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NY-ESO-1 TCR (TAEST16001)for Patients With Advanced NSCLC

Primary Purpose

Lung Cancer, Nonsmall Cell, Recurrent

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Cyclophosphamide and Fludarabine
Anti-NY-ESO-1 TCR transduced T cells
Sponsored by
Guangzhou Institute of Respiratory Disease
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lung Cancer, Nonsmall Cell, Recurrent

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. ≥18 and ≤75 years old while signing the informed consent;
  2. Sign an informed consent before undertaking any trial-related activities;
  3. Stage IIIb-IV NSCLC patients diagnosed by licensed pathologist, NY-ESO-1 positive cells >10% by IHC.
  4. Received at least one run of standard therapy(surgery, chemo, radiation and targeted therapy) or first line and second line treatment failure; If the patient has EGFR mutation or ALK gene rearrangement, they can be enrolled after the appropriate EGFR or ALK tyrosine kinase inhibitor treatment failed;
  5. Have one positive indication of the following immunological biomarkers during the screening stage: HLA-A*0201+, NYESO-1+;
  6. ECOG score 0-1(see appendix);Life expectancy is longer than 3 months;
  7. No Chinese herbal medicine usage within 4 weeks before enrollment;
  8. left ventricular ejection fraction≥50%
  9. Lab test results meet the following requirements:

    White blood cell count≥3.0×109/L; ANC≥1.5 ×109/L (No GCSF support); PLT≥75 ×109/L; Hemoglobin≥10g/dL (No transfusion in the last 7 days); Prothrombin time or INR ≤1.5× normal upper limit, except taking anticoagulant therapy; PTT≤1.5× normal upper limit, except taking Anticoagulant therapy;a 24-hour creatinine clearance rate≥60mL/ min; AST/SGOT≤2.5 ×ULN; ALT/SGPT≤2.5 ×ULN; ALP≤2.5 ×ULN; TBIL≤1.5×ULN (expect that the subject has Gilber's syndrome).

  10. Levels of calcium, potassium, and magnesium in serum are within the normal range;
  11. 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;
  12. Can regularly visit the research institutions for tests, evaluations, and monitoring throughout the study period.

Exclusion Criteria:

  1. SCLC;
  2. Received major surgery, conventional chemotherapy, large-area radiotherapy, immune therapy or any biological anti-tumor therapy within 4 weeks prior to the study;
  3. Allergic to any components of the therapy;
  4. Never recovered to <2 grade CTCAE from prior surgery or treatment-related adverse events;
  5. With two types of primary solid tumors;
  6. 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 according to New York Heart Association Grading (See Appendix) Congestive, or severe arrhythmia can not be controlled by medication or has a potential impact on the study; With consecutive three times of obvious abnormality on electrocardiogram or average QTc interval ≥450 ms;
  7. With other serious organic disease and/or mental illness;
  8. With systemic active infections that need treatments, including active tuberculosis, HIV-positive or clinically active hepatitis A, B and C;
  9. 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);
  10. Within 4 weeks prior the infusion, received chronic systemic steroid cortisone, Hydroxyurea, immunomodulatory treatment (for example: Interleukin 2, alpha or gamma interferon, GCSF, mTOR inhibitors, cyclosporine etc.);
  11. History of organ allografts, autologous / allogeneic stem cell transplantation, and renal replacement therapy;
  12. With central nervous system metastasis. Patients with neurological symptoms need a brain CT/MRI examination to rule out brain metastases;
  13. With uncontrolled diabetes, pulmonary fibrosis, interstitial lung disease, acute lung disease, or liver failure;
  14. History of alcohol and / or drug abuse;
  15. Pregnant or lactating female patients;
  16. Received concomitant medication prohibited by the protocol;
  17. With any medical condition or disease determined by the investigators that may be detrimental to this trial;
  18. No capacity or limited capacity to make juridical acts.

Sites / Locations

  • Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Anti-NY-ESO-1 TCR-transduced T cells

Arm Description

NYESO-1 TCR-T cell are prepared via lentiviral infection. DLT was administered in a dose escalation test according to the 3 + 3 design. Seven days prior to infusion of TCR-T cell, subjects receive cytoreductive chemotherapy with Cyclophosphamide (250-500mg/m2/day) and Fludarabine (25mg/m2/day) for 3 days. A single dose of Anti-NY-ESO-1 TCR transduced T cells (about 5×109) will be intravenously (i.v.) administered Additionally, following infusion of Anti-NY-ESO-1 TCR transduced T cells, IL-2 subcutaneous injections (500,000 IU/day) will be administered for 14 days concomitantly to each subject.

