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Phase I Clinical Trial of RC1012 Injection in Patients With r/r AML

Primary Purpose

Acute Myeloid Leukemia

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
RC1012 injection (allo-DNT cells)
Sponsored by
Guangdong Ruishun Biotech Co., Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring r/r AML, Cell Therapy

Eligibility Criteria

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

Inclusion Criteria:

  1. Voluntarily sign an ICF and expect to complete the study procedures for follow-up examinations and treatment.
  2. Aged 18 to 70 years (including cut-offs), regardless of gender.
  3. Accordance with the diagnostic criteria of AML in the 2016 WHO staging and meeting the diagnostic criteria of relapsed and refractory in the Chinese Guidelines for the Treatment of Relapsed/Refractory Acute Myeloid Leukemia (2017 edition).

    • Diagnostic criteria for Relapsed AML: reappearance of leukemic cells in peripheral blood or >5% primitive/naive cells in bone marrow after CR (except for other causes such as bone marrow regeneration after consolidation chemotherapy) or extra-marrow infiltration of leukemic cells.
    • Diagnostic criteria for refractory AML: primary refractory disease that has not achieved complete remission after two courses of induction chemotherapy with a standard regimen (containing cytarabine and an anthracycline or anthraquinone).
  4. The patient has recovered from the toxicity of the prior treatment, i.e., less than a grade 2 CTCAE toxicity rating (unless the abnormality is tumor-related).
  5. ECOG score 0 to 1.
  6. Appropriate organ function, and accordance with the following criteria within 7 days prior to lymphodepleting chemotherapy.

    • Glutathione aminotransferase (AST) ≤ 3 times the upper limit of normal (ULN)
    • Glutamic aminotransferase (ALT) ≤ 3 times ULN.
    • Total bilirubin ≤ 1.5 times ULN, unless the patient has documented Gilbert syndrome. Patients with Gilbert-Meulengracht syndrome with total bilirubin ≤ 3.0 times ULN and direct bilirubin ≤ 1.5 times ULN may be included.
    • Serum creatinine ≤ 1.5 times ULN or a creatinine clearance ≥ 60 ml/min.
    • Hemoglobin ≥ 60 g/L or hemoglobin maintained at that level following transfusion.
    • Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L.
    • A platelet count ≥ 30 x 10^9/L or a platelet count maintained at that level following a platelet transfusion
    • Left ventricular ejection fraction (LVEF) ≥ 45%.
  7. Female patients with of childbearing potential should have a negative pregnancy test during the screening period. Any male and female patients of childbearing potential must agree to use an effective contraception method for at least six months from the time that they sign the informed consent form until the end of the cell infusion. Female patients without childbearing potential (meeting at least 1 of the following criteria) is described below.

    • Have undergone a hysterectomy or bilateral oophorectomy
    • Medically recognized as ovarian failure.
    • Medically recognized as post-menopausal (at least 12 consecutive months of menopause without pathological or physiological cause).

Exclusion Criteria:

  1. A diagnosis of acute promyelocytic leukemia.
  2. Patients with extramedullary infiltration of leukemia.
  3. Evidence or history of central nervous system invasion or cranial neuropathy.
  4. Patients with positive hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and peripheral blood hepatitis B virus (HBV) DNA titration assay not within the normal reference range, positive hepatitis C virus (HCV) antibody and peripheral blood HCV RNA ,positive for human immunodeficiency virus (HIV), or positive for cytomegalovirus (CMV) DNA, or positive syphilis test.
  5. Persons with hypersensitivity to excipients of RC1012 injection (e.g., human albumin) or other drugs recommended in the study protocol (e.g., lymphodepleting treatment, Tocilizumab).
  6. Serious cardiac disease, including but not limited to severe arrhythmia, unstable angina, massive heart attack, New York Heart Association class III or IV cardiac insufficiency, refractory hypertension.
  7. Persons who have previously received an organ transplant or are preparing to receive an organ transplant (except for hematopoietic stem cell transplantation)
  8. Persons with acute and chronic graft-vs-host disease (GVHD)
  9. Those who have received a hematopoietic stem cell transplant within 2 months prior to screening tests.
  10. Active neurological autoimmune or inflammatory diseases (e.g. Guillain-Barre Syndrome (GBS), Amyotrophic lateral sclerosis (ALS)) and clinically significant active cerebrovascular disease (e.g. cerebral oedema, Posterior Reversible Encephalopathy Syndrome (PRES)).
  11. Patients with a life expectancy of less than 3 months
  12. Patients have been involved in other clinical studies within 3 months prior to screening.
  13. Patients, in the judgement of the investigator and/or clinical criteria, are contraindicated to any study procedure or have other medical conditions that may place them at unacceptable risk.

