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Dose-escalating Trial With Allo-RevCAR01-T Cells in Combination With CD123 Target Module (R-TM123) for Participants With Selected Hematologic Malignancies Positive for CD123

Primary Purpose

Acute Myeloid Leukemia, in Relapse, Acute Myeloid Leukemia Refractory

Status
Not yet recruiting
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
Cyclophosphamide (Non-IMP, Lymphodepletion)
Fludarabine (Non-IMP, Lymphodepletion)
R-TM123
Allo-RevCAR01-T
Sponsored by
AvenCell Europe GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

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

Inclusion Criteria: Male or female participants, age ≥18 years. HLA type of participant must match at HLA B and C loci Participants with CD123+ AML (defined as ≥20% of leukemic cells expressing CD123 at any point in the course of disease) - Participants with MRD+ AML are eligible but must meet specific criteria Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Life expectancy of at least 3 months in the judgment of the investigator. Adequate renal and hepatic laboratory assessments: Adequate cardiac function Permanent venous access existing (e.g., port-system) or willing to have such a device inserted. Able to give written informed consent. Weight ≥45 kg. Negative pregnancy; routinely using a highly effective method of birth control Exclusion Criteria: Acute promyelocytic leukemia (t15;17). History of AML in the central nervous system. Bone marrow failure syndromes Cardiac disease: heart failure (New York Heart Association III or IV); unstable coronary artery disease, myocardial infarction, or serious cardiac ventricular arrhythmias requiring anti-arrhythmic therapy within the last 6 months prior to study entry. Active pulmonary disease with clinically relevant hypoxia Parkinson's disease or epilepsy. Stroke, seizure, or intracranial hemorrhage in the past 12 months. History or presence of disseminated intravascular coagulation (DIC) or thromboembolism within 3 months prior to start of treatment. Active infectious disease considered by investigator to be incompatible with protocol or being contraindications for lymphodepletion therapy Toxicity from prior anticancer treatment has not resolved to Grade ≤1 or baseline. Allogeneic stem cell transplantation within last 2 months or GvHD requiring immunosuppressive therapy. Vaccination with live viruses <2 weeks prior to lymphodepletion therapy. Major surgery within 28 days prior to start of R-TM123 infusion. Prior malignancy in the past 3 years or any malignancy requiring ongoing active therapy other than adjuvant endocrine therapy. Participants with resected or ablated tumors, such as basal cell carcinoma of skin, carcinoma-in-situ of the cervix, or other tumors considered cured by local treatment may be considered for the study with Sponsor approval. Treatment with any investigational drug substance or experimental therapy within 4 weeks or 5 half-lives (whichever is shorter) of the substance prior to lymphodepletion. Treatment with anti-leukemic therapy within 4 weeks or 5 half-lives (whichever is shorter) prior to lymphodepletion. Prior treatment with gene modified cell products. Use of checkpoint inhibitors within 5 half-lives of the specific drug. Autoimmune diseases requiring systemic steroids or other systemic immunosuppressants. Pregnant or breastfeeding women. Psychologic disorders with treatment modifications required within the last 3 months, drug and/or significant active alcohol abuse as per investigator's medical judgement. Depression or anxiety due to presence of the underlying malignancy may be exempted with Sponsor approval. History of human immunodeficiency virus (HIV) or active/chronic infection with hepatitis C virus (HCV) or hepatitis B virus (HBV). Presence of autoantibodies against lupus La protein (La)/ Sjögren syndrome type B antigen (SS-B) or presence or history of autoimmune diseases associated with such antibodies Known hypersensitivity to cellular component (Allo-RevCAR01-T) and/or TM (R-TM123) excipients or to compounds of the lymphodepletion therapy, tocilizumab, or corticosteroids. Evidence that the participant is not likely or able to follow the study protocol (e.g., lacking compliance) in the judgment of the investigator. Participant unable to understand the informed consent and possible consequences of the participation in the clinical trial in the judgement of the investigator.

