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A Study to Evaluate the Safety, Tolerance and Initial Efficacy of EGFRvIII CAR-T on Glioblastoma

Primary Purpose

Recurrent Glioblastoma

Status
Not yet recruiting
Phase
Early Phase 1
Locations
Study Type
Interventional
Intervention
Targeted Epidermal Growth Factor Receptor Variant III(EGFRvIII) autochimeric antigen receptor T cell injection
Sponsored by
Beijing Tsinghua Chang Gung Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Glioblastoma

Eligibility Criteria

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

Inclusion Criteria: 18 ≤ age ≤ 70 years old, gender unlimited; Patients with recurrent glioblastoma confirmed by histology or cytology after surgery and treated with STUPP regimen (TMZ concurrent radiochemotherapy and adjuvant chemotherapy regimen); According to the response assessment in neuro-oncology(RANO) standard, tumor lesions with evaluable or measurable (measurable enhancement lesions are defined as enhancement lesions with clear boundary on CT or MRI, which can be developed on ≥ 2 axial films with a thickness of 5 mm, and the length and diameter of each other are more than 10 mm. If the scanning layer thickness is large, the minimum measurable lesion should be more than 2 times the layer thickness); Clinical pathology (immunohistochemical staining) confirmed the positive expression of EGFRvIII in the tumor; Sufficient peripheral blood can be obtained through vein, and there is no other contraindication for lymphocyte collection; The peripheral blood cells can be collected according to the requirements of cell preparation; KPS score ≥ 70 points; Estimated survival time ≥ 3 months; Subjects must give informed consent to the test before the test, and the written informed consent form shall be signed voluntarily by themselves (or their legal representatives).- Exclusion Criteria: Those who have received radiotherapy after recurrence; They received immunosuppressive or glucocorticoid treatment within 2 weeks before enrollment; Those who receive live vaccine within 4 weeks before enrollment and/or plan to participate in the trial; He received other chemical drugs except lymphocyte clearance within 2 weeks before enrollment; Not recovered from the adverse events caused by previous anti-tumor treatment before enrollment (according to NCI-CTCAE v5.0, recovered to ≤ 1 level), excluding hair loss and sequelae; Previously received targeted drug therapy, cell therapy, gene therapy or other immunotherapy; Have received organ transplantation in the past; Those who are unable to perform brain MRI examination; Any of the following exceptions occurred in the laboratory inspection: Blood routine test: absolute neutrophil count (ANC) < 1.5 × 10 ⁹/L, or platelet (PLT) < 80 × 10 ⁹/L, or hemoglobin (HGB) < 100 g/L; Coagulation function: prothrombin time (PT), or activated partial thromboplastin time (APTT), or INR > 1.5 × ULN; Liver function: total bilirubin (TBIL)>2 × ULN (upper limit of normal value), or alanine transferase (ALT), aspartate transferase (AST) > 3 × ULN; Renal function: serum creatinine (Cr) ≥ 1.5 × ULN, or glomerular filtration rate (GFR) < 60ml/min · 1.73m2; Subjects with active hepatitis B after treatment (HBsAg positive and HBV-DNA more than 1000 copies/ml (200 IU/ml) or higher than the lower detection limit, whichever is higher) are required to receive anti hepatitis B virus treatment during the study treatment; Active hepatitis C subjects (HCV antibody positive and HCV-RNA level higher than the lower limit of detection), human immunodeficiency virus or acquired immunodeficiency syndrome (HIV) related diseases. Note: Hepatocellular carcinoma(HCC) subjects with Hepatitis B virus(HBV) may be included in the study only after the researchers determine that their hepatitis is in a clinical stable state; No HCC subjects undergoing treatment are allowed to be enrolled with HCV; Cardiac ultrasound: left ventricular ejection fraction Left ventricular ejection fraction(LVEF)<50%; Acute bacterial or fungal infection requiring intravenous antibiotics during cell transfusion; Negligent compensatory heart failure (NYHA grade III and IV), unstable angina pectoris, acute myocardial infarction, persistent and clinically significant arrhythmia occurred within 3 months before enrollment; Those who need to inhale oxygen to maintain blood oxygen saturation above 95% before entering the group and cannot return to normal within 2 weeks; Having other malignant tumors and not being effectively controlled; Have a history of tuberculosis; Those who are known or expected to have allergic reactions or have a history of allergy to any component of the test treatment; Known contrast agent allergy; Have a clear history of mental disorders in the past; Previous history of drug abuse or drug abuse; Pregnant or lactating women, or those who plan to become pregnant during the study period; Women of childbearing age and men with fertility cannot take effective and adequate contraceptive measures (such as intrauterine devices, condoms, spermicidal gel plus condoms, diaphragms, etc.) during the period of receiving the study drug and three months after the end of the study; Those who participated in other clinical trials within 30 days before study enrollment; The investigator judged that it was not suitable to participate in this clinical trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    The dose increase phase of this study adopts a 3+3 half-step design

