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Anti-FLT3 CAR-T Cell (TAA05 Cell Injection) in the Treatment of Relapsed / Refractory Acute Myeloid Leukemia

Primary Purpose

Acute Myeloid Leukemia

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Fludarabine + Cyclophosphamide + TAA05 Cell Injection
Sponsored by
Wuhan Union Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring FLT3 positive Acute Myeloid Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  1. Aged 18 ~ 70 years old (including boundary value), regardless of gender;
  2. FLT-3 positive acute myeloid leukemia;
  3. The expected survival time was more than 3 months;
  4. ECOG score 0-2;
  5. Refractory or relapsed AML patients after standardized treatment who meet any of the following criteria:

    1. After complete remission (CR), there were ≥5% leukemia cells or blast cells in the bone marrow(except for other reasons such as bone marrow regeneration after consolidation chemotherapy)in the peripheral blood and extramedullary lesions;
    2. Naive patients who are treated with 2 courses of treatment and are ineffective;
    3. Those who have relapsed within 12 months after CR after consolidation and intensive treatment;
    4. Those who relapse after 12 months but are ineffective after conventional chemotherapy;
    5. Subjects who experienced relapses twice or multiple times; with persistent extramedullary leukemia.
  6. Kidney function, cardiopulmonary function, liver function, and coagulation function meet the following requirements:

    1. Creatinine ≤ 1.5 ULN;
    2. Left ventricular ejection fraction ≥ 50% and echocardiography does not reveal pericardial effusions and ECG does not reveal clinically significant abnormal bands;
    3. Blood oxygen saturation > 92%;
    4. Total bilirubin ≤ 2 × ULN; ALT and AST ≤ 2.5 × ULN; for the patients with ALT and AST abnormalities caused by disease which researchers judge (e.g. liver infiltrates or bile duct obstruction), the indicators of which can be relaxed to ≤5× ULN;
    5. PT/INR and PTT ≤ 1.5 ULN;
  7. Patients understand the trial and have signed the informed consent form.

Exclusion Criteria:

  1. Patients with malignant tumors other than acute myeloid leukemia within 5 years before the screening, except fully treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after the radical operation, and breast ductal carcinoma in situ after radical operation;
  2. Patients with hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood hepatitis B virus (HBV) DNA titer detection is not within the normal reference range; Hepatitis C virus (HCV) antibody positive and hepatitis C virus (HCV) RNA positive in peripheral blood; Human immunodeficiency virus (HIV) antibody-positive; Cytomegalovirus (CMV) DNA positive; Syphilis test positive;
  3. Patients with severe heart disease: including but not limited to unstable angina pectoris, myocardial infarction (within 6 months before screening), congestive heart failure (New York Heart Association [NYHA] classification ≥ grade III), severe arrhythmia;
  4. Patients with unstable systemic diseases judged by the researcher: including but not limited to severe liver, kidney, or metabolic diseases requiring drug treatment;
  5. Within 7 days before screening, there were active or uncontrollable infections requiring systemic treatment (except mild urogenital infection and upper respiratory tract infection);
  6. Pregnant or lactating women, female subjects who planned pregnancy within 2 years after cell reinfusion, or male subjects whose partners planned pregnancy within 2 years after cell reinfusion;
  7. Subjects who were receiving systemic steroid treatment within 7 days before screening or who were determined by the investigator to need long-term systemic steroid treatment during treatment (except inhalation or local use);
  8. Participated in other clinical studies within 1 month before screening;
  9. There was evidence of central nervous system invasion during subject screening(e.g. detection of tumor cells in cerebrospinal fluid or imaging suggests central infiltrates;);
  10. Patients with graft-versus-host disease (GVHD) or requiring immunosuppressive agents;
  11. Patients with a history of epilepsy or other central nervous system disorders;
  12. Patients with primary immunodeficiency diseases;
  13. Patients who are not suitable for cell construction judged by researchers;
  14. Other situation researchers believe that it is not suitable for inclusion.

Sites / Locations

  • Wuhan Union HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TAA05 Cell Injection

Arm Description

Fludarabine + Cyclophosphamide + TAA05 Cell Injection Patients will receive lymphodepletion with fludarabine (25 mg/kg) and cyclophosphamide (250 mg/kg) for 3 days on day -7~-2, followed by the infusion of TAA05 Cell with the dose of 1×10^8, 2×10^8 or 4×10^8 cells on day 0. If no dose-limited toxicity(DLT) emerges in the group, then the subsequent higher dose will be used in the next group. If DLT emerges in a single subject in any dose level, 3 more subjects will be enrolled to the same dose level. After the end of dose climbing, if the maximum dose group(MTD) is still not observed, the highest dose group is defined as MTD.