Sites / Locations

  • Universitätsklinikum Ulm
  • Universitätsklinikum Würzburg
  • Universitätsklinikum Marburg
  • Universitätsklinikum Dresden
  • Charité Universitätsmedizin Berlin

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Allo-RevCAR01-T-CD123 treatment

Arm Description

Following lymphodepleting therapy, R-TM123 will be administered as continuous infusion from Cycle 1 Day 1 and then will continue for 20 days. After 4 hours (±30 minutes) of R TM123 start on Day 1, a single dose of Allo-RevCAR01-T will be administered as IV infusion

Outcomes

Primary Outcome Measures

To assess the safety profile of the treatment
Incidence and intensity of adverse events (AEs) graded according to Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0, except for cytokine release syndrome (CRS), immune effector cell associated neurotoxicity syndrome (ICANS), tumor lysis syndrome, and graft versus host disease (GvHD), which will be graded according to widely accepted specialized criteria
To determine the incidence of dose-limiting toxicities (DLT)
Incidence of DLTs
To determine the maximum tolerated dose (MTD)
MTD

Secondary Outcome Measures

Evidence of biological and clinical activity including best response rate
Complete remission (CR, CRh, CRi, CRMRDneg, CRMRDpos) Partial remission (PR) Overall response rate (ORR) Stable disease (SD) Best response rate Duration of response
Survival rates
Progression free survival Overall survival
Response rate to cycles 2 to 4
Complete remission (CR, CRh, CRi, CRMRDneg, CRMRDpos), Partial remission (PR) Overall response rate (ORR) Stable disease (SD) Best response rate Duration of response
Establishing recommended Phase 2 dose (RP2D)
Based on assessments of MTD and DLTs

Full Information

First Posted
June 23, 2023
Last Updated
July 24, 2023
Sponsor
AvenCell Europe GmbH
Collaborators
Allucent
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1. Study Identification

Unique Protocol Identification Number
NCT05949125
Brief Title
Dose-escalating Trial With Allo-RevCAR01-T Cells in Combination With CD123 Target Module (R-TM123) for Participants With Selected Hematologic Malignancies Positive for CD123
Official Title
Multicenter, Open-label, Phase 1 Study of Allo-RevCAR01-T-CD123 Consisting of Genetically Modified T Cells Carrying Reverse Chimeric Antigen Receptors (Allo RevCAR01 T) in Combination With CD123 Target Module (R-TM123) for the Treatment of Patients With Selected Hematologic Malignancies Positive for CD123
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
August 2023 (Anticipated)
Primary Completion Date
June 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AvenCell Europe GmbH
Collaborators
Allucent

