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Dendritic Killer Cell-based Immunotherapy for Solid Tumors

Primary Purpose

Colorectal Neoplasms, Hepatocellular Carcinoma, Neoplasm Metastasis

Status
Unknown status
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Dendritic Killer Cell (DKC)
Sponsored by
FullHope Biomedical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Neoplasms focused on measuring Clinical Trial, Phase I

Eligibility Criteria

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

Inclusion Criteria:

  1. Capable and willing of providing signed informed consent before study
  2. Patient age ≥20 at date of consent
  3. Performance status (ECOG) ≤2
  4. Patients have a life expectancy of > 3 months
  5. Patients agree to be in compliant to clinical protocol planned treatment plan
  6. Histologically confirmed metastatic solid tumor, including colon cancer, gastric cancer, pancreatic cancer, bile duct cancer, liver cancer
  7. Patient with histological and conventional imaging proven measurable lesion
  8. Patients not pregnant. All male and female patients with reproduction ability should use appropriate contraception method(s) during the study period
  9. Patient is not currently under immunosuppressive treatment for previous or recurred autoimmune disease
  10. Patient should have received and failed prior standard cancer therapies (according to TVGH standard cancer treatment procedures, or National Comprehensive Cancer Network clinical practice guidelines in oncology)
  11. Patient with adequate hematology function:

    Absolute neutrophil count (ANC) ≥ 1,500 cells Total white blood cell (WBC) ≥ 3,000 cells /mm3 Hemoglobin ≥ 9 g/dl Platelets ≥ 100,000 counts /mm3

  12. Patient with adequate hepatic and renal function Serum creatinine ≤ 1.5X Upper Limit of Normal (ULN) Total bilirubin (TB) ≤ 1.5X ULN, or ≤ 2.5X ULN for patients with primary HCC or liver metastasis ALT and AST ≤ 2.5X ULN, or ≤ 5X ULN for patients with primary HCC or liver metastasis Alkaline phosphatase (ALP) ≤ 5X ULN
  13. Patient showing negative response in syphilis, HIV, HBV and HCV test

Exclusion Criteria:

  1. Any other investigational drug used within 28 days prior to first DKC administration
  2. Patient with known brain metastasis or metastasis to central nervous system
  3. Patient with pulmonary fibrosis
  4. Patient with pleural effusion or as cites correspond to CTCAE grading > 2
  5. Patient with uncontrolled disease including but not limit to cardiovascular disease, liver disease, renal disease or infectious disease
  6. Patients being diagnosed with any cognitive or psychiatric illness
  7. Patient not suitable to participate the trial for safety concerns as judged by the investigator

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Dendritic Killer Cell (DKC)

    Arm Description

    All enrolled patients received one treatment cycle of DKC cell therapy, which consists of 5 infusion cycles approximately 23 days apart. There were 3 dose levels: 5 x 10^6, 1 x 10^7, and 5 x 10^7 cells, and the protocol followed a traditional 3+3 dose escalation design.