Sites / Locations

  • First Affiliated Hospital of Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

RC1012 injection (allo-DNT Cells)

Arm Description

Experimental: RC1012 injection (allo-DNT Cells) The trial is divided into two parts: Part A1 is a single- dose escalation trial with three dose groups (5×10^7 cells/kg, 1.5×10^8 cells/kg, 4.5×10^8 cells/kg), with 9-18 patients planned to be enrolled. Part A2 is a multiple-dose escalation trial consisting of 2 dose groups (1.5×10^8 cells/kg and 4.5×10^8 cells/ kg at day 0, day 7 and day 14), with 9-12 patients planned to be enrolled. Part B is a multiple-dose extension trial in which the Safety Review Committee evaluates whether to extend an additional 3-6 patients to receive the multiple cell infusions based on available PK and safety data.

Outcomes

Primary Outcome Measures

Dose-Limiting Toxicity (DLT)
To evaluate the safety, tolerability, and determine the recommended dosage of allo-DNT Cell Therapy for Relapsed/Refractory Acute Myelocytic Leukemia
Maximum Tolerated Dose (MTD)
MTD was the highest dose for DLT in ≤1/6 subjects
Incidence of abnormalities
Incidence of abnormalities in AE/SAE/laboratory tests/electrocardiograms/vital signs.

Secondary Outcome Measures

Pharmacokinetics (PK) indicator (Cmax)
The peak concentration of allo-DNT cells amplified in the peripheral blood (Cmax, detected by Flow Cytometry).
Pharmacokinetics (PK) indicator (AUC)
Allo-DNT cells blood concentrations will be measured at different time points to evaluate the area under the curve (AUC). (AUC, detected by Flow Cytometry).
Pharmacokinetics (PK) indicator (Tmax)
Allo-DNT cells blood concentrations will be measured at different time points to evaluate the peak time (Tmax) in peripheral blood. Tmax is defined as the time to reach the highest concentration (Tmax, detected by Flow Cytometry).
Pharmacokinetics (PK) indicator (T1/2)
Allo-DNT cells blood concentrations will be measured at different time points to evaluate the elimination half-life in hours (T1/2). T1/2 is defined as the time point when the concentration of allo-DNT reaches half of maximum in a patient's peripheral blood (T1/2, detected by Flow Cytometry).
Overall Response Rate
ORR includes complete response (CR), CRi and PR. CR was defined as < 5% bone marrow blasts in an aspirate with spicules, no blasts with Auer rods or persistence of extramedullary disease, and independent of transfusions; CRi: was defined as<5% bone marrow blasts, either ANC<1×10^9/L or platelets<100×10^9/L, transfusion independence but with persistence of cytopenia; PR was defined as decrease of at least 50% in the percentage of blasts to 5-25% in the bone marrow aspirate and the normalization of blood counts.
Event-Free Survival
From the date of enrollment in the clinical trial until the failure of treatment, relapse or death.
Duration of Response
The time from the start of the first assessment of CR or PR to the first assessment as disease recurrence or progression or death
Relapse-Free Survival
Relapse-free survival is the time from study enrollment until documented disease relapse, or death from any cause.
Overall Survival
From the date of entry into the clinical study until death from any cause.

Full Information

First Posted
July 20, 2022
Last Updated
May 17, 2023
Sponsor
Guangdong Ruishun Biotech Co., Ltd
Collaborators
First Affiliated Hospital of Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT05471323
Brief Title
Phase I Clinical Trial of RC1012 Injection in Patients With r/r AML
Official Title
A Single-arm, Single/Multiple Dose-escalation and Dose-extension Phase I Clinical Trial of RC1012 Injection (Allogeneic DNT Cells) in Patients With Relapsed/Refractory Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
January 14, 2021 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Guangdong Ruishun Biotech Co., Ltd
Collaborators
First Affiliated Hospital of Zhejiang 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
To evaluate the safety and tolerability of RC1012 infusion in patients with relapsed or refractory Acute Myelocytic Leukemia (r/r AML).
Detailed Description
This study aims to evaluate the safety and tolerability of RC1012 injection in patients with relapsed or refractory Acute Myelocytic Leukemia (r/r AML). DNT cells are mature T lymphocytes that comprise 3-10% of T cells in human peripheral blood mononuclear cells (PBMC). Allo-DNT cells from healthy donors have been proved to be safe and demonstrated potent cytotoxicity against AML blasts from AML patients in preclinical and preliminary clinical studies. Allo-DNT cells will be collected from healthy donors (NO MHC match needed) and infused into patients. The drug for this study is an off-the-shelf product. Patients DO NOT need to wait for the cell manufacturing.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
r/r AML, Cell Therapy

