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Anti-CD70 CAR-T Cell Injection in Patients With CD70-positive Advanced Urologic Neoplasms

Primary Purpose

CD70-positive Advanced Urologic Neoplasms

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Anti-CD70 CAR-T cells
Sponsored by
Changhai Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for CD70-positive Advanced Urologic Neoplasms focused on measuring Anti-CD70 CAR-T, Urologic Neoplasms

Eligibility Criteria

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

Inclusion Criteria: 1. Subject is≥18 years old (including cut-off value), gender is not limited. 2. Histopathologically confirmed tumors of the urinary system (including renal cancers and urothelial cancers). Renal cancers should have failed after targeted therapy and/or immunotherapy. Urothelial cancers should have failed after chemotherapy and/or immunotherapy. Or subjects are unable to tolerate or lack effective therapies. 3. At least one measurable lesion according to RECIST v1.1. 4. CD70 should be positive confirmed by Immunohistochemistry/Immunocytochemistry/ Flow Cytometry (IHC/ICC/FCM) in tumor tissue samples. 5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. 6. Life expectancy ≥ 3 months. 7. Adequate function defined as: Hematological functions: Absolute neutrophil count (ANC) ≥ 1.5 × 109/L (Patients should not receive G-CSF support within 7 days before laboratory examination); Absolute Lymphocyte Count (ALC) ≥ 0.5 × 109/L; Hemoglobin (HGB) ≥ 80 g/L (Patients should not be transfused red cells within 7 days before the laboratory examination); Platelet count (PLT) ≥ 75 × 109/L (Patients should not receive transfusion support within 7 days before the laboratory examination). Hepatic functions: Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 × upper limit of normal (ULN); AST and ALT of patients with liver metastasis ≤ 5 × ULN; Total bilirubin (TBIL) ≤ 1.5 × ULN; TBIL of patients with liver metastasis must ≤ 3.0 × ULN; TBIL of patients with Gilbert's Syndrome ≤ 3.0 × ULN and Direct bilirubin (DBIL) ≤ 1.5 × ULN. Coagulation functions: International normalized ratio (INR) ≤ 1.5 × ULN; Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN (Except for patients who are receiving therapeutic anticoagulants.). Renal functions: Serum creatinine (Cr) ≤ 1.5 × ULN; or Estimated glomerular filtration rate (eGFR) ≥30ml/(min·1.73 m2)(Calculated by CKD⁃EPI). Cardiac functions: Left ventricular ejection fraction (LVEF) > 50%; Pulmonary function: Oxygen saturation (SpO2) > 92%. 8. Female participants of childbearing potential must undergo a pregnancy test and the results must be negative. Female participants of childbearing potential or male participants whose sex partner has childbearing potential must be willing to use effective methods of contraception from screening period to at least 1 year after infusion. 9. Participants must be able to understand the protocol and be willing to enroll the study, sign the informed consent, and be able to comply with the study and follow-up procedures. Exclusion Criteria: 1. Patients have received systemic therapy with cytotoxic chemicals, monoclonal antibodies, or immunotherapy within 4 weeks or 5 half-lives (which is shorter) prior to signing informed consent; Patients have received systemic glucocorticoids (prednisone at a dose of ≥10 mg per day or equivalent) or other immune-suppressive therapy within 2 weeks prior to signing informed consent; Patients have received systemic antitumor therapy with a biologic agent or other approved targeted small-molecule inhibitor within 1 week or five half-lives (which is shorter) prior to signing informed consent; Patients have received Chinese herbal medicine or Chinese patent medicine with anti-tumor indication within 1 week prior to signing informed consent. 2. Pregnant or lactating women. 3. Patients with hepatitis B surface antigen (HBsAg) positive. Patients who is hepatitis B core antibody (HBcAb) positive and the quantification of HBV DNA in peripheral blood is higher than the lower limit of detection. Patients who is hepatitis C virus (HCV) antibody positive and quantification of HCV DNA in peripheral blood is higher than the lower limit of detection. Patients with human immunodeficiency virus (HIV) antibody positive. Patients with syphilis antibody positive and tolulized red unheated serum test (TRUST) titer ≥ 1:4. 