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Phase I/II Randomized Trial of Cord Blood-derived NK Cells Genetically Engineered With NY-ESO-1 TCR/IL-15 Cell Receptor for Relapsed/Refractory Multiple Myeloma

Primary Purpose

Myeloma

Status
Not yet recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Fludarabine phosphate
Cyclophosphamide
NY-ESO-1 TCR/IL-15 NK
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myeloma

Eligibility Criteria

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

Inclusion criteria: Patients with multiple myeloma with an expression of NY-ESO-1 by immunohistochemistry in the pre-enrollment tumor sample Patients are HLA-A*02:01positive on HLA typing Patients with relapsed or refractory MM (patients with solitary plasmacytoma are not eligible) who meet the following criteria: > or = 4 prior lines of therapy (including exposure to at least one proteasome inhibitor, ImiD, and anti-cd38 antibody and bcma targeted agent have measurable disease (serum monoclonal (M) protein level ≥0.5 g/dL, and/or urine M protein level ≥200 mg/day, and/or involved serum FLC level ≥10 mg/dL provided the serum-free light-chain ratio is abnormal *refractory is defined as a documented progressive disease during or within 60 days [measured from the last dose of any drug within the regimen] of completing treatment with the last anti-myeloma regimen before study entry. Patients with relapsed or refractory plasma cell leukemia who have received at least two previous regimens Patients at least 2 weeks from the last anti-myeloma therapy at the time of starting lymphodepleting chemotherapy. Patients may continue tyrosine kinase inhibitors or other targeted therapies until at least three days prior to administration of lymphodepleting chemotherapy. Small molecule targeted therapies will not include targeted immune therapies, such as daratumumab, isatuximab or elotuzumab. Prior autologous/allogeneic transplants are allowed. Prior cell therapy is allowed against targets other than NY-ESO-1. Patients must have recovered from systemic toxicity of prior anti-myeloma therapy at the start of lymphodepletion. No active or uncontrolled infection at the start of lymphodepletion and/or cell infusion. No therapeutic systemic corticosteroids (>/= 20 mg prednisone or equivalent) within 72 hours of lymphodepleting therapy. Patients with concurrent autoimmune diseases with neurologic involvement, such as multiple sclerosis will be excluded. Localized radiotherapy to one or more disease sites is allowed prior the infusion provided that there are additional disease sites that are not irradiated Karnofsky Performance Scale > 50%. Adequate organ function: Renal: Serum creatinine </= 1.5 mg/dL or estimated Glomerular Filtration Rate (eGFR using the CKI-EPI equation) >/= 45 ml/min/1.73 m2. Hepatic: ALT/AST </= 2.5 x ULN or </= 5 x ULN if documented liver metastases, Total bilirubin </= 1.5 mg/dL, except in subjects with Gilbert's Syndrome in whom total bilirubin must be </= 3.0 mg/dL. No history of liver cirrhosis. No ascites. Cardiac: Cardiac ejection fraction >/= 50%, no clinically significant pericardial effusion as determined by an ECHO or MUGA, and no uncontrolled arrhythmias or symptomatic cardiac disease. Pulmonary: No clinically significant pleural effusion (per PI discretion), baseline oxygen saturation > 92% on room air. Able to provide written informed consent. 18-80 years of age. Weight ≥40 kg All participants who are able to have children must practice effective birth control while on study and up to 3 months post completion of study therapy. Acceptable forms of birth control for female patients include: hormonal birth control, intrauterine device, diaphragm with spermicide, condom with spermicide, or abstinence, for the length of the study. If the participant is a female and becomes pregnant or suspects pregnancy, she must immediately notify her doctor. If the participant becomes pregnant during this study, she will be taken off this study. Men who are able to have children must use effective birth control while on the study. If the male participant fathers a child or suspects that he has fathered a child while on the study, he must immediately notify his doctor. Signed consent to long-term follow-up protocol PA17-0483 to fulfill the institutional responsibilities to various regulatory agencies. Participants must not have received any live vaccines within 30 days prior to enrollment. No active infection requiring systemic antibiotics Adequate bone marrow function without the need for transfusion in the last 7 days as described below, unless the pancytopenia is due to marrow replacement by myeloma: Absolute neutrophil count (ANC) ≥1000 /µL Hemoglobin ≥8 g/dL Platelet count ≥50,000 /µL No bridging anti-myeloma therapy within 14 days of lymphodepleting therapy Criteria for Cell Infusion- Patients who meet one of the following criteria on the day of infusion will have their administration delayed for 24 hours. If these problems persist beyond 24 hours, patients will not receive their cell infusion. cardiac arrhythmias not controlled with medical management hypotension requiring vasopressor support suspected or active uncontrolled infection Exclusion Criteria: 1. None