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The Allo-RevCAR01-T-CD123 drug is a combination of a cellular component (Allo-RevCAR01-T) with a recombinant antibody derivative (R-TM123), which together form the active drug. The cellular component Allo-RevCAR01-T consists of an allogeneic human T-cell genetically multi-edited and expressing a reversed, universal chimeric antigen receptor (RevCAR) presenting an extracellular peptide epitope (RevCAR epitope). R TM123 functions as a bridging module between Allo RevCAR01-T and a CD123-expressing target cancer cell by selectively binding the RevCAR epitope and CD123.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Dose escalation follows a BOIN comb design with 3 dose levels of 100, 250, and 500 million Allo-RevCAR01-T and 3 dose levels of R-TM123 resulting in a maximum of 9 dose levels. Given 1 participant dose level cohorts, there will be an inherent stagger between each participant equivalent to the DLT window of 28 days
Masking
None (Open Label)
Allocation
N/A
Enrollment
37 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Allo-RevCAR01-T-CD123 treatment
Arm Type
Experimental
Arm Description
Following lymphodepleting therapy, R-TM123 will be administered as continuous infusion from Cycle 1 Day 1 and then will continue for 20 days. After 4 hours (±30 minutes) of R TM123 start on Day 1, a single dose of Allo-RevCAR01-T will be administered as IV infusion
Intervention Type
Other
Intervention Name(s)
Cyclophosphamide (Non-IMP, Lymphodepletion)
Intervention Description
Intravenous infusion over 3 days (d-5 to d-3)
Intervention Type
Other
Intervention Name(s)
Fludarabine (Non-IMP, Lymphodepletion)
Intervention Description
Intravenous infusion over 3 days (d-5 to d-3)
Intervention Type
Drug
Intervention Name(s)
R-TM123
Other Intervention Name(s)
R-TM123 is one component of the Allo-RevCAR01-T-CD123 treatment
Intervention Description
Intravenous infusion over 20 days
Intervention Type
Drug
Intervention Name(s)
Allo-RevCAR01-T
Other Intervention Name(s)
Allo-RevCAR01-T is one component of the Allo-RevCAR01-T-CD123 treatment
Intervention Description
A single dose of Allo-RevCAR01-T will be administered as IV infusion on Treatment day 1. Allo-RevCAR01-T will not be administered again within this study.
Primary Outcome Measure Information:
Title
To assess the safety profile of the treatment
Description
Incidence and intensity of adverse events (AEs) graded according to Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0, except for cytokine release syndrome (CRS), immune effector cell associated neurotoxicity syndrome (ICANS), tumor lysis syndrome, and graft versus host disease (GvHD), which will be graded according to widely accepted specialized criteria
Time Frame
At the end of cycle 1 (in total 28 days, given no treatment interruptions)
Title
To determine the incidence of dose-limiting toxicities (DLT)
Description
Incidence of DLTs
Time Frame
At the end of cycle 1 (in total 28 days, given no treatment interruptions)
Title
To determine the maximum tolerated dose (MTD)
Description
MTD
Time Frame
At the End of Cycle 1 (in total 28 days, given no treatment interruptions)
Secondary Outcome Measure Information:
Title
Evidence of biological and clinical activity including best response rate
Description
Complete remission (CR, CRh, CRi, CRMRDneg, CRMRDpos) Partial remission (PR) Overall response rate (ORR) Stable disease (SD) Best response rate Duration of response
Time Frame
At any timepoint until end of study (6 months after the end of last R-TM123 administration)
Title
Survival rates
Description
Progression free survival Overall survival
Time Frame
At end of study visit (6 months after the end of last R-TM123 administration)
Title
Response rate to cycles 2 to 4
Description
Complete remission (CR, CRh, CRi, CRMRDneg, CRMRDpos), Partial remission (PR) Overall response rate (ORR) Stable disease (SD) Best response rate Duration of response
Time Frame
At any timepoint until end of study (6 months after the end of last R-TM123 administration)
Title
Establishing recommended Phase 2 dose (RP2D)
Description
Based on assessments of MTD and DLTs
Time Frame