4. The toxicities caused by the prior therapy (surgery, chemotherapy, radiotherapy, targeted therapy, immunotherapy, etc.) have not recovered to grade 1 according to CTCAE, except for hair loss and peripheral sensory nerve disorders. 5. Have received any allogeneic tissue/organ transplantation (including bone marrow transplantation, stem cell transplantation, liver transplantation, kidney transplantation), except for the transplantation that does not require immunosuppressive therapy (such as: corneal transplantation, hair transplantation.) 6. Patients have received anti-CD70 CAR-T cell therapy. 7. Patients who have history of major surgery and unrecovered severe trauma within 4 weeks prior to signing informed consent; or plan to have major surgery within 12 weeks of cell therapy. 8. Presence of known central nervous system metastases, but the following patients will be allowed: a) Asymptomatic brain metastases; b) Clinically stable (no radiographic progression within 4 weeks before apheresis and return of any neurologic symptoms to baseline), and with no need for corticosteroids or other treatment for brain metastases for ≥ 4 weeks. 9. Patients with clinically significant systemic disease (such as: severe active infection or significant cardiac, pulmonary, hepatic, nervous system, or other organ dysfunction) that evaluated by the investigator would impair the patients' ability to tolerate the treatments used in this study or significantly increase the risk of complications. Uncontrolled severe active infection (sepsis, bacteremia, viremia, etc.); Congestive heart failure with New York Heart Association (NYHA) functional class > 1; Clinically significant severe aortic stenosis and symptomatic mitral stenosis; Electrocardiogram QTc > 450 msec or QTc > 480 msec in patients with bundle-branch block; Uncontrolled clinically significant arrhythmia within 6 months prior to signing informed consent; Acute coronary syndrome (such as: unstable angina, myocardial infarction) within 6 months prior to signing informed consent; Drug-uncontrolled hypertension (systolic pressure ≥ 160 mmHg and/or diastolic pressure ≥ 100 mmHg) or pulmonary hypertension; Cerebrovascular accident occurred within 6 months prior to signing informed consent, including transient ischemic attack (TIA), cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage; A history of active, chronic, or recurrent (within 1 year prior to signing informed consent) severe autoimmune disease or immune-mediated disease requiring steroids or other immunosuppressive therapy, including but not limited to systemic lupus erythematosus, psoriasis, rheumatoid arthritis, inflammatory bowel disease, Hashimoto's thyroiditis, autoimmune thyroid disease, multiple sclerosis. Exceptions: hypothyroidism that can be controlled only by hormone replacement therapy, skin diseases (such as: vitiligo, psoriasis) that do not require systemic treatment, coeliac disease that has been controlled; 10. Any form of primary or secondary immunodeficiency, such as severe combined immunodeficiency (SCID); 11. History of severe systemic hypersensitivity reaction to the drugs/ingredients [fludarabine, cyclophosphamide, dimethyl sulfoxide (DMSO), low molecular dextran, human serum albumin (HSA), etc.] used in this study. 12. Patients have received attenuated vaccine within 4 weeks prior to signing informed consent. 13. Patients have received other clinical trials within 4 weeks prior to signing informed consent. 14. History of another malignancy tumor within the previous five years, except for adequately treated non-melanoma skin cancer, carcinoma in situ of bladder, stomach, colon, cervix/dysplasia, melanoma, or breast. 15. History of neuropsychiatric diseases diagnosed by the ICD-11 criteria or evaluated by investigator, including but not limited to epilepsy, schizophrenia, dementia, drug and alcohol addictions. 16. For any other reasons, the patients are believed not suitable for participation in this study by investigators.

