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LILRB4 STAR-T Cells in the Treatment of Relapsed/Refractory Acute Myeloid Leukemia

Primary Purpose

Relapsed/Refractory Acute Myeloid Leukemia

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
LILRB4 STAR-T cells
Sponsored by
Peking University People's Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed/Refractory Acute Myeloid Leukemia focused on measuring LILRB4 STAR-T cells

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Aged 18-70 years, gender is not limited
  2. Subjects diagnosed with AML according to WHO 2016 criteria and according to the "Chinese Guidelines for the Diagnosis and Treatment of Relapsed and Refractory Acute Myeloid Leukemia (2021 Edition)" should meet any of the following relapsed and refractory (R/R) AML patients:

    1. Patients who have failed two cycles of standard chemotherapy;
    2. Relapse within 12 months after consolidation and intensification therapy after complete remission (CR);
    3. Relapse after 12 months but failed to respond to conventional treatment
    4. two or more recurrences;
    5. persistent extramedullary leukemia
  3. ECOG physical status level is 0 to 2;
  4. Bone marrow sample must be LILRB4 positive(Flow Cytometry)
  5. Major organs must meet the following criteria:

    1. Liver function: Total bilirubin≤1.5 times the upper limit of normal,ALT and AST≤3 times the upper limit of normal,
    2. Renal function:Creatinine≤1.5 times the upper limit of normal (ULN) or creatinine clearance rate ≥60ml/min,
    3. Cardiac function:LVEF≥50%,
    4. Lung function:Defined as ≤grade 1 dyspnea and blood oxygen saturation >92%;
  6. Female subjects of reproductive age or male subjects whose partners are women of reproductive age agree to use an effective method of contraception throughout the trial and for 12 months after cell infusion;
  7. The subjects voluntarily joined the study, signed the informed consent form, had good compliance, and cooperated with the follow-up.

Exclusion Criteria:

  1. Received CAR-T therapy or other gene-modified cell therapy in the past or participated in other clinical investigators within 1 month before screening;
  2. Any of the following cardiovascular and cerebrovascular diseases occurred within 6 months before screening:

    1. congestive heart failure(NYHA stage III),myocardial infarction,unstable angina pectoris,congenital long QT syndrom,Anterior left block,coronary angioplasty,stent implantation,Coronary/peripheral artery bypass grafting,CVA,Transient ischemic attack or pulmonary embolism,Asymptomatic right bundle branch block was allowed;
    2. Serious arrhythmias requiring treatment (eg, sustained ventricular tachycardia, ventricular fibrillation, torsades de pointes, etc.);
    3. uncontrolled hypertension (systolic blood pressure greater than 160 mmHg and/or diastolic blood pressure greater than 100 mmHg), a history of hypertensive crisis or hypertensive encephalopathy.
  3. The subject is positive for hepatitis B surface antigen or HBV DNA is higher than the detection limit of analysis method;Positive hepatitis C antibody or HCV RNA is higher than the detection limit of the analytical method;The subjects were positive for syphilis antibody.
  4. The subject with known systemic lupus erythematosus, active or uncontrolled autoimmune disease (such as Crohns disease, rheumatoid arthritis, autoimmune hemolytic anemia, etc.), primary or secondary immunodeficiency (such as HIV infection or serious infectious disease, etc.).
  5. Previous or concurrent other incurable malignancies with unstable control,Affect the long-term survival of subjects, except for cured cervical carcinoma in situ, non-invasive basal cell or squamous cell skin cancer or other local prostate cancer after radical treatment, ductal carcinoma in situ after radical resection and at least 5 Years without recurrence of malignant tumor.
  6. Subjects with current or previous history of central nervous system disease, such as seizures, stroke, severe brain injury, aphasia, paralysis, dementia, Parkinson's disease, mental illness, etc. or central nervous system leukemia (CNSL).
  7. Subjects with a history of solid organ transplantation or hematopoietic stem cell transplantation (HSCT) within 6 months prior to screening.
  8. Subjects with aGVHD and cGVHD at screening.
  9. Subjects who have had any of the following drugs or treatments within the specified time period prior to apheresis:

    1. Administered any immunosuppressant within 2 weeks prior to apheresis;
    2. Received any chemotherapy within 2 weeks or 3 half-lives, whichever is shorter, prior to apheresis;
    3. Received any macromolecule or small molecule targeted therapy such as monoclonal antibody, antibody-drug conjugate (ADC), double antibody, etc. within 4 weeks before apheresis or within 3 half-lives (whichever is shorter).
  10. Those with mental illness or history of drug abuse.
  11. Pregnant or breastfeeding subjects.
  12. The investigator believes that there are other factors that are not suitable for inclusion or that affect subjects participating in or completing the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    LILRB4 STAR-T cells

    Arm Description

    LILRB4 STAR-T cells are prepared via lentiviral infection. 5 days prior to infusion of STAR-T cells, subjects receive fludarabine at dose 25-30mg/m2/day and cyclophosphamide treatment at dose 250-300mg/m2 for 3 days and take a rest for 2 days before infusion. STAR-T cells will be intravenously infused with a escalated dose of 1E6#3E6#6E6#1E7 cells/kg.