Sites / Locations

  • M D Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Part A: Cell therapy with NY-ESO-1 TCR/IL-15 NK - INPATIENT

Part A2: Cell therapy with NY-ESO-1 TCR/IL-15 NK - OUTPATIENT

Part B: Cell therapy with NY-ESO-1 TCR/IL-15 NK - INPATIENT

Part B2: Cell therapy with NY-ESO-1 TCR/IL-15 NK - OUTPATIENT

Arm Description

Outcomes

Primary Outcome Measures

Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5.0

Secondary Outcome Measures

Full Information

First Posted
September 27, 2023
Last Updated
September 27, 2023
Sponsor
M.D. Anderson Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT06066359
Brief Title
Phase I/II Randomized Trial of Cord Blood-derived NK Cells Genetically Engineered With NY-ESO-1 TCR/IL-15 Cell Receptor for Relapsed/Refractory Multiple Myeloma
Official Title
Phase I/II Randomized Trial of Cord Blood-derived NK Cells Genetically Engineered With NY-ESO-1 TCR/IL-15 Cell Receptor for Relapsed/Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
May 1, 2024 (Anticipated)
Primary Completion Date
August 31, 2026 (Anticipated)
Study Completion Date
August 31, 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
M.D. Anderson Cancer Center

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
To find the recommended dose of NY-ESO-1 TCR/IL-15 NK cells that can be given to patients with relapsed or refractory MM. To learn if the dose of NY-ESO-1 TCR/IL-15 NK cells found in Part A can help to control the disease.
Detailed Description
Primary Objectives: Part A: To assess dose-limiting toxicity (DLT) and determine the safety and optimal cell dose of NY-ESO-1 TCR/IL-15 NK cells in patients with relapsed/refractory multiple myeloma. Part B: To assess the day +90 overall response rate in patients treated at the optimal cell dose. Secondary Objectives: Assess day +180 progression-free survival (PFS). Quantify the persistence of infused allogeneic donor TCR-transduced CB-derived NK cells in the recipient. To conduct comprehensive immune reconstitution studies. To obtain preliminary data on quality of life and patient experience. Assess duration of response (DOR) Secondary end points Day +180 PFS rate; NY-ESO-1 TCR/IL-15 NK cell numbers in peripheral blood vs time profile; Characterization of lymphocyte populations at various time points; PROMIS-29 quality of life questionnaire score. Duration of response