Sites / Locations

  • Changhai HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Anti-CD70 CAR-T cells

Arm Description

Anti-CD70 CAR-T cells are autologous genetically modified T cells.

Outcomes

Primary Outcome Measures

Adverse Events (AEs)
Incidence and severity of adverse events.
Serious Adverse Events (SAEs)
Incidence and severity of serious adverse events.
Adverse Events of Special Interest (AESI)
Incidence and severity of adverse event of special interest.
Identification of Maximum Tolerated Dose (MTD)
Incidence and severity of dose-limiting toxicities (DLTs) following infusion of UCL70802 cell injection, at each dose level tested in dose escalation phase.

Secondary Outcome Measures

Objective Response Rate (ORR)
The Objective Response Rate (ORR) is the percentage of participants who achieved Complete Response (CR) or Partial Response (PR) based on RECIST version 1.1.
Duration of Overall Response (DOR)
Time from documentation of disease response to disease progression.
Progression-Free Survival (PFS)
PFS is defined as the time from CAR-T infusion to the date of the disease progression or death from any cause.
Overall Survival (OS)
OS is defined as the time from CAR-T infusion to the date of death due to any cause.
Bio-distribution of Anti-CD70 CAR-T cells
CAR copies will be measured by qPCR to evaluate the expansion and persistence of CAR-T cells in vivo.
Cytokine Level in Peripheral Blood
Level of cytokines (IFN-γ, IL-6, IL-2, etc.) in serum.
Number of participants with anti-drug antibodies.

Full Information

First Posted
August 7, 2023
Last Updated
August 11, 2023
Sponsor
Changhai Hospital
Collaborators
UTC Therapeutics Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05990621
Brief Title
Anti-CD70 CAR-T Cell Injection in Patients With CD70-positive Advanced Urologic Neoplasms
Official Title
A Single-arm, Open-label, Dose-escalation/Expansion, Early-phase Clinical Study of Anti-CD70 CAR-T Cell Injection in Patients With CD70-positive Advanced Urological Neoplasms
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 31, 2023 (Actual)
Primary Completion Date
January 31, 2026 (Anticipated)
Study Completion Date
March 31, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Changhai Hospital
Collaborators
UTC Therapeutics Inc.

