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E7 T-cell Receptor (TCR) -T Cell Induction Therapy for Locoregionally Advanced HPV-associated Cancers

Primary Purpose

HPV-Associated Cervical Carcinoma, HPV-Related Carcinoma, HPV-Related Malignancy

Status
Not yet recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Conditioning, E7 TCR-T cells, and aldesleukin
Sponsored by
Christian Hinrichs
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HPV-Associated Cervical Carcinoma focused on measuring HPV, Cell therapy, Adoptive cell therapy, Immunotherapy, Radiation, Chemoradiation, CAR-T, cell therapy, Tumor infiltrating lymphocyte, TCR, T cell, Gene therapy, Cervical cancer, Oropharyngeal cancer, Anal cancer, Vulvar cancer, Vaginal cancer, Penile cancer, Induction therapy

Eligibility Criteria

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

Inclusion Criteria: Histologically confirmed carcinoma of a primary tumor site and stage indicated in Table 3 of the protocol. Tumor with HPV16 genotype as determined by testing performed in a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory. HLA haplotype that demonstrates the HLA-A*02:01 allele as determined by testing performed in a CLIA certified laboratory. Participants may be enrolled based on low resolution typing (i.e., HLA-A*02) but the HLA-A*02:01 allele type must be confirmed prior to apheresis. Measureable disease per RECIST Criteria Version 1.1 or PERCIST. Age > 18 years. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at screening. Negative pregnancy test for women under 55 and all women who have had a menstrual period in the last 12 months. A pregnancy tests is not required for women who have had a bilateral oophorectomy or hysterectomy. Women of child-bearing potential must agree to use adequate contraception (i.e., intrauterine device, hormonal barrier method of birth control; abstinence; tubal ligation or vasectomy) prior to study entry and for four months after treatment. Should a women become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately. Seronegative for HIV antibody, hepatitis B surface antigen (sAg), and hepatitis C antibody. If a hepatitis C antibody test is positive, then testing for antigen by reverse transcription polymerase chain reaction (RT-PCR) must be negative. Participants must have organ and marrow function as defined below: Leukocytes > 3,000/Mantle cell lymphoma (mcL) Absolute neutrophil count > 1,500/mcL Platelets > 100,000/mcL Hemoglobin > 9.0 g/dL Total bilirubin within normal institutional limits except in participants with Gilbert's Syndrome who must have a total bilirubin < 3.0 mg/dL. Serum aspartate aminotransferase (AST) (SGOT)/ alanine transaminase (ALT)(SGPT) < 2.5 x upper limit of normal (ULN) Calculated creatinine clearance (CrCl) >50 mL/min/1.73 m2for participants with creatinine levels above institutional normal (by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation). international normalized ratio (INR) or activated partial thromboplastin time ( aPTT) ≤1.5 X ULN unless the subject is receiving anticoagulant therapy. Subjects on anticoagulant therapy must have a PT or aPTT within therapeutic range and no history of severe hemorrhage. Participants must be able to understand and be willing to sign the written informed consent document. Participants must agree to participate in protocol CINJ 192103 (Pro2021002307) for gene therapy long term follow up and in protocol Cancer Institute of New Jersey (CINJ) 192002 (Pro2021000281) for biospecimen collection study.

Sites / Locations

  • Rutgers Cancer Institute of New Jersey
  • RWJBarnabas Health - Robert Wood Johnson University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Conditioning, E7 TCR-T cells, and aldesleukin

Arm Description

Participants will receive a conditioning regimen consisting of cyclophosphamide and fludarabine followed by E7 TCR-T cells cells IV x 1 dose, followed by aldesleukin every 8 hours for up to 3 doses.

Outcomes

Primary Outcome Measures

Feasibility of administering E7 TCR-T cell therapy as induction treatment for LAHPVC
Proportion of subjects who complete treatment without an event that meets criteria for feasibility failure

Secondary Outcome Measures

Objective tumor response rate at 6-weeks after treatment
Tumor response as assessed by imaging using Response Evaluation Criteria in Solid Tumors (RECIST) criteria Version 1.1 or PERCIST
2-year and 5-year disease free survival (DFS)
DFS will be determined using the Kaplan-Meier method

