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E7 TCR-T Cell Immunotherapy for Human Papillomavirus (HPV) Associated Cancers

Primary Purpose

Cervical Cancer, Throat Cancer, Oropharynx Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
E7 TCR-T cells
Sponsored by
Christian Hinrichs
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cervical Cancer focused on measuring Chimeric antigen receptors (CAR-T), Tumor infiltrating lymphocyte, TCR-T, immunotherapy, T cell, adoptive cell therapy, cellular therapy, gene therapy, human papillomavirus, HPV, E7, T cell receptor, TCR, E7 TCR, lymphocyte, cell therapy, cervical cancer, oropharyngeal cancer, anal cancer, vulvar cancer, vaginal cancer, penile cancer, tumor infiltrating lymphocytes (TIL), TIL therapy

Eligibility Criteria

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

Inclusion Criteria: Histologically or cytologically confirmed metastatic or refractory/recurrent HPV-16+ cancer. Tumor with HPV16 genotype as determined by testing performed in a CLIA certified laboratory. HLA-A*02:01 allele as determined by testing performed in a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory. Participants may be enrolled based on low resolution typing (i.e., HLA-A*02) but the HLA-A*02:01 allele type must be confirmed prior to apheresis. Measurable disease as assessed by RECIST Criteria Version 1.114. Age ≥ 18 years. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 at screening. Must have received prior first line standard therapy or have declined standard therapy. Standard treatment options for first and second-line therapy must be presented and formally declined (Appendix VII). Patients with three or fewer brain metastases that have been treated with surgery or stereotactic radiosurgery are eligible. Lesions that have been treated with stereotactic radiosurgery must be clinically stable for one month before protocol treatment. Patients must be fully recovered from surgery. Negative pregnancy test for women under 55 and all women who have had a menstrual period in the last 12 months. A pregnancy tests is not required for women who have had a bilateral oophorectomy or hysterectomy. Men and women of child-bearing potential must agree to use adequate contraception (i.e., intrauterine device, hormonal barrier method of birth control; abstinence; tubal ligation or vasectomy) prior to study entry and for four months after treatment. Should a women become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately. Seronegative for HIV antibody, hepatitis B antigen, and hepatitis C antibody. If a hepatitis C antibody test is positive, then testing for antigen by RT-PCR for Hepatitis C (HCV) RNA must be negative. Participants must have organ and marrow function as defined below: Leukocytes > 3,000/microliter (mcL) Absolute neutrophil count > 1,500/mcL Platelets > 100,000/mcL Hemoglobin > 8.0 g/dL Total bilirubin within normal institutional limits except in participants with Gilbert's Syndrome who must have a total bilirubin < 3.0 mg/dL. Serum aspartate transferase (AST) (SGOT)/alanine transaminase (ALT) (SGPT) < 2.5 x upper limit of normal (ULN) Calculated creatinine clearance (CrCl) >50 mL/min/1.73 m2for participants with creatinine levels above institutional normal (by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation). international normalized ratio (INR) or activated partial thromboplastin time ( aPTT) ≤1.5 X ULN unless the subject is receiving anticoagulant therapy. Subjects on anticoagulant therapy must have a PT or aPTT within therapeutic range and no history of severe hemorrhage. More than four weeks must have elapsed since any prior systemic therapy at the time the patient receives the E7 TCR cells. Participants must be able to understand and be willing to sign the written informed consent document. Participants must agree to participate in protocol Cancer Institute of New Jersey (CINJ) 192103 (Pro2021002307) for gene therapy long term follow up and in protocol CINJ 192002 (Pro2021000281) for biospecimen collection study.

Sites / Locations

  • Rutgers Cancer Institute of New JerseyRecruiting
  • RWJBarnabas Health - Robert Wood Johnson University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

E7 TCR-T cells

Arm Description

Subjects will receive a conditioning regimen, E7 TCR-T cells, and aldesleukin.

