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Safety and Efficacy Study of CI-135 CAR-T Cells in Subjects With Relapsed or Refractory Acute Myeloid Leukemia

Primary Purpose

Acute Myeloid Leukemia

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CI-135 CAR-T cells (0.5 x 10^6 CAR-T+ cells/kg,1.0 x 10^6 CAR-T+ cells/kg)
Sponsored by
Beijing Boren Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring CAR-T, Leukemia, Acute Myeloid Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥5 years old and ≤70 years old, male or female;
  2. Expected survival exceeds 12 weeks;
  3. Diagnosed as primary or secondary AML patients that meet the World Health Organization (WHO) classification, and meet any of the following conditions: a) AML patients who have not reached complete remission after at least 3 cycles of standard induction chemotherapy B) AML patients who have achieved complete remission after induction chemotherapy and relapse within 1 year; c) AML patients who have relapsed after achieving complete remission after induction chemotherapy for more than 1 year and have not remitted after 1 course of induction chemotherapy; d) AML patients who have relapsed after transplantation ; E) AML patients who have experienced 2 or more relapses. For patients who meet one of a), b), and c) and have FLT-3 mutations, in addition to induction therapy, they should also receive at least one TKI treatment and has not achieved complete remission or relapsed after complete remission (except patients who cannot tolerate TKI treatment or have contraindications to TKI treatment).
  4. The FLT-3 mutation is positive by the leukemia cell gene detection, or the FLT-3 expression is ≥35%;
  5. ECOG score 1-2;
  6. Liver, kidney, heart and lung functions meet the following requirements:

    1. Glomerular filtration rate ≥60 ml/min/1.73 m2 or serum creatinine ≤2 times the upper limit of normal;
    2. Serum AST, ALT≤3 times the upper limit of normal, and total bilirubin≤1.5 times the upper limit of normal;
    3. Blood oxygen saturation> 92%;
    4. The ventricular ejection fraction ≥50%, there is no pericardial effusion detected by ultrasound, and no clinically significant ECG changes.
  7. Able to understand this experiment and sign the informed consent form.

Exclusion Criteria:

  1. Diagnosed as acute promyelocytic leukemia (APL M3);
  2. Accompanied with other uncontrolled malignant tumors (except those that would not interfere with the safety or efficacy evaluation of the trial).
  3. Have received CAR-T cell or other genetically modified cell therapy in the past;
  4. Medical history or evidence of significant cardiovascular risk, including any of the following conditions: congestive heart failure, unstable angina, clinically significant arrhythmia (such as ventricular fibrillation, ventricular tachycardia, etc.), performed coronary angioplasty 6 months before infusion, intracardiac defibrillator or any clinically-related complications that may pose a risk to the safety of the subject or interfere with the evaluation, procedures or completion of the research;
  5. Subjects who are positive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and whose peripheral blood HBV DNA titer test is greater than or equal to the lower limit of detection; those who are positive for hepatitis C virus (HCV) antibody and positive for peripheral blood HCV RNA; Human immunodeficiency virus (HIV) antibody positive; syphilis test positive;
  6. Acute or chronic hepatitis C is positive. Exceptions: acute hepatitis C with complete clearance of the virus; chronic hepatitis C, with a sustained virological response 24 weeks after completion of hepatitis C treatment (SVR24) determined an undetectable viral load;
  7. A history of arterial or venous thrombosis within 3 months before enrollment;
  8. Any graft-versus-host disease that requires systemic application of immunomodulators;
  9. A history of central nervous system disease or subjects who need treatment (for example, uncontrolled seizures);
  10. Active infection that cannot be controlled.
  11. Subjects who are known to be allergic to the components of CI-135 CAR-T cells or any components of the lymphodepletion regimen (cyclophosphamide and fludarabine).
  12. Women who are pregnant or breastfeeding, and female patients who plan to become pregnant within 1 year after cell infusion, or male patients whose partners plan to become pregnant within 1 year after their infusion.
  13. Other situations that are considered to be unsuitable to participate in the study by researchers.