At any timepoint until end of study (6 months after the end of last R-TM123 administration)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female participants, age ≥18 years. HLA type of participant must match at HLA B and C loci Participants with CD123+ AML (defined as ≥20% of leukemic cells expressing CD123 at any point in the course of disease) - Participants with MRD+ AML are eligible but must meet specific criteria Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Life expectancy of at least 3 months in the judgment of the investigator. Adequate renal and hepatic laboratory assessments: Adequate cardiac function Permanent venous access existing (e.g., port-system) or willing to have such a device inserted. Able to give written informed consent. Weight ≥45 kg. Negative pregnancy; routinely using a highly effective method of birth control Exclusion Criteria: Acute promyelocytic leukemia (t15;17). History of AML in the central nervous system. Bone marrow failure syndromes Cardiac disease: heart failure (New York Heart Association III or IV); unstable coronary artery disease, myocardial infarction, or serious cardiac ventricular arrhythmias requiring anti-arrhythmic therapy within the last 6 months prior to study entry. Active pulmonary disease with clinically relevant hypoxia Parkinson's disease or epilepsy. Stroke, seizure, or intracranial hemorrhage in the past 12 months. History or presence of disseminated intravascular coagulation (DIC) or thromboembolism within 3 months prior to start of treatment. Active infectious disease considered by investigator to be incompatible with protocol or being contraindications for lymphodepletion therapy Toxicity from prior anticancer treatment has not resolved to Grade ≤1 or baseline. Allogeneic stem cell transplantation within last 2 months or GvHD requiring immunosuppressive therapy. Vaccination with live viruses <2 weeks prior to lymphodepletion therapy. Major surgery within 28 days prior to start of R-TM123 infusion. Prior malignancy in the past 3 years or any malignancy requiring ongoing active therapy other than adjuvant endocrine therapy. Participants with resected or ablated tumors, such as basal cell carcinoma of skin, carcinoma-in-situ of the cervix, or other tumors considered cured by local treatment may be considered for the study with Sponsor approval. Treatment with any investigational drug substance or experimental therapy within 4 weeks or 5 half-lives (whichever is shorter) of the substance prior to lymphodepletion. Treatment with anti-leukemic therapy within 4 weeks or 5 half-lives (whichever is shorter) prior to lymphodepletion. Prior treatment with gene modified cell products. Use of checkpoint inhibitors within 5 half-lives of the specific drug. Autoimmune diseases requiring systemic steroids or other systemic immunosuppressants. Pregnant or breastfeeding women. Psychologic disorders with treatment modifications required within the last 3 months, drug and/or significant active alcohol abuse as per investigator's medical judgement. Depression or anxiety due to presence of the underlying malignancy may be exempted with Sponsor approval. History of human immunodeficiency virus (HIV) or active/chronic infection with hepatitis C virus (HCV) or hepatitis B virus (HBV). Presence of autoantibodies against lupus La protein (La)/ Sjögren syndrome type B antigen (SS-B) or presence or history of autoimmune diseases associated with such antibodies Known hypersensitivity to cellular component (Allo-RevCAR01-T) and/or TM (R-TM123) excipients or to compounds of the lymphodepletion therapy, tocilizumab, or corticosteroids. Evidence that the participant is not likely or able to follow the study protocol (e.g., lacking compliance) in the judgment of the investigator. Participant unable to understand the informed consent and possible consequences of the participation in the clinical trial in the judgement of the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Martina Raupach
Phone
+493514466450
Ext
0
Email
AVC-201-01@avencell.com
First Name & Middle Initial & Last Name or Official Title & Degree
Katja Jersemann, Dr.
Phone
+493514466450
Ext
0
Email
AVC-201-01@avencell.com
Facility Information:
Facility Name
Universitätsklinikum Ulm
City
Ulm
State/Province
Baden-Württemberg
ZIP/Postal Code
89081
Country
Germany
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elisa Sala, MD
Email
elisa.sala@uniklinik-ulm.de
Facility Name
Universitätsklinikum Würzburg
City
Würzburg
State/Province
Bayern
ZIP/Postal Code
97080
Country
Germany
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chatterjee Manik, MD
Email
Chatterjee_m@ukw.de
Facility Name
Universitätsklinikum Marburg
City
Marburg
State/Province
Hessen
ZIP/Postal Code
35032
Country
Germany
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stephan Metzelder, Prof.
Email
metzelde@med.uni-marburg.de
Facility Name
Universitätsklinikum Dresden
City
Dresden
State/Province
Sachsen
ZIP/Postal Code
01307
Country
Germany
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Martin Wermke, Prof.
Email
martin.wermke@ukdd.de
Facility Name
Charité Universitätsmedizin Berlin
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jörg Westermann, Prof.
Email
joerg.westermann@charite.de

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Dose-escalating Trial With Allo-RevCAR01-T Cells in Combination With CD123 Target Module (R-TM123) for Participants With Selected Hematologic Malignancies Positive for CD123

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