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EBV-TCR-T(YT-E001)for Patients With EBV-positive Recurrent or Metastatic NPC

Primary Purpose

Nasopharyngeal Carcinoma

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
EBV-TCR-T (YT-E001) cells
Sponsored by
Fujian Cancer Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nasopharyngeal Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  1. ≥18 years old;
  2. Sign an informed consent before undertaking any trial-related activities;
  3. NPC patients diagnosed by licensed pathologist, EBV DNA copy number >500.
  4. Received at least one run of standard therapy (surgery, chemo, radiation and targeted therapy) or first line and second line treatment failure;
  5. HLA-A*0201/2402/1101;
  6. ECOG score 0-2;Life expectancy is longer than 3 months;
  7. No Chinese herbal medicine usage within 4 weeks before enrollment;
  8. Lab test results meet the following requirements:

    White blood cell count≥4.0×109/L; ANC≥1.5 ×109/L; PLT≥100 ×109/L; Hemoglobin≥90g/L; Prothrombin time or INR ≤1.5× normal upper limit, except taking anticoagulant therapy; PTT≤1.5× normal upper limit;AST≤3×ULN; ALT≤3×ULN; ALP≤3×ULN; TBIL≤1.5×ULN。

  9. Levels of calcium, potassium, and magnesium in serum are within the normal range;
  10. Pregnancy test is negative for female subjects with reproductive capability before participating the study Female subjects must consent using birth control during the study or prohibit any homo or heterosexual behavior;
  11. Can regularly visit the research institutions for tests, evaluations, and monitoring throughout the study period.

Exclusion Criteria:

  1. Received major surgery, conventional chemotherapy, large-area radiotherapy, immune therapy or any biological anti-tumor therapy within 4 weeks prior to the study;
  2. Allergic to any components of the therapy;
  3. Never recovered to <2 grade CTCAE from prior surgery or treatment-related adverse events;
  4. With two or other types of primary solid tumors;
  5. Poorly managed hypertension (systolic blood pressure >160 mmHg and / or diastolic blood pressure > 90 mmHg) or clinically significant(for example, active) cardiovascular and cerebrovascular diseases such as cerebrovascular incident (within 6 months prior to signing the informed consent), myocardial infarction (within 6 months prior to signing the informed consent), unstable angina, grade II or above heart failure, Congestive, or severe arrhythmia can not be controlled by medication or has a potential impact on the study;
  6. With other serious organic disease and/or mental illness;
  7. With systemic active infections that need treatments, including active tuberculosis, HIV/HBV/HCV- positive or clinically active hepatitis A, B and C;
  8. With autoimmune diseases: such as a history of inflammatory bowel disease (IBD) or other autoimmune diseases determined by the investigator to be unsuitable for the study (e.g. systemic lupus erythematosus (SLE), vasculitis, invasive pulmonary disease);
  9. Within 4 weeks prior the infusion, received chronic systemic steroid cortisone, Hydroxyurea, immunomodulatory treatment (for example: Interleukin 2, alpha or gamma interferon, GCSF, cyclosporine etc.);
  10. History of organ allografts, autologous / allogeneic stem cell transplantation, and renal replacement therapy;
  11. With central nervous system metastasis.
  12. With uncontrolled diabetes, pulmonary fibrosis, interstitial lung disease, acute lung disease, or liver failure;
  13. Pregnant or lactating female patients;
  14. Received concomitant medication prohibited by the protocol;
  15. With any medical condition or disease determined by the investigators that may be detrimental to this trial;

Sites / Locations

  • Fujian Cancer HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

EBV-TCR-T cells(YT-E001)

Arm Description

EBV-TCR-T (YT-E001) cells are prepared via lentiviral infection. 6-10 days prior to infusion of TCR-T cells (YT-E001), subjects receive fludarabine at dose 30mg/m2/day for 4 days and cyclophosphamide treatment at dose 30mg/kg/day for 2 days and take a rest for one day before infusion. A single dose of EBV-TCR(YT-E001) transduced T cells (about 2×108) will be intravenously (i.v.) administered.

Outcomes

Primary Outcome Measures

Number of participants with adverse events
To evaluate the safety and feasibility of the administration of EBV-TCR transduced T cells(YT-E001) in patients with EBV+ NPC.

Secondary Outcome Measures

Number of participants with clinical responses
To evaluate the efficacy of EBV positive NPC patients treated with EBV antigen specific affinity-enhanced TCR transduced autologous T cell therapy(YT-E001).