    Arm Description

    The main research objective of active comparator is to observe the efficacy and safety of Epidermal Growth Factor Receptor Variant III Chimeric antigen receptor T cells(EGFRvIII CAR-T cells) injected by local administration (Omaya capsule administration) in the treatment of Glioblastoma(GBM). Initial dose 22 × 10^6 cells will adopt accelerated titration (ATD); 60 × 10^6 cells,160 × 10^6 cells and 220 × 10^6 cells will use the BOIN method to increase the dose. The planned dose increase scheme is divided into accelerated titration stage (ATD) and BOIN stage

    Outcomes

    Primary Outcome Measures

    Incidence of adverse events
    Will assess dose limiting toxicity and all toxicities. Toxicity is the primary endpoint and will be assessed using the National Cancer Institute (NCI)'s Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 . Rates and associated 95% Clopper and Pearson binomial confidence limits (95% confidence interval [CI]) will be estimated for participants' experiencing dose limiting toxicity (DLT). All toxicities and side effects will be summarized in tables by dose, time period, organ, and severity.
    Dose-limiting toxicity (DLT)
    A toxicity that causes side effects that are serious enough to prevent an increase in dose or level of that treatment.

    Secondary Outcome Measures

    T cell levels
    Will assess chimeric antigen receptor (CAR) T levels and phenotype detected in peripheral blood (PB) (absolute number per ul by flow). Will assess EGFRvIII CAR gene copies in peripheral blood (PB)(Q-PCR method ). Statistical and graphical methods will be used to describe persistence and expansion.
    Cytokine levels in PB
    Statistical and graphical methods will be used to describe persistence and expansion.
    Disease response
    By Response Assessment in Neuro-Oncology (RANO) criteria with the need for Avastin as an additional indicator of progression.
    Time to progression
    Progression is defined by RANO with the need for Avastin as an additional indicator of progression.
    Complete response (CR)
    Kaplan Meier methods will be used to estimate median CR and graph the results.
    Partial Response (PR)
    Kaplan Meier methods will be used to estimate median PR and graph the results.
    Stable disease (SD)
    Kaplan Meier methods will be used to estimate median SD and graph the results.
    Progressive disease (PD)
    Kaplan Meier methods will be used to estimate median PD and graph the results.
    Progression free survival (PFS)
    Kaplan Meier methods will be used to estimate median PFS and graph the results.
    Overall survival (OS)
    Kaplan Meier methods will be used to estimate median OS and graph the results.
    Quality of life (QOL)
    Will estimate the mean and standard error for change from baseline during treatment and post treatment in the quality of life functioning scale, symptom scale and item scores from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30(EORTC QLQ-C30). Health-Related Quality of Life and Sympotoms will be assessed from the International Validation Study of the EORTC Brain Cancer Module(EORTC QLQ-BN20)

    Full Information

    First Posted
    March 16, 2023
    Last Updated
    August 24, 2023
    Sponsor
    Beijing Tsinghua Chang Gung Hospital
    Collaborators
    Beijing DCTY® Biotech Co.,Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05802693
    Brief Title
    A Study to Evaluate the Safety, Tolerance and Initial Efficacy of EGFRvIII CAR-T on Glioblastoma
    Official Title
    An Open Clinical Study to Evaluate the Safety, Tolerance and Initial Efficacy of Epidermal Growth Factor Receptor Variant III Chimeric Antigen Receptor T(EGFRvIII CAR-T) in the Treatment of Recurrent Glioblastoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    November 15, 2023 (Anticipated)
    Primary Completion Date
    November 14, 2025 (Anticipated)
    Study Completion Date
    November 14, 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Beijing Tsinghua Chang Gung Hospital
    Collaborators
    Beijing DCTY® Biotech 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 single-center, open, dose-increasing study. For subjects with recurrent glioblastomaIt ,is estimated that about 22 subjects will be enrolled, The main purpose was to evaluate the safety and tolerance of Epidermal Growth Factor Receptor Variant III Chimeric antigen receptor T(EGFRvIII CAR-T) in the treatment of patients with recurrent glioblastoma.The secondary purpose is to preliminarily evaluate the anti-tumor activity of Epidermal Growth Factor Receptor Variant III Chimeric antigen receptor T(EGFRvIII CAR-T) in the treatment of patients with recurrent glioblastoma, and preliminarily evaluate the relationship between the clinical efficacy, safety and pharmacokinetics of Epidermal Growth Factor Receptor Variant III Chimeric antigen receptor T cells(EGFRvIII CAR-T cells) preparation, as well as their correlation with tumor markers or other potential biomarkers. This clinical study is an open clinical study, including dose increasing stage and expansion stage. The main objective of the study was to observe the efficacy and safety of Epidermal Growth Factor Receptor Variant III Chimeric antigen receptor T cells(EGFRvIII CAR-T cells) in the treatment of Glioblastoma (GBM) by local administration (Omaya capsule administration). The study will be divided into the following stages: screening stage, baseline stage, treatment stage, short-term follow-up and long-term follow-up stage.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Recurrent Glioblastoma

