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A Phase I/II Study Evaluating Temferon in Multiple Myeloma Patients With Early Relapse After Front Line Therapy (TEM-MM)

Primary Purpose

Multiple Myeloma

Status
Terminated
Phase
Phase 1
Locations
Italy
Study Type
Interventional
Intervention
Temferon
Sponsored by
Genenta Science
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring Temferon, Gene Therapy, Immunotherapy, Hematological malignancy

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Multiple myeloma patients with early relapse after intensive front-line treatment and disease measurable by serum biomarkers, who have obtained at least a VGPR after second-line salvage treatment.
  • Able and willing to provide written informed consent.
  • Able to comply with study protocol and procedures.
  • Performance status scores: Eastern Cooperative Oncology Group (ECOG) < 2 and Karnofsky > 70%.
  • Life expectancy of ≥ 6 months.
  • Adequate cardiac, renal, hepatic and pulmonary functions as evidenced by (at screening and prior to conditioning):

    • Left ventricular ejection fraction (LVEF) ≥ 45% by echo and normal electrocardiogram (ECG) or presence of abnormalities not significant for cardiac disease. Absence of severe pulmonary hypertension;
    • Diffusing capacity of the lung for carbon monoxide (DLCO) >50% and forced expiratory volume in 1 sec (FEV1) and forced expiratory vital capacity (FVC) > 60% predicted (if non cooperative: pulse oximetry > 95 % in room air);
    • Serum creatinine < 2x ULN and estimated glomerular filtration rate (eGFR) > 30 ml/min/1.73m2;
    • Alkaline phosphatase (ALP), alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) ≤ 2.5 x ULN, and total bilirubin ≤ 2.0 mg/dl.
  • Women of child-bearing potential enrolled in the study must have a negative pregnancy test at screening and agree to use two distinct acceptable methods of contraception during the trial.
  • Men enrolled in the study with partners who are women of child bearing potential, must be willing to use an acceptable barrier contraceptive method during the trial or have undergone successful vasectomy at least 6 months prior to entry into the study. Successful vasectomy needs to have been confirmed by semen analysis.

Exclusion Criteria:

  • Use of other investigational agents within 4 weeks prior to experimental treatment (within 6 weeks if use of long-acting agents).
  • Severe active viral, bacterial, or fungal infection at eligibility evaluation.
  • Active autoimmune disease or a clinically relevant autoimmune manifestations, requiring immunosuppressive treatment, i.e. psoriasis, systemic lupus erythematosus, rheumatoid arthritis, vasculitis, immune-mediated peripheral neuropathies.
  • Active sarcoidosis requiring steroid or other immunosuppressive treatment.
  • Primary amyloidosis.
  • History of neuropsychiatric illness including severe depression, schizophrenia, bipolar disorders, impaired cognitive function, dementia or suicidal tendency.
  • Neuropathy > grade 2.
  • History of severe cardiovascular disease such as prior stroke, coronary artery disease requiring intervention, unresolved arrhythmias.
  • Malignant neoplasia (except local skin cancer or cervical intraepithelial neoplasia) or family history of familial cancer syndromes.
  • Myelodysplasia, cytogenetic or molecular alterations specifically associated with clonal hematopoiesis of the myeloid lineage, or other serious hematological disorder other than the plasma cell dyscrasia.
  • Other clinical conditions judged by the Investigator non-compatible with the study procedures.
  • Positivity for HIV-1 or HIV-2 (serology or RNA), and/or Hepatitis B Virus Surface Antigen (HbsAg) and/or Hepatitis B Virus (HBV) DNA and/or Hepatitis C Virus (HCV) RNA (or negative HCV RNA but on antiviral treatment) and/or Treponema Pallidum or Mycoplasma active infection.
  • Active alcohol or substance abuse within 6 months of the study.
  • Pregnancy or lactation.
  • Previous allogeneic bone marrow transplantation, kidney or liver transplant, or gene therapy.
  • Prior to conditioning: inability to meet the target mobilization cell number needed to manufacture the Drug Product after at least 2 attempts of HSPC collection.