Outcomes

Primary Outcome Measures

Maximal tolerable dose (MTD)
Fludarabine + Cyclophosphamide + TAA05 Cell Injection Patients will receive lymphodepletion with fludarabine (25 mg/kg) and cyclophosphamide (250 mg/kg) for 3 days on day -7~-2, followed by the infusion of TAA05 Cell with the dose of 1×10^8, 2×10^8 or 4×10^8 cells on day 0. If no dose-limited toxicity(DLT) emerges in the group, then the subsequent higher dose will be used in the next group. If DLT emerges in a single subject in any dose level, 3 more subjects will be enrolled to the same dose level. MTD is defined as the highest dose at which DLT occurs in no more than 2 of the 6 patients. After the end of dose climbing, if the maximum dose group(MTD) is still not observed, the highest dose group is defined as MTD.

Secondary Outcome Measures

Incidence of Treatment-related Adverse Events
Adverse events will be assessed according to NCI-CTCAE v5.0, cytokine release syndrome and CAR-T cell-related encephalopathy syndrome will be assessed according to ASTCT criteria.
Overall response rate(ORR) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
OR will be assessed from CAR T cell infusion to death or last follow-up (censored).
Complete response rate(CRR) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
CRR will be assessed from CAR T cell infusion to death or last follow-up (censored).
Overall survival(OS) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
OS will be assessed from CAR T cell infusion to death or last follow-up (censored).
Progress-free survival(PFS) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
PFS will be assessed from CAR T cell infusion to death or last follow-up (censored).
Duration of Response(DOR) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
DOR will be assessed from CAR T cell infusion to death or last follow-up (censored).
In vivo expansion and survival of Anti-FLT3 CAR-T Cell
Quantity of CAR copies in bone marrow and peripheral blood will be determined by using qPCR.

Full Information

First Posted
June 23, 2022
Last Updated
June 29, 2022
Sponsor
Wuhan Union Hospital, China
Collaborators
PersonGen BioTherapeutics (Suzhou) Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05445011
Brief Title
Anti-FLT3 CAR-T Cell (TAA05 Cell Injection) in the Treatment of Relapsed / Refractory Acute Myeloid Leukemia
Official Title
Safety and Efficacy of Anti-FLT3 CAR- T Cell (TAA05 Cell Injection) in the Treatment of Relapsed/ Refractory Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Recruiting
Study Start Date
June 14, 2022 (Actual)
Primary Completion Date
June 14, 2025 (Anticipated)
Study Completion Date
June 14, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Wuhan Union Hospital, China
Collaborators
PersonGen BioTherapeutics (Suzhou) Co., Ltd.