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-arm, open-label, exploratory clinical study to evaluate the safety, tolerability and preliminary efficacy of Anti-CD70 CAR-T cell injection in patients with CD70-positive Advanced Urologic Neoplasms.
Detailed Description
This study will include two parts, dose escalation phase (accelerated titration and 3+3 design) followed by a dose expansion phase. All eligible participants will receive a conditioning chemotherapy regimen of fludarabine and cyclophosphamide followed by CAR-T cell injection. The dose escalation phase will determine the maximum tolerated dose (MTD) of Anti-CD70 CAR-T cell injection. Additional patients will be enrolled in the dose expansion phase to further characterize the safety profile and evaluate the efficacy of Anti-CD70 CAR-T cell injection, and establish recommended phase 2 dose (RP2D).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
CD70-positive Advanced Urologic Neoplasms
Keywords
Anti-CD70 CAR-T, Urologic Neoplasms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
Accelerated titration and 3+3 design dose escalation phase followed by dose expansion phase
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Anti-CD70 CAR-T cells
Arm Type
Experimental
Arm Description
Anti-CD70 CAR-T cells are autologous genetically modified T cells.
Intervention Type
Biological
Intervention Name(s)
Anti-CD70 CAR-T cells
Intervention Description
0.6×106/Kg ~ 5.0×106/Kg; cells will be infused intravenously.
Primary Outcome Measure Information:
Title
Adverse Events (AEs)
Description
Incidence and severity of adverse events.
Time Frame
2 years
Title
Serious Adverse Events (SAEs)
Description
Incidence and severity of serious adverse events.
Time Frame
2 years
Title
Adverse Events of Special Interest (AESI)
Description
Incidence and severity of adverse event of special interest.
Time Frame
2 years
Title
Identification of Maximum Tolerated Dose (MTD)
Description
Incidence and severity of dose-limiting toxicities (DLTs) following infusion of UCL70802 cell injection, at each dose level tested in dose escalation phase.
Time Frame
4 weeks after the CAR-T cells infusion
Secondary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
The Objective Response Rate (ORR) is the percentage of participants who achieved Complete Response (CR) or Partial Response (PR) based on RECIST version 1.1.
Time Frame
2 years
Title
Duration of Overall Response (DOR)
Description
Time from documentation of disease response to disease progression.
Time Frame
2 years
Title
Progression-Free Survival (PFS)
Description
PFS is defined as the time from CAR-T infusion to the date of the disease progression or death from any cause.
Time Frame
2 years
Title
Overall Survival (OS)
Description
OS is defined as the time from CAR-T infusion to the date of death due to any cause.
Time Frame
2 years
Title
Bio-distribution of Anti-CD70 CAR-T cells
Description
CAR copies will be measured by qPCR to evaluate the expansion and persistence of CAR-T cells in vivo.
Time Frame
2 years
Title
Cytokine Level in Peripheral Blood
Description
Level of cytokines (IFN-γ, IL-6, IL-2, etc.) in serum.
Time Frame
2 years
Title
Number of participants with anti-drug antibodies.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Subject is≥18 years old (including cut-off value), gender is not limited. 2. Histopathologically confirmed tumors of the urinary system (including renal cancers and urothelial cancers). Renal cancers should have failed after targeted therapy and/or immunotherapy. Urothelial cancers should have failed after chemotherapy and/or immunotherapy. Or subjects are unable to tolerate or lack effective therapies. 3. At least one measurable lesion according to RECIST v1.1. 4. CD70 should be positive confirmed by Immunohistochemistry/Immunocytochemistry/ Flow Cytometry (IHC/ICC/FCM) in tumor tissue samples. 5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. 6. Life expectancy ≥ 3 months. 7. Adequate function defined as: Hematological functions: Absolute neutrophil count (ANC) ≥ 1.5 × 109/L (Patients should not receive G-CSF support within 7 days before laboratory examination); Absolute Lymphocyte Count (ALC) ≥ 0.5 × 109/L; Hemoglobin (HGB) ≥ 80 g/L (Patients should not be transfused red cells within 7 days before the laboratory examination); Platelet count (PLT) ≥ 75 × 109/L (Patients should not receive transfusion support within 7 days before the laboratory examination). Hepatic functions: Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 × upper limit of normal (ULN); AST and ALT of patients with liver metastasis ≤ 5 × ULN; Total bilirubin (TBIL) ≤ 1.5 × ULN; TBIL of patients with liver metastasis must ≤ 3.0 × ULN; TBIL of patients with Gilbert's Syndrome ≤ 3.0 × ULN and Direct bilirubin (DBIL) ≤ 1.5 × ULN. Coagulation functions: International normalized ratio (INR) ≤ 1.5 × ULN; Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN (Except for patients who are receiving therapeutic anticoagulants.). Renal functions: Serum creatinine (Cr) ≤ 1.5 × ULN; or Estimated glomerular filtration rate (eGFR) ≥30ml/(min·1.73 m2)(Calculated by CKD⁃EPI). Cardiac functions: Left ventricular ejection fraction (LVEF) > 50%; Pulmonary function: Oxygen saturation (SpO2) > 92%. 8. Female participants of childbearing potential must undergo a pregnancy test and the results must be negative. Female participants of childbearing potential or male participants whose sex partner has childbearing potential must be willing to use effective methods of contraception from screening period to at least 1 year after infusion. 