Sites / Locations

  • Ospedale San Raffaele

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Temferon

Arm Description

Autologous CD34+-enriched hematopoietic progenitor cells exposed ex vivo to a specific lentiviral vector encoding for the human IFN-ɑ2 gene. Its expression is tightly controlled by the human TIE2 enhancer/promoter sequence and by a post-transcriptional regulation layer represented by target miRNA sequences. This enables suppression of IFN-ɑ2 expression in HSPCs, thereby further increasing the specificity of the delivery strategy for their Tie2 expressing myeloid cell progeny.

Outcomes

Primary Outcome Measures

Tolerability and Safety of Temferon Over the First 90 Days Following Administration as Determined by the Incidence of CTCAEs
0 participants analyzed. All the patients were withdrawn before treatment

Secondary Outcome Measures

Long Term Tolerability and Safety of Temferon as Determined by the Incidence of CTCAEs
0 participants analyzed. All the patients were withdrawn before treatment
Proportion of Patients Achieving Hematologic Recovery by Day +30 (Defined as the First of at Least 3 Consecutive Days With a Neutrophil Count >0.5 x 10^9/L and Platelet Count >20 x 10^9/L) in the Absence of Transfusions
Determine the Maximum Tolerated Dose of Temferon
Identify Presence of Transduced Myeloid Cells in Bone Marrow as Determined by Vector Copy Number
Identify Presence of Transduced Myeloid Cells in Peripheral Blood as Determined by Vector Copy Number
Identify Persistence of Transduced Myeloid Cells in Bone Marrow and Peripheral Blood as Determined by Vector Copy Number
Determine Clinical Response in Patients as Determined by IMWG Response Criteria
Fraction of Patients Achieving Complete Response With Minimal Residual Disease (MRD) Negativity
Determine Progression Free Survival in Patients
Determine Overall Survival in Patients
Changes in Functional Status (Eastern Cooperative Oncology Group, ECOG)
Changes in Functional Status (Karnofsky)
Changes in Quality of Life: European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30
Changes in Quality of Life: European Organisation for Research and Treatment of Cancer (EORTC) QLQ-MY20

Full Information

First Posted
March 13, 2019
Last Updated
January 27, 2022
Sponsor
Genenta Science
Collaborators
IRCCS San Raffaele
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1. Study Identification

Unique Protocol Identification Number
NCT03875495
Brief Title
A Phase I/II Study Evaluating Temferon in Multiple Myeloma Patients With Early Relapse After Front Line Therapy (TEM-MM)
Official Title
A Phase I/II Dose Escalation Study Evaluating Safety and Activity of Autologous CD34+-Enriched Hematopoietic Progenitor Cells Genetically Modified With a Lentiviral Vector Encoding for the Human Interferon-ɑ2 Gene in Multiple Myeloma Patients With Early Relapse After Intensive Front Line Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Terminated
Why Stopped
Failure to recruit patients
Study Start Date
March 6, 2019 (Actual)
Primary Completion Date
April 2, 2021 (Actual)
Study Completion Date
April 2, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genenta Science
Collaborators
IRCCS San Raffaele

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
This is a non-randomized, open label, phase I/II, dose-escalation study, involving a single injection of Temferon, an investigational advanced therapy consisting of autologous CD34+-enriched hematopoietic stem and progenitor cells exposed to transduction with a lentiviral vector driving myeloid-specific interferon-ɑ2 expression, which will be administered to up to 9 patients affected by multiple myeloma in early relapse after intensive front line treatment.
Detailed Description
This is a non-randomized, open label, single center, phase I/II, therapeutic exploratory, dose-escalation, prospective study, involving a single intravenous infusion of Temferon, an investigational advanced therapy consisting of autologous CD34+-enriched hematopoietic stem and progenitor cells (HSPCs) exposed to transduction with a third-generation, vesicular stomatitis virus-G (VSV-G) pseudo-typed lentiviral vector driving myeloid-specific interferon-ɑ2 (IFN-ɑ2) expression, which will be administered to up to 9 patients affected by multiple myeloma in early relapse after intensive front line treatment. The study will recruit, treat and follow-up patients at a specialist hematology and bone marrow transplantation unit at Ospedale San Raffaele (OSR) in Milan, Italy. The study will enrol multiple myeloma patients that have experienced an early relapse after intensive front line treatment, have been treated with an approved second line combination treatment regimen and obtained at least a very good partial remission (VGPR) according to International Myeloma Working Group (IMWG) criteria. Once the written informed consent is obtained, and screening procedures have been completed, harvesting of HSPCs will occur. Patients will be offered maintenance treatment during Temferon production and release. Upon Temferon release for clinical use, patients will be admitted to the transplantation unit for receipt of a reduced-intensity conditioning regimen consisting of melphalan. This will be followed by autologous stem cell transplant (ASCT) and administration of Temferon. In-patient monitoring will occur until hematological recovery occurs. Thereafter, regular follow-up of patients will occur up to 2 years (+730 days). At the +730 day visit, patients will be invited to participate in a long term follow-up study which will last for an additional 6 years. 3 cohorts of 3 patients will receive escalating doses of Temferon. In the event that MM disease progression occurs, patients will be managed according to best clinical practice.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Temferon, Gene Therapy, Immunotherapy, Hematological malignancy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Temferon
Arm Type
Experimental
Arm Description
Autologous CD34+-enriched hematopoietic progenitor cells exposed ex vivo to a specific lentiviral vector encoding for the human IFN-ɑ2 gene. Its expression is tightly controlled by the human TIE2 enhancer/promoter sequence and by a post-transcriptional regulation layer represented by target miRNA sequences. This enables suppression of IFN-ɑ2 expression in HSPCs, thereby further increasing the specificity of the delivery strategy for their Tie2 expressing myeloid cell progeny.
Intervention Type
Drug
Intervention Name(s)
Temferon
Intervention Description
Genetically modified autologous HSPCs
Primary Outcome Measure Information:
Title
Tolerability and Safety of Temferon Over the First 90 Days Following Administration as Determined by the Incidence of CTCAEs
Description
0 participants analyzed. All the patients were withdrawn before treatment
Time Frame
90 days
Secondary Outcome Measure Information:
Title
Long Term Tolerability and Safety of Temferon as Determined by the Incidence of CTCAEs
Description
0 participants analyzed. All the patients were withdrawn before treatment
Time Frame
2 years
Title
Proportion of Patients Achieving Hematologic Recovery by Day +30 (Defined as the First of at Least 3 Consecutive Days With a Neutrophil Count >0.5 x 10^9/L and Platelet Count >20 x 10^9/L) in the Absence of Transfusions
Time Frame
30 days
Title
Determine the Maximum Tolerated Dose of Temferon
Time Frame
30 days
Title
Identify Presence of Transduced Myeloid Cells in Bone Marrow as Determined by Vector Copy Number
Time Frame
Up to 2 years
Title
Identify Presence of Transduced Myeloid Cells in Peripheral Blood as Determined by Vector Copy Number
Time Frame
Up to 2 years
Title
Identify Persistence of Transduced Myeloid Cells in Bone Marrow and Peripheral Blood as Determined by Vector Copy Number
Time Frame
At least 12 weeks
Title
Determine Clinical Response in Patients as Determined by IMWG Response Criteria
Time Frame
Up to 2 years
Title
Fraction of Patients Achieving Complete Response With Minimal Residual Disease (MRD) Negativity
Time Frame
Up to 2 years
Title
Determine Progression Free Survival in Patients
Time Frame
Up to 2 years
Title
Determine Overall Survival in Patients
Time Frame
2 years
Title
Changes in Functional Status (Eastern Cooperative Oncology Group, ECOG)
Time Frame
2 years
Title
Changes in Functional Status (Karnofsky)
Time Frame
2 years
Title
Changes in Quality of Life: European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30
Time Frame
2 years
Title
Changes in Quality of Life: European Organisation for Research and Treatment of Cancer (EORTC) QLQ-MY20
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Multiple myeloma patients with early relapse after intensive front-line treatment and disease measurable by serum biomarkers, who have obtained at least a VGPR after second-line salvage treatment. Able and willing to provide written informed consent. Able to comply with study protocol and procedures. Performance status scores: Eastern Cooperative Oncology Group (ECOG) < 2 and Karnofsky > 70%. Life expectancy of ≥ 6 months. Adequate cardiac, renal, hepatic and pulmonary functions as evidenced by (at screening and prior to conditioning): Left ventricular ejection fraction (LVEF) ≥ 45% by echo and normal electrocardiogram (ECG) or presence of abnormalities not significant for cardiac disease. Absence of severe pulmonary hypertension; Diffusing capacity of the lung for carbon monoxide (DLCO) >50% and forced expiratory volume in 1 sec (FEV1) and forced expiratory vital capacity (FVC) > 60% predicted (if non cooperative: pulse oximetry > 95 % in room air); Serum creatinine < 2x ULN and estimated glomerular filtration rate (eGFR) > 30 ml/min/1.73m2; Alkaline phosphatase (ALP), alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) ≤ 2.5 x ULN, and total bilirubin ≤ 2.0 mg/dl. Women of child-bearing potential enrolled in the study must have a negative pregnancy test at screening and agree to use two distinct acceptable methods of contraception during the trial. Men enrolled in the study with partners who are women of child bearing potential, must be willing to use an acceptable barrier contraceptive method during the trial or have undergone successful vasectomy at least 6 months prior to entry into the study. Successful vasectomy needs to have been confirmed by semen analysis. Exclusion Criteria: Use of other investigational agents within 4 weeks prior to experimental treatment (within 6 weeks if use of long-acting agents). Severe active viral, bacterial, or fungal infection at eligibility evaluation. Active autoimmune disease or a clinically relevant autoimmune manifestations, requiring immunosuppressive treatment, i.e. psoriasis, systemic lupus erythematosus, rheumatoid arthritis, vasculitis, immune-mediated peripheral neuropathies. Active sarcoidosis requiring steroid or other immunosuppressive treatment. Primary amyloidosis. History of neuropsychiatric illness including severe depression, schizophrenia, bipolar disorders, impaired cognitive function, dementia or suicidal tendency. Neuropathy > grade 2. History of severe cardiovascular disease such as prior stroke, coronary artery disease requiring intervention, unresolved arrhythmias. Malignant neoplasia (except local skin cancer or cervical intraepithelial neoplasia) or family history of familial cancer syndromes. Myelodysplasia, cytogenetic or molecular alterations specifically associated with clonal hematopoiesis of the myeloid lineage, or other serious hematological disorder other than the plasma cell dyscrasia. Other clinical conditions judged by the Investigator non-compatible with the study procedures. Positivity for HIV-1 or HIV-2 (serology or RNA), and/or Hepatitis B Virus Surface Antigen (HbsAg) and/or Hepatitis B Virus (HBV) DNA and/or Hepatitis C Virus (HCV) RNA (or negative HCV RNA but on antiviral treatment) and/or Treponema Pallidum or Mycoplasma active infection. Active alcohol or substance abuse within 6 months of the study. Pregnancy or lactation. Previous allogeneic bone marrow transplantation, kidney or liver transplant, or gene therapy. Prior to conditioning: inability to meet the target mobilization cell number needed to manufacture the Drug Product after at least 2 attempts of HSPC collection.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Fabio Ciceri, MD
Organizational Affiliation
Ospedale San Raffaele, Milan, Italy
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ospedale San Raffaele
City
Milan
ZIP/Postal Code
20132
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase I/II Study Evaluating Temferon in Multiple Myeloma Patients With Early Relapse After Front Line Therapy (TEM-MM)

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