Sites / Locations

  • Beijing Gaobo Boren HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CI-135 CAR-T

Arm Description

chimeric antigen receptor T cell treatment

Outcomes

Primary Outcome Measures

Dose-limiting toxicity (DLT)
Dose-limiting toxicity (DLT)

Secondary Outcome Measures

Adverse events
Incidence and severity of adverse events as assessed by NCI-CTCAE 5.0
Concentration of PK CAR positive T cells in peripheral blood
PK CAR positive T cells in peripheral blood, PK CAR transgene levels in peripheral blood
Pharmacodynamic data in peripheral blood
Time profile of CAR positive T cells concentrations in peripheral blood
Objective response rate (ORR)
Objective response rate (ORR)
Duration of remission (DOR) after infusion
refers to the time from the first assessment of CR or PR to the first assessment of disease progression or death from any cause
Progression-free survival (PFS) after infusion
refers to the time from cell infusion to the first assessment of tumor progression or recurrence or death from any cause
Overall survival (OS) after infusion
efers to the time from cell infusion to death due to any cause. For subjects who have dropped out before death, the dates of their last visit would be counted as their time of death; if the subject receives other new treatments, the time of death will be calculated based on the start date of the new treatment; if the study ends, the time of death will be calculated based on the end date
Time of human anti-mouse antibody production persist in human body (Immunogenicity)
Immunogenicity will be analyzed during the study, including the time of human anti-mouse antibody production and how long will it last in the body.

Full Information

First Posted
December 29, 2021
Last Updated
March 23, 2023
Sponsor
Beijing Boren Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05266950
Brief Title
Safety and Efficacy Study of CI-135 CAR-T Cells in Subjects With Relapsed or Refractory Acute Myeloid Leukemia
Official Title
First-in-Human (FIH), Open-Label, Non-Randomized, Single-Arm Phase 1 Study to Evaluate the Safety and Efficacy of CI-135 CAR-T Cells in Subjects With Relapsed or Refractory Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 14, 2021 (Actual)
Primary Completion Date
December 1, 2024 (Anticipated)
Study Completion Date
December 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Beijing Boren Hospital