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 clinical trial of Anti-FLT3 CAR-T Cell (TAA05 Cell Injection) in the treatment of patients with relapsed / refractory acute myeloid leukemia. The purpose is to evaluate the safety and efficacy of anti-FLT3 CAR-T cells in patients with relapsed / refractory acute myeloid leukemia.
Detailed Description
Acute myeloid leukemia (AML) is a hematological malignancy characterized by clonal proliferation of hematopoietic stem cells or progenitor cells. AML is the most common type of leukemia in adults; the 5-year survival rate is only 24%. Moreover, 40%-50% of young patients and most elderly patients eventually suffered relapses. FMS-like tyrosine kinase 3 (FLT3) is a member of the class III receptor tyrosine kinases, mainly expressed on the cell surface of hematopoietic progenitor cells and plays an important role in normal hematopoiesis such as proliferation, differentiation and survival. The variable expression of FLT3 can be found on leukemia blasts from over 90% of AML patients. Although about 30% of AML have FLT3 gene mutations, the ectodomain of the FLT3 molecule is usually spared so that cellular immunotherapy against it has great therapeutic potential. It is shown that FLT3 expression is detected in more than half of hematopoietic stem cell (HSC) and multipotent progenitor (MPP) cells on average, while the average positive rate of lymphoid progenitor (CLP) cells is less than 20%. Since the expression level of FLT3 on hematopoietic cells is not as high as CD33 and CD123, potential hematological toxicity has been supposed to be less obstructive to the development of FLT3-CAR-T Cell products. Besides, the expression of FLT3 is not found in other normal tissues. And it is reported that FLT3 CAR T cells did not deplete CD34(+) HSCs and preserve HSC differentiation in the mice model. Therefore, conducting CAR-T cell therapy targeting the FLT3 molecule could be very promising in the clinical practice of treating AML. TAA05 Cell Injection is a kind of FLT3-targeted CAR-T cell containing an optimized CD28 costimulatory domain which could help reduce the risk of toxic side effects. This clinical trial aims to evaluate the safety and efficacy of TAA05 Cell Injection in patients with FLT3 positive AML.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
FLT3 positive 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
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
TAA05 Cell Injection
Arm Type
Experimental
Arm Description
Fludarabine + Cyclophosphamide + TAA05 Cell Injection Patients will receive lymphodepletion with fludarabine (25 mg/kg) and cyclophosphamide (250 mg/kg) for 3 days on day -7~-2, followed by the infusion of TAA05 Cell with the dose of 1×10^8, 2×10^8 or 4×10^8 cells on day 0. If no dose-limited toxicity(DLT) emerges in the group, then the subsequent higher dose will be used in the next group. If DLT emerges in a single subject in any dose level, 3 more subjects will be enrolled to the same dose level. After the end of dose climbing, if the maximum dose group(MTD) is still not observed, the highest dose group is defined as MTD.
Intervention Type
Drug
Intervention Name(s)
Fludarabine + Cyclophosphamide + TAA05 Cell Injection
Other Intervention Name(s)
Fludarabine + Cyclophosphamide + Anti-FLT3 CAR-T Cell
Intervention Description
Fludarabine + Cyclophosphamide + TAA05 Cell Injection Fludarabine 25 mg/kg * 3d on day-7~-2; Cyclophosphamide 250 mg/kg *3d on day-7~-2; TAA05 Cell Injection on day 0.
Primary Outcome Measure Information:
Title
Maximal tolerable dose (MTD)
Description
Fludarabine + Cyclophosphamide + TAA05 Cell Injection Patients will receive lymphodepletion with fludarabine (25 mg/kg) and cyclophosphamide (250 mg/kg) for 3 days on day -7~-2, followed by the infusion of TAA05 Cell with the dose of 1×10^8, 2×10^8 or 4×10^8 cells on day 0. If no dose-limited toxicity(DLT) emerges in the group, then the subsequent higher dose will be used in the next group. If DLT emerges in a single subject in any dose level, 3 more subjects will be enrolled to the same dose level. MTD is defined as the highest dose at which DLT occurs in no more than 2 of the 6 patients. After the end of dose climbing, if the maximum dose group(MTD) is still not observed, the highest dose group is defined as MTD.
Time Frame
within 2 yeas after infusion
Secondary Outcome Measure Information:
Title
Incidence of Treatment-related Adverse Events
Description
Adverse events will be assessed according to NCI-CTCAE v5.0, cytokine release syndrome and CAR-T cell-related encephalopathy syndrome will be assessed according to ASTCT criteria.
Time Frame
within 2 yeas after infusion
Title
Overall response rate(ORR) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
Description
OR will be assessed from CAR T cell infusion to death or last follow-up (censored).
Time Frame
within 2 yeas after infusion
Title
Complete response rate(CRR) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
Description
CRR will be assessed from CAR T cell infusion to death or last follow-up (censored).
Time Frame
within 2 yeas after infusion
Title
Overall survival(OS) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
Description
OS will be assessed from CAR T cell infusion to death or last follow-up (censored).
Time Frame
within 2 yeas after infusion
Title
Progress-free survival(PFS) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
Description
PFS will be assessed from CAR T cell infusion to death or last follow-up (censored).
Time Frame
within 2 yeas after infusion
Title
Duration of Response(DOR) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
Description
DOR will be assessed from CAR T cell infusion to death or last follow-up (censored).
Time Frame
within 2 yeas after infusion
Title
In vivo expansion and survival of Anti-FLT3 CAR-T Cell
Description
Quantity of CAR copies in bone marrow and peripheral blood will be determined by using qPCR.
Time Frame
within 2 yeas after infusion

