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Phase I/II Study of CAR.70- Engineered IL15-transduced Cord Blood-derived NK Cells in Conjunction With Lymphodepleting Chemotherapy for the Management of Relapse/Refractory Hematological Malignances

Primary Purpose

B-Cell Lymphoma, Myelodysplastic Syndromes (MDS), Acute Myeloid Leukemia (AML)

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Cyclophosphamide
CAR.70/IL15-transduced CB-NK cells
Fludarabine phosphate
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-Cell Lymphoma

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  • Patients with hematological malignances with an expression of CD70 in the pre-enrollment tumor sample ≥ 10% measured by immunohistochemistry or flow cytometry.
  • Patients must meet diseases specific eligibility criteria (see below)
  • Patients at least 3 weeks from last cytotoxic chemotherapy at the time of starting lymphodepleting chemotherapy. Patients may continue tyrosine kinase inhibitors or other targeted therapies until at least three days prior to administration of lymphodepleting chemotherapy.
  • Localized radiotherapy to one or more disease sites are allowed prior the infusion provided that there are additional disease sites that are not irradiated
  • Karnofsky Performance Scale > 50%.
  • Adequate organ function:

    1. Renal: Serum creatinine </= 1.5 mg/dL and estimated Glomerular Filtration Rate (eGFR using the CKI-EPI equation) >/= 30 ml/min/1.73 m2.
    2. Hepatic: ALT/AST </= 2.5 x ULN or </= 5 x ULN if documented liver metastases, Total bilirubin </= 1.5 mg/dL, except in subjects with Gilbert's Syndrome in whom total bilirubin must be </= 3.0 mg/dL. No history of liver cirrhosis. No ascites.
    3. Cardiac: Cardiac ejection fraction >/= 50%, no clinically significant pericardial effusion as determined by an ECHO or MUGA, and no uncontrolled arrhythmias or symptomatic cardiac disease.
    4. Pulmonary: No clinically significant, , pleural effusion (per PI discretion), baseline oxygen saturation > 92% on room air and adequate pulmonary function with FEV1, FVC and DLCO (corrected for Hgb) >50%.
  • Able to provide written informed consent.
  • 18-80 years of age.
  • Weight ≥40 kg
  • All participants who are able to have children must practice effective birth control while on study and up to 3 months post completion of study therapy. Acceptable forms of birth control for female patients include: hormonal birth control, intrauterine device, diaphragm with spermicide, condom with spermicide, or abstinence, for the length of the study. If the participant is a female and becomes pregnant or suspects pregnancy, she must immediately notify her doctor. If the participant becomes pregnant during this study, she will be taken off this study. Men who are able to have children must use effective birth control while on the study. If the male participant fathers a child or suspects that he has fathered a child while on the study, he must immediately notify his doctor.
  • Signed consent to long-term follow-up protocol PA17-0483.

Exclusion criteria:

  • Positive beta HCG in female of child-bearing potential defined as not postmenopausal for 24 months or no previous surgical sterilization or lactating females.
  • Presence of clinically significant Grade 3 or greater toxicity from the previous treatment, as determined by PI.
  • Presence of uncontrolled fungal, bacterial, viral, or other infection not responding to appropriate therapy.
  • HIV with detectable viral load
  • Presence of active neurological disorder(s).
  • Active autoimmune disease within 12 months of enrollment
  • Amyloidosis or POEMS syndrome
  • Active cerebral or meningeal involvement by the malignancy
  • Active (defined as requiring therapy) acute or chronic GVHD
  • Any other malignancy known to be active, except for treated cervical intra-epithelial neoplasia and non-melanoma skin cancer.
  • Presence of any other serious medical condition that may endanger the patient at investigator discretion.
  • Major surgery <4 weeks prior to first dose of the preparatory chemotherapy
  • Allogeneic SCT or DLI <12 weeks prior to first dose of preparatory chemotherapy
  • Concomitant use of other investigational agents.
  • Concomitant use of other anti-cancer agents.
  • Patients receiving systemic steroid therapy at time of enrollment (physiological substitutive doses are allowed), or have received antithymocyte globulin or lymphocyte immune globulin within 14 days of enrollment or alemtuzumab within 28 days of enrollment.
  • Patients receiving immunosuppressive therapy

Sites / Locations

  • M D Anderson Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Cyclophosphamide

CAR.70/IL15-transduced CB-NK cells

Fludarabine phosphate

Arm Description

Cyclophosphamide is dosed per adjusted body weight for patients weighing > 20% above their ideal body weight using the calculation.