    Outcomes

    Primary Outcome Measures

    Safety of DKC as assessed by adverse event (AE)
    The coding system used for AE is MedDRA. Only treatment-emergent adverse events (TEAEs) are considered for primary endpoint. Frequency table of subjects with pre-treatment and treatment-emergent AE are presented by each cohort and overall trial. AE incidents are summarized descriptively by system organ class and preferred term using MedDRA for each cohort and overall trial.
    Safety of DKC as assessed by serious adverse event (SAE)
    Serious adverse event incidence is summarized descriptively by system organ class and preferred term for each cohort and overall trial. The causality of SAEs will be assessed by the principal investigator for its relationship to study medication.
    Safety of DKC as assessed by dose-limiting toxicity (DLT)
    DLT is defined as Grade ≧ 3 (according to NCI-CTCAE 4.03 grading system), study medication-related (i.e. with causality determined as at least possibly related to study medication), and worsened in comparison to baseline (pre-treatment condition). DLT is determined after first infusion cycle and maximum tolerated dose (MTD) is determined as the highest dose without DLT. DLT is defined by the items listed below: Blood and lymphatic system disorders: Grade ≧ 3 of (1) Any febrile neutropenia, (2) Leukocytosis, (3) Anemia Other disorders: Grade ≧ 3 of (1) Diarrhea, (2) Vomiting, (3) Fever, (4) Nausea, (5) Anaphylaxis
    Safety of DKC as assessed by combining with concomitant anticancer treatment
    The subjects enrolled in the study are cancer patients, who were treated with anticancer drugs before, and possibly during, DKC immunotherapy. Potential adverse drug-drug interaction (DDI) is monitored during treatment and follow-up period.
    Safety of DKC as assessed by laboratory examinations
    For each cohort, there are 5 baselines (taken 9 days before infusion) for 5 infusion cycles, and there are 2 evaluation time points in each infusion cycle (at end of first week and second week after infusion) and 4 in the follow-up period (at every 12 weeks). The laboratory evaluation results are tabulated in two aspects: 1) the percentage changes between each evaluation and corresponding baselines, and 2) the mean baseline values of each cycle in each cohort. Laboratory results regarding different functional categories are described separately in following areas. Hematology related items: Hb (g/dL), WBC (count/uL), Platelet (x 10^3 count/uL), ANC (count/uL) Liver function related items: C-RP (mg/dL), Glucose AC (mg/dL), Total Bilirubin (mg/dL), AST (U/L), ALT (U/L), LDH (U/L), ALP (U/L), gammaGT (U/L) Serum lipids and proteins, renal function, and electrolytes related items: HDL-C (mg/dL), Total Cholesterol (mg/dL), Triglyceride (mg/dL), Creatinine (mg/dL), BUN (mg/dL)

    Secondary Outcome Measures

    Efficacy of DKC as assessed by tumor specific T cell response
    The tumor specific T cell response was assessed by the detection of CD3+CD8+CD69+IFN-gamma+ T lymphocytes in percentage relative to total peripheral blood mononuclear cells (PBMCs). Baseline value was measured before first infusion cycle, and subsequent evaluation time points were measured right after infusion cycles 2, 3, and 4.
    Efficacy of DKC as assessed by change in quality of life
    The quality of life as assessed by the WHO QoL-BREF questionnaire, and the transformed scores (0-100) was used to facilitate the interpretation. Baseline value was measured before first infusion cycle, and evaluation time points were taken right after infusion cycles 2, 3, 4, and 5. During the follow-up period, evaluation time points were taken at every 12 weeks for a total of 4 time points.

    Full Information

    First Posted
    August 18, 2016
    Last Updated
    August 24, 2016
    Sponsor
    FullHope Biomedical Co., Ltd.
    Collaborators
    Taipei Veterans General Hospital, Taiwan
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02882659
    Brief Title
    Dendritic Killer Cell-based Immunotherapy for Solid Tumors
    Official Title
    Phase I Clinical Trial of Autologous Dendritic Killer Cell-based Immunotherapy for Solid Tumors
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2016
    Overall Recruitment Status
    Unknown status
    Study Start Date
    August 2014 (undefined)
    Primary Completion Date
    January 2016 (Actual)
    Study Completion Date
    December 2017 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    FullHope Biomedical Co., Ltd.
    Collaborators
    Taipei Veterans General Hospital, Taiwan

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The primary objective of this study is to evaluate the safety of autologous dendritic killer cell (DKC) in patients with metastatic solid tumor and to evaluate the maximum tolerated dose (MTD) of DKC. The primary endpoint of safety evaluation includes physical examination, assessment of vital sign, laboratory test, concomitant medication, and adverse event (AE). The secondary endpoints regarding efficacy includes the generation of tumor specific immune response by detecting CD3+ CD8+ CD69+ IFN-gamma+ T cells, and the improvement of quality of life