Full Information

First Posted
November 28, 2022
Last Updated
October 10, 2023
Sponsor
Christian Hinrichs
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT05639972
Brief Title
E7 T-cell Receptor (TCR) -T Cell Induction Therapy for Locoregionally Advanced HPV-associated Cancers
Official Title
A Feasibility Study of E7 TCR-T Cell Induction Therapy for Locoregionally Advanced HPV-Associated Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
June 12, 2024 (Anticipated)
Primary Completion Date
October 1, 2026 (Anticipated)
Study Completion Date
October 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Christian Hinrichs
Collaborators
National Cancer Institute (NCI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The goal of this study is to determine the feasibility of administration of a single dose of E7 TCR-T cells as induction therapy prior to definitive treatment (chemoradiation or surgery) of locoregionally advanced HPV-associated cancers. The intent of E7 TCR-T cell treatment is to shrink or eliminate tumors and thereby facilitate definitive therapy and increase overall survival. This study seeks to determine 1) if E7 TCR-T cell can be administered without undue delay in definitive treatment, 2) the tumor response rate to E7 TCR-T cell treatment, 3) and the disease-free survival rate at 2 and 5 years. Participants will undergo an apheresis procedure to obtain T cells that will be genetically engineered to generate E7 TCR-T cells. They will receive a conditioning regimen, a single infusion of their own E7 TCR-T cells, and adjuvant aldesleukin. Participants will follow up to assess safety and determine tumor response and will return to their primary oncology team for definitive therapy.
Detailed Description
This is a single-arm, single-cohort, single-center, feasibility study to determine the feasibility of E7 TCR-T cell induction therapy for locoregionally advanced human papillomavirus (HPV)-associated cancers (LAHPVC). Participants must have LAHPVC with HPV-16-positive cancer (tumor test) and the human leukocyte antigens (HLA)-A*02:01 allele (blood test). Participants will undergo apheresis for generation of autologous, gene-engineered, E7 TCR-T cells. One week after apheresis, they will receive a non-myeloablative lymphocyte-depleting preparative regimen of cyclophosphamide and fludarabine. Conditioning will be followed by a single infusion of E7 TCR T cells and adjuvant high-dose aldesleukin. Participants will follow up 3 weeks and 6 weeks after treatment. Tumor response will be assessed by imaging studies at the 6-week time point. Participants will be referred back to their primary oncology team for definitive therapy after the 6-week assessment (or earlier if tumors do not appear to be responding). Participants will be followed to determine 2- and 5-year disease free survival.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HPV-Associated Cervical Carcinoma, HPV-Related Carcinoma, HPV-Related Malignancy, HPV Positive Oropharyngeal Squamous Cell Carcinoma, HPV-Related Adenocarcinoma, HPV-Related Adenosquamous Carcinoma, HPV-Related Squamous Cell Carcinoma, HPV-Related Anal Squamous Cell Carcinoma, HPV-Related Penile Squamous Cell Carcinoma, HPV-Related Vulvar Squamous Cell Carcinoma, HPV-Related Endocervical Adenocarcinoma, Cervical Cancer, Oropharynx Cancer, Anal Cancer, Vulvar Cancer, Penile Cancer, Vaginal Cancer
Keywords
HPV, Cell therapy, Adoptive cell therapy, Immunotherapy, Radiation, Chemoradiation, CAR-T, cell therapy, Tumor infiltrating lymphocyte, TCR, T cell, Gene therapy, Cervical cancer, Oropharyngeal cancer, Anal cancer, Vulvar cancer, Vaginal cancer, Penile cancer, Induction therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
This is a single-arm feasibility study.
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Conditioning, E7 TCR-T cells, and aldesleukin
Arm Type
Experimental
Arm Description
Participants will receive a conditioning regimen consisting of cyclophosphamide and fludarabine followed by E7 TCR-T cells cells IV x 1 dose, followed by aldesleukin every 8 hours for up to 3 doses.
Intervention Type
Drug
Intervention Name(s)
Conditioning, E7 TCR-T cells, and aldesleukin
Other Intervention Name(s)
E7 TCR-T cells, E7 TCR, HPV TCR, TIL, Adoptive cell transfer, CAR-T, TCR
Intervention Description
Participants will receive induction E7 TCR-T cell therapy.
Primary Outcome Measure Information:
Title
Feasibility of administering E7 TCR-T cell therapy as induction treatment for LAHPVC
Description
Proportion of subjects who complete treatment without an event that meets criteria for feasibility failure