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
RC1012 injection (allo-DNT Cells)
Arm Type
Experimental
Arm Description
Experimental: RC1012 injection (allo-DNT Cells) The trial is divided into two parts: Part A1 is a single- dose escalation trial with three dose groups (5×10^7 cells/kg, 1.5×10^8 cells/kg, 4.5×10^8 cells/kg), with 9-18 patients planned to be enrolled. Part A2 is a multiple-dose escalation trial consisting of 2 dose groups (1.5×10^8 cells/kg and 4.5×10^8 cells/ kg at day 0, day 7 and day 14), with 9-12 patients planned to be enrolled. Part B is a multiple-dose extension trial in which the Safety Review Committee evaluates whether to extend an additional 3-6 patients to receive the multiple cell infusions based on available PK and safety data.
Intervention Type
Biological
Intervention Name(s)
RC1012 injection (allo-DNT cells)
Intervention Description
RC1012 injection (allo-DNT cells) from healthy donors and have been proved to be safe and demonstrated potent cytotoxicity against AML blasts from AML patients in preclinical and preliminary clinical studies. Allo- DNT cells will be collected from healthy donors (NO MHC match needed) and injected into patients. The drug for this study is an off-the-shelf product. Patients DO NOT need to wait for the cell manufacturing.
Primary Outcome Measure Information:
Title
Dose-Limiting Toxicity (DLT)
Description
To evaluate the safety, tolerability, and determine the recommended dosage of allo-DNT Cell Therapy for Relapsed/Refractory Acute Myelocytic Leukemia
Time Frame
Up to 28 days
Title
Maximum Tolerated Dose (MTD)
Description
MTD was the highest dose for DLT in ≤1/6 subjects
Time Frame
Up to 28 days
Title
Incidence of abnormalities
Description
Incidence of abnormalities in AE/SAE/laboratory tests/electrocardiograms/vital signs.
Time Frame
Up to 28 days
Secondary Outcome Measure Information:
Title
Pharmacokinetics (PK) indicator (Cmax)
Description
The peak concentration of allo-DNT cells amplified in the peripheral blood (Cmax, detected by Flow Cytometry).
Time Frame
Up to 90 days
Title
Pharmacokinetics (PK) indicator (AUC)
Description
Allo-DNT cells blood concentrations will be measured at different time points to evaluate the area under the curve (AUC). (AUC, detected by Flow Cytometry).
Time Frame
Up to 2 years
Title
Pharmacokinetics (PK) indicator (Tmax)
Description
Allo-DNT cells blood concentrations will be measured at different time points to evaluate the peak time (Tmax) in peripheral blood. Tmax is defined as the time to reach the highest concentration (Tmax, detected by Flow Cytometry).
Time Frame
Up to 2 years
Title
Pharmacokinetics (PK) indicator (T1/2)
Description
Allo-DNT cells blood concentrations will be measured at different time points to evaluate the elimination half-life in hours (T1/2). T1/2 is defined as the time point when the concentration of allo-DNT reaches half of maximum in a patient's peripheral blood (T1/2, detected by Flow Cytometry).
Time Frame
Up to 2 years
Title
Overall Response Rate
Description
ORR includes complete response (CR), CRi and PR. CR was defined as < 5% bone marrow blasts in an aspirate with spicules, no blasts with Auer rods or persistence of extramedullary disease, and independent of transfusions; CRi: was defined as<5% bone marrow blasts, either ANC<1×10^9/L or platelets<100×10^9/L, transfusion independence but with persistence of cytopenia; PR was defined as decrease of at least 50% in the percentage of blasts to 5-25% in the bone marrow aspirate and the normalization of blood counts.
Time Frame
Up to 2 