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Colorectal Neoplasms, Hepatocellular Carcinoma, Neoplasm Metastasis
    Keywords
    Clinical Trial, Phase I

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Dendritic Killer Cell (DKC)
    Arm Type
    Experimental
    Arm Description
    All enrolled patients received one treatment cycle of DKC cell therapy, which consists of 5 infusion cycles approximately 23 days apart. There were 3 dose levels: 5 x 10^6, 1 x 10^7, and 5 x 10^7 cells, and the protocol followed a traditional 3+3 dose escalation design.
    Intervention Type
    Biological
    Intervention Name(s)
    Dendritic Killer Cell (DKC)
    Other Intervention Name(s)
    FullHope Cell Therapy A (FHCTA)
    Intervention Description
    DKC is a hybrid cell type capable of dual functionality, i.e. cytotoxicity and antigen presentation, similar to NK cells and DCs, respectively.
    Primary Outcome Measure Information:
    Title
    Safety of DKC as assessed by adverse event (AE)
    Description
    The coding system used for AE is MedDRA. Only treatment-emergent adverse events (TEAEs) are considered for primary endpoint. Frequency table of subjects with pre-treatment and treatment-emergent AE are presented by each cohort and overall trial. AE incidents are summarized descriptively by system organ class and preferred term using MedDRA for each cohort and overall trial.
    Time Frame
    Entire treatment period (cycle 1-5, 116 +/- 4 days) and follow-up period (452 +/- 4 days)
    Title
    Safety of DKC as assessed by serious adverse event (SAE)
    Description
    Serious adverse event incidence is summarized descriptively by system organ class and preferred term for each cohort and overall trial. The causality of SAEs will be assessed by the principal investigator for its relationship to study medication.
    Time Frame
    Entire treatment period (cycle 1-5, 116 +/- 4 days) and follow-up period (452 +/- 4 days)
    Title
    Safety of DKC as assessed by dose-limiting toxicity (DLT)
    Description
    DLT is defined as Grade ≧ 3 (according to NCI-CTCAE 4.03 grading system), study medication-related (i.e. with causality determined as at least possibly related to study medication), and worsened in comparison to baseline (pre-treatment condition). DLT is determined after first infusion cycle and maximum tolerated dose (MTD) is determined as the highest dose without DLT. DLT is defined by the items listed below: Blood and lymphatic system disorders: Grade ≧ 3 of (1) Any febrile neutropenia, (2) Leukocytosis, (3) Anemia Other disorders: Grade ≧ 3 of (1) Diarrhea, (2) Vomiting, (3) Fever, (4) Nausea, (5) Anaphylaxis
    Time Frame
    Entire treatment period (cycle 1-5, 116 +/- 4 days) and follow-up period (452 +/- 4 days)
    Title
    Safety of DKC as assessed by combining with concomitant anticancer treatment
    Description
    The subjects enrolled in the study are cancer patients, who were treated with anticancer drugs before, and possibly during, DKC immunotherapy. Potential adverse drug-drug interaction (DDI) is monitored during treatment and follow-up period.
    Time Frame
    Entire treatment period (cycle 1-5, 116 +/- 4 days) and follow-up period (452 +/- 4 days)
    Title
    Safety of DKC as assessed by laboratory examinations
    Description
    For each cohort, there are 5 baselines (taken 9 days before infusion) for 5 infusion cycles, and there are 2 evaluation time points in each infusion cycle (at end of first week and second week after infusion) and 4 in the follow-up period (at every 12 weeks). The laboratory evaluation results are tabulated in two aspects: 1) the percentage changes between each evaluation and corresponding baselines, and 2) the mean baseline values of each cycle in each cohort. Laboratory results regarding different functional categories are described separately in following areas. Hematology related items: Hb (g/dL), WBC (count/uL), Platelet (x 10^3 count/uL), ANC (count/uL) Liver function related items: C-RP (mg/dL), Glucose AC (mg/dL), Total Bilirubin (mg/dL), AST (U/L), ALT (U/L), LDH (U/L), ALP (U/L), gammaGT (U/L) Serum lipids and proteins, renal function, and electrolytes related items: HDL-C (mg/dL), Total Cholesterol (mg/dL), Triglyceride (mg/dL), Creatinine (mg/dL), BUN (mg/dL)