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Objective tumor response rate at 6-weeks after treatment
Description
Tumor response as assessed by imaging using Response Evaluation Criteria in Solid Tumors (RECIST) criteria Version 1.1 or PERCIST
Time Frame
6 weeks
Title
2-year and 5-year disease free survival (DFS)
Description
DFS will be determined using the Kaplan-Meier method
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed carcinoma of a primary tumor site and stage indicated in Table 3 of the protocol. Tumor with HPV16 genotype as determined by testing performed in a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory. HLA haplotype that demonstrates the HLA-A*02:01 allele as determined by testing performed in a CLIA certified laboratory. Participants may be enrolled based on low resolution typing (i.e., HLA-A*02) but the HLA-A*02:01 allele type must be confirmed prior to apheresis. Measureable disease per RECIST Criteria Version 1.1 or PERCIST. Age > 18 years. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at screening. Negative pregnancy test for women under 55 and all women who have had a menstrual period in the last 12 months. A pregnancy tests is not required for women who have had a bilateral oophorectomy or hysterectomy. Women of child-bearing potential must agree to use adequate contraception (i.e., intrauterine device, hormonal barrier method of birth control; abstinence; tubal ligation or vasectomy) prior to study entry and for four months after treatment. Should a women become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately. Seronegative for HIV antibody, hepatitis B surface antigen (sAg), and hepatitis C antibody. If a hepatitis C antibody test is positive, then testing for antigen by reverse transcription polymerase chain reaction (RT-PCR) must be negative. Participants must have organ and marrow function as defined below: Leukocytes > 3,000/Mantle cell lymphoma (mcL) Absolute neutrophil count > 1,500/mcL Platelets > 100,000/mcL Hemoglobin > 9.0 g/dL Total bilirubin within normal institutional limits except in participants with Gilbert's Syndrome who must have a total bilirubin < 3.0 mg/dL. Serum aspartate aminotransferase (AST) (SGOT)/ alanine transaminase (ALT)(SGPT) < 2.5 x upper limit of normal (ULN) Calculated creatinine clearance (CrCl) >50 mL/min/1.73 m2for participants with creatinine levels above institutional normal (by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation). international normalized ratio (INR) or activated partial thromboplastin time ( aPTT) ≤1.5 X ULN unless the subject is receiving anticoagulant therapy. Subjects on anticoagulant therapy must have a PT or aPTT within therapeutic range and no history of severe hemorrhage. Participants must be able to understand and be willing to sign the written informed consent document. Participants must agree to participate in protocol CINJ 192103 (Pro2021002307) for gene therapy long term follow up and in protocol Cancer Institute of New Jersey (CINJ) 192002 (Pro2021000281) for biospecimen collection study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Christian S Hinrichs, MD
Phone
732-235-9806
Email
ch977@cinj.rutgers.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Carrie Snyder
Phone
732-235-7356
Email
cs1449@cinj.rutgers.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christian S Hinrichs, MD
Organizational Affiliation
Rutgers Cancer Institute of New Jersey
Official's Role
Principal Investigator
Facility Information:
Facility Name
Rutgers Cancer Institute of New Jersey
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08903
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christian S Hinrichs, MD
Phone
732-235-7921
Email
ch977@cinj.rutgers.edu
Facility Name
RWJBarnabas Health - Robert Wood Johnson University Hospital
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08903
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Carrie Snyder
Phone
732-235-7356
Email
cs1449@cinj.rutgers.edu

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33558725
Citation
Nagarsheth NB, Norberg SM, Sinkoe AL, Adhikary S, Meyer TJ, Lack JB, Warner AC, Schweitzer C, Doran SL, Korrapati S, Stevanovic S, Trimble CL, Kanakry JA, Bagheri MH, Ferraro E, Astrow SH, Bot A, Faquin WC, Stroncek D, Gkitsas N, Highfill S, Hinrichs CS. TCR-engineered T cells targeting E7 for patients with metastatic HPV-associated epithelial cancers. Nat Med. 2021 Mar;27(3):419-425. doi: 10.1038/s41591-020-01225-1. Epub 2021 Feb 8.
Results Reference
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E7 T-cell Receptor (TCR) -T Cell Induction Therapy for Locoregionally Advanced HPV-associated Cancers

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