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    The dose increase phase of this study adopts a 3+3 half-step design
    Arm Type
    Experimental
    Arm Description
    The main research objective of active comparator is to observe the efficacy and safety of Epidermal Growth Factor Receptor Variant III Chimeric antigen receptor T cells(EGFRvIII CAR-T cells) injected by local administration (Omaya capsule administration) in the treatment of Glioblastoma(GBM). Initial dose 22 × 10^6 cells will adopt accelerated titration (ATD); 60 × 10^6 cells,160 × 10^6 cells and 220 × 10^6 cells will use the BOIN method to increase the dose. The planned dose increase scheme is divided into accelerated titration stage (ATD) and BOIN stage
    Intervention Type
    Drug
    Intervention Name(s)
    Targeted Epidermal Growth Factor Receptor Variant III(EGFRvIII) autochimeric antigen receptor T cell injection
    Other Intervention Name(s)
    DCTY0801 Autologous T lymphocyte injection
    Intervention Description
    Infusion of Epidermal Growth Factor Receptor Variant III Chimeric antigen receptor T(EGFRvIII CAR-T) with Omaya capsule
    Primary Outcome Measure Information:
    Title
    Incidence of adverse events
    Description
    Will assess dose limiting toxicity and all toxicities. Toxicity is the primary endpoint and will be assessed using the National Cancer Institute (NCI)'s Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 . Rates and associated 95% Clopper and Pearson binomial confidence limits (95% confidence interval [CI]) will be estimated for participants' experiencing dose limiting toxicity (DLT). All toxicities and side effects will be summarized in tables by dose, time period, organ, and severity.
    Time Frame
    Up to 15 years
    Title
    Dose-limiting toxicity (DLT)
    Description
    A toxicity that causes side effects that are serious enough to prevent an increase in dose or level of that treatment.
    Time Frame
    Up to 28 days
    Secondary Outcome Measure Information:
    Title
    T cell levels
    Description
    Will assess chimeric antigen receptor (CAR) T levels and phenotype detected in peripheral blood (PB) (absolute number per ul by flow). Will assess EGFRvIII CAR gene copies in peripheral blood (PB)(Q-PCR method ). Statistical and graphical methods will be used to describe persistence and expansion.
    Time Frame
    Up to 15 years
    Title
    Cytokine levels in PB
    Description
    Statistical and graphical methods will be used to describe persistence and expansion.
    Time Frame
    Up to 15 years
    Title
    Disease response
    Description
    By Response Assessment in Neuro-Oncology (RANO) criteria with the need for Avastin as an additional indicator of progression.
    Time Frame
    Up to 15 years
    Title
    Time to progression
    Description
    Progression is defined by RANO with the need for Avastin as an additional indicator of progression.
    Time Frame
    Up to 15 years
    Title
    Complete response (CR)
    Description
    Kaplan Meier methods will be used to estimate median CR and graph the results.
    Time Frame
    Up to 15 years
    Title
    Partial Response (PR)
    Description
    Kaplan Meier methods will be used to estimate median PR and graph the results.
    Time Frame
    Up to 15 years
    Title
    Stable disease (SD)
    Description
    Kaplan Meier methods will be used to estimate median SD and graph the results.
    Time Frame
    Up to 15 years
    Title
    Progressive disease (PD)
    Description
    Kaplan Meier methods will be used to estimate median PD and graph the results.
    Time Frame
    Up to 15 years
    Title
    Progression free survival (PFS)
    Description
    Kaplan Meier methods will be used to estimate median PFS and graph the results.
    Time Frame
    Up to 15 years
    Title
    Overall survival (OS)
    Description
    Kaplan Meier methods will be used to estimate median OS and graph the results.
    Time Frame
    Up to 15 years
    Title
    Quality of life (QOL)
    Description
    Will estimate the mean and standard error for change from baseline during treatment and post treatment in the quality of life functioning scale, symptom scale and item scores from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30(EORTC QLQ-C30). Health-Related Quality of Life and Sympotoms will be assessed from the International Validation Study of the EORTC Brain Cancer Module(EORTC QLQ-BN20)
    Time Frame
