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Base-edited Autologous Hematopoietic Stem Cell Transplantation in Treating Patients With β-thalassemia Major

Primary Purpose

Beta-Thalassemia

Status
Not yet recruiting
Phase
Early Phase 1
Locations
Study Type
Interventional
Intervention
CS-101 injection
Sponsored by
Children's Hospital of Fudan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Beta-Thalassemia

Eligibility Criteria

3 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 6 to 17 years old(inclusive) male or female subjects at the time of informed consenting Diagnosis of β-thalassemia, genotypes include but are not limited to β+β0, βEβ0, β0β0, etc Generally in good condition, Karnofsky performance score≥60 points for subjects≥16 years old at the time of autologous hematopoietic stem cell collection, or Lansky Play-Performance score≥60 points for subjects under 16 years old, or equivalent clinical evaluation as the investigator site's common practice Exclusion Criteria: Treatment with other investigational medications or other experimental interventions 30 days prior to signing informed consent or within 6 half-lives of the drug, whichever is longer. Subjects who have received or are receiving thalidomide and/or Luspatercept, when their drug-drug interaction on the efficacy and safety of CS-101 cannot be ruled out, unless at least there are 3 test results showing the total hemoglobin level before transfusion is below 9g/dL in the past 6 months before screening. Previously received allogeneic hematopoietic stem cell transplantation or gene(edited) therapy. Subjects have available related fully matching donors and are eligible and prepared for allogeneic hematopoietic stem cell transplantation. Those with active infections, including but not limited to: HIV, hepatitis B, hepatitis C, cytomegalovirus, Epstein-Barr virus and treponema pallidum test positive, or known tuberculosis, parasitic infection, etc. who are judged by the investigator to be unsuitable to participate in this study Echocardiography results with ejection fraction below 45% Advanced liver disease, defined as aspartate aminotransferase (AST), alanine aminotransferase (ALT) >3 × upper limit of normal (ULN) or baseline International Normalized Ratio (INR) >1.5 × ULN MRI during the screening period showed heavy iron overload and is judged by the investigator to be unable to participate in the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    CS-101 injection

    Arm Description

    Autologous CD34+(cluster of differentiation 34) hematopoietic stem cell suspension modified by in vitro base editing technique

    Outcomes

    Primary Outcome Measures

    Frequency and severity of adverse events(AEs) as assessed by CTCAE v5.0
    Occurrence of engraftment
    Subjects with engraftment is defined as neutrophil engrafted
    Time to neutrophil and platelet engraftment
    Time to neutrophil engraftment is defined as first day of 3 consecutive measurements of absolute neutrophil count≥0.5×10^9/L on three different days; Time to platelet engraftment is defined as first day of 3 consecutive measurements of absolute platelet count≥20×10^9/L on three different days and without platelet transfusion
    Occurrence of transplant-related death
    Occurrence of all-cause death
    Occurrence of achieving transfusion reduction for at least 3 consecutive months

    Secondary Outcome Measures

    Occurrence of achieving transfusion independence for at least 3 consecutive months
    Time to last red blood cell(RBC) transfusion
    Change in total hemoglobin(Hb) concentration over time
    Change in fetal hemoglobin(HbF) concentration over time
    Chimerism level in Peripheral blood and bone marrow
    Proportion of alleles with intended genetic modification in peripheral blood leukocytes and bone marrow over time

    Full Information

    First Posted
    September 27, 2023
    Last Updated
    September 27, 2023
    Sponsor
    Children's Hospital of Fudan University
    Collaborators
    CorrectSequence Therapeutics Co., Ltd
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06065189
    Brief Title
    Base-edited Autologous Hematopoietic Stem Cell Transplantation in Treating Patients With β-thalassemia Major
    Official Title
    Evaluation and Promotion of Key Technologies of Base-edited Autologous Hematopoietic Stem Cell Transplantation in Treating Patients With β-thalassemia Major
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    October 16, 2023 (Anticipated)
    Primary Completion Date
    October 16, 2024 (Anticipated)
    Study Completion Date
    December 31, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Children's Hospital of Fudan University
    Collaborators
    CorrectSequence Therapeutics Co., Ltd

    4. Oversight

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

    5. Study Description

    Brief Summary
    The goal of this open label, single-arm clinical study is to learn about the safety and efficacy of base-edited autologous hematopoietic stem cell transplantation(CS-101) in treating patients with β-thalassemia major.
    Detailed Description
    CS-101 is an autologous CD34+ cell suspension modified by ex vivo base editing technology, removing the inhibitory effect of BCL11A on the γ-globin coding gene, inducing the production of γ-globin chains, increasing the concentration of fetal hemoglobin (HbF) in the blood, compensating for the loss of adult hemoglobin (HbA) to treat transfusion-dependent type/ Major β - thalassemia. The therapy addresses two major challenges in the treatment of the disease: lack of matching donors and graft-versus-host responses commonly seen in allogeneic hematopoietic stem cell transplantation. The study consists of the following five phases: Screening phase: Sign informed consent, complete screening assessments, and confirm the eligibility for enrollment; Baseline: check the subject's baseline status; Mobilization, collection and manufacturing phase: mobilize, collect autologous CD34+ cells and manufacture, release and transport CS-101 product; Conditioning and treatment phase: including myeloablation and CS-101 product infusion; Follow-up phase: 180 days post-infusion.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Beta-Thalassemia

    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
    5 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    CS-101 injection
    Arm Type
    Experimental
    Arm Description
    Autologous CD34+(cluster of differentiation 34) hematopoietic stem cell suspension modified by in vitro base editing technique
    Intervention Type
    Biological
    Intervention Name(s)
    CS-101 injection
    Intervention Description
    Autologous CD34+ hematopoietic stem cell suspension modified by in vitro base editing technique
    Primary Outcome Measure Information:
    Title
    Frequency and severity of adverse events(AEs) as assessed by CTCAE v5.0
    Time Frame
    From signing informed consent to 180 days post-CS-101 infusion
    Title
    Occurrence of engraftment
    Description
    Subjects with engraftment is defined as neutrophil engrafted
    Time Frame
    within 42 days post-CS-101 infusion
    Title
    Time to neutrophil and platelet engraftment
    Description
    Time to neutrophil engraftment is defined as first day of 3 consecutive measurements of absolute neutrophil count≥0.5×10^9/L on three different days; Time to platelet engraftment is defined as first day of 3 consecutive measurements of absolute platelet count≥20×10^9/L on three different days and without platelet transfusion
    Time Frame
    Days post-CS-101 infusion
    Title
    Occurrence of transplant-related death
    Time Frame
    baseline to 100 days post-CS-101 infusion
    Title
    Occurrence of all-cause death
    Time Frame
    From signing informed consent to 180 days post-CS-101 infusion
    Title
    Occurrence of achieving transfusion reduction for at least 3 consecutive months
    Time Frame
    From 3 months post -CS-101 infusion to 3 months post -CS-101 infusion
    Secondary Outcome Measure Information:
    Title
    Occurrence of achieving transfusion independence for at least 3 consecutive months
    Time Frame
    From 3 months up to 180 days post-CS-101 infusion
    Title
    Time to last red blood cell(RBC) transfusion
    Time Frame
    Days post-CS-101 infusion
    Title
    Change in total hemoglobin(Hb) concentration over time
    Time Frame
    up to 180 days post-CS-101 infusion
    Title
    Change in fetal hemoglobin(HbF) concentration over time
    Time Frame
    up to 180 days post-CS-101 infusion
    Title
    Chimerism level in Peripheral blood and bone marrow
    Description
    Proportion of alleles with intended genetic modification in peripheral blood leukocytes and bone marrow over time
    Time Frame
    up to 180 days post-CS-101 infusion

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    3 Years
    Maximum Age & Unit of Time
    17 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: 6 to 17 years old(inclusive) male or female subjects at the time of informed consenting Diagnosis of β-thalassemia, genotypes include but are not limited to β+β0, βEβ0, β0β0, etc Generally in good condition, Karnofsky performance score≥60 points for subjects≥16 years old at the time of autologous hematopoietic stem cell collection, or Lansky Play-Performance score≥60 points for subjects under 16 years old, or equivalent clinical evaluation as the investigator site's common practice Exclusion Criteria: Treatment with other investigational medications or other experimental interventions 30 days prior to signing informed consent or within 6 half-lives of the drug, whichever is longer. Subjects who have received or are receiving thalidomide and/or Luspatercept, when their drug-drug interaction on the efficacy and safety of CS-101 cannot be ruled out, unless at least there are 3 test results showing the total hemoglobin level before transfusion is below 9g/dL in the past 6 months before screening. Previously received allogeneic hematopoietic stem cell transplantation or gene(edited) therapy. Subjects have available related fully matching donors and are eligible and prepared for allogeneic hematopoietic stem cell transplantation. Those with active infections, including but not limited to: HIV, hepatitis B, hepatitis C, cytomegalovirus, Epstein-Barr virus and treponema pallidum test positive, or known tuberculosis, parasitic infection, etc. who are judged by the investigator to be unsuitable to participate in this study Echocardiography results with ejection fraction below 45% Advanced liver disease, defined as aspartate aminotransferase (AST), alanine aminotransferase (ALT) >3 × upper limit of normal (ULN) or baseline International Normalized Ratio (INR) >1.5 × ULN MRI during the screening period showed heavy iron overload and is judged by the investigator to be unable to participate in the study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Xiaowen Zhai, M.D.
    Phone
    862164931126
    Email
    zhaixiaowendy@163.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Zifeng Li, M.S.
    Phone
    +8613920704768
    Email
    zfli18@fudan.edu.cn
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Xiaowen Zhai, M.D.
    Organizational Affiliation
    Children's Hospital of Fudan University
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

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