Outcomes

Primary Outcome Measures

Number of participants with adverse events
To evaluate the safety and feasibility of the administration of anti-NY-ESO-1 TCR transduced T cells in patients with HLA-A2+ NY-ESO-1 expressing NSCLC.

Secondary Outcome Measures

Number of participants with clinical responses
To evaluate the efficacy of NYESO-1 positive NSCLS patients treated with NY-ESO-1 antigen specific affinity-enhanced TCR transduced autologous T cell therapy.

Full Information

First Posted
January 20, 2017
Last Updated
January 16, 2019
Sponsor
Guangzhou Institute of Respiratory Disease
Collaborators
Xiangxue Life Science Research Center, Guangdong Xiangxue Precision Medical Technology Co., Ltd., Xiangxue Pharmaceutical
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1. Study Identification

Unique Protocol Identification Number
NCT03029273
Brief Title
NY-ESO-1 TCR (TAEST16001)for Patients With Advanced NSCLC
Official Title
Pilot Study of Affinity-enhanced Anti-NY-ESO-1 TCR Engineered Autologous T Cells in NSCLC Patients
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Unknown status
Study Start Date
March 21, 2017 (Actual)
Primary Completion Date
March 2019 (Anticipated)
Study Completion Date
March 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Guangzhou Institute of Respiratory Disease
Collaborators
Xiangxue Life Science Research Center, Guangdong Xiangxue Precision Medical Technology Co., Ltd., Xiangxue Pharmaceutical

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
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. Another report of a phase I / II clinical trial for multiple myeloma showed that 20 patients received high affinity anti-NY-ESO-1 and LAGE-1 specific TCR-T treatment, 16 of them (80%) had the average progression-free survival of 19.1 months with minor side effect. These 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. This study is mainly focused on tumor testis antigen (Cancer-Testis Antigen), because it is not expressed in normal cells. NY-ESO-1 antigen is commonly expressed in 10-50% of melanoma, lung, liver, esophageal, breast, prostate, bladder, thyroid and ovarian cancer cases, 60% of multiple myeloma cases, and 70-80% of synovial cell sarcoma. Approximately 700,000 new cases of lung cancer are identified each year in China, 70% of them die within one to two years after diagnosis due to the lack of effective treatment. To address that unmet needs, our TCR-T treatment targets non-small cell lung cancer with NY-ESO-1 antigen expression. This study will investigate the safety and tolerability of TAEST16001 (TAEST: TCR Affinity Enhancing Specific T cell Therapy, autologous T cells transduced with affinity enhanced NY-ESO-1 TCR) cell therapy in subjects with NSCLC who have received prior therapy for their disease but their disease has progressed or relapsed.
Detailed Description
This Phase 1 study is designed as a cell dose escalation trial evaluating the safety of TAEST16001 T cell therapy in subjects with NSCLC 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-A2*02:01 and have tumor that express NY-ESO-1. The subjects will be evaluated DLT and MTD using a modified 3+3 cell dose escalation design to determine the cell dose range. Subjects will receive cytoreductive chemotherapy with cyclophosphamide (250-500mg/m2/day) plus fludarabine (25mg/m2/day) on day -7 to day -5 followed by infusion of dose of about 5×109 TAEST16001 and IL-2(s.c.). 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, 12 weeks, 16 weeks and every 3 months until progression of their disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Cancer, Nonsmall Cell, Recurrent