Outcomes

Primary Outcome Measures

Tumor response
Objective tumor response as measured by RECIST

Secondary Outcome Measures

Adverse Events
Adverse events as measured by CTCAE

Full Information

First Posted
December 25, 2022
Last Updated
October 10, 2023
Sponsor
Christian Hinrichs
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1. Study Identification

Unique Protocol Identification Number
NCT05686226
Brief Title
E7 TCR-T Cell Immunotherapy for Human Papillomavirus (HPV) Associated Cancers
Official Title
A Phase II Trial of T Cell Receptor Gene Therapy Targeting Human Papillomavirus ( HPV) 16 E7 for HPV-Associated Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 7, 2023 (Actual)
Primary Completion Date
January 1, 2025 (Anticipated)
Study Completion Date
January 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Christian Hinrichs

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
This is a phase II clinical trial to assess the clinical activity of immunotherapy with E7 TCR-T cells for metastatic HPV-associated cancers. HPV-associated cancers in include cervical, throat, penile, vulvar, vaginal, anal, and other cancers. Participants will receive a conditioning regimen, E7 TCR-T cells, and aldesleukin. Clinical response to treatment will be determined.
Detailed Description
This study will determine the tumor response rate for the treatment of HPV-associated cancers with E7 TCR-T cells. E7 TCR-T cells are autologous gene-engineered T cells that target HPV16 E7 through a T cell receptor (TCR). E7 is an HPV oncoprotein that is present in HPV-associated cancers. Participants must have the HLA-A*02:01 allele, which is required for tumor targeting by the E7 TCR. Treatment consists of a conditioning regimen (cyclophosphamide and fludarabine), a single infusion of E7 TCR-T cells, and adjuvant aldesleukin. Tumor response rate and response duration will be determined. Safety data will also be collected.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cervical Cancer, Throat Cancer, Oropharynx Cancer, Anal Cancer, Vulva Cancer, Vaginal Cancer, Penile Cancer, Metastatic Cancer, HPV-Related Malignancy, HPV-Related Carcinoma, HPV-Related Cervical Carcinoma, HPV-Related Squamous Cell Carcinoma, HPV-Related Adenocarcinoma, HPV Positive Oropharyngeal Squamous Cell Carcinoma, HPV-Associated Vaginal Adenocarcinoma, HPV-Related Adenosquamous Carcinoma, HPV-Related Endocervical Adenocarcinoma, HPV-Related Anal Squamous Cell Carcinoma, HPV-Related Penile Squamous Cell Carcinoma, HPV-Related Vulvar Squamous Cell Carcinoma, HPV Positive Rectal Squamous Cell Carcinoma
Keywords
Chimeric antigen receptors (CAR-T), Tumor infiltrating lymphocyte, TCR-T, immunotherapy, T cell, adoptive cell therapy, cellular therapy, gene therapy, human papillomavirus, HPV, E7, T cell receptor, TCR, E7 TCR, lymphocyte, cell therapy, cervical cancer, oropharyngeal cancer, anal cancer, vulvar cancer, vaginal cancer, penile cancer, tumor infiltrating lymphocytes (TIL), TIL therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
This is a single-arm phase II clinical trial.
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
E7 TCR-T cells
Arm Type
Experimental
Arm Description
Subjects will receive a conditioning regimen, E7 TCR-T cells, and aldesleukin.
Intervention Type
Biological
Intervention Name(s)
E7 TCR-T cells
Intervention Description
Participants will receive a conditioning regimen (cyclophosphamide and fludarabine), E7 TCR-T cells as a single infusion, and adjuvant high-dose aldesleukin.
Primary Outcome Measure Information:
Title
Tumor response
Description
Objective tumor response as measured by RECIST
Time Frame
Five years
Secondary Outcome Measure Information:
Title
Adverse Events
Description
Adverse events as measured by CTCAE
