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Dual-targeting VEGFR1 and PD-L1 CAR-T for Cancers Patients With Pleural or Peritoneal Metastases

Primary Purpose

Malignant Peritoneal Effusion, Malignant Ascites, Serous Cavity Metastatises

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Dual-targeting VEGFR1 and PD-L1 CAR-T cells
Sponsored by
Sichuan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant Peritoneal Effusion focused on measuring CAR-T regional injection, Solid Tumors, Serosal Cavity metastases

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female, Age 18-65 years old; negative results of serum or urine pregnancy test within 48 hours before treatment are needed to provide for fertile women (or women who have undergone sterilization or at least 2 years after menopause can be regarded as infertile);
  2. Patients diagnosed as ovarian cancer, non-small cell lung cancer, breast cancer, gastric cancer, etc., accompanied by serous cavity metastasis, have received systemic standard treatment, and have clinical symptoms of serous cavity metastasis;
  3. The Eastern Cooperative Oncology Group (ECOG) performance status score is 0-2;
  4. Estimated life expectancy ≥ 3 months (according to investigator's judgement);
  5. Absolute neutrophil count ≥ 1.5×10^9/L, platelet count ≥ 90×10^9/L, absolute lymphocyte count ≥1×10^8/L, hemoglobin ≥ 9.0 g/dL;
  6. Creatinine clearance rate ≥60 mL/min, Serum ALT/AST≤2.5 times of the normal level, and total bilirubin≤1.5 times of the normal level;
  7. Cardiac ejection fraction ≥50%, no pericardial effusion;
  8. No other serious diseases (autoimmune diseases or any immune deficiency disease or other disease in need of immunosuppressive therapy);
  9. Patients must stop chemotherapy and targeted therapy for at least 3 weeks before starting treatment;
  10. Patients must take reliable contraceptive measures before entering the trial, during the research process until 1 year after CAR-T infusion; reliable contraceptive measures will be determined by the main investigator or designated personnel;
  11. Voluntarily participate in the research, understand and sign the informed consent;
  12. The side effect of the last anti-tumor treatment was reduced to ≤1 grade, except for hair loss.

Exclusion Criteria:

  1. Had accepted any treatment of CAR-T therapy;
  2. Allergic to cytokines; uncontrolled activity infection;
  3. Acute or chronic (graft-versus-host disease) GVHD;
  4. Accompanied by other uncontrolled malignant tumors;
  5. Patient with hepatitis B or C active period, HIV infection ≥ the upper limit of the normal level;
  6. Other uncontrolled diseases in active period that hinder participation in the trial;
  7. Suffer from serious diseases such as coronary heart disease, angina pectoris, myocardial infarction, arrhythmia, cerebral thrombosis, cerebral hemorrhage, etc.;
  8. Patients with grade 2-3 hypertension or poorly controlled;
  9. History of mental illness that is difficult to control;
  10. Patients have used immunosuppressive agents for a long time after organ transplantation, except for recent or current inhaled corticosteroid therapy;
  11. The existing medical history or mental state history or laboratory abnormalities may increase the risk associated with participating in the study or the administration of the study drug from the point view of PI;
  12. Unstable pulmonary embolism, deep venous embolism or other major arterial/venous thromboembolic events occurred within 6 months before enrollment. If receiving anticoagulant therapy;
  13. Pregnant or nursing women, or plan to become pregnant during the treatment period or within 1 year after the treatment ends;
  14. Female subjects of childbearing age were reluctant to accept high-efficiency contraceptive measures during the treatment period or within 1 year after the treatment ends;
  15. Patient suffering from diseases that have signed written informed consent or comply with research procedures; or are unwilling or unable to comply with research requirements;
  16. Patients who are inappropriate to participate in this experiment as considered by PI.

Sites / Locations

  • West China Hospital, Sichuan UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CAR-T cell therapy

Arm Description

Dual-targeting VEGFR1 and PD-L1 CAR-T cells

Outcomes

Primary Outcome Measures

AEs will be recorded and evaluated by CTCAT 5.0.
Safety
Recommended phase II dose (RP2D).
Efficacy dose
Therapeutic efficacy will be evaluated according to RECIST1.1.
Ant-tumor effects
Dose-limiting toxicity (DLT) will be assessed by CTCAE 5.0.
Tolerability evaluation

Secondary Outcome Measures

Objective Remission Rate (ORR).
Include CR (complete response) and PR (partial response).
Progression-Free Survival (PFS ).
The time from CAR-T administration to disease progression or death.
Duration Of Control Rate (DCR).
The number of cases in which response (PR + CR) and stable disease (SD) are achieved from the start of cell infusion/the total number of evaluable cases (%).
Duration Of Response (DOR).
It refers to the time from the first evaluation of CR or PR to the first evaluation of PD(Progressive Disease) or death from any reason.
Overall-Survival (OS).
It defined as the time from randomization to death from any cause, is a direct measure of clinical benefit to a patient. Patients alive or lost to follow-up are censored.
Anti-CAR antibody production
Immunogenicity
CAR-T cell numbers.
PK/PD