    Up to 15 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: 18 ≤ age ≤ 70 years old, gender unlimited; Patients with recurrent glioblastoma confirmed by histology or cytology after surgery and treated with STUPP regimen (TMZ concurrent radiochemotherapy and adjuvant chemotherapy regimen); According to the response assessment in neuro-oncology(RANO) standard, tumor lesions with evaluable or measurable (measurable enhancement lesions are defined as enhancement lesions with clear boundary on CT or MRI, which can be developed on ≥ 2 axial films with a thickness of 5 mm, and the length and diameter of each other are more than 10 mm. If the scanning layer thickness is large, the minimum measurable lesion should be more than 2 times the layer thickness); Clinical pathology (immunohistochemical staining) confirmed the positive expression of EGFRvIII in the tumor; Sufficient peripheral blood can be obtained through vein, and there is no other contraindication for lymphocyte collection; The peripheral blood cells can be collected according to the requirements of cell preparation; KPS score ≥ 70 points; Estimated survival time ≥ 3 months; Subjects must give informed consent to the test before the test, and the written informed consent form shall be signed voluntarily by themselves (or their legal representatives).- Exclusion Criteria: Those who have received radiotherapy after recurrence; They received immunosuppressive or glucocorticoid treatment within 2 weeks before enrollment; Those who receive live vaccine within 4 weeks before enrollment and/or plan to participate in the trial; He received other chemical drugs except lymphocyte clearance within 2 weeks before enrollment; Not recovered from the adverse events caused by previous anti-tumor treatment before enrollment (according to NCI-CTCAE v5.0, recovered to ≤ 1 level), excluding hair loss and sequelae; Previously received targeted drug therapy, cell therapy, gene therapy or other immunotherapy; Have received organ transplantation in the past; Those who are unable to perform brain MRI examination; Any of the following exceptions occurred in the laboratory inspection: Blood routine test: absolute neutrophil count (ANC) < 1.5 × 10 ⁹/L, or platelet (PLT) < 80 × 10 ⁹/L, or hemoglobin (HGB) < 100 g/L; Coagulation function: prothrombin time (PT), or activated partial thromboplastin time (APTT), or INR > 1.5 × ULN; Liver function: total bilirubin (TBIL)>2 × ULN (upper limit of normal value), or alanine transferase (ALT), aspartate transferase (AST) > 3 × ULN; Renal function: serum creatinine (Cr) ≥ 1.5 × ULN, or glomerular filtration rate (GFR) < 60ml/min · 1.73m2; Subjects with active hepatitis B after treatment (HBsAg positive and HBV-DNA more than 1000 copies/ml (200 IU/ml) or higher than the lower detection limit, whichever is higher) are required to receive anti hepatitis B virus treatment during the study treatment; Active hepatitis C subjects (HCV antibody positive and HCV-RNA level higher than the lower limit of detection), human immunodeficiency virus or acquired immunodeficiency syndrome (HIV) related diseases. Note: Hepatocellular carcinoma(HCC) subjects with Hepatitis B virus(HBV) may be included in the study only after the researchers determine that their hepatitis is in a clinical stable state; No HCC subjects undergoing treatment are allowed to be enrolled with HCV; Cardiac ultrasound: left ventricular ejection fraction Left ventricular ejection fraction(LVEF)<50%; Acute bacterial or fungal infection requiring intravenous antibiotics during cell transfusion; Negligent compensatory heart failure (NYHA grade III and IV), unstable angina pectoris, acute myocardial infarction, persistent and clinically significant arrhythmia occurred within 3 months before enrollment; Those who need to inhale oxygen to maintain blood oxygen saturation above 95% before entering the group and cannot return to normal within 2 weeks; Having other malignant tumors and not being effectively controlled; Have a history of tuberculosis; Those who are known or expected to have allergic reactions or have a history of allergy to any component of the test treatment; Known contrast agent allergy; Have a clear history of mental disorders in the past; Previous history of drug abuse or drug abuse; Pregnant or lactating women, or those who plan to become pregnant during the study period; Women of childbearing age and men with fertility cannot take effective and adequate contraceptive measures (such as intrauterine devices, condoms, spermicidal gel plus condoms, diaphragms, etc.) during the period of receiving the study drug and three months after the end of the study; Those who participated in other clinical trials within 30 days before study enrollment; The investigator judged that it was not suitable to participate in this clinical trial.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Yang Xuejun
    Phone
    13011329950
    Email
    yxja03728@btch.edu.cn
    First Name & Middle Initial & Last Name or Official Title & Degree
    Zuo Ran
    Phone
    15110273315
    Email
    zr@taiyuanshengwu.com

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    A Study to Evaluate the Safety, Tolerance and Initial Efficacy of EGFRvIII CAR-T on Glioblastoma

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