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CAR-GPC3 T Cells in Patients With Refractory Hepatocellular Carcinoma

Primary Purpose

Hepatocellular Carcinoma

Status
Completed
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
CAR-GPC3 T cells
Sponsored by
RenJi Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma

Eligibility Criteria

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

Inclusion criteria:

  1. Age of 18-70 years;
  2. Pathologically confirmed advanced hepatocellular carcinoma (HCC);
  3. ≥1 measurable target lesion per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1);
  4. Tumor tissue positive for GPC3 expression per immunohistochemical staining (IHC) assay;
  5. Estimated survival > 12 weeks;
  6. Child-Pugh grade A;
  7. ECOG performance score of 0-1;
  8. HBV-DNA < 200 IU/mL if positive for HBsAg or HBcAb. Patients positive for HBsAg shall receive anti-viral treatment per "The guideline of prevention and treatment for chronic hepatitis B: a 2015 update";
  9. Have adequate venous access for apheresis or venous blood collection;
  10. White blood cells ≥ 2.5 x 109/L, platelet ≥ 60×109/L, haemoglobin ≥ 9.0 g/dL, lymphocyte ≥ 0.4×109/L
  11. Serum albumin ≥ 30 g/dL, serum lipase and amylase≤1.5 upper limit of normal (ULN), serum creatinine ≤ 1.5 ULN and endogenous creatinine clearance ≥ 40mL/min, ALT and AST ≤ 5 ULN, Serum total bilirubin ≤ 2.5 ULN, Prothrombin Time is less than 4s longer than normal;
  12. Negative serum pregnancy test within 14 days before CAR T infusion, and with willingness to use reliable contraceptive methods to avoid pregnancy until 12 months after CAR T infusions for females of childbearing age; Having undergone sterilization procedure or with willingness to use reliable contraceptive methods to avoid pregnancy for males with female partner of childbearing age during the study;
  13. Able to understand and sign the informed consent form

Exclusion criteria:

If the patient meets any of the exclusion criteria, the patient must be excluded from the study.

  1. Pregnant or lactating female patients;
  2. Positive serum tests for HCV, HIV, or syphilis;
  3. Presence of HBV/HCV coinfection;
  4. Presence of any uncontrollable active infection, such as, but not limited to, active tuberculosis
  5. History of systemic administration of steroids (not including inhaled steroids), or other immunosuppressant drugs within 2 weeks before apheresis;
  6. History of allergy to immunotherapy and related drugs, or β-lactam antibiotics, or history of other severe allergy;
  7. History or current presence of hepatic encephalopathy;
  8. Presence of ascites with clinical significance that is defined as positive focused physical examination for ascites, or ascites that requires treatment intervention (not including any ascites shown on image examinations without the need for clinical intervention);
  9. ≥ 50% of normal liver occupied with HCC tumor tissue, or presence of tumor thrombus in the portal vein, or mesenteric vein, or inferior vena based on image analysis;
  10. Presence of HCC metastatic lesion in the central nervous system, or presence of other diseases of central nervous system with clinical significance;
  11. Presence of heart disease that requires treatment intervention, or poorly controlled hypertension (systolic pressure > 160 mmHg, or diastolic pressure > 100 mmHg);
  12. Presence of active auto-immune disease that requires immunosuppressant treatment;
  13. History of organ transplantation or currently on the waiting list for organ transplantation, including, but not limited to, liver transplantation;
  14. Anti-HCC therapies including, but not limited to, surgical resection, interventional therapy, radiation therapy, chemotherapy, and immunotherapy, within 2 weeks before apheresis;
  15. History of receiving anti-PD-1 or anti-PD-L1 monoclonal antibodies, or other immunotherapy;
  16. History of other malignancies in the past 5 years, or presence of other active malignancies (not including cervical cancer in situ and basal cell carcinomas);
  17. Presence of other serious diseases or conditions, including uncontrolled diabetes (HbA1c > 7% with treatment); severe cardiac dysfunction with LVEF < 45%; myocardial infarction, unstable angina, or unstable arrhythmia in the past 6 months pulmonary embolism; chronic obstructive pulmonary disease; interstitial lung disease; forced expiratory volume in 1 second (FEV1) < 60%, gastric ulcer; history of gastrointestinal bleeding, or confirmed tendency for gastrointestinal bleeding;
  18. Determined by the investigator to be lack of compliance for the study.

