search
Back to results

Cytokine-Induced Memory-Like Natural Killer Cells (CIML-NK) for Relapsed & Refractory Acute Myeloid Leukemia (AML)

Primary Purpose

Acute Myeloid Leukemia

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
CIML-NK Cells
Sponsored by
Children's Hospital Medical Center, Cincinnati
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  • Of age ≥ 18 years of age at the time of study enrollment
  • With AML diagnosed per 2016 WHO criteria (11)
  • With relapsed or refractory AML in their bone marrow
  • Refractory disease: Patients must have ≥ 5% blasts in the bone marrow after 2 courses of intensive induction treatment
  • Relapsed disease: Patients must have ≥ 5% blasts in the bone marrow, or reappearance of blasts in the blood, within 6 months of initial CR
  • With available haploidentical related donors. Donor specific antibody (DSA) testing will be done on the recipient prior to or upon enrollment.
  • With performance level of ≥ 50% on Karnofsky scale for patients > 16 years of age and ≥ 50% on Lansky scale for patients ≤ 16 years of age

Exclusion Criteria:

  • Disease: isolated central nervous system (CNS) disease, or isolated extramedullary disease, or diagnosis of acute promyelocytic leukemia (APML). Patients with extramedullary disease in combination with bone marrow disease are eligible for enrollment.
  • Infectious Disease: Active uncontrolled infection
  • Renal function: Patients with serum creatinine higher than threshold creatinine values derived from the Schwartz formula for estimating GFR utilizing child length and stature data published by the CDC.
  • Cardiac function: Systolic ejection fraction <45% by echocardiogram
  • Pulmonary Function: Oxygen saturation <92% on room air
  • Hepatic function: Total bilirubin > 2mg/dL, AST and ALT more than three times the upper limit of normal
  • Concomitant medications: receiving either >10mg prednisone equivalent daily, or >0.5mg/kg prednisone equivalent daily, whichever is less Concomitant investigational treatments: receiving other investigational therapies
  • Known allergy or hypersensitivity reaction to IL-2 injections
  • Pregnant or breastfeeding women will not be entered on this study due to risks of fetal and teratogenic adverse events with lymphodepleting chemotherapy. Pregnancy tests must be obtained for female patients. Males or females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method while on study treatment and for six months following completion. Effective contraceptive methods include oral contraceptive pills, patches, or injections, intrauterine devices, having a tubal ligation, having a partner who has had a vasectomy, or not having sex.

Sites / Locations

  • Cincinnati Children's Hospital Medical CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cytokine-Induced Memory-Like Natural Killer (CIML-NK) Cells

Arm Description

The investigational cell product is a cytokine-induced memory-like natural killer cell preparation, derived from the recipient's haploidentical donor's apheresis product.

Outcomes

Primary Outcome Measures

Feasibility of infusion
Number of patients who receive CIML-NK infusion without grade 3-4 infusional toxicity events as assessed by CTCAE v5.0 divided by the number of patients enrolled.

Secondary Outcome Measures

Clinical Response to CIML-NK Infusion
Clinical response to CIML-NK infusion assessed by bone marrow morphology per standard International Working Group CR/CRi criteria (Complete Remission (CR)
Persistence of CIML-NK cells in the recipients' peripheral blood
Persistence of CIML-NK cells in the recipients' peripheral blood, assessed by flow cytometry
Proceed to Hematopoietic Stem Cell Transplant (HSCT)
Proportion of patients who are able to proceed to hematopoietic stem cell transplant

Full Information

First Posted
October 7, 2022
Last Updated
May 24, 2023
Sponsor
Children's Hospital Medical Center, Cincinnati
search

1. Study Identification

Unique Protocol Identification Number
NCT05580601
Brief Title
Cytokine-Induced Memory-Like Natural Killer Cells (CIML-NK) for Relapsed & Refractory Acute Myeloid Leukemia (AML)
Official Title
Haploidentical Donor Cytokine-Induced Memory-Like Natural Killer Cells (CIML-NK) for Relapsed & Refractory Acute Myeloid Leukemia (AML)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 5, 2023 (Actual)
Primary Completion Date
February 2025 (Anticipated)
Study Completion Date
July 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Children's Hospital Medical Center, Cincinnati

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 objective of this study is to demonstrate that cytokine-induced memory-like natural killer cells can be generated from donor cells and infused safely into patients with relapsed or refractory acute myeloid leukemia (AML). A secondary objective is to assess efficacy of the CIML-NK cells in treating AML.
Detailed Description
The goal of treatment of relapsed or refractory acute myeloid leukemia (AML) is to achieve remission and proceed to hematopoietic stem cell transplant (HSCT). Unfortunately, standard protocols have limited success. In this study the investigators will identify patients with relapsed or refractory AML who are unlikely to benefit from standard chemotherapy protocols and do not qualify for, or do not wish to participate in, institutional chemotherapy trials. Peripheral blood from a related haploidentical donor will be collected for the isolation of natural killer (NK) cells. NK cells will be induced into a memory-like state using cytokine supplementation only. In this Phase I/II study, Patients will receive a lymphodepleting chemotherapy regimen, after which the cytokine-induced memory-like NK cells (CIML-NKs) will be infused. The primary study endpoint is the feasibility and safety of infusion of the cells. The secondary endpoints are efficacy, as measured by clinical response per standard CR/CRi criteria and ability to subsequently undergo allogeneic HSCT, and the persistence of memory-like NK cells in the blood as measured by flow cytometry.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia

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
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cytokine-Induced Memory-Like Natural Killer (CIML-NK) Cells
Arm Type
Experimental
Arm Description
The investigational cell product is a cytokine-induced memory-like natural killer cell preparation, derived from the recipient's haploidentical donor's apheresis product.
Intervention Type
Drug
Intervention Name(s)
CIML-NK Cells
Intervention Description
The investigational cell product is a cytokine-induced memory-like natural killer cell preparation, derived from the recipient's haploidentical donor's apheresis product. At the time of infusion, the product is comprised of: Cytokine-Induced Memory-Like NK cells (CIML-NK cells) Human Serum Albumin Plasmalyte The concentration and total cell number of CIML-NK cells in the product will vary based on the recipient body weight and the dose requested.
Primary Outcome Measure Information:
Title
Feasibility of infusion
Description
Number of patients who receive CIML-NK infusion without grade 3-4 infusional toxicity events as assessed by CTCAE v5.0 divided by the number of patients enrolled.
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Clinical Response to CIML-NK Infusion
Description
Clinical response to CIML-NK infusion assessed by bone marrow morphology per standard International Working Group CR/CRi criteria (Complete Remission (CR)
Time Frame
30 days
Title
Persistence of CIML-NK cells in the recipients' peripheral blood
Description
Persistence of CIML-NK cells in the recipients' peripheral blood, assessed by flow cytometry
Time Frame
Assessed at day 7, 14, 21, 28
Title
Proceed to Hematopoietic Stem Cell Transplant (HSCT)
Description
Proportion of patients who are able to proceed to hematopoietic stem cell transplant
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Of age ≥ 18 years of age at the time of study enrollment With AML diagnosed per 2016 WHO criteria (11) With relapsed or refractory AML in their bone marrow Refractory disease: Patients must have ≥ 5% blasts in the bone marrow after 2 courses of intensive induction treatment Relapsed disease: Patients must have ≥ 5% blasts in the bone marrow, or reappearance of blasts in the blood, within 6 months of initial CR With available haploidentical related donors. Donor specific antibody (DSA) testing will be done on the recipient prior to or upon enrollment. With performance level of ≥ 50% on Karnofsky scale for patients > 16 years of age and ≥ 50% on Lansky scale for patients ≤ 16 years of age Exclusion Criteria: Disease: isolated central nervous system (CNS) disease, or isolated extramedullary disease, or diagnosis of acute promyelocytic leukemia (APML). Patients with extramedullary disease in combination with bone marrow disease are eligible for enrollment. Infectious Disease: Active uncontrolled infection Renal function: radioisotope determined Glomerular Function Rate <50 mL/min/1.73m2 Cardiac function: Systolic ejection fraction <45% by echocardiogram Pulmonary Function: Oxygen saturation <92% on room air Hepatic function: Total bilirubin > 2mg/dL, AST and ALT more than three times the upper limit of normal Concomitant medications: receiving either >10mg prednisone equivalent daily, or >0.5mg/kg prednisone equivalent daily, whichever is less Concomitant investigational treatments: receiving other investigational therapies Known allergy or hypersensitivity reaction to IL-2 injections Pregnant or breastfeeding women will not be entered on this study due to risks of fetal and teratogenic adverse events with lymphodepleting chemotherapy. Pregnancy tests must be obtained for female patients. Males or females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method while on study treatment and for six months following completion. Effective contraceptive methods include oral contraceptive pills, patches, or injections, intrauterine devices, having a tubal ligation, having a partner who has had a vasectomy, or not having sex.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Michele Wang
Phone
513-517-7219
Email
YunZu.Wang@cchmc.org
First Name & Middle Initial & Last Name or Official Title & Degree
Evelyn Nguyen
Phone
513-636-4379
Email
Evelyn.Nguyen@cchmc.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michele Wang
Organizational Affiliation
Children's Hospital Medical Center, Cincinnati
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Evelyn Nguyen
Email
Evelyn.Nguyen@cchmc.org
First Name & Middle Initial & Last Name & Degree
Richard Cooper
Email
richard.cooper@cchmc.org
First Name & Middle Initial & Last Name & Degree
Michele Wang, MD

12. IPD Sharing Statement

Learn more about this trial

Cytokine-Induced Memory-Like Natural Killer Cells (CIML-NK) for Relapsed & Refractory Acute Myeloid Leukemia (AML)

We'll reach out to this number within 24 hrs