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CD33KO-HSPC Infusion Followed by CART-33 Infusion(s) for Refractory/Relapsed AML

Primary Purpose

Leukemia, Myeloid, Acute

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
CD33KO-HSPC; CART33
Sponsored by
University of Pennsylvania
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia, Myeloid, Acute

Eligibility Criteria

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

Inclusion Criteria: Male or female 18 years of age or older Subjects with AML unlikely to be cured with currently available therapies AML that has not achieved a complete remission or morphologic leukemia free state by ELN criteria109; partial remission or refractory disease (including primary refractory) are eligible; OR: AML relapsed following allogeneic stem cell transplantation (including MDS evolved to AML post-allogeneic stem cell transplantation). Note: morphologic relapse is not required; persistent/recurrent disease-associated molecular, phenotypic or cytogenetic abnormalities (measurable residual disease, MRD) at any time after allogeneic HCT is eligible; OR: Subjects with relapsed disease after prior transplant must be off systemic immunosuppression for at least 1 month at the time of enrollment. Subjects must have a suitable stem cell donor. Satisfactory organ function Creatinine clearance > 40 ml/min ALT/AST must be ≤ 5x upper limit of normal unless related to disease and < 20 x upper limit of normal if related to disease Direct bilirubin < 2.0 mg/dl, unless subject has Gilbert's syndrome (≤ 3.0 mg/dL) Left ventricular ejection fraction ≥ 40% as confirmed by echocardiogram or MUGA DLCO > 45% predicted ECOG performance status 0-1 Written informed consent is given Subjects of reproductive potential must agree to use acceptable birth control methods Exclusion Criteria: Pregnant or lactating (nursing) women Active hepatitis B or hepatitis C or HIV infection Concurrent use of systemic steroids or immunosuppressant medications Any uncontrolled active medical disorder that would preclude participation as outlined Subjects with signs or symptoms indicative of CNS involvement. Known history of allergy or hypersensitivity to study product excipients (human serum albumin, DMSO, and Dextran 40) Class III/IV cardiovascular disability according to New York Heart Association Classification Subjects with a known history or prior diagnosis of optic neuritis or other immunologic or inflammatory disease affecting the central nervous system, and unrelated to leukemia or previous leukemia treatment. Subjects with clinically apparent arrhythmia, or arrhythmias that are not stable on medical management, within 2 weeks of the screening/enrollment visit.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    CD33KO-HSPC followed by CART33

    Arm Description

    All subjects will receive CD33KO-HSPC, followed by 1-3 CART-33 infusions

    Outcomes

    Primary Outcome Measures

    Manufacturing feasibility
    Proportion of subjects whose Product 1 (CD33KO-HSPC) meets release criteria.
    Occurrence of dose-limiting toxicities related to CD33KO-HSPC
    Safety of alloHSCT: occurrence of dose-limiting toxicities related to CD33KO-HSPC
    Occurrence of dose-limiting toxicities related to CART-33
    Safety of CART-33: occurrence of dose-limiting toxicities related to CART-33

    Secondary Outcome Measures

    Efficacy of CD33KO-HSPC
    Proportion of subjects with hematopoietic engraftment according to standard criteria
    Efficacy of at least 1 dose of CART-33
    Proportion of subjects with residual or recurrent AML before CART-33 infusion who attain a clinical response
    Overall Survival (OS)
    Proportion of patients who are alive at 6 months and at 12 months
    Progression free survival (PFS)
    Proportion of patients who remained in response at 6 and 12 months after attaining a response to the first CART-33 infusion. Median time to progression of AML from infusion of CART-33.
    Duration of Response (DOR)
    Median number of months in remission. Median time to relapse in patients who receive CART-33 and attain a response.

    Full Information

    First Posted
    July 6, 2023
    Last Updated
    October 19, 2023
    Sponsor
    University of Pennsylvania
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05945849
    Brief Title
    CD33KO-HSPC Infusion Followed by CART-33 Infusion(s) for Refractory/Relapsed AML
    Official Title
    Phase 1 Study of Lentivirally Transduced T Cells Engineered to Contain Anti-CD33 Linked to TCRζ And 4-1BB Signaling Domains In Combination With CD33KO-HSPC In Subjects With Refractory Or Relapsed Acute Myeloid Leukemia
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 1, 2023 (Anticipated)
    Primary Completion Date
    December 1, 2028 (Anticipated)
    Study Completion Date
    December 1, 2043 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    University of Pennsylvania

    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 purpose of this study is to provide a new type of treatment for AML. This treatment combines a new type of stem cell transplant along with treatment using chimeric antigen receptor (CAR) T cells that have been engineered to recognize and attack your AML cells. The first treatment is a modified stem cell transplant, using blood-forming stem cells donated from a healthy donor. From the same donor, we will also make CAR T-cells, which are leukemia fighting cells, which will be given to the patient via an infusion into the vein after the transplanted stem cells have started to grow healthy blood cells. The modification of the stem cell transplant means that the healthy bone marrow cells will be "invisible" to the CAR T-cells that are trying to kill the leukemia cells.

