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Clinical Study on the Safety, Pharmacokinetics, and Efficacy of ScTIL (Genetically Modified Tumor Infiltrating Lymphocytes) in the Treatment of Gynecological Malignancies

Primary Purpose

Cervical Cancer, Ovarian Cancer, Malignant Trophoblastic Tumor

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Toripalimab + ScTIL
Sponsored by
Peking Union Medical College Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cervical Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age ≥ 18 and ≤ 75, female;
  2. Expected survival time > 3 months;
  3. Clinically diagnosed advanced gynecological tumors, including:

    1. cervical cancer;
    2. Ovarian cancer;
    3. Malignant trophoblastic tumor;
  4. Patients who have received radical surgery ± adjuvant radiotherapy and chemotherapy, or who have disease progression or recurrence after receiving too many lines of radiotherapy and chemotherapy, who have been unable to be resected again or who cannot tolerate radiotherapy and chemotherapy;
  5. Patients with cervical and ovarian cancer have at least one measurable lesion according to RECIST version 1.1 standard; Patients with malignant trophoblastic tumor β HCG ≥ 5, with or without measurable lesions.
  6. Voluntarily accept peripheral blood apheresis ± surgical resection of fresh tumor tissue to obtain cells for cell preparation, and the proportion of peripheral blood PD-1 positive T cells in the total T cells is ≥ 18%. For patients who have received PD-1 monoclonal antibody treatment before screening, the proportion of peripheral blood PD1 positive T cells in the total T cells is ≥ 10%;
  7. The ECOG physical condition score is 0 to 1;
  8. Have sufficient bone marrow and organ functions:

    Blood system (no blood transfusion or hematopoietic stimulating factor treatment within 14 days):

    Neutrophil count (ANC) ≥ 1.5 × one hundred and nine Platelet (PLT) ≥ 75 × 109/L Hemoglobin (HB) ≥ 90g / L Lymphocyte count (lym) ≥ 60% of the lower limit of normal value Lymphocyte subsets: proportion of B lymphocytes (CD19 +) in lymphocytes ≥ lower limit of normal value

    Liver function:

    Total bilirubin (TBIL) ≤ 1.5 × ULN Alanine aminotransferase (ALT) ≤ 3 × ULN Patients with liver metastasis or liver cancer: ≤ 5 × ULN Aspartic acid amino transfer (AST) ≤ 3 × ULN Patients with liver metastasis or liver cancer: ≤ 5 × ULN

    Renal function Creatinine ≤ 1.5 × ULN Coagulation function Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN International normalized ratio (INR) ≤ 1.5 × ULN

  9. Fertile women must agree to permanently use reliable contraceptive methods (hormone or barrier method or abstinence, etc.) with their partners during and after the trial; Women of childbearing age (as defined in Appendix 9) must have a negative blood or urine pregnancy test within 7 days before the first use of the study drug;
  10. The subjects must be informed of the study before the test and voluntarily sign a written informed consent.

Exclusion Criteria:

  1. Central nervous system metastasis or meningeal metastasis with clinical symptoms, or there is other evidence that the patient's central nervous system metastasis or meningeal metastasis has not been controlled, which is not suitable for inclusion according to the judgment of the researcher;
  2. Subjects with a history of second malignancy within 5 years before signing the informed consent;
  3. Patients who had previously received PD-L1 mAb;
  4. Those who have active infection within 1 week before apheresis and currently need systematic anti infection treatment;
  5. Received chemotherapy, radiotherapy, biological therapy, endocrine therapy, immunotherapy, traditional Chinese medicine with anti-tumor indications and other anti-tumor treatments within 2 weeks before apheresis, Except for the following:

    1. Nitrosourea or mitomycin C were within 6 weeks before single harvest;
    2. Oral fluorouracils and small molecule targeted drugs were taken 1 week before apheresis.
  6. Within 2 weeks before apheresis:

    1. Have received systemic glucocorticoid (prednisone > 10mg/day or equivalent dose of similar drugs) or other immunosuppressant treatment; Except for the following cases: local, eye, intra-articular, intranasal and inhaled glucocorticoids; Short term use of glucocorticoids for preventive treatment (e.g. prevention of contrast agent allergy);
    2. Used immunomodulatory drugs, including but not limited to thymosin, interleukin-2, interferon, etc;
  7. Within 4 weeks before apheresis:

    1. Have received other unlisted clinical research drugs or treatments;
    2. Have undergone major organ surgery (excluding puncture biopsy) or significant trauma, or need to undergo elective surgery during the trial;
    3. Used live attenuated vaccine;
  8. Currently suffering from interstitial lung disease;
  9. Had received PD-1 monoclonal antibody treatment and had ≥ grade 2 Irae; Or other immunotherapy with ≥ grade 3 Irae;
  10. Patients with active, or had, and relapsed autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, vasculitis, etc., except for clinically stable autoimmune thyroid disease and well controlled type I diabetes.
  11. The adverse reactions of previous anti-tumor treatment have not recovered to CTCAE 5.0 and the evaluation is ≤ 1 (except for the toxicity without safety risk judged by the researchers such as hair loss).
  12. Have a history of immune deficiency, including HIV antibody test positive;
  13. Hepatitis B: the titer of HBsAg (+) and/or hepatitis B DNA is higher than that of the research center. And/or hepatitis C: anti HCV positive; And/or Treponema pallidum antibody positive;
  14. Have a history of serious cardiovascular and cerebrovascular diseases, including but not limited to:

    1. There are serious cardiac rhythm or conduction abnormalities, such as ventricular arrhythmia requiring clinical intervention, ⅱ-ⅲ degree atrioventricular block, etc.
    2. Acute coronary syndrome, congestive heart failure, aortic dissection, stroke or other grade 3 and above cardiovascular events occurred within 6 months before the first administration.
    3. New York Heart Association (NYHA) cardiac function grade ≥ grade II or left ventricular ejection fraction (LVEF) < 50%, or structural heart disease with high risk judged by other researchers;
    4. Clinically uncontrollable hypertension.
  15. Serous effusion beyond clinical control is not suitable to be included in the group according to the judgment of the researcher;
  16. Known alcohol or drug dependence;
  17. Mental disorder or poor compliance;
  18. Women with reproductive needs and pregnant or lactating women;
  19. There are other serious or uncontrolled systemic diseases, or other reasons that are not suitable to participate in this clinical study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    Cohort 1

    Cohort 2

    Cohort 3

    Arm Description

    Study subjects: Patient with cervical carcinoma

    Study subjects: Patient with ovarian cancer

    Study subjects: Patient with malignant trophoblastic tumor

    Outcomes

    Primary Outcome Measures

    Objective response rate
    The proportion of patients with complete or partial response of cervical and ovarian cancer according to RECIST version 1.1, malignant trophoblastic tumor according to serum hCG level. Complete response was defined as a normal hCG level measured for 3 consecutive weeks. Partial response was defined as a ≥50% decrease in hCG level from baseline after 2 cycles.

    Secondary Outcome Measures

    Disease control rate (DCR)
    The percentage of cases with remission and stable lesions after treatment in the total number of evaluable cases.
    Duration of response (DOR)
    The time from the first evidence of response to disease progression or death, whichever comes first.
    Progression-free survival
    The time from the treatment initiation to disease progression or death, whichever comes first.
    Overall survival
    The time from the treatment initiation to the date of death or end of follow-up.

    Full Information

    First Posted
    March 9, 2022
    Last Updated
    April 17, 2022
    Sponsor
    Peking Union Medical College Hospital
    Collaborators
    Chineo Medicine (Beijing) Co., Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05342506
    Brief Title
    Clinical Study on the Safety, Pharmacokinetics, and Efficacy of ScTIL (Genetically Modified Tumor Infiltrating Lymphocytes) in the Treatment of Gynecological Malignancies
    Official Title
    A Open, Single Arm, Phase IIa Clinical Study on the Safety, Pharmacokinetics, and Efficacy of ScTIL (Genetically Modified Tumor Infiltrating Lymphocytes) in the Treatment of Gynecological Malignancies
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    April 18, 2022 (Anticipated)
    Primary Completion Date
    February 28, 2024 (Anticipated)
    Study Completion Date
    May 31, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Peking Union Medical College Hospital
    Collaborators
    Chineo Medicine (Beijing) Co., Ltd.