    Outcomes

    Primary Outcome Measures

    Evaluate safety and tolerability
    Subjects are observed for dose-limiting toxicity(DLT) after LILRB4 STAR-T cells infusion, with the recording of adverse events(AE) and serious adverse events(SAE), with a focus on cytokine release syndrome(CRS) and immune cell-associated neurotoxicity(ICANS).All of the AE ratings were assessed according to the CTCAE.

    Secondary Outcome Measures

    Autitumor efficacy
    After infusion of LILRB4 STAR-T cells, the subjects underwent bone marrow puncture every month to evaluate the tumor load in the bone marrow. The efficacy evaluation included complete morphological remission, complete remission with incomplete recovery of blood cytology, and partial remission.

    Full Information

    First Posted
    September 16, 2022
    Last Updated
    September 16, 2022
    Sponsor
    Peking University People's Hospital
    Collaborators
    Beijing Qingyi Taike Pharmaceutical Technology Co., Ltd
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05548088
    Brief Title
    LILRB4 STAR-T Cells in the Treatment of Relapsed/Refractory Acute Myeloid Leukemia
    Official Title
    An Exploratory Clinical Study on the Safety and Efficacy of LILRB4 STAR-T Cells in the Treatment of Relapsed/Refractory Acute Myeloid Leukemia (R/R AML)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    November 30, 2022 (Anticipated)
    Primary Completion Date
    December 30, 2023 (Anticipated)
    Study Completion Date
    August 30, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Peking University People's Hospital
    Collaborators
    Beijing Qingyi Taike Pharmaceutical Technology 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
    No

    5. Study Description

    Brief Summary
    This is a single-center, single-arm, open-label phase I clinical study to determine the safety and efficacy of LILRB4 STAR-T cells in Relapsed/Refractory Acute Myeloid Leukemia subjects.
    Detailed Description
    This study will recruit LILRB4 positive AML subjects,and Subjects will receive cytoreductive chemotherapy with cyclophosphamide and fludarabine on days -5, -4 and -3 followed by infusion of LILRB4 STAR-T cells. LILRB4 STAR-T cells will be intravenously infused with a escalated dose of 1E6、3E6、6E6、1E7 cells/kg.The purpose of current study is to evaluate the clinical safety and tolerability of LILRB4 STAR-T cells therapy in patients with refractory and relapsed AML.Safety and efficacy of LILRB4 STAR-T cells therapy will be monitored.The primary endpoint of the study is to observe DLT, AE, SAE, CRS and ICANS. Secondary objectives are to observe the efficacy of LILRB4 STAR-T cells, including RFS, EFS and OS, and PK.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Relapsed/Refractory Acute Myeloid Leukemia
    Keywords
    LILRB4 STAR-T cells