    Time Frame
    Entire treatment period (cycle 1-5, 116 +/- 4 days) and follow-up period (452 +/- 4 days)
    Secondary Outcome Measure Information:
    Title
    Efficacy of DKC as assessed by tumor specific T cell response
    Description
    The tumor specific T cell response was assessed by the detection of CD3+CD8+CD69+IFN-gamma+ T lymphocytes in percentage relative to total peripheral blood mononuclear cells (PBMCs). Baseline value was measured before first infusion cycle, and subsequent evaluation time points were measured right after infusion cycles 2, 3, and 4.
    Time Frame
    Entire treatment period (cycle 1-5, 116 +/- 4 days)
    Title
    Efficacy of DKC as assessed by change in quality of life
    Description
    The quality of life as assessed by the WHO QoL-BREF questionnaire, and the transformed scores (0-100) was used to facilitate the interpretation. Baseline value was measured before first infusion cycle, and evaluation time points were taken right after infusion cycles 2, 3, 4, and 5. During the follow-up period, evaluation time points were taken at every 12 weeks for a total of 4 time points.
    Time Frame
    Entire treatment period (cycle 1-5, 116 +/- 4 days) and follow-up period (452 +/- 4 days)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    20 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Capable and willing of providing signed informed consent before study Patient age ≥20 at date of consent Performance status (ECOG) ≤2 Patients have a life expectancy of > 3 months Patients agree to be in compliant to clinical protocol planned treatment plan Histologically confirmed metastatic solid tumor, including colon cancer, gastric cancer, pancreatic cancer, bile duct cancer, liver cancer Patient with histological and conventional imaging proven measurable lesion Patients not pregnant. All male and female patients with reproduction ability should use appropriate contraception method(s) during the study period Patient is not currently under immunosuppressive treatment for previous or recurred autoimmune disease Patient should have received and failed prior standard cancer therapies (according to TVGH standard cancer treatment procedures, or National Comprehensive Cancer Network clinical practice guidelines in oncology) Patient with adequate hematology function: Absolute neutrophil count (ANC) ≥ 1,500 cells Total white blood cell (WBC) ≥ 3,000 cells /mm3 Hemoglobin ≥ 9 g/dl Platelets ≥ 100,000 counts /mm3 Patient with adequate hepatic and renal function Serum creatinine ≤ 1.5X Upper Limit of Normal (ULN) Total bilirubin (TB) ≤ 1.5X ULN, or ≤ 2.5X ULN for patients with primary HCC or liver metastasis ALT and AST ≤ 2.5X ULN, or ≤ 5X ULN for patients with primary HCC or liver metastasis Alkaline phosphatase (ALP) ≤ 5X ULN Patient showing negative response in syphilis, HIV, HBV and HCV test Exclusion Criteria: Any other investigational drug used within 28 days prior to first DKC administration Patient with known brain metastasis or metastasis to central nervous system Patient with pulmonary fibrosis Patient with pleural effusion or as cites correspond to CTCAE grading > 2 Patient with uncontrolled disease including but not limit to cardiovascular disease, liver disease, renal disease or infectious disease Patients being diagnosed with any cognitive or psychiatric illness Patient not suitable to participate the trial for safety concerns as judged by the investigator
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Yee Chou, M.D., Ph.D.
    Organizational Affiliation
    Taipei Veteran General Hospital, Taiwan R.O.C.
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided

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