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    The purpose of this study is to evaluate the safety and clinical efficacy of ScTIL in the treatment of recurrent or refractory cervical cancer, ovarian cancer and malignant trophoblastic tumor, to evaluate the pharmacokinetic characteristics of ScTIL, and to explore and analyze the changes of CTC, ctDNA and immunohistochemical Library of malignant tumor subjects before and after ScTIL treatment.Treatment will be terminated upon progressive disease, unacceptable toxicity, or withdrawal of consent. Subjects with responses other than progressive disease will receive subsequent rounds of ScTIL treatment.
    Detailed Description
    The purpose of this study is to evaluate the safety and clinical efficacy of ScTIL in the treatment of recurrent or refractory cervical cancer, ovarian cancer and malignant trophoblastic tumor, to evaluate the pharmacokinetic characteristics of ScTIL, and to explore and analyze the changes of CTC, ctDNA and immunohistochemical Library of malignant tumor subjects before and after ScTIL treatment. Treatment will be terminated upon progressive disease, unacceptable toxicity, or withdrawal of consent. Subjects with responses other than progressive disease will receive subsequent rounds of ScTIL treatment. The primary endpoint was objective response rate, defined as the proportion of patients with complete or partial response. Secondary endpoints were duration of response (time from the first evidence of response to disease progression or death, whichever came first), progression-free survival (time from the treatment initiation to disease progression or death, whichever came first), overall survival (time from the treatment initiation to the date of death or end of follow-up).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Cervical Cancer, Ovarian Cancer, Malignant Trophoblastic Tumor

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Cohort 1
    Arm Type
    Experimental
    Arm Description
    Study subjects: Patient with cervical carcinoma
    Arm Title
    Cohort 2
    Arm Type
    Experimental
    Arm Description
    Study subjects: Patient with ovarian cancer
    Arm Title
    Cohort 3
    Arm Type
    Experimental
    Arm Description
    Study subjects: Patient with malignant trophoblastic tumor
    Intervention Type
    Drug
    Intervention Name(s)
    Toripalimab + ScTIL
    Intervention Description
    Toripalimab (80 mg iv) 24 hours before or concomitantly with ScTIL 3-5x10^9 intravenous reinfusion.
    Primary Outcome Measure Information:
    Title
    Objective response rate
    Description
    The proportion of patients with complete or partial response of cervical and ovarian cancer according to RECIST version 1.1, malignant trophoblastic tumor according to serum hCG level. Complete response was defined as a normal hCG level measured for 3 consecutive weeks. Partial response was defined as a ≥50% decrease in hCG level from baseline after 2 cycles.
    Time Frame
    12 weeks
    Secondary Outcome Measure Information:
    Title
    Disease control rate (DCR)
    Description
    The percentage of cases with remission and stable lesions after treatment in the total number of evaluable cases.
    Time Frame
    12 weeks
    Title
    Duration of response (DOR)
    Description
    The time from the first evidence of response to disease progression or death, whichever comes first.
    Time Frame
    12 weeks
    Title
    Progression-free survival
    Description
    The time from the treatment initiation to disease progression or death, whichever comes first.
    Time Frame
    12 weeks
    Title
    Overall survival
    Description
    The time from the treatment initiation to the date of death or end of follow-up.
    Time Frame
    12 weeks