Full Information

First Posted
August 24, 2018
Last Updated
August 9, 2020
Sponsor
Fujian Cancer Hospital
Collaborators
China Immunotech (Beijing) Biotechnology Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03648697
Brief Title
EBV-TCR-T(YT-E001)for Patients With EBV-positive Recurrent or Metastatic NPC
Official Title
A Pilot Study of EBV-TCR-T(YT-E001) in NPC Patients
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Unknown status
Study Start Date
October 10, 2018 (Actual)
Primary Completion Date
October 8, 2021 (Anticipated)
Study Completion Date
October 10, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fujian Cancer Hospital
Collaborators
China Immunotech (Beijing) Biotechnology Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
TCR-T cell therapy experienced a breakthrough for treating tumors in recent years. Phase I / II trial of NY-ESO-1-specific TCR-T treatment for synovial sarcoma and melanoma conducted by the Rosenberg team at the National Cancer Institute showed that 61% Synovial cell sarcoma and 55% melanoma had therapeutic responses. These and lots of clinical achievements indicate that TCR-T cell therapy can target a variety of tumors including solid tumors without any severe side effects found in CAR-T trials. Nasopharyngeal carcinoma (NPC), a kinds of head-neck malignant tumor, which used to appear mostly in southern China (especially in Fujian and Guangdong and Guangxi provinces). Most patients with NPC show evidence of infection with the Epstein Barr virus (EBV) before or at the time of their diagnosis. EBV is found in the cancer cells of almost all patients with advanced stage NPC, and play a role in causing and inducing the disease program and development. The cancer cells infected by EBV are able to hide from the body's immune system and escape destruction. We want to see if EBV antigen special T cells (YT-E001) could recognize and kill special parts of EBV infected cells, and finally inhibit the tumor recurrence or metastasis of NPC patients. This study will focus on the NPC highly expressed EBV antigen such as LMP1, LMP2 and EBNA1,the high affinity TCR target the above EBV antigen were screened from the healthy donor using the sorting and single cell cloning technique. Then, using the lentivirus to transduce the TCR gene to the autologous T cells. This study will investigate the safety and tolerability of EBV-TCR-T cell therapy in subjects with NPC who had received prior therapy for their disease but their disease has progressed or relapsed. The chemotherapy we will use for lymphodepletion is a combination of cyclophosphamide and fludarabine. Cyclophosphamide and fludarabine are the chemotherapy agents most commonly used for lymphodepletion in immunotherapy clinical trials.
Detailed Description
This Phase I/II study is designed as single dose pilot trial evaluating the safety and of EBV-TCR-TT cell therapy in subjects with NPC who have received prior therapy for their disease but the disease has progressed or relapsed. Anti-tumor activity and other exploratory objectives will be assessed. Subjects enter from a Screening Protocol and are positive for HLA- A02:01/24:02/11:01, and EBV serum positive. Subjects will receive cytoreductive chemotherapy with cyclophosphamide and fludarabine on days -6 and -4 followed by infusion of dose of about 2×108 EBV-TCR-T(YT-E001). Subjects will stay in hospital for safety and efficacy assessment daily from T cell infusion (Day 0) through Day 7, and then weekly until week 4 and then at 8 weeks every 8 weeks until progression of their disease or the end or termination of trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nasopharyngeal Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Single arm, open label, single dose phase I/II study of safety and efficacy.
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
EBV-TCR-T cells(YT-E001)
Arm Type
Experimental
Arm Description
EBV-TCR-T (YT-E001) cells are prepared via lentiviral infection. 6-10 days prior to infusion of TCR-T cells (YT-E001), subjects receive fludarabine at dose 30mg/m2/day for 4 days and cyclophosphamide treatment at dose 30mg/kg/day for 2 days and take a rest for one day before infusion. A single dose of EBV-TCR(YT-E001) transduced T cells (about 2×108) will be intravenously (i.v.) administered.
Intervention Type
Biological
Intervention Name(s)
EBV-TCR-T (YT-E001) cells
Other Intervention Name(s)
Fludarabine, Cyclophosphamide
Intervention Description
EBV-TCR-T (YT-E001) cells are prepared via lentiviral infection. 6-10 days prior to infusion of TCR-T cells (YT-E001), subjects receive fludarabine at dose 30mg/m2/day for 4 days and cyclophosphamide treatment at dose 30mg/kg/day for 2 days and take a rest for one day before infusion. Patients, who receive an infusion of YT-E001, will remain in the hospital to be monitored for adverse events until they have recovered from the treatment. Patients will have frequent follow-up visit to monitor the persistence of modified T cells and efficacy of the treatment.
Primary Outcome Measure Information:
Title
Number of participants with adverse events
Description
To evaluate the safety and feasibility of the administration of EBV-TCR transduced T cells(YT-E001) in patients with EBV+ NPC.
Time Frame
60 days
Secondary Outcome Measure Information:
Title
Number of participants with clinical responses
Description
To evaluate the efficacy of EBV positive NPC patients treated with EBV antigen specific affinity-enhanced TCR transduced autologous T cell therapy(YT-E001).
Time Frame
1 YEAR