    6. Conditions and Keywords

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

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    CD33KO-HSPC followed by CART33
    Arm Type
    Experimental
    Arm Description
    All subjects will receive CD33KO-HSPC, followed by 1-3 CART-33 infusions
    Intervention Type
    Biological
    Intervention Name(s)
    CD33KO-HSPC; CART33
    Intervention Description
    CD33KO-HSPC: Stem cell transplant (also known as bone marrow transplant) is a common treatment used for patients with blood cancers, but for this transplant we will first modify the cells, in order to make the CAR T-cell treatment safer for when the patient receives them later. The modification is a type of gene editing - this means changing the DNA of the cells, so that a protein that the bone marrow stem cells usually show on their surface is not shown any more. This makes the bone marrow cells "invisible" to the CAR T-cells, and makes this therapy safer for the patient. The protein is called CD33. CART33: Chimeric Antigen Receptor T-cells (CART) are immune cells which are modified by adding a CAR molecule, which makes them much more efficient at finding and killing cancer cells. In this case, the CAR T-cells are programmed to target a protein called CD33, which is found on the surface of leukemia cells, and on healthy bone marrow cells.
    Primary Outcome Measure Information:
    Title
    Manufacturing feasibility
    Description
    Proportion of subjects whose Product 1 (CD33KO-HSPC) meets release criteria.
    Time Frame
    1 month
    Title
    Occurrence of dose-limiting toxicities related to CD33KO-HSPC
    Description
    Safety of alloHSCT: occurrence of dose-limiting toxicities related to CD33KO-HSPC
    Time Frame
    3 months
    Title
    Occurrence of dose-limiting toxicities related to CART-33
    Description
    Safety of CART-33: occurrence of dose-limiting toxicities related to CART-33
    Time Frame
    6 months
    Secondary Outcome Measure Information:
    Title
    Efficacy of CD33KO-HSPC
    Description
    Proportion of subjects with hematopoietic engraftment according to standard criteria
    Time Frame
    1 month
    Title
    Efficacy of at least 1 dose of CART-33
    Description
    Proportion of subjects with residual or recurrent AML before CART-33 infusion who attain a clinical response
    Time Frame
    6 months
    Title
    Overall Survival (OS)
    Description
    Proportion of patients who are alive at 6 months and at 12 months
    Time Frame
    6 months, 12 months
    Title
    Progression free survival (PFS)
    Description
    Proportion of patients who remained in response at 6 and 12 months after attaining a response to the first CART-33 infusion. Median time to progression of AML from infusion of CART-33.
    Time Frame
    6 months, 12 months
    Title
    Duration of Response (DOR)
    Description
    Median number of months in remission. Median time to relapse in patients who receive CART-33 and attain a response.
    Time Frame
    15 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male or female 18 years of age or older Subjects with AML unlikely to be cured with currently available therapies AML that has not achieved a complete remission or morphologic leukemia free state by ELN criteria109; partial remission or refractory disease (including primary refractory) are eligible; OR: AML relapsed following allogeneic stem cell transplantation (including MDS evolved to AML post-allogeneic stem cell transplantation). Note: morphologic relapse is not required; persistent/recurrent disease-associated molecular, phenotypic or cytogenetic abnormalities (measurable residual disease, MRD) at any time after allogeneic HCT is eligible; OR: Subjects with relapsed disease after prior transplant must be off systemic immunosuppression for at least 1 month at the time of enrollment. Subjects must have a suitable stem cell donor. Satisfactory organ function Creatinine clearance > 40 ml/min ALT/AST must be ≤ 5x upper limit of normal unless related to disease and < 20 x upper limit of normal if related to disease Direct bilirubin < 2.0 mg/dl, unless subject has Gilbert's syndrome (≤ 3.0 mg/dL) Left ventricular ejection fraction ≥ 40% as confirmed by echocardiogram or MUGA DLCO > 45% predicted ECOG performance status 0-1 Written informed consent is given Subjects of reproductive potential must agree to use acceptable birth control methods Exclusion Criteria: Pregnant or lactating (nursing) women Active hepatitis B or hepatitis C or HIV infection Concurrent use of systemic steroids or immunosuppressant medications Any uncontrolled active medical disorder that would preclude participation as outlined Subjects with signs or symptoms indicative of CNS involvement. Known history of allergy or hypersensitivity to study product excipients (human serum albumin, DMSO, and Dextran 40) Class III/IV cardiovascular disability according to New York Heart Association Classification Subjects with a known history or prior diagnosis of optic neuritis or other immunologic or inflammatory disease affecting the central nervous system, and unrelated to leukemia or previous leukemia treatment. Subjects with clinically apparent arrhythmia, or arrhythmias that are not stable on medical management, within 2 weeks of the screening/enrollment visit.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Abramson Cancer Center Clinical Trials Service
    Phone
    855-216-0098
    Email
    PennCancerTrials@careboxhealth.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    David Porter, MD
    Organizational Affiliation
    University of Pennsylvania
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    CD33KO-HSPC Infusion Followed by CART-33 Infusion(s) for Refractory/Relapsed AML

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