Sites / Locations

  • Renji Hospital, Shanghai Jiaotong University School of Medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CAR-GPC3 T cells

Arm Description

Autologous T Cells with a GPC3-redirected Chimeric Antigen Receptor. Route of administration: Intravenous injection. Lymphodepletion conditioning regimen: A combination of fludarabine and cyclophosphamide will be administered at Day -6 to Day -3 prior to CAR-GPC3 T cells infusion.

Outcomes

Primary Outcome Measures

Safety and tolerance
Study related adverse events are defined as signs above CTCAE Grade 3, laboratory toxicities and clinical events occurred at any time from the first day of infusion to week 24 that are "possibly", "likely", or "definitely" related to the study, including infusion related toxicity and CAR-GPC3 T cells related toxicity. Include but not limited to: Fever; Chills; Nausea, vomiting and other gastrointestinal symptoms; Fatigue; Hypotension; Respiratory distress; Tumor lysis syndrome; Cytokine release syndrome; Neutropenia, thrombocytopenia; Liver and kidney dysfunction; Other toxicities.

Secondary Outcome Measures

Engraftment
Duration of in vivo survival of CAR-GPC3 T cells is defined as "engraftment". The primary engraftment endpoint is the number of DNA vector copies per mL blood of CAR-GPC3 T cells at regular intervals through week 4 following the initial infusion. Q-PCR for CAR-GPC3 vector sequences will be performed until any 2 sequential tests are negative, documented as engraftment and persistence of CAR-GPC3 T cells.

Full Information

First Posted
April 24, 2017
Last Updated
August 22, 2019
Sponsor
RenJi Hospital
Collaborators
CARsgen Therapeutics Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03146234
Brief Title
CAR-GPC3 T Cells in Patients With Refractory Hepatocellular Carcinoma
Official Title
Clinical Study of Redirected Autologous T Cells With a GPC3-targeted Chimeric Antigen Receptor in Patients With Refractory Hepatocellular Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2018
Overall Recruitment Status
Completed
Study Start Date
March 17, 2017 (Actual)
Primary Completion Date
October 18, 2018 (Actual)
Study Completion Date
October 18, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
RenJi Hospital
Collaborators
CARsgen 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
Yes

5. Study Description

Brief Summary
This study is designed to determine the safety and efficacy of CAR-GPC3 T cells in patients with relapsed or refractory hepatocellular carcinoma. Single or multiple doses of GPC3-targeted CAR T cells will be given to subjects with unmet medical needs for which there are no effective therapies known at this time.
Detailed Description
A single arm, open-label pilot study is designed to determine the safety, tolerability and engraftment potential of CAR-GPC3 T cells in patients with GPC3-positive hepatocellular carcinoma. Primary objectives: Determine the safety, tolerability and cytokinetics of the autologous T cells transduced with the anti- GPC3 lentiviral vector in patients with hepatocellular carcinoma. Secondary objectives: Make a preliminary evaluation on the efficacy of CAR-GPC3 T cells in patients with hepatocellular carcinoma by the following parameters: Objective response rate (ORR); Disease Control Rate (DCR); Time of tumor progression (TTP); Overall survival (OS).