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
One arm, open label, dose escalation, single dose phase I study of safety and tolerability. NYESO-1 TCR-T cell are prepared via lentiviral infection. DLT was administered in a dose escalation test according to the 3 + 3 design. Seven days prior to infusion of TCR-T cell, subjects receive cytoreductive chemotherapy with cyclophosphamide (250-500mg/m2/day) plus fludarabine (25mg/m2/day) for 3 days. Patients, who receive an infusion of TAEST16001, 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.
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Anti-NY-ESO-1 TCR-transduced T cells
Arm Type
Experimental
Arm Description
NYESO-1 TCR-T cell are prepared via lentiviral infection. DLT was administered in a dose escalation test according to the 3 + 3 design. Seven days prior to infusion of TCR-T cell, subjects receive cytoreductive chemotherapy with Cyclophosphamide (250-500mg/m2/day) and Fludarabine (25mg/m2/day) for 3 days. A single dose of Anti-NY-ESO-1 TCR transduced T cells (about 5×109) will be intravenously (i.v.) administered Additionally, following infusion of Anti-NY-ESO-1 TCR transduced T cells, IL-2 subcutaneous injections (500,000 IU/day) will be administered for 14 days concomitantly to each subject.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide and Fludarabine
Intervention Description
Seven days prior to infusion of TCR-T cell, subjects receive cytoreductive chemotherapy with cyclophosphamide (250-500mg/m2/day) plus fludarabine (25mg/m2/day) for 3 days.
Intervention Type
Biological
Intervention Name(s)
Anti-NY-ESO-1 TCR transduced T cells
Intervention Description
A single dose of Anti-NY-ESO-1 TCR transduced T cells (about 5×109) will be intravenously (i.v.) administered Additionally, following infusion of Anti-NY-ESO-1 TCR transduced T cells, IL-2 subcutaneous injections (500,000 IU/day) will be administered for 14 days concomitantly to each subject.
Primary Outcome Measure Information:
Title
Number of participants with adverse events
Description
To evaluate the safety and feasibility of the administration of anti-NY-ESO-1 TCR transduced T cells in patients with HLA-A2+ NY-ESO-1 expressing NSCLC.
Time Frame
30 Days
Secondary Outcome Measure Information:
Title
Number of participants with clinical responses
Description
To evaluate the efficacy of NYESO-1 positive NSCLS patients treated with NY-ESO-1 antigen specific affinity-enhanced TCR transduced autologous T cell therapy.
Time Frame
270 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: ≥18 and ≤75 years old while signing the informed consent; Sign an informed consent before undertaking any trial-related activities; Stage IIIb-IV NSCLC patients diagnosed by licensed pathologist, NY-ESO-1 positive cells >10% by IHC. Received at least one run of standard therapy(surgery, chemo, radiation and targeted therapy) or first line and second line treatment failure; If the patient has EGFR mutation or ALK gene rearrangement, they can be enrolled after the appropriate EGFR or ALK tyrosine kinase inhibitor treatment failed; Have one positive indication of the following immunological biomarkers during the screening stage: HLA-A*0201+, NYESO-1+; ECOG score 0-1(see appendix);Life expectancy is longer than 3 months; No Chinese herbal medicine usage within 4 weeks before enrollment; left ventricular ejection fraction≥50% Lab test results meet the following requirements: White blood cell count≥3.0×109/L; ANC≥1.5 ×109/L (No GCSF support); PLT≥75 ×109/L; Hemoglobin≥10g/dL (No transfusion in the last 7 days); Prothrombin time or INR ≤1.5× normal upper limit, except taking anticoagulant therapy; PTT≤1.5× normal upper limit, except taking Anticoagulant therapy;a 24-hour creatinine clearance rate≥60mL/ min; AST/SGOT≤2.5 ×ULN; ALT/SGPT≤2.5 ×ULN; ALP≤2.5 ×ULN; TBIL≤1.5×ULN (expect that the subject has Gilber's syndrome). 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: SCLC; 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 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 according to New York Heart Association Grading (See Appendix) Congestive, or severe arrhythmia can not be controlled by medication or has a potential impact on the study; With consecutive three times of obvious abnormality on electrocardiogram or average QTc interval ≥450 ms; With other serious organic disease and/or mental illness; With systemic active infections that need treatments, including active tuberculosis, HIV-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, mTOR inhibitors, cyclosporine etc.); History of organ allografts, autologous / allogeneic stem cell transplantation, and renal replacement therapy; With central nervous system metastasis. Patients with neurological symptoms need a brain CT/MRI examination to rule out brain metastases; With uncontrolled diabetes, pulmonary fibrosis, interstitial lung disease, acute lung disease, or liver failure; History of alcohol and / or drug abuse; 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; No capacity or limited capacity to make juridical acts.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shiyue Li, MD
Phone
8620-83062896
Email
lishiyue@188.com
First Name & Middle Initial & Last Name or Official Title & Degree
Chengzhi Zhou, MD
Phone
8620-83062832
Email
doctorzcz@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shiyue Li, MD
Organizational Affiliation
Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Chengzhi Zhou, MD
Organizational Affiliation
Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510120
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shiyue Li, MD
Phone
8620-83062896
Email
lishiyue@188.com
First Name & Middle Initial & Last Name & Degree
Shiyue Li, MD
First Name & Middle Initial & Last Name & Degree
Chengzhi Zhou, MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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NY-ESO-1 TCR (TAEST16001)for Patients With Advanced NSCLC

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