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
This is a FIH, single center, open label, non-randomized, single-arm, Phase I clinical trial to evaluate the safety and efficacy of CI-135 CAR-T cells in subjects with relapsed or refractory Acute Lymphoblastic Leukemia. This study is a dose-escalation study that includes 2 dose levels, and a total of 4-7 subjects will be enrolled. CI-135 CAR-T cells will be manufactured using PBMC collected from the subjects, and will be infused intravenously into subjects after lymphodepletion.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CI-135 CAR-T
Arm Type
Experimental
Arm Description
chimeric antigen receptor T cell treatment
Intervention Type
Biological
Intervention Name(s)
CI-135 CAR-T cells (0.5 x 10^6 CAR-T+ cells/kg,1.0 x 10^6 CAR-T+ cells/kg)
Intervention Description
Recommended lymphodepletion regimen: cyclophosphamide (250 mg/m2/d, ×3d) and fludarabine (30 mg/m2/d, ×3d). If the patient has a hematological toxicity of grade 3 or higher, the alternative regimen is: cyclophosphamide (125mg/m2/d, ×3d) and fludarabine (15 mg/m2/d, ×3d). During lymphodepletion, physicians can give anti-myeloid drugs such as demethoxydaunorubicin or daunorubicin as appropriate.
Primary Outcome Measure Information:
Title
Dose-limiting toxicity (DLT)
Description
Dose-limiting toxicity (DLT)
Time Frame
28 days post intravenous infusion
Secondary Outcome Measure Information:
Title
Adverse events
Description
Incidence and severity of adverse events as assessed by NCI-CTCAE 5.0
Time Frame
until two years after cell infusion
Title
Concentration of PK CAR positive T cells in peripheral blood
Description
PK CAR positive T cells in peripheral blood, PK CAR transgene levels in peripheral blood
Time Frame
until two years after cell infusion
Title
Pharmacodynamic data in peripheral blood
Description
Time profile of CAR positive T cells concentrations in peripheral blood
Time Frame
until two years after cell infusion
Title
Objective response rate (ORR)
Description
Objective response rate (ORR)
Time Frame
until two years after cell infusion
Title
Duration of remission (DOR) after infusion
Description
refers to the time from the first assessment of CR or PR to the first assessment of disease progression or death from any cause
Time Frame
until two years after cell infusion
Title
Progression-free survival (PFS) after infusion
Description
refers to the time from cell infusion to the first assessment of tumor progression or recurrence or death from any cause
Time Frame
until two years after cell infusion
Title
Overall survival (OS) after infusion
Description
efers to the time from cell infusion to death due to any cause. For subjects who have dropped out before death, the dates of their last visit would be counted as their time of death; if the subject receives other new treatments, the time of death will be calculated based on the start date of the new treatment; if the study ends, the time of death will be calculated based on the end date
Time Frame
until two years after cell infusion
Title
Time of human anti-mouse antibody production persist in human body (Immunogenicity)
Description
Immunogenicity will be analyzed during the study, including the time of human anti-mouse antibody production and how long will it last in the body.
Time Frame
until two years after cell infusion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
5 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥5 years old and ≤70 years old, male or female; Expected survival exceeds 12 weeks; Diagnosed as primary or secondary AML patients that meet the World Health Organization (WHO) classification, and meet any of the following conditions: a) AML patients who have not reached complete remission after at least 3 cycles of standard induction chemotherapy B) AML patients who have achieved complete remission after induction chemotherapy and relapse within 1 year; c) AML patients who have relapsed after achieving complete remission after induction chemotherapy for more than 1 year and have not remitted after 1 course of induction chemotherapy; d) AML patients who have relapsed after transplantation ; E) AML patients who have experienced 2 or more relapses. For patients who meet one of a), b), and c) and have FLT-3 mutations, in addition to induction therapy, they should also receive at least one TKI treatment and has not achieved complete remission or relapsed after complete remission (except patients who cannot tolerate TKI treatment or have contraindications to TKI treatment). The FLT-3 mutation is positive by the leukemia cell gene detection, or the FLT-3 expression is ≥35%; ECOG score 1-2; Liver, kidney, heart and lung functions meet the following requirements: Glomerular filtration rate ≥60 ml/min/1.73 m2 or serum creatinine ≤2 times the upper limit of normal; Serum AST, ALT≤3 times the upper limit of normal, and total bilirubin≤1.5 times the upper limit of normal; Blood oxygen saturation> 92%; The ventricular ejection fraction ≥50%, there is no pericardial effusion detected by ultrasound, and no clinically significant ECG changes. Able to understand this experiment and sign the informed consent form. Exclusion Criteria: Diagnosed as acute promyelocytic leukemia (APL M3); Accompanied with other uncontrolled malignant tumors (except those that would not interfere with the safety or efficacy evaluation of the trial). Have received CAR-T cell or other genetically modified cell therapy in the past; Medical history or evidence of significant cardiovascular risk, including any of the following conditions: congestive heart failure, unstable angina, clinically significant arrhythmia (such as ventricular fibrillation, ventricular tachycardia, etc.), performed coronary angioplasty 6 months before infusion, intracardiac defibrillator or any clinically-related complications that may pose a risk to the safety of the subject or interfere with the evaluation, procedures or completion of the research; Subjects who are positive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and whose peripheral blood HBV DNA titer test is greater than or equal to the lower limit of detection; those who are positive for hepatitis C virus (HCV) antibody and positive for peripheral blood HCV RNA; Human immunodeficiency virus (HIV) antibody positive; syphilis test positive; Acute or chronic hepatitis C is positive. Exceptions: acute hepatitis C with complete clearance of the virus; chronic hepatitis C, with a sustained virological response 24 weeks after completion of hepatitis C treatment (SVR24) determined an undetectable viral load; A history of arterial or venous thrombosis within 3 months before enrollment; Any graft-versus-host disease that requires systemic application of immunomodulators; A history of central nervous system disease or subjects who need treatment (for example, uncontrolled seizures); Active infection that cannot be controlled. Subjects who are known to be allergic to the components of CI-135 CAR-T cells or any components of the lymphodepletion regimen (cyclophosphamide and fludarabine). Women who are pregnant or breastfeeding, and female patients who plan to become pregnant within 1 year after cell infusion, or male patients whose partners plan to become pregnant within 1 year after their infusion. Other situations that are considered to be unsuitable to participate in the study by researchers.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jing Pan, MD/PhD
Phone
+8618911067969
Email
panj@borenhospital.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jing Pan, MD/PhD
Organizational Affiliation
Beijing Gaobo Boren Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Gaobo Boren Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100070
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jing Pan, MD/PhD
Phone
+8618911067969
Email
panj@borenhospital.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Safety and Efficacy Study of CI-135 CAR-T Cells in Subjects With Relapsed or Refractory Acute Myeloid Leukemia

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