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CAR-GPC3 T cells
Arm Type
Experimental
Arm Description
Autologous T Cells with a GPC3-redirected Chimeric Antigen Receptor. Route of administration: Intravenous injection. Lymphodepletion conditioning regimen: A combination of fludarabine and cyclophosphamide will be administered at Day -6 to Day -3 prior to CAR-GPC3 T cells infusion.
Intervention Type
Genetic
Intervention Name(s)
CAR-GPC3 T cells
Other Intervention Name(s)
GPC3 Redirected Autologous Cells
Intervention Description
Self-controlled dose escalation will be applied to the first 3 - 6 subjects enrolled. Classical "3+3" dose escalation will be applied to subsequent subjects based on the self-controlled dose escalation study.
Primary Outcome Measure Information:
Title
Safety and tolerance
Description
Study related adverse events are defined as signs above CTCAE Grade 3, laboratory toxicities and clinical events occurred at any time from the first day of infusion to week 24 that are "possibly", "likely", or "definitely" related to the study, including infusion related toxicity and CAR-GPC3 T cells related toxicity. Include but not limited to: Fever; Chills; Nausea, vomiting and other gastrointestinal symptoms; Fatigue; Hypotension; Respiratory distress; Tumor lysis syndrome; Cytokine release syndrome; Neutropenia, thrombocytopenia; Liver and kidney dysfunction; Other toxicities.
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Engraftment
Description
Duration of in vivo survival of CAR-GPC3 T cells is defined as "engraftment". The primary engraftment endpoint is the number of DNA vector copies per mL blood of CAR-GPC3 T cells at regular intervals through week 4 following the initial infusion. Q-PCR for CAR-GPC3 vector sequences will be performed until any 2 sequential tests are negative, documented as engraftment and persistence of CAR-GPC3 T cells.
Time Frame
2 years
Other Pre-specified Outcome Measures:
Title
Anti-tumor responses to CAR-GPC3 T cell infusions
Description
Objective response rate (ORR); Progression-free survival (PFS); Time of tumor progression (TTP); Overall survival (OS).
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: Age of 18-70 years; Pathologically confirmed advanced hepatocellular carcinoma (HCC); ≥1 measurable target lesion per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1); Tumor tissue positive for GPC3 expression per immunohistochemical staining (IHC) assay; Estimated survival > 12 weeks; Child-Pugh grade A; ECOG performance score of 0-1; HBV-DNA < 200 IU/mL if positive for HBsAg or HBcAb. Patients positive for HBsAg shall receive anti-viral treatment per "The guideline of prevention and treatment for chronic hepatitis B: a 2015 update"; Have adequate venous access for apheresis or venous blood collection; White blood cells ≥ 2.5 x 109/L, platelet ≥ 60×109/L, haemoglobin ≥ 9.0 g/dL, lymphocyte ≥ 0.4×109/L Serum albumin ≥ 30 g/dL, serum lipase and amylase≤1.5 upper limit of normal (ULN), serum creatinine ≤ 1.5 ULN and endogenous creatinine clearance ≥ 40mL/min, ALT and AST ≤ 5 ULN, Serum total bilirubin ≤ 2.5 ULN, Prothrombin Time is less than 4s longer than normal; Negative serum pregnancy test within 14 days before CAR T infusion, and with willingness to use reliable contraceptive methods to avoid pregnancy until 12 months after CAR T infusions for females of childbearing age; Having undergone sterilization procedure or with willingness to use reliable contraceptive methods to avoid pregnancy for males with female partner of childbearing age during the study; Able to understand and sign the informed consent form Exclusion criteria: If the patient meets any of the exclusion criteria, the patient must be excluded from the study. Pregnant or lactating female patients; Positive serum tests for HCV, HIV, or syphilis; Presence of HBV/HCV coinfection; Presence of any uncontrollable active infection, such as, but not limited to, active tuberculosis History of systemic administration of steroids (not including inhaled steroids), or other immunosuppressant drugs within 2 weeks before apheresis; History of allergy to immunotherapy and related drugs, or β-lactam antibiotics, or history of other severe allergy; History or current presence of hepatic encephalopathy; Presence of ascites with clinical significance that is defined as positive focused physical examination for ascites, or ascites that requires treatment intervention (not including any ascites shown on image examinations without the need for clinical intervention); ≥ 50% of normal liver occupied with HCC tumor tissue, or presence of tumor thrombus in the portal vein, or mesenteric vein, or inferior vena based on image analysis; Presence of HCC metastatic lesion in the central nervous system, or presence of other diseases of central nervous system with clinical significance; Presence of heart disease that requires treatment intervention, or poorly controlled hypertension (systolic pressure > 160 mmHg, or diastolic pressure > 100 mmHg); Presence of active auto-immune disease that requires immunosuppressant treatment; History of organ transplantation or currently on the waiting list for organ transplantation, including, but not limited to, liver transplantation; Anti-HCC therapies including, but not limited to, surgical resection, interventional therapy, radiation therapy, chemotherapy, and immunotherapy, within 2 weeks before apheresis; History of receiving anti-PD-1 or anti-PD-L1 monoclonal antibodies, or other immunotherapy; History of other malignancies in the past 5 years, or presence of other active malignancies (not including cervical cancer in situ and basal cell carcinomas); Presence of other serious diseases or conditions, including uncontrolled diabetes (HbA1c > 7% with treatment); severe cardiac dysfunction with LVEF < 45%; myocardial infarction, unstable angina, or unstable arrhythmia in the past 6 months pulmonary embolism; chronic obstructive pulmonary disease; interstitial lung disease; forced expiratory volume in 1 second (FEV1) < 60%, gastric ulcer; history of gastrointestinal bleeding, or confirmed tendency for gastrointestinal bleeding; Determined by the investigator to be lack of compliance for the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bo Zhai, MD
Organizational Affiliation
RenJi Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Renji Hospital, Shanghai Jiaotong University School of Medicine
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
20001
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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CAR-GPC3 T Cells in Patients With Refractory Hepatocellular Carcinoma

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