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed metastatic or refractory/recurrent HPV-16+ cancer. Tumor with HPV16 genotype as determined by testing performed in a CLIA certified laboratory. HLA-A*02:01 allele as determined by testing performed in a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory. Participants may be enrolled based on low resolution typing (i.e., HLA-A*02) but the HLA-A*02:01 allele type must be confirmed prior to apheresis. Measurable disease as assessed by RECIST Criteria Version 1.114. Age ≥ 18 years. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 at screening. Must have received prior first line standard therapy or have declined standard therapy. Standard treatment options for first and second-line therapy must be presented and formally declined (Appendix VII). Patients with three or fewer brain metastases that have been treated with surgery or stereotactic radiosurgery are eligible. Lesions that have been treated with stereotactic radiosurgery must be clinically stable for one month before protocol treatment. Patients must be fully recovered from surgery. Negative pregnancy test for women under 55 and all women who have had a menstrual period in the last 12 months. A pregnancy tests is not required for women who have had a bilateral oophorectomy or hysterectomy. Men and women of child-bearing potential must agree to use adequate contraception (i.e., intrauterine device, hormonal barrier method of birth control; abstinence; tubal ligation or vasectomy) prior to study entry and for four months after treatment. Should a women become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately. Seronegative for HIV antibody, hepatitis B antigen, and hepatitis C antibody. If a hepatitis C antibody test is positive, then testing for antigen by RT-PCR for Hepatitis C (HCV) RNA must be negative. Participants must have organ and marrow function as defined below: Leukocytes > 3,000/microliter (mcL) Absolute neutrophil count > 1,500/mcL Platelets > 100,000/mcL Hemoglobin > 8.0 g/dL Total bilirubin within normal institutional limits except in participants with Gilbert's Syndrome who must have a total bilirubin < 3.0 mg/dL. Serum aspartate transferase (AST) (SGOT)/alanine transaminase (ALT) (SGPT) < 2.5 x upper limit of normal (ULN) Calculated creatinine clearance (CrCl) >50 mL/min/1.73 m2for participants with creatinine levels above institutional normal (by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation). international normalized ratio (INR) or activated partial thromboplastin time ( aPTT) ≤1.5 X ULN unless the subject is receiving anticoagulant therapy. Subjects on anticoagulant therapy must have a PT or aPTT within therapeutic range and no history of severe hemorrhage. More than four weeks must have elapsed since any prior systemic therapy at the time the patient receives the E7 TCR cells. Participants must be able to understand and be willing to sign the written informed consent document. Participants must agree to participate in protocol Cancer Institute of New Jersey (CINJ) 192103 (Pro2021002307) for gene therapy long term follow up and in protocol CINJ 192002 (Pro2021000281) for biospecimen collection study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Carrie Snyder
Phone
732-235-7356
Email
cs1449@cinj.rutgers.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christian Hinrichs, MD
Organizational Affiliation
Rutgers Cancer Institute of New Jersey
Official's Role
Principal Investigator
Facility Information:
Facility Name
Rutgers Cancer Institute of New Jersey
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Carrie Snyder
Phone
732-235-7356
Email
cs1449@cinj.rutgers.edu
Facility Name
RWJBarnabas Health - Robert Wood Johnson University Hospital
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Carrie Snyder
Phone
732-235-7356
Email
cs1449@cinj.rutgers.edu

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Primary and secondary endpoint data will be shared.
IPD Sharing Time Frame
Data will be made available through the publisher at the time of publication.
IPD Sharing Access Criteria
Data will be accessible through the publisher.
Citations:
PubMed Identifier
33558725
Citation
Nagarsheth NB, Norberg SM, Sinkoe AL, Adhikary S, Meyer TJ, Lack JB, Warner AC, Schweitzer C, Doran SL, Korrapati S, Stevanovic S, Trimble CL, Kanakry JA, Bagheri MH, Ferraro E, Astrow SH, Bot A, Faquin WC, Stroncek D, Gkitsas N, Highfill S, Hinrichs CS. TCR-engineered T cells targeting E7 for patients with metastatic HPV-associated epithelial cancers. Nat Med. 2021 Mar;27(3):419-425. doi: 10.1038/s41591-020-01225-1. Epub 2021 Feb 8.
Results Reference
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E7 TCR-T Cell Immunotherapy for Human Papillomavirus (HPV) Associated Cancers

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