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: ≥18 years old; Sign an informed consent before undertaking any trial-related activities; NPC patients diagnosed by licensed pathologist, EBV DNA copy number >500. Received at least one run of standard therapy (surgery, chemo, radiation and targeted therapy) or first line and second line treatment failure; HLA-A*0201/2402/1101; ECOG score 0-2;Life expectancy is longer than 3 months; No Chinese herbal medicine usage within 4 weeks before enrollment; Lab test results meet the following requirements: White blood cell count≥4.0×109/L; ANC≥1.5 ×109/L; PLT≥100 ×109/L; Hemoglobin≥90g/L; Prothrombin time or INR ≤1.5× normal upper limit, except taking anticoagulant therapy; PTT≤1.5× normal upper limit;AST≤3×ULN; ALT≤3×ULN; ALP≤3×ULN; TBIL≤1.5×ULN。 Levels of calcium, potassium, and magnesium in serum are within the normal range; Pregnancy test is negative for female subjects with reproductive capability before participating the study Female subjects must consent using birth control during the study or prohibit any homo or heterosexual behavior; Can regularly visit the research institutions for tests, evaluations, and monitoring throughout the study period. Exclusion Criteria: Received major surgery, conventional chemotherapy, large-area radiotherapy, immune therapy or any biological anti-tumor therapy within 4 weeks prior to the study; Allergic to any components of the therapy; Never recovered to <2 grade CTCAE from prior surgery or treatment-related adverse events; With two or other types of primary solid tumors; Poorly managed hypertension (systolic blood pressure >160 mmHg and / or diastolic blood pressure > 90 mmHg) or clinically significant(for example, active) cardiovascular and cerebrovascular diseases such as cerebrovascular incident (within 6 months prior to signing the informed consent), myocardial infarction (within 6 months prior to signing the informed consent), unstable angina, grade II or above heart failure, Congestive, or severe arrhythmia can not be controlled by medication or has a potential impact on the study; With other serious organic disease and/or mental illness; With systemic active infections that need treatments, including active tuberculosis, HIV/HBV/HCV- positive or clinically active hepatitis A, B and C; With autoimmune diseases: such as a history of inflammatory bowel disease (IBD) or other autoimmune diseases determined by the investigator to be unsuitable for the study (e.g. systemic lupus erythematosus (SLE), vasculitis, invasive pulmonary disease); Within 4 weeks prior the infusion, received chronic systemic steroid cortisone, Hydroxyurea, immunomodulatory treatment (for example: Interleukin 2, alpha or gamma interferon, GCSF, cyclosporine etc.); History of organ allografts, autologous / allogeneic stem cell transplantation, and renal replacement therapy; With central nervous system metastasis. With uncontrolled diabetes, pulmonary fibrosis, interstitial lung disease, acute lung disease, or liver failure; Pregnant or lactating female patients; Received concomitant medication prohibited by the protocol; With any medical condition or disease determined by the investigators that may be detrimental to this trial;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
JianJi Pan
Phone
0591-83660063
Email
panjianji@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
QiaoJuan Guo
Phone
15080013157
Email
guoqiaojuan@163.com
Facility Information:
Facility Name
Fujian Cancer Hospital
City
Fuzhou
State/Province
Fujian
ZIP/Postal Code
350014
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jianji Pan
Phone
0591-83660063
Email
panjianji@126.com

12. IPD Sharing Statement

Plan to Share IPD
No

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EBV-TCR-T(YT-E001)for Patients With EBV-positive Recurrent or Metastatic NPC

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