life questionnaires at various time points.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
DC vaccine
Arm Type
Experimental
Arm Description
Vaccination with autologous or HLA-matched donors' WT1/TERT/survivin loaded DCs plus follow-up care.
Intervention Type
Biological
Intervention Name(s)
DC vaccine
Intervention Description
Autologous/or HLA-matched donors' DCs loaded with WT1/TERT/survivin
Primary Outcome Measure Information:
Title
the Incidence of Treatment Adverse Events
Description
To determine the safety of autologous/or HLA-matched DCs loaded with WT1/TERT/Survivin. The primary objective of this single-arm phase I clinical study is to determine the safety and feasibility of WT1/TERT/survivin-targeted DC vaccination in adult AML patients with MRD at very high risk of relapse.
Time Frame
through study completion,an average of 3 years
Secondary Outcome Measure Information:
Title
OS
Description
Overall survival
Time Frame
through study completion,an average of 3 years
Title
Complete MRD response rate
Description
To determine the Complete MRD response rate
Time Frame
through study completion,an average of 3 years
Title
Relapse rate
Description
(time frame: at study completion, an average of 5 year)
Time Frame
through study completion,an average of 3 years
Title
Relapse-free survival
Description
(time frame: at study completion, an average of 5 year)
Time Frame
through study completion,an average of 3 years
Title
Change in WT1 mRNA levels from peripheral blood samples and/or bone marrow biopsy samples.
Description
Efficacy assessment will also be performed on a molecular level. Bone marrow biopsy samples obtained from participants will be examined, and part of samples will be analyzed by qRT-PCR for WT1 expression.
Time Frame
through study completion,an average of 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of acute myeloid leukemia (AML) according to the 2008 criteria of the World Health Organization (WHO). Patients completed induction and consolidation chemotherapy and have achieved complete remission (CR) by bone marrow biopsy criteria but with persistent MRD (defined by upregulated WT1 level and less than 5% of blast cells in bone marrow biopsy) and are not eligible for stem cell transplant Patients have MRD molecular relapse (defined by upregulated WT1 level and less than 5% of blast cells in bone marrow biopsy) after achieved CR following induction and consolidation chemotherapy. Patients with molecular relapse (define by upregulated WT1 level and less than 5% of blast cells in bone marrow biopsy) after allogeneic stem cell transplant Leukemic cells express at least one of the following antigens: WT1, hTERT or survivin detected by qRT-PCR and/or flow cytometry or immunohistochemistry Karnofsky PS ≥60% or ECOG PS≤2. Patients must have organ and marrow function as defined below: leukocytes >=3,000/mcL absolute neutrophil count >=1,500/mcL platelets >=100,000/mcL hemoglobin >=9.0 g/dL total bilirubin within normal institutional limits except in patients with Gilberts Syndrome who must have a total bilirubin < 3.0 mg/dL AST(SGOT)/ALT(SGPT) Serum ALT/AST < 2.5X ULN creatinine clearance Calculated creatinine clearance (CrCl) >=50 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal (by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation) Adequate cardiac function: LVEF ≥50% by MUGA Ability of subject to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Participation in any other interventional clinical trial during the study period. History or concomitant presence of any other malignancy, except for any other effectively treated malignancy that has been in remission for >5 years or that is highly likely to be cured at the time of enrollment. Patients with a second invasive malignancy requiring treatment within the last 2 years are not eligible. Patients with any form of systemic immunodeficiency, including AIDS or primary immunodeficiency such as Severe Combined Immunodeficiency Disease, are ineligible. The experimental treatment being evaluated in this protocol depends on an intact immune system. Patients who have decreased immune competence may be less responsive to the treatment. Active hepatitis B, C infection Patients on immunosuppressive drugs including corticosteroids. Patients with autoimmune diseases such as Crohn s disease, ulcerative colitis, rheumatoid arthritis, autoimmune hepatitis, autoimmune pancreatitis, or systemic lupus erythematosus. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations at the time of treatment that would limit compliance with study requirements. Allergic to human albumin or IL-2. History of severe allergic reactions attributed to compounds of similar chemical or biologic composition to agents used in study. Pregnant or breast-feeding.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sun Yao, M.D.,Ph.D.
Phone
010-66947402
Email
suny320@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Wang Yu xin, M.D.
Phone
010-66947109
Email
wyx15147159987@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Liangding Hu, M.D.
Organizational Affiliation
the Fifth Medical Center the PLA General Hospital
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Liangding Hu, M.D.
Organizational Affiliation
the Fifth Medical Center the PLA General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of hematology
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100071
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sun Yao, M.D.,Ph.D.
Phone
+86-010-6694-7402
Email
suny320@126.com

12. IPD Sharing Statement

Learn more about this trial

Clinical Study of DC-AML Cells in the Treatment of Acute Myeloid Leukemia

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