    10. Eligibility

    Sex
    Female
    Gender Based
    Yes
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age ≥ 18 and ≤ 75, female; Expected survival time > 3 months; Clinically diagnosed advanced gynecological tumors, including: cervical cancer; Ovarian cancer; Malignant trophoblastic tumor; Patients who have received radical surgery ± adjuvant radiotherapy and chemotherapy, or who have disease progression or recurrence after receiving too many lines of radiotherapy and chemotherapy, who have been unable to be resected again or who cannot tolerate radiotherapy and chemotherapy; Patients with cervical and ovarian cancer have at least one measurable lesion according to RECIST version 1.1 standard; Patients with malignant trophoblastic tumor β HCG ≥ 5, with or without measurable lesions. Voluntarily accept peripheral blood apheresis ± surgical resection of fresh tumor tissue to obtain cells for cell preparation, and the proportion of peripheral blood PD-1 positive T cells in the total T cells is ≥ 18%. For patients who have received PD-1 monoclonal antibody treatment before screening, the proportion of peripheral blood PD1 positive T cells in the total T cells is ≥ 10%; The ECOG physical condition score is 0 to 1; Have sufficient bone marrow and organ functions: Blood system (no blood transfusion or hematopoietic stimulating factor treatment within 14 days): Neutrophil count (ANC) ≥ 1.5 × one hundred and nine Platelet (PLT) ≥ 75 × 109/L Hemoglobin (HB) ≥ 90g / L Lymphocyte count (lym) ≥ 60% of the lower limit of normal value Lymphocyte subsets: proportion of B lymphocytes (CD19 +) in lymphocytes ≥ lower limit of normal value Liver function: Total bilirubin (TBIL) ≤ 1.5 × ULN Alanine aminotransferase (ALT) ≤ 3 × ULN Patients with liver metastasis or liver cancer: ≤ 5 × ULN Aspartic acid amino transfer (AST) ≤ 3 × ULN Patients with liver metastasis or liver cancer: ≤ 5 × ULN Renal function Creatinine ≤ 1.5 × ULN Coagulation function Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN International normalized ratio (INR) ≤ 1.5 × ULN Fertile women must agree to permanently use reliable contraceptive methods (hormone or barrier method or abstinence, etc.) with their partners during and after the trial; Women of childbearing age (as defined in Appendix 9) must have a negative blood or urine pregnancy test within 7 days before the first use of the study drug; The subjects must be informed of the study before the test and voluntarily sign a written informed consent. Exclusion Criteria: Central nervous system metastasis or meningeal metastasis with clinical symptoms, or there is other evidence that the patient's central nervous system metastasis or meningeal metastasis has not been controlled, which is not suitable for inclusion according to the judgment of the researcher; Subjects with a history of second malignancy within 5 years before signing the informed consent; Patients who had previously received PD-L1 mAb; Those who have active infection within 1 week before apheresis and currently need systematic anti infection treatment; Received chemotherapy, radiotherapy, biological therapy, endocrine therapy, immunotherapy, traditional Chinese medicine with anti-tumor indications and other anti-tumor treatments within 2 weeks before apheresis, Except for the following: Nitrosourea or mitomycin C were within 6 weeks before single harvest; Oral fluorouracils and small molecule targeted drugs were taken 1 week before apheresis. Within 2 weeks before apheresis: Have received systemic glucocorticoid (prednisone > 10mg/day or equivalent dose of similar drugs) or other immunosuppressant treatment; Except for the following cases: local, eye, intra-articular, intranasal and inhaled glucocorticoids; Short term use of glucocorticoids for preventive treatment (e.g. prevention of contrast agent allergy); Used immunomodulatory drugs, including but not limited to thymosin, interleukin-2, interferon, etc; Within 4 weeks before apheresis: Have received other unlisted clinical research drugs or treatments; Have undergone major organ surgery (excluding puncture biopsy) or significant trauma, or need to undergo elective surgery during the trial; Used live attenuated vaccine; Currently suffering from interstitial lung disease; Had received PD-1 monoclonal antibody treatment and had ≥ grade 2 Irae; Or other immunotherapy with ≥ grade 3 Irae; Patients with active, or had, and relapsed autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, vasculitis, etc., except for clinically stable autoimmune thyroid disease and well controlled type I diabetes. The adverse reactions of previous anti-tumor treatment have not recovered to CTCAE 5.0 and the evaluation is ≤ 1 (except for the toxicity without safety risk judged by the researchers such as hair loss). Have a history of immune deficiency, including HIV antibody test positive; Hepatitis B: the titer of HBsAg (+) and/or hepatitis B DNA is higher than that of the research center. And/or hepatitis C: anti HCV positive; And/or Treponema pallidum antibody positive; Have a history of serious cardiovascular and cerebrovascular diseases, including but not limited to: There are serious cardiac rhythm or conduction abnormalities, such as ventricular arrhythmia requiring clinical intervention, ⅱ-ⅲ degree atrioventricular block, etc. Acute coronary syndrome, congestive heart failure, aortic dissection, stroke or other grade 3 and above cardiovascular events occurred within 6 months before the first administration. New York Heart Association (NYHA) cardiac function grade ≥ grade II or left ventricular ejection fraction (LVEF) < 50%, or structural heart disease with high risk judged by other researchers; Clinically uncontrollable hypertension. Serous effusion beyond clinical control is not suitable to be included in the group according to the judgment of the researcher; Known alcohol or drug dependence; Mental disorder or poor compliance; Women with reproductive needs and pregnant or lactating women; There are other serious or uncontrolled systemic diseases, or other reasons that are not suitable to participate in this clinical study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Yang Xiang
    Phone
    010-69156068
    Email
    XiangY@pumch.cn

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Clinical Study on the Safety, Pharmacokinetics, and Efficacy of ScTIL (Genetically Modified Tumor Infiltrating Lymphocytes) in the Treatment of Gynecological Malignancies

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