9. Participants must be able to understand the protocol and be willing to enroll the study, sign the informed consent, and be able to comply with the study and follow-up procedures. Exclusion Criteria: 1. Patients have received systemic therapy with cytotoxic chemicals, monoclonal antibodies, or immunotherapy within 4 weeks or 5 half-lives (which is shorter) prior to signing informed consent; Patients have received systemic glucocorticoids (prednisone at a dose of ≥10 mg per day or equivalent) or other immune-suppressive therapy within 2 weeks prior to signing informed consent; Patients have received systemic antitumor therapy with a biologic agent or other approved targeted small-molecule inhibitor within 1 week or five half-lives (which is shorter) prior to signing informed consent; Patients have received Chinese herbal medicine or Chinese patent medicine with anti-tumor indication within 1 week prior to signing informed consent. 2. Pregnant or lactating women. 3. Patients with hepatitis B surface antigen (HBsAg) positive. Patients who is hepatitis B core antibody (HBcAb) positive and the quantification of HBV DNA in peripheral blood is higher than the lower limit of detection. Patients who is hepatitis C virus (HCV) antibody positive and quantification of HCV DNA in peripheral blood is higher than the lower limit of detection. Patients with human immunodeficiency virus (HIV) antibody positive. Patients with syphilis antibody positive and tolulized red unheated serum test (TRUST) titer ≥ 1:4. 4. The toxicities caused by the prior therapy (surgery, chemotherapy, radiotherapy, targeted therapy, immunotherapy, etc.) have not recovered to grade 1 according to CTCAE, except for hair loss and peripheral sensory nerve disorders. 5. Have received any allogeneic tissue/organ transplantation (including bone marrow transplantation, stem cell transplantation, liver transplantation, kidney transplantation), except for the transplantation that does not require immunosuppressive therapy (such as: corneal transplantation, hair transplantation.) 6. Patients have received anti-CD70 CAR-T cell therapy. 7. Patients who have history of major surgery and unrecovered severe trauma within 4 weeks prior to signing informed consent; or plan to have major surgery within 12 weeks of cell therapy. 8. Presence of known central nervous system metastases, but the following patients will be allowed: a) Asymptomatic brain metastases; b) Clinically stable (no radiographic progression within 4 weeks before apheresis and return of any neurologic symptoms to baseline), and with no need for corticosteroids or other treatment for brain metastases for ≥ 4 weeks. 9. Patients with clinically significant systemic disease (such as: severe active infection or significant cardiac, pulmonary, hepatic, nervous system, or other organ dysfunction) that evaluated by the investigator would impair the patients' ability to tolerate the treatments used in this study or significantly increase the risk of complications. Uncontrolled severe active infection (sepsis, bacteremia, viremia, etc.); Congestive heart failure with New York Heart Association (NYHA) functional class > 1; Clinically significant severe aortic stenosis and symptomatic mitral stenosis; Electrocardiogram QTc > 450 msec or QTc > 480 msec in patients with bundle-branch block; Uncontrolled clinically significant arrhythmia within 6 months prior to signing informed consent; Acute coronary syndrome (such as: unstable angina, myocardial infarction) within 6 months prior to signing informed consent; Drug-uncontrolled hypertension (systolic pressure ≥ 160 mmHg and/or diastolic pressure ≥ 100 mmHg) or pulmonary hypertension; Cerebrovascular accident occurred within 6 months prior to signing informed consent, including transient ischemic attack (TIA), cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage; A history of active, chronic, or recurrent (within 1 year prior to signing informed consent) severe autoimmune disease or immune-mediated disease requiring steroids or other immunosuppressive therapy, including but not limited to systemic lupus erythematosus, psoriasis, rheumatoid arthritis, inflammatory bowel disease, Hashimoto's thyroiditis, autoimmune thyroid disease, multiple sclerosis. Exceptions: hypothyroidism that can be controlled only by hormone replacement therapy, skin diseases (such as: vitiligo, psoriasis) that do not require systemic treatment, coeliac disease that has been controlled; 10. Any form of primary or secondary immunodeficiency, such as severe combined immunodeficiency (SCID); 11. History of severe systemic hypersensitivity reaction to the drugs/ingredients [fludarabine, cyclophosphamide, dimethyl sulfoxide (DMSO), low molecular dextran, human serum albumin (HSA), etc.] used in this study. 12. Patients have received attenuated vaccine within 4 weeks prior to signing informed consent. 13. Patients have received other clinical trials within 4 weeks prior to signing informed consent. 14. History of another malignancy tumor within the previous five years, except for adequately treated non-melanoma skin cancer, carcinoma in situ of bladder, stomach, colon, cervix/dysplasia, melanoma, or breast. 15. History of neuropsychiatric diseases diagnosed by the ICD-11 criteria or evaluated by investigator, including but not limited to epilepsy, schizophrenia, dementia, drug and alcohol addictions. 16. For any other reasons, the patients are believed not suitable for participation in this study by investigators.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yewei Bao
Phone
13612400566
Email
16ywbao@alumni.stu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Linhui Wang
Organizational Affiliation
Changhai Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Changhai Hospital
City
Shanghai
State/Province
Shanghai
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yewei Bao
Phone
13612400566
Email
16ywbao@alumni.stu.edu.cn

12. IPD Sharing Statement

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Anti-CD70 CAR-T Cell Injection in Patients With CD70-positive Advanced Urologic Neoplasms

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