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Administration of T Lymphocytes for Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma (CART CD30)

Primary Purpose

Non-Hodgkin's Lymphoma, Hodgkin's Lymphoma

Status
Withdrawn
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
CAR.CD30 T cells
Sponsored by
UNC Lineberger Comprehensive Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Hodgkin's Lymphoma focused on measuring Hodgkin's Lymphoma, Non-Hodgkin's Lymphoma, Lymphoma, T lymphocytes

Eligibility Criteria

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

INCLUSION CRITERIA

Procurement Inclusion Criteria:

Referred patients will initially be consented for procurement of blood for generation of the transduced ATL. Eligibility criteria at this stage include:

  • Diagnosis of recurrent CD30+ HL or CD30+ NHL, or newly diagnosed patients unable to receive or complete standard therapy OR diagnosis of relapsed/refractory CD30+ HL or CD30+ NHL with a treatment plan that will include high dose therapy and stem cell transplantation
  • CD30 positive tumor (result can be pending at this time)
  • Hgb > 8.0
  • Informed consent explained to, understood by and signed by patient/guardian. Patient/guardian given copy of informed consent.
  • Karnofsky or Lansky score greater than 60%

Procurement Exclusion Criteria

- Active infection with HIV, HTLV, HBV, HCV (can be pending at this time).

Treatment Inclusion Criteria:

Diagnosis - CD30+ HL or CD30+ NHL:

  1. During the Dose Escalation Phase: only adult patients with active disease failing standard therapy
  2. After Dose Escalation: any patient (children or adults) newly diagnosed, unable to receive or complete standard therapy OR diagnosis of relapsed/refractory CD30+ HL or CD30+ NHL with a treatment plan that will include high dose therapy and autologous stem cell transplantation. (During dose escalation: only adult patients (age 18 and older; After Dose Escalation: any patient (children ages 0-17 or adults)

    • CD30 positive tumor
    • Bilirubin 1.5 times or less than upper limit of normal.
    • AST 3 times or less than upper limit of normal.
    • Serum creatinine 1.5 times or less than upper limit of normal.
    • Pulse oximetry of > 90% on room air
    • Karnofsky or Lansky score of > 60%.
    • Available autologous T cells with 15% or more expression of CD30CAR determined by flow-cytometry.
    • Recovered from acute toxic effects of all prior chemotherapy at least one week and 30 days from prior chemotherapy before entering this study
    • Adequate pulmonary function with FEV1, FVC and DLCO greater than or equal to 50% of expected corrected for hemoglobin.
    • Sexually active patients must be willing to utilize one of the more effective birth control methods during the study and for 6 months after the study is concluded. The male partner should use a condom.
    • Patients or legal guardians must sign an informed consent indicating that they are aware this is a research study and have been told of its possible benefits and toxic side effects. Patients or their guardians will be given a copy of the consent form.

EXCLUSION CRITERIA:

Procurement Exclusion Criteria:

- Active infection with HIV, HTLV, HBV, HCV (can be pending at this time).

Treatment Exclusion Criteria:

  • Currently receiving any investigational agents or received any tumor vaccines within the previous six weeks.
  • Received anti-CD30 antibody-based therapy within the previous 4 weeks.
  • History of hypersensitivity reactions to murine protein-containing products.
  • Pregnant or lactating.
  • Tumor in a location where enlargement could cause airway obstruction.
  • Current use of systemic corticosteroids.

Sites / Locations

  • University of North Carolina Chapel Hill
  • Houston Methodist Hospital
  • Texas Children's Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CAR.CD30 T cells

Arm Description

Three dose levels will be evaluated. Using the modified continual reassessment method, cohorts of size two will be enrolled at each dose level. Each patient will receive one injection (IV) according to the dosing schedules: starting with the lowest cell dose (2×10^7 cells/m2) and then escalate the cell dose to the highest cell dose (2×10^8/m2) as per study design.

Outcomes

Primary Outcome Measures

Number of participants with adverse events as a measure of safety and tolerability of escalating doses of autologous activated T lymphocytes
To evaluate the safety of escalating doses of autologous activated T lymphocytes (ATL), genetically modified to express an artificial chimeric antigen receptor (CAR) that targets the CD30 molecule (CAR.CD30) and also contains the CD28 endodomain, in patients with CD30+ refractory/relapsed Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL).

Secondary Outcome Measures

Measure the survival of CAR.CD30 in vivo
To measure the survival of CAR.CD30 transduced ATL in vivo.
Measure the response of the subjects tumor to the CAR.CD30 transduced ATL
To measure the anti-tumor effects of CAR.CD30 transduced ATL in patients with CD30+ refractory/relapsed Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL).

Full Information

First Posted
March 4, 2011
Last Updated
March 17, 2023
Sponsor
UNC Lineberger Comprehensive Cancer Center
Collaborators
The Methodist Hospital Research Institute, Baylor College of Medicine, Center for Cell and Gene Therapy, Baylor College of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT01316146
Brief Title
Administration of T Lymphocytes for Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma (CART CD30)
Official Title
Phase I Study of the Administration of T Lymphocytes Expressing the CD30 Chimeric Antigen Receptor for Relapsed CD30+ Hodgkin's Lymphoma and CD30+ Non-Hodgkin's Lymphoma (CART CD30)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Withdrawn
Why Stopped
Study never truly opened to accrual at UNC. Study and data were transfered to UNC as the IND for the study was transfered to UNC. IRB closed the study.
Study Start Date
October 3, 2011 (Actual)
Primary Completion Date
January 28, 2016 (Actual)
Study Completion Date
May 4, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
UNC Lineberger Comprehensive Cancer Center
Collaborators
The Methodist Hospital Research Institute, Baylor College of Medicine, Center for Cell and Gene Therapy, Baylor College of Medicine

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
The body has different ways of fighting infection and disease. No single way seems perfect for fighting cancer. This research study combines two different ways of fighting disease: antibodies and T cells. Antibodies are proteins that protect the body from diseases caused by germs or toxic substances. They work by binding those germs or substances, which stops them from growing and causing bad effects. T cells, also called T lymphocytes, are special infection-fighting blood cells that can kill other cells, including tumor cells or cells that are infected with germs. Both antibodies and T cells have been used to treat patients with cancers: they both have shown promise, but have not been strong enough to cure most patients. Investigators hope that both will work better together. Investigators have found from previous research that they can put a new gene into T cells that will make them recognize cancer cells and kill them. Investigators now want to see if they can attach a gene to T cells that will help them do a better job at recognizing and killing lymphoma cells. The new gene that investigators will put in T cells makes an antibody called anti-CD30. This antibody sticks to lymphoma cells because of a substance on the outside of the cells called CD30. Anti-CD30 antibodies have been used to treat people with lymphoma, but have not been strong enough to cure most patients. For this study, the anti-CD30 antibody has been changed so that instead of floating free in the blood it is now joined to the T cells. When an antibody is joined to a T cell in this way, it is called a chimeric receptor. These CD30 chimeric receptor-activated T cells seem to kill some of the tumor, but they don't last very long and so their chances of fighting the cancer are unknown.
Detailed Description
When the patient enrolls on this study, they will be assigned a dose of CD30 chimeric receptor-activated T cells. The dose level of cells that they will receive will not be based on a medical determination of what is best for the patient, instead the dose is based on the order in which the patient enrolled on the study relative to other participants. Subjects enrolled earlier in the study will receive a lower dose of cells than those enrolled later in the study. The risks of harm and discomfort from the study treatment may bear some relationship to the dose level. The potential for direct benefit, if any, may also vary with the dose level. The patient will be given an injection of CD30 chimeric receptor-activated T cells into the vein through an IV line at the assigned dose. The injection will take 1-10 minutes. Investigators will follow the subject in the clinic after the injection for up to 4 hours. To learn more about the way the CD30 chimeric receptor-activated T cells are working and how long they last in the body, extra blood will be drawn. If the patient has stable disease (the lymphoma did not grow) or there is a reduction in the size of the lymphoma on imaging studies after the T-cell infusion, s/he can receive up to six additional doses of the T cells at 8 to 12 weeks intervals if s/he wishes. After each T-cell infusion, s/he will be monitored as described above.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Hodgkin's Lymphoma, Hodgkin's Lymphoma
Keywords
Hodgkin's Lymphoma, Non-Hodgkin's Lymphoma, Lymphoma, T lymphocytes

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CAR.CD30 T cells
Arm Type
Experimental
Arm Description
Three dose levels will be evaluated. Using the modified continual reassessment method, cohorts of size two will be enrolled at each dose level. Each patient will receive one injection (IV) according to the dosing schedules: starting with the lowest cell dose (2×10^7 cells/m2) and then escalate the cell dose to the highest cell dose (2×10^8/m2) as per study design.
Intervention Type
Drug
Intervention Name(s)
CAR.CD30 T cells
Intervention Description
Three dose levels will be evaluated: Group One, 2x10^7 cells/m^2 Group Two, 1x10^8 cells/m^2 Group Three, 2x10^8 cells/m^2; Cell Administration: CAR+ ATL will be given by intravenous injection over 1-10 minutes through either a peripheral or a central line. The expected volume will be 1-50cc.
Primary Outcome Measure Information:
Title
Number of participants with adverse events as a measure of safety and tolerability of escalating doses of autologous activated T lymphocytes
Description
To evaluate the safety of escalating doses of autologous activated T lymphocytes (ATL), genetically modified to express an artificial chimeric antigen receptor (CAR) that targets the CD30 molecule (CAR.CD30) and also contains the CD28 endodomain, in patients with CD30+ refractory/relapsed Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL).
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Measure the survival of CAR.CD30 in vivo
Description
To measure the survival of CAR.CD30 transduced ATL in vivo.
Time Frame
15 years
Title
Measure the response of the subjects tumor to the CAR.CD30 transduced ATL
Description
To measure the anti-tumor effects of CAR.CD30 transduced ATL in patients with CD30+ refractory/relapsed Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL).
Time Frame
15 years

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA Procurement Inclusion Criteria: Referred patients will initially be consented for procurement of blood for generation of the transduced ATL. Eligibility criteria at this stage include: Diagnosis of recurrent CD30+ HL or CD30+ NHL, or newly diagnosed patients unable to receive or complete standard therapy OR diagnosis of relapsed/refractory CD30+ HL or CD30+ NHL with a treatment plan that will include high dose therapy and stem cell transplantation CD30 positive tumor (result can be pending at this time) Hgb > 8.0 Informed consent explained to, understood by and signed by patient/guardian. Patient/guardian given copy of informed consent. Karnofsky or Lansky score greater than 60% Procurement Exclusion Criteria - Active infection with HIV, HTLV, HBV, HCV (can be pending at this time). Treatment Inclusion Criteria: Diagnosis - CD30+ HL or CD30+ NHL: During the Dose Escalation Phase: only adult patients with active disease failing standard therapy After Dose Escalation: any patient (children or adults) newly diagnosed, unable to receive or complete standard therapy OR diagnosis of relapsed/refractory CD30+ HL or CD30+ NHL with a treatment plan that will include high dose therapy and autologous stem cell transplantation. (During dose escalation: only adult patients (age 18 and older; After Dose Escalation: any patient (children ages 0-17 or adults) CD30 positive tumor Bilirubin 1.5 times or less than upper limit of normal. AST 3 times or less than upper limit of normal. Serum creatinine 1.5 times or less than upper limit of normal. Pulse oximetry of > 90% on room air Karnofsky or Lansky score of > 60%. Available autologous T cells with 15% or more expression of CD30CAR determined by flow-cytometry. Recovered from acute toxic effects of all prior chemotherapy at least one week and 30 days from prior chemotherapy before entering this study Adequate pulmonary function with FEV1, FVC and DLCO greater than or equal to 50% of expected corrected for hemoglobin. Sexually active patients must be willing to utilize one of the more effective birth control methods during the study and for 6 months after the study is concluded. The male partner should use a condom. Patients or legal guardians must sign an informed consent indicating that they are aware this is a research study and have been told of its possible benefits and toxic side effects. Patients or their guardians will be given a copy of the consent form. EXCLUSION CRITERIA: Procurement Exclusion Criteria: - Active infection with HIV, HTLV, HBV, HCV (can be pending at this time). Treatment Exclusion Criteria: Currently receiving any investigational agents or received any tumor vaccines within the previous six weeks. Received anti-CD30 antibody-based therapy within the previous 4 weeks. History of hypersensitivity reactions to murine protein-containing products. Pregnant or lactating. Tumor in a location where enlargement could cause airway obstruction. Current use of systemic corticosteroids.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Barbara Savoldo, MD, PhD
Organizational Affiliation
University of North Carolina, Chapel Hill
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of North Carolina Chapel Hill
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Texas Children's Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28805662
Citation
Ramos CA, Ballard B, Zhang H, Dakhova O, Gee AP, Mei Z, Bilgi M, Wu MF, Liu H, Grilley B, Bollard CM, Chang BH, Rooney CM, Brenner MK, Heslop HE, Dotti G, Savoldo B. Clinical and immunological responses after CD30-specific chimeric antigen receptor-redirected lymphocytes. J Clin Invest. 2017 Sep 1;127(9):3462-3471. doi: 10.1172/JCI94306. Epub 2017 Aug 14.
Results Reference
derived

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Administration of T Lymphocytes for Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma (CART CD30)

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