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    LILRB4 STAR-T cells
    Arm Type
    Experimental
    Arm Description
    LILRB4 STAR-T cells are prepared via lentiviral infection. 5 days prior to infusion of STAR-T cells, subjects receive fludarabine at dose 25-30mg/m2/day and cyclophosphamide treatment at dose 250-300mg/m2 for 3 days and take a rest for 2 days before infusion. STAR-T cells will be intravenously infused with a escalated dose of 1E6#3E6#6E6#1E7 cells/kg.
    Intervention Type
    Biological
    Intervention Name(s)
    LILRB4 STAR-T cells
    Intervention Description
    Subjects with relapsed/refractory acute myeloid leukemia will be enrolled in the study, and Subjects will receive cytoreductive chemotherapy with cyclophosphamide and fludarabine on days -5, -4and-3followed by infusion of STAR-T cells. STAR-T cells will be intravenously infused with a escalated dose of 1E6#3E6#6E6#1E7 cells/kg。
    Primary Outcome Measure Information:
    Title
    Evaluate safety and tolerability
    Description
    Subjects are observed for dose-limiting toxicity(DLT) after LILRB4 STAR-T cells infusion, with the recording of adverse events(AE) and serious adverse events(SAE), with a focus on cytokine release syndrome(CRS) and immune cell-associated neurotoxicity(ICANS).All of the AE ratings were assessed according to the CTCAE.
    Time Frame
    12 months
    Secondary Outcome Measure Information:
    Title
    Autitumor efficacy
    Description
    After infusion of LILRB4 STAR-T cells, the subjects underwent bone marrow puncture every month to evaluate the tumor load in the bone marrow. The efficacy evaluation included complete morphological remission, complete remission with incomplete recovery of blood cytology, and partial remission.
    Time Frame
    12 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Aged 18-70 years, gender is not limited Subjects diagnosed with AML according to WHO 2016 criteria and according to the "Chinese Guidelines for the Diagnosis and Treatment of Relapsed and Refractory Acute Myeloid Leukemia (2021 Edition)" should meet any of the following relapsed and refractory (R/R) AML patients: Patients who have failed two cycles of standard chemotherapy; Relapse within 12 months after consolidation and intensification therapy after complete remission (CR); Relapse after 12 months but failed to respond to conventional treatment two or more recurrences; persistent extramedullary leukemia ECOG physical status level is 0 to 2; Bone marrow sample must be LILRB4 positive(Flow Cytometry) Major organs must meet the following criteria: Liver function: Total bilirubin≤1.5 times the upper limit of normal,ALT and AST≤3 times the upper limit of normal, Renal function:Creatinine≤1.5 times the upper limit of normal (ULN) or creatinine clearance rate ≥60ml/min, Cardiac function:LVEF≥50%, Lung function:Defined as ≤grade 1 dyspnea and blood oxygen saturation >92%; Female subjects of reproductive age or male subjects whose partners are women of reproductive age agree to use an effective method of contraception throughout the trial and for 12 months after cell infusion; The subjects voluntarily joined the study, signed the informed consent form, had good compliance, and cooperated with the follow-up. Exclusion Criteria: Received CAR-T therapy or other gene-modified cell therapy in the past or participated in other clinical investigators within 1 month before screening; Any of the following cardiovascular and cerebrovascular diseases occurred within 6 months before screening: congestive heart failure(NYHA stage III),myocardial infarction,unstable angina pectoris,congenital long QT syndrom,Anterior left block,coronary angioplasty,stent implantation,Coronary/peripheral artery bypass grafting,CVA,Transient ischemic attack or pulmonary embolism,Asymptomatic right bundle branch block was allowed; Serious arrhythmias requiring treatment (eg, sustained ventricular tachycardia, ventricular fibrillation, torsades de pointes, etc.); uncontrolled hypertension (systolic blood pressure greater than 160 mmHg and/or diastolic blood pressure greater than 100 mmHg), a history of hypertensive crisis or hypertensive encephalopathy. The subject is positive for hepatitis B surface antigen or HBV DNA is higher than the detection limit of analysis method;Positive hepatitis C antibody or HCV RNA is higher than the detection limit of the analytical method;The subjects were positive for syphilis antibody. The subject with known systemic lupus erythematosus, active or uncontrolled autoimmune disease (such as Crohns disease, rheumatoid arthritis, autoimmune hemolytic anemia, etc.), primary or secondary immunodeficiency (such as HIV infection or serious infectious disease, etc.). Previous or concurrent other incurable malignancies with unstable control,Affect the long-term survival of subjects, except for cured cervical carcinoma in situ, non-invasive basal cell or squamous cell skin cancer or other local prostate cancer after radical treatment, ductal carcinoma in situ after radical resection and at least 5 Years without recurrence of malignant tumor. Subjects with current or previous history of central nervous system disease, such as seizures, stroke, severe brain injury, aphasia, paralysis, dementia, Parkinson's disease, mental illness, etc. or central nervous system leukemia (CNSL). Subjects with a history of solid organ transplantation or hematopoietic stem cell transplantation (HSCT) within 6 months prior to screening. Subjects with aGVHD and cGVHD at screening. Subjects who have had any of the following drugs or treatments within the specified time period prior to apheresis: Administered any immunosuppressant within 2 weeks prior to apheresis; Received any chemotherapy within 2 weeks or 3 half-lives, whichever is shorter, prior to apheresis; Received any macromolecule or small molecule targeted therapy such as monoclonal antibody, antibody-drug conjugate (ADC), double antibody, etc. within 4 weeks before apheresis or within 3 half-lives (whichever is shorter). Those with mental illness or history of drug abuse. Pregnant or breastfeeding subjects. The investigator believes that there are other factors that are not suitable for inclusion or that affect subjects participating in or completing the study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Xiangyu Zhao
    Phone
    010-88325949
    Email
    zhao_xy@bjmu.edu.cn
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Xiangyu Zhao
    Organizational Affiliation
    PEKING UNICERSITY PEOPLE'S HOSPITAL
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    LILRB4 STAR-T Cells in the Treatment of Relapsed/Refractory Acute Myeloid Leukemia

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