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: Aged 18 ~ 70 years old (including boundary value), regardless of gender; FLT-3 positive acute myeloid leukemia; The expected survival time was more than 3 months; ECOG score 0-2; Refractory or relapsed AML patients after standardized treatment who meet any of the following criteria: After complete remission (CR), there were ≥5% leukemia cells or blast cells in the bone marrow(except for other reasons such as bone marrow regeneration after consolidation chemotherapy)in the peripheral blood and extramedullary lesions; Naive patients who are treated with 2 courses of treatment and are ineffective; Those who have relapsed within 12 months after CR after consolidation and intensive treatment; Those who relapse after 12 months but are ineffective after conventional chemotherapy; Subjects who experienced relapses twice or multiple times; with persistent extramedullary leukemia. Kidney function, cardiopulmonary function, liver function, and coagulation function meet the following requirements: Creatinine ≤ 1.5 ULN; Left ventricular ejection fraction ≥ 50% and echocardiography does not reveal pericardial effusions and ECG does not reveal clinically significant abnormal bands; Blood oxygen saturation > 92%; Total bilirubin ≤ 2 × ULN; ALT and AST ≤ 2.5 × ULN; for the patients with ALT and AST abnormalities caused by disease which researchers judge (e.g. liver infiltrates or bile duct obstruction), the indicators of which can be relaxed to ≤5× ULN; PT/INR and PTT ≤ 1.5 ULN; Patients understand the trial and have signed the informed consent form. Exclusion Criteria: Patients with malignant tumors other than acute myeloid leukemia within 5 years before the screening, except fully treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after the radical operation, and breast ductal carcinoma in situ after radical operation; Patients with hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood hepatitis B virus (HBV) DNA titer detection is not within the normal reference range; Hepatitis C virus (HCV) antibody positive and hepatitis C virus (HCV) RNA positive in peripheral blood; Human immunodeficiency virus (HIV) antibody-positive; Cytomegalovirus (CMV) DNA positive; Syphilis test positive; Patients with severe heart disease: including but not limited to unstable angina pectoris, myocardial infarction (within 6 months before screening), congestive heart failure (New York Heart Association [NYHA] classification ≥ grade III), severe arrhythmia; Patients with unstable systemic diseases judged by the researcher: including but not limited to severe liver, kidney, or metabolic diseases requiring drug treatment; Within 7 days before screening, there were active or uncontrollable infections requiring systemic treatment (except mild urogenital infection and upper respiratory tract infection); Pregnant or lactating women, female subjects who planned pregnancy within 2 years after cell reinfusion, or male subjects whose partners planned pregnancy within 2 years after cell reinfusion; Subjects who were receiving systemic steroid treatment within 7 days before screening or who were determined by the investigator to need long-term systemic steroid treatment during treatment (except inhalation or local use); Participated in other clinical studies within 1 month before screening; There was evidence of central nervous system invasion during subject screening(e.g. detection of tumor cells in cerebrospinal fluid or imaging suggests central infiltrates;); Patients with graft-versus-host disease (GVHD) or requiring immunosuppressive agents; Patients with a history of epilepsy or other central nervous system disorders; Patients with primary immunodeficiency diseases; Patients who are not suitable for cell construction judged by researchers; Other situation researchers believe that it is not suitable for inclusion.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Heng Mei
Phone
027-8572600
Email
hmei@hust.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Chenggong Li
Phone
18868112136
Email
chenggongli@hust.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Heng Mei
Organizational Affiliation
Wuhan Union Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wuhan Union Hospital
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430022
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Heng Mei, M.D., Ph.D
Phone
027-8572600
Email
hmei@hust.edu.cn
First Name & Middle Initial & Last Name & Degree
Zhuolin Wu
Phone
13380211102
Email
sherrysdreams@hotmail.com
First Name & Middle Initial & Last Name & Degree
Heng Mei, M.D., Ph.D

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28496177
Citation
Chen L, Mao H, Zhang J, Chu J, Devine S, Caligiuri MA, Yu J. Targeting FLT3 by chimeric antigen receptor T cells for the treatment of acute myeloid leukemia. Leukemia. 2017 Aug;31(8):1830-1834. doi: 10.1038/leu.2017.147. Epub 2017 May 12. No abstract available.
Results Reference
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Anti-FLT3 CAR-T Cell (TAA05 Cell Injection) in the Treatment of Relapsed / Refractory Acute Myeloid Leukemia

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