Patients will receive a single flat dose of CAR-NK.

Fludarabine is dosed using actual body weight.

Outcomes

Primary Outcome Measures

Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE Version 5.0.
CTCAE Version 5.0 - General grading: Grade 1: Mild: discomfort present with no disruption of daily activity, no treatment required beyond prophylaxis. Grade 2: Moderate: discomfort present with some disruption of daily activity, require treatment. Grade 3: Severe: discomfort that interrupts normal daily activity, not responding to first line treatment. Grade 4: Life Threatening: discomfort that represents immediate risk of death
Number of Participants with Complete or Partial Response
Number of Participants who are Alive and in Remission
Number of Participants who are Alive and in Remission after 6 months.

Secondary Outcome Measures

Full Information

First Posted
October 13, 2021
Last Updated
October 18, 2023
Sponsor
M.D. Anderson Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT05092451
Brief Title
Phase I/II Study of CAR.70- Engineered IL15-transduced Cord Blood-derived NK Cells in Conjunction With Lymphodepleting Chemotherapy for the Management of Relapse/Refractory Hematological Malignances
Official Title
Phase I/II Study of CAR.70- Engineered IL15-transduced Cord Blood-derived NK Cells in Conjunction With Lymphodepleting Chemotherapy for the Management of Relapse/Refractory Hematological Malignances
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 1, 2022 (Actual)
Primary Completion Date
August 31, 2026 (Anticipated)
Study Completion Date
August 31, 2026 (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
Yes