Full Information

First Posted
May 7, 2022
Last Updated
September 15, 2022
Sponsor
Sichuan University
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1. Study Identification

Unique Protocol Identification Number
NCT05477927
Brief Title
Dual-targeting VEGFR1 and PD-L1 CAR-T for Cancers Patients With Pleural or Peritoneal Metastases
Official Title
A Phase Ia/Ib, Open-label, Single-arm, Dose-escalation and Expansion Study of Specific Dual-targeting VEGFR1 and PD-L1 CAR-T in Cancer Patients With Pleural or Peritoneal Metastases
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
October 30, 2022 (Anticipated)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sichuan University

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
Serosal cavity metastases of malignant tumor seriously affects the quality of life and survival time of patients with cancers in advanced stage. VEGFR1 is frequently expressed in breast cancer, ovarian cancer, lung cancer, gastric cancer and other malignant tumors and their metastases. The VEGFR1/PD-L1 dual-targeting CAR-T will be investigated in cancer patients with serosal cavity metastases.
Detailed Description
In this study, VEGFR1 will be used as the general target of serosal cavity metastasis of malignant tumor, and the dual-targeting CAR-T of VEGFR1/PD-L1 will be injected in to pleural or peritoneal cavity of patients with advanced serous cavity metastases, such as ovarian cancer, breast cancer, lung cancer and gastric cancer, who had nearly no response to standard treatment. The safety and effectiveness will be evaluated. The safety evaluation standard refers to the standard of CTCAE 5.0. The evaluation standard of effectiveness refers to the evaluation standard of solid tumor curative effect RECIST 1.1 to evaluate the curative effect. There are two part of this study, the first is dose escalation part, 18 patients with malignant tumor (failure of standard treatment will be enrolled at least, patients with peritonea cavity metastases are planned to be enrolled in the cohort 1, and those with pleural cavity metastasis are enrolled in the cohort 2. The second is dose expansion part, the curative effect has observed in the first part, and after the DLT observation period of the related dose group was finished, the PI will decided whether to conduct the dose expansion research finally. It was planned to enroll 40 patients with serous cavity metastases , two cohorts were divided the same as mentioned above in dose escalation part.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Peritoneal Effusion, Malignant Ascites, Serous Cavity Metastatises
Keywords
CAR-T regional injection, Solid Tumors, Serosal Cavity metastases