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
44 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Part A: Cell therapy with NY-ESO-1 TCR/IL-15 NK - INPATIENT
Arm Type
Experimental
Arm Title
Part A2: Cell therapy with NY-ESO-1 TCR/IL-15 NK - OUTPATIENT
Arm Type
Experimental
Arm Title
Part B: Cell therapy with NY-ESO-1 TCR/IL-15 NK - INPATIENT
Arm Type
Experimental
Arm Title
Part B2: Cell therapy with NY-ESO-1 TCR/IL-15 NK - OUTPATIENT
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Fludarabine phosphate
Other Intervention Name(s)
Fludarabine, Fludara®
Intervention Description
Given by (IV) vein
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Other Intervention Name(s)
Cytoxan®, Neosar®
Intervention Description
Given by (IV) vein
Intervention Type
Drug
Intervention Name(s)
NY-ESO-1 TCR/IL-15 NK
Intervention Description
Given by (IV) vein
Primary Outcome Measure Information:
Title
Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5.0
Time Frame
through study completion; an average of 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Patients with multiple myeloma with an expression of NY-ESO-1 by immunohistochemistry in the pre-enrollment tumor sample Patients are HLA-A*02:01positive on HLA typing Patients with relapsed or refractory MM (patients with solitary plasmacytoma are not eligible) who meet the following criteria: > or = 4 prior lines of therapy (including exposure to at least one proteasome inhibitor, ImiD, and anti-cd38 antibody and bcma targeted agent have measurable disease (serum monoclonal (M) protein level ≥0.5 g/dL, and/or urine M protein level ≥200 mg/day, and/or involved serum FLC level ≥10 mg/dL provided the serum-free light-chain ratio is abnormal *refractory is defined as a documented progressive disease during or within 60 days [measured from the last dose of any drug within the regimen] of completing treatment with the last anti-myeloma regimen before study entry. Patients with relapsed or refractory plasma cell leukemia who have received at least two previous regimens Patients at least 2 weeks from the last anti-myeloma therapy at the time of starting lymphodepleting chemotherapy. Patients may continue tyrosine kinase inhibitors or other targeted therapies until at least three days prior to administration of lymphodepleting chemotherapy. Small molecule targeted therapies will not include targeted immune therapies, such as daratumumab, isatuximab or elotuzumab. Prior autologous/allogeneic transplants are allowed. Prior cell therapy is allowed against targets other than NY-ESO-1. Patients must have recovered from systemic toxicity of prior anti-myeloma therapy at the start of lymphodepletion. No active or uncontrolled infection at the start of lymphodepletion and/or cell infusion. No therapeutic systemic corticosteroids (>/= 20 mg prednisone or equivalent) within 72 hours of lymphodepleting therapy. Patients with concurrent autoimmune diseases with neurologic involvement, such as multiple sclerosis will be excluded. Localized radiotherapy to one or more disease sites is allowed prior the infusion provided that there are additional disease sites that are not irradiated Karnofsky Performance Scale > 50%. Adequate organ function: Renal: Serum creatinine </= 1.5 mg/dL or estimated Glomerular Filtration Rate (eGFR using the CKI-EPI equation) >/= 45 ml/min/1.73 m2. Hepatic: ALT/AST </= 2.5 x ULN or </= 5 x ULN if documented liver metastases, Total bilirubin </= 1.5 mg/dL, except in subjects with Gilbert's Syndrome in whom total bilirubin must be </= 3.0 mg/dL. No history of liver cirrhosis. No ascites. Cardiac: Cardiac ejection fraction >/= 50%, no clinically significant pericardial effusion as determined by an ECHO or MUGA, and no uncontrolled arrhythmias or symptomatic cardiac disease. Pulmonary: No clinically significant pleural effusion (per PI discretion), baseline oxygen saturation > 92% on room air. Able to provide written informed consent. 18-80 years of age. Weight ≥40 kg All participants who are able to have children must practice effective birth control while on study and up to 3 months post completion of study therapy. Acceptable forms of birth control for female patients include: hormonal birth control, intrauterine device, diaphragm with spermicide, condom with spermicide, or abstinence, for the length of the study. If the participant is a female and becomes pregnant or suspects pregnancy, she must immediately notify her doctor. If the participant becomes pregnant during this study, she will be taken off this study. Men who are able to have children must use effective birth control while on the study. If the male participant fathers a child or suspects that he has fathered a child while on the study, he must immediately notify his doctor. Signed consent to long-term follow-up protocol PA17-0483 to fulfill the institutional responsibilities to various regulatory agencies. Participants must not have received any live vaccines within 30 days prior to enrollment. No active infection requiring systemic antibiotics Adequate bone marrow function without the need for transfusion in the last 7 days as described below, unless the pancytopenia is due to marrow replacement by myeloma: Absolute neutrophil count (ANC) ≥1000 /µL Hemoglobin ≥8 g/dL Platelet count ≥50,000 /µL No bridging anti-myeloma therapy within 14 days of lymphodepleting therapy Criteria for Cell Infusion- Patients who meet one of the following criteria on the day of infusion will have their administration delayed for 24 hours. If these problems persist beyond 24 hours, patients will not receive their cell infusion. cardiac arrhythmias not controlled with medical management hypotension requiring vasopressor support suspected or active uncontrolled infection Exclusion Criteria: 1. None
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Muzaffar Qazilbash, M D
Phone
(713) 745-3458
Email
mqazilba@mdanderson.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Muzaffar Qazilbash, M D
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
M D Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Muzaffar Qazilbash, M D
Phone
713-745-3458
Email
mqazilba@mdanderson.org
First Name & Middle Initial & Last Name & Degree
Muzaffar Qazilbash, M D

12. IPD Sharing Statement

Links:
URL
http://www.mdanderson.org
Description
M D Anderson Cancer Center

Learn more about this trial

Phase I/II Randomized Trial of Cord Blood-derived NK Cells Genetically Engineered With NY-ESO-1 TCR/IL-15 Cell Receptor for Relapsed/Refractory Multiple Myeloma

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