5. Study Description

Brief Summary
The goal of this clinical research study is to learn about the safety of giving immune cells called natural killer (NK) cells with chemotherapy to patients with leukemia, lymphoma, or multiple myeloma. Immune system cells (such as NK cells) are made by the body to attack foreign or cancerous cells. Researchers think that NK cells you receive from a donor may react against cancer cells in your body, which may help to control the disease.
Detailed Description
Primary Objective: To determine the safety, efficacy and optimal cell dose of CAR.70/IL15-transduced CB-NK cells in patients with relapsed/refractory hematological malignances. The efficacy and optimal dose will be identified for individual diseases. Secondary Objectives: To quantify persistence of infused allogeneic donor CAR-transduced CB-derived NK cells in the recipient. To conduct comprehensive immune reconstitution studies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
B-Cell Lymphoma, Myelodysplastic Syndromes (MDS), Acute Myeloid Leukemia (AML)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
94 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cyclophosphamide
Arm Type
Experimental
Arm Description
Cyclophosphamide is dosed per adjusted body weight for patients weighing > 20% above their ideal body weight using the calculation.
Arm Title
CAR.70/IL15-transduced CB-NK cells
Arm Type
Experimental
Arm Description
Patients will receive a single flat dose of CAR-NK.
Arm Title
Fludarabine phosphate
Arm Type
Experimental
Arm Description
Fludarabine is dosed using actual body weight.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Other Intervention Name(s)
Cytoxan®, Neosar®
Intervention Description
Given by IV
Intervention Type
Drug
Intervention Name(s)
CAR.70/IL15-transduced CB-NK cells
Intervention Description
Given by IV
Intervention Type
Drug
Intervention Name(s)
Fludarabine phosphate
Other Intervention Name(s)
Fludarabine, Fludara®
Intervention Description
Given by IV
Primary Outcome Measure Information:
Title
Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE Version 5.0.
Description
CTCAE Version 5.0 - General grading: Grade 1: Mild: discomfort present with no disruption of daily activity, no treatment required beyond prophylaxis. Grade 2: Moderate: discomfort present with some disruption of daily activity, require treatment. Grade 3: Severe: discomfort that interrupts normal daily activity, not responding to first line treatment. Grade 4: Life Threatening: discomfort that represents immediate risk of death
Time Frame
through study completion, an average of 1 year
Title
Number of Participants with Complete or Partial Response
Time Frame
Up to 30 days after the last treatment
Title
Number of Participants who are Alive and in Remission
Description
Number of Participants who are Alive and in Remission after 6 months.
Time Frame
Up to 180 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Patients with hematological malignances with an expression of CD70 in the pre-enrollment tumor sample ≥ 10% measured by immunohistochemistry or flow cytometry. Patients must meet diseases specific eligibility criteria (see below) Patients at least 3 weeks from last cytotoxic chemotherapy at the time of starting lymphodepleting chemotherapy. Patients may continue tyrosine kinase inhibitors or other targeted therapies until at least three days prior to administration of lymphodepleting chemotherapy. Localized radiotherapy to one or more disease sites are allowed prior the infusion provided that there are additional disease sites that are not irradiated Karnofsky Performance Scale > 50%. Adequate organ function: Renal: Serum creatinine </= 1.5 mg/dL and estimated Glomerular Filtration Rate (eGFR using the CKI-EPI equation) >/= 30 ml/min/1.73 m2. Hepatic: ALT/AST </= 2.5 x ULN or </= 5 x ULN if documented liver metastases, Total bilirubin </= 1.5 mg/dL, except in subjects with Gilbert's Syndrome in whom total bilirubin must be </= 3.0 mg/dL. No history of liver cirrhosis. No ascites. Cardiac: Cardiac ejection fraction >/= 50%, no clinically significant pericardial effusion as determined by an ECHO or MUGA, and no uncontrolled arrhythmias or symptomatic cardiac disease. Pulmonary: No clinically significant, , pleural effusion (per PI discretion), baseline oxygen saturation > 92% on room air and adequate pulmonary function with FEV1, FVC and DLCO (corrected for Hgb) >50%. Able to provide written informed consent. 18-75 years of age. Weight ≥40 kg All participants who are able to have children must practice effective birth control while on study and up to 3 months post completion of study therapy. Acceptable forms of birth control for female patients include: hormonal birth control, intrauterine device, diaphragm with spermicide, condom with spermicide, or abstinence, for the length of the study. If the participant is a female and becomes pregnant or suspects pregnancy, she must immediately notify her doctor. If the participant becomes pregnant during this study, she will be taken off this study. Men who are able to have children must use effective birth control while on the study. If the male participant fathers a child or suspects that he has fathered a child while on the study, he must immediately notify his doctor. Signed consent to long-term follow-up protocol PA17-0483. Exclusion criteria: Positive beta HCG in female of child-bearing potential defined as not postmenopausal for 24 months or no previous surgical sterilization or lactating females. Presence of clinically significant Grade 3 or greater toxicity from the previous treatment, as determined by PI. Presence of uncontrolled fungal, bacterial, viral, or other infection not responding to appropriate therapy. HIV with detectable viral load Presence of active neurological disorder(s). Active autoimmune disease within 12 months of enrollment Amyloidosis or POEMS syndrome Active cerebral or meningeal involvement by the malignancy Active (defined as requiring therapy) acute or chronic GVHD Any other malignancy known to be active, except for treated cervical intra-epithelial neoplasia and non-melanoma skin cancer. Presence of any other serious medical condition that may endanger the patient at investigator discretion. Major surgery <4 weeks prior to first dose of the preparatory chemotherapy Allogeneic SCT or DLI <12 weeks prior to first dose of preparatory chemotherapy Concomitant use of other investigational agents. Concomitant use of other anti-cancer agents. Patients receiving systemic steroid therapy at time of enrollment (physiological substitutive doses are allowed), or have received antithymocyte globulin or lymphocyte immune globulin within 14 days of enrollment or alemtuzumab within 28 days of enrollment. Patients receiving immunosuppressive therapy
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
David Marin
Phone
(713) 792-4179
Email
dmarin@mdanderson.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Marin, MD
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
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
David Marin, MD
Phone
713-792-4179
Email
dmarin@mdanderson.org
First Name & Middle Initial & Last Name & Degree
David Marin, MD

12. IPD Sharing Statement

Links:
URL
http://www.mdanderson.org
Description
M D Anderson Cancer Center

Learn more about this trial

Phase I/II Study of CAR.70- Engineered IL15-transduced Cord Blood-derived NK Cells in Conjunction With Lymphodepleting Chemotherapy for the Management of Relapse/Refractory Hematological Malignances

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