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CAR-T cell therapy
Arm Type
Experimental
Arm Description
Dual-targeting VEGFR1 and PD-L1 CAR-T cells
Intervention Type
Biological
Intervention Name(s)
Dual-targeting VEGFR1 and PD-L1 CAR-T cells
Intervention Description
In the dose escalation part, the dose levels will be escalated following a traditional escalation scheme for 3+3 design. In the dose expansion part, patients will be assigned to different groups based on pleural or peritoneal metastases condition.
Primary Outcome Measure Information:
Title
AEs will be recorded and evaluated by CTCAT 5.0.
Description
Safety
Time Frame
28 days
Title
Recommended phase II dose (RP2D).
Description
Efficacy dose
Time Frame
Approximately 18 months.
Title
Therapeutic efficacy will be evaluated according to RECIST1.1.
Description
Ant-tumor effects
Time Frame
Approximately 18 months.
Title
Dose-limiting toxicity (DLT) will be assessed by CTCAE 5.0.
Description
Tolerability evaluation
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Objective Remission Rate (ORR).
Description
Include CR (complete response) and PR (partial response).
Time Frame
3 months
Title
Progression-Free Survival (PFS ).
Description
The time from CAR-T administration to disease progression or death.
Time Frame
Approximately 18 months.
Title
Duration Of Control Rate (DCR).
Description
The number of cases in which response (PR + CR) and stable disease (SD) are achieved from the start of cell infusion/the total number of evaluable cases (%).
Time Frame
3 months
Title
Duration Of Response (DOR).
Description
It refers to the time from the first evaluation of CR or PR to the first evaluation of PD(Progressive Disease) or death from any reason.
Time Frame
Approximately 18 months.
Title
Overall-Survival (OS).
Description
It defined as the time from randomization to death from any cause, is a direct measure of clinical benefit to a patient. Patients alive or lost to follow-up are censored.
Time Frame
Approximately 18 months.
Title
Anti-CAR antibody production
Description
Immunogenicity
Time Frame
12 months.
Title
CAR-T cell numbers.
Description
PK/PD
Time Frame
12 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, Age 18-65 years old; negative results of serum or urine pregnancy test within 48 hours before treatment are needed to provide for fertile women (or women who have undergone sterilization or at least 2 years after menopause can be regarded as infertile); Patients diagnosed as ovarian cancer, non-small cell lung cancer, breast cancer, gastric cancer, etc., accompanied by serous cavity metastasis, have received systemic standard treatment, and have clinical symptoms of serous cavity metastasis; The Eastern Cooperative Oncology Group (ECOG) performance status score is 0-2; Estimated life expectancy ≥ 3 months (according to investigator's judgement); Absolute neutrophil count ≥ 1.5×10^9/L, platelet count ≥ 90×10^9/L, absolute lymphocyte count ≥1×10^8/L, hemoglobin ≥ 9.0 g/dL; Creatinine clearance rate ≥60 mL/min, Serum ALT/AST≤2.5 times of the normal level, and total bilirubin≤1.5 times of the normal level; Cardiac ejection fraction ≥50%, no pericardial effusion; No other serious diseases (autoimmune diseases or any immune deficiency disease or other disease in need of immunosuppressive therapy); Patients must stop chemotherapy and targeted therapy for at least 3 weeks before starting treatment; Patients must take reliable contraceptive measures before entering the trial, during the research process until 1 year after CAR-T infusion; reliable contraceptive measures will be determined by the main investigator or designated personnel; Voluntarily participate in the research, understand and sign the informed consent; The side effect of the last anti-tumor treatment was reduced to ≤1 grade, except for hair loss. Exclusion Criteria: Had accepted any treatment of CAR-T therapy; Allergic to cytokines; uncontrolled activity infection; Acute or chronic (graft-versus-host disease) GVHD; Accompanied by other uncontrolled malignant tumors; Patient with hepatitis B or C active period, HIV infection ≥ the upper limit of the normal level; Other uncontrolled diseases in active period that hinder participation in the trial; Suffer from serious diseases such as coronary heart disease, angina pectoris, myocardial infarction, arrhythmia, cerebral thrombosis, cerebral hemorrhage, etc.; Patients with grade 2-3 hypertension or poorly controlled; History of mental illness that is difficult to control; Patients have used immunosuppressive agents for a long time after organ transplantation, except for recent or current inhaled corticosteroid therapy; The existing medical history or mental state history or laboratory abnormalities may increase the risk associated with participating in the study or the administration of the study drug from the point view of PI; Unstable pulmonary embolism, deep venous embolism or other major arterial/venous thromboembolic events occurred within 6 months before enrollment. If receiving anticoagulant therapy; Pregnant or nursing women, or plan to become pregnant during the treatment period or within 1 year after the treatment ends; Female subjects of childbearing age were reluctant to accept high-efficiency contraceptive measures during the treatment period or within 1 year after the treatment ends; Patient suffering from diseases that have signed written informed consent or comply with research procedures; or are unwilling or unable to comply with research requirements; Patients who are inappropriate to participate in this experiment as considered by PI.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
XIA HE, Ph.D
Phone
18583365730
Email
18583365730@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
DAN LI, Ph.D
Phone
13880025826
Email
lidan@wchscu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
YongShen Wang, Prof.
Organizational Affiliation
West China Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
West China Hospital, Sichuan University
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610041
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
XIA HE, PhD.
Phone
(+86)18583365730
Email
18583365730@163.com
First Name & Middle Initial & Last Name & Degree
DAN LI, PhD.
Phone
(+86)13880025826
Email
lidan@wchscu.cn
First Name & Middle Initial & Last Name & Degree
YongShen Wang, Prof.

12. IPD Sharing Statement

Citations:
PubMed Identifier
23559882
Citation
Cheema PK, Burkes RL. Overall survival should be the primary endpoint in clinical trials for advanced non-small-cell lung cancer. Curr Oncol. 2013 Apr;20(2):e150-60. doi: 10.3747/co.20.1226.
Results Reference
background
PubMed Identifier
33633361
Citation
Wagner DL, Fritsche E, Pulsipher MA, Ahmed N, Hamieh M, Hegde M, Ruella M, Savoldo B, Shah NN, Turtle CJ, Wayne AS, Abou-El-Enein M. Immunogenicity of CAR T cells in cancer therapy. Nat Rev Clin Oncol. 2021 Jun;18(6):379-393. doi: 10.1038/s41571-021-00476-2. Epub 2021 Feb 25.
Results Reference
background

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Dual-targeting VEGFR1 and PD-L1 CAR-T for Cancers Patients With Pleural or Peritoneal Metastases

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