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ATL001 in Patients With Metastatic or Recurrent Melanoma

Primary Purpose

Melanoma

Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
ATL001
Checkpoint Inhibitor
Sponsored by
Achilles Therapeutics UK Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient must be at least 18 years old at the screening visit.
  2. Patient must have given written informed consent to participate in the study.
  3. Patients must have histologically confirmed diagnosis of melanoma.
  4. Patients must have received a PD-1/ PD-L1 inhibitor prior to treatment with ATL001 (unless contraindicated).
  5. Patients whose tumour is known to have a BRAF V600 mutation must have received BRAF targeted therapy (as well as a PD- 1/PD-L1 inhibitor unless contraindicated) prior to treatment with ATL001.
  6. Patient is considered medically fit enough to undergo all study procedures and interventions: procedures to procure blood and tumour tissue, including a general anaesthetic if required, and to receive fludarabine, cyclophosphamide and IL-2 at protocol doses and schedules.
  7. Patient is considered, in the opinion of the Investigator, capable of adhering to the protocol.
  8. Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1.
  9. Adequate organ function per the laboratory parameters defined in the protocol.
  10. Female patients who are of childbearing potential must agree to use a highly effective method of contraception during the study for at least 12 months after the ATL001 infusion. Non-sterilised male participants who intend to be sexually active with a female partner of childbearing potential must use an acceptable method of contraception from the time of screening, throughout the duration of the study and for at least 6 months after the ATL001 infusion.
  11. Anticipated life expectancy ≥ 6 months at the time of tissue procurement.
  12. Patient must have measurable disease according to RECIST v1.1

Additional Inclusion criteria will apply as per the protocol.

Exclusion Criteria:

  1. Patients with known leptomeningeal or CNS metastases at the time of screening.
  2. Patients with ocular, acral or mucosal melanoma.
  3. Patients with active infectious disease.
  4. Patients with active, known, or suspected, autoimmune disease requiring immunosuppressive treatments.
  5. Patients requiring regular treatment with steroids at a dose higher than prednisolone 10mg/day (or equivalent).
  6. Patients with a current or recent history, as determined by the Investigator, of clinically significant, progressive, and/or uncontrolled renal, hepatic, haematological, endocrine, pulmonary, cardiac, gastroenterological or neurological disease.
  7. Patients with a history of immune mediated central nervous system toxicity that was caused by, or suspected to be caused by, immunotherapy.
  8. Patients with a history of ≥ Grade 2 diarrhoea/colitis caused by previous immunotherapy within 6 months of screening. Patients that have been asymptomatic for at least 6 months or have had a normal colonoscopy post-immunotherapy (with uninflamed mucosa by visual assessment) are not excluded.
  9. Patients who are pregnant or breastfeeding.
  10. Patients who have undergone major surgery in the previous 3 weeks.
  11. Patients with an active concurrent cancer or a history of cancer within the past 3 years (except for in situ carcinomas, early prostate cancer with normal Prostate-Specific Antigen (PSA) or non-melanomatous skin cancers).
  12. Patients with a history of organ transplantation.
  13. Patients who have previously received any investigational cell or gene therapies.
  14. Patients with contraindications for cyclophosphamide, fludarabine and IL-2 at per protocol doses (see Investigator's Brochure for details).
  15. Patients with a known history of allergic reactions to amphotericin b, penicillin and/or streptomycin.

Additional Exclusion criteria will apply as per the protocol.

Sites / Locations

  • Instituto de Investigación Sanitaria Fundación Jimenez DíazRecruiting
  • Cambridge University Hospitals NHS Foundation Trust, Addenbrookes HospitalRecruiting
  • University College London Hospitals (UCLH) NHS Foundation Trust, University College HospitalRecruiting
  • Royal Free London NHS Foundation Trust, Royal Free HospitalRecruiting
  • Guys and St Thomas' NHS Foundation Trust, Guy's HospitalRecruiting
  • The Royal Marsden NHS Foundation Trust, The Royal Marsden HospitalRecruiting
  • The Christie NHS Foundation Trust, Christie HospitalRecruiting
  • The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Freeman HospitalRecruiting
  • University Hospital Southampton NHS Foundation Trust, Southampton General HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Cohort A

Cohort B

Cohort C

Arm Description

Following lymphodepletion, infusion of cell therapy product ATL001, followed by a low dose regimen of IL- 2.

Following lymphodepletion, infusion of cell therapy product ATL001 in combination with a checkpoint inhibitor, followed by a low dose regimen of IL-2.

Following lymphodepletion, infusion of cell therapy product ATL001, followed by a higher dose regimen of IL-2.

Outcomes

Primary Outcome Measures

Assessment of Treatment Emergent Adverse Events to evaluate Safety and Tolerability: CTCAE
Evaluate treatment-emergent adverse events (TEAEs) and serious AEs, per CTCAE, by incidence, severity and relationship to ATL001

Secondary Outcome Measures

Disease Assessment for Change from Baseline in Tumour Size
Evaluate the clinical activity of ATL001 in patients with recurrent or metastatic melanoma using change from baseline in tumour size at week 6, week 12 and best overall change from baseline, as assessed by investigator and independent central review (ICR).
Disease Assessment for Overall Response Rate
Evaluate the endpoint of overall response rate (ORR), as assessed by investigator and ICR, per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune modified RECIST( im-RECIST).
Disease Assessment for Time to Response and Duration of Response
Evaluate the endpoints of time to response and duration of response (DOR) by the investigator and ICR, per RECIST v1.1 and im-RECIST.
Disease Assessment for Disease Control Rate
Evaluate the endpoints of disease control rate (DCR) as assessed by the investigator and ICR per RECIST v1.1 and im-RECIST.
Disease Assessment for Progression-Free Survival
Evaluate the efficacy endpoints of progression-free survival (PFS) as assessed by the investigator and ICR per RECIST v1.1 and im-RECIST.
Overall survival
Evaluate overall survival (OS) by investigator

Full Information

First Posted
February 4, 2019
Last Updated
January 6, 2023
Sponsor
Achilles Therapeutics UK Limited
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1. Study Identification

Unique Protocol Identification Number
NCT03997474
Brief Title
ATL001 in Patients With Metastatic or Recurrent Melanoma
Official Title
An Open-Label, Multi-Centre Phase I/IIa Study Evaluating the Safety and Clinical Activity of Neoantigen Reactive T Cells in Patients With Metastatic or Recurrent Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 15, 2019 (Actual)
Primary Completion Date
July 1, 2025 (Anticipated)
Study Completion Date
December 31, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Achilles Therapeutics UK Limited

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
This is a first-in-human, open-label, multi-centre, phase I/IIa study to characterize the safety and clinical activity of ATL001, autologous clonal neoantigen reactive T cells (cNeT) administered intravenously in adults with metastatic or recurrent melanoma.
Detailed Description
This is a first-in-human, open-label, multi-centre, phase I/IIa study to characterize the safety and clinical activity autologous clonal neoantigen reactive T cells (cNeT) administered intravenously in adults with metastatic or recurrent melanoma. Patients will initially enter the study for procurement of tumour materials required to manufacture ATL001. Following manufacture of ATL001, the product will be given back to eligible patients following lymphodepletion. Patients will be followed up for a period of 24 months post ATL001 infusion in the study. Patients will then be requested to enter a separate long term follow up protocol for a further 5 years (total 84 months)

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort A
Arm Type
Experimental
Arm Description
Following lymphodepletion, infusion of cell therapy product ATL001, followed by a low dose regimen of IL- 2.
Arm Title
Cohort B
Arm Type
Experimental
Arm Description
Following lymphodepletion, infusion of cell therapy product ATL001 in combination with a checkpoint inhibitor, followed by a low dose regimen of IL-2.
Arm Title
Cohort C
Arm Type
Experimental
Arm Description
Following lymphodepletion, infusion of cell therapy product ATL001, followed by a higher dose regimen of IL-2.
Intervention Type
Biological
Intervention Name(s)
ATL001
Intervention Description
ATL001 infusion
Intervention Type
Drug
Intervention Name(s)
Checkpoint Inhibitor
Intervention Description
Nivolumab
Primary Outcome Measure Information:
Title
Assessment of Treatment Emergent Adverse Events to evaluate Safety and Tolerability: CTCAE
Description
Evaluate treatment-emergent adverse events (TEAEs) and serious AEs, per CTCAE, by incidence, severity and relationship to ATL001
Time Frame
Maximum 84 month
Secondary Outcome Measure Information:
Title
Disease Assessment for Change from Baseline in Tumour Size
Description
Evaluate the clinical activity of ATL001 in patients with recurrent or metastatic melanoma using change from baseline in tumour size at week 6, week 12 and best overall change from baseline, as assessed by investigator and independent central review (ICR).
Time Frame
Every 6 weeks for 6 months, then every 3 months for a maximum of 84 months
Title
Disease Assessment for Overall Response Rate
Description
Evaluate the endpoint of overall response rate (ORR), as assessed by investigator and ICR, per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune modified RECIST( im-RECIST).
Time Frame
Every 6 weeks for 6 months, then every 3 months for a maximum of 84 months
Title
Disease Assessment for Time to Response and Duration of Response
Description
Evaluate the endpoints of time to response and duration of response (DOR) by the investigator and ICR, per RECIST v1.1 and im-RECIST.
Time Frame
Every 6 weeks for 6 months, then every 3 months for a maximum of 84 months
Title
Disease Assessment for Disease Control Rate
Description
Evaluate the endpoints of disease control rate (DCR) as assessed by the investigator and ICR per RECIST v1.1 and im-RECIST.
Time Frame
Every 6 weeks for 6 months, then every 3 months for a maximum of 84 months
Title
Disease Assessment for Progression-Free Survival
Description
Evaluate the efficacy endpoints of progression-free survival (PFS) as assessed by the investigator and ICR per RECIST v1.1 and im-RECIST.
Time Frame
Every 6 weeks for 6 months, then every 3 months for a maximum of 84 months
Title
Overall survival
Description
Evaluate overall survival (OS) by investigator
Time Frame
Every 6 weeks for 6 months, then every 3 months for a maximum of 84 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient must be at least 18 years old at the screening visit. Patient must have given written informed consent to participate in the study. Patients must have histologically confirmed diagnosis of melanoma. Patients must have received a PD-1/ PD-L1 inhibitor prior to treatment with ATL001 (unless contraindicated). Patients whose tumour is known to have a BRAF V600 mutation must have received BRAF targeted therapy (as well as a PD- 1/PD-L1 inhibitor unless contraindicated) prior to treatment with ATL001. Patient is considered medically fit enough to undergo all study procedures and interventions: procedures to procure blood and tumour tissue, including a general anaesthetic if required, and to receive fludarabine, cyclophosphamide and IL-2 at protocol doses and schedules. Patient is considered, in the opinion of the Investigator, capable of adhering to the protocol. Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1. Adequate organ function per the laboratory parameters defined in the protocol. Female patients who are of childbearing potential must agree to use a highly effective method of contraception during the study for at least 12 months after the ATL001 infusion. Non-sterilised male participants who intend to be sexually active with a female partner of childbearing potential must use an acceptable method of contraception from the time of screening, throughout the duration of the study and for at least 6 months after the ATL001 infusion. Anticipated life expectancy ≥ 6 months at the time of tissue procurement. Patient must have measurable disease according to RECIST v1.1 Additional Inclusion criteria will apply as per the protocol. Exclusion Criteria: Patients with known leptomeningeal or CNS metastases at the time of screening. Patients with ocular, acral or mucosal melanoma. Patients with active infectious disease. Patients with active, known, or suspected, autoimmune disease requiring immunosuppressive treatments. Patients requiring regular treatment with steroids at a dose higher than prednisolone 10mg/day (or equivalent). Patients with a current or recent history, as determined by the Investigator, of clinically significant, progressive, and/or uncontrolled renal, hepatic, haematological, endocrine, pulmonary, cardiac, gastroenterological or neurological disease. Patients with a history of immune mediated central nervous system toxicity that was caused by, or suspected to be caused by, immunotherapy. Patients with a history of ≥ Grade 2 diarrhoea/colitis caused by previous immunotherapy within 6 months of screening. Patients that have been asymptomatic for at least 6 months or have had a normal colonoscopy post-immunotherapy (with uninflamed mucosa by visual assessment) are not excluded. Patients who are pregnant or breastfeeding. Patients who have undergone major surgery in the previous 3 weeks. Patients with an active concurrent cancer or a history of cancer within the past 3 years (except for in situ carcinomas, early prostate cancer with normal Prostate-Specific Antigen (PSA) or non-melanomatous skin cancers). Patients with a history of organ transplantation. Patients who have previously received any investigational cell or gene therapies. Patients with contraindications for cyclophosphamide, fludarabine and IL-2 at per protocol doses (see Investigator's Brochure for details). Patients with a known history of allergic reactions to amphotericin b, penicillin and/or streptomycin. Additional Exclusion criteria will apply as per the protocol.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Achilles Therapeutics
Phone
+44 (0)20 8154 4600
Email
info@achillestx.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Monitor, MD
Organizational Affiliation
Achilles Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
Instituto de Investigación Sanitaria Fundación Jimenez Díaz
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Individual Site Status
Recruiting
Facility Name
Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital
City
Cambridge
ZIP/Postal Code
CB2 0QQ
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
University College London Hospitals (UCLH) NHS Foundation Trust, University College Hospital
City
London
ZIP/Postal Code
NW12PG
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Royal Free London NHS Foundation Trust, Royal Free Hospital
City
London
ZIP/Postal Code
NW3 2QG
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Guys and St Thomas' NHS Foundation Trust, Guy's Hospital
City
London
ZIP/Postal Code
SE19RT
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
The Royal Marsden NHS Foundation Trust, The Royal Marsden Hospital
City
London
ZIP/Postal Code
SW3 6JJ
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
The Christie NHS Foundation Trust, Christie Hospital
City
Manchester
ZIP/Postal Code
M20 4BX
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital
City
Newcastle Upon Tyne
ZIP/Postal Code
NE7 7DN
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
University Hospital Southampton NHS Foundation Trust, Southampton General Hospital
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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ATL001 in Patients With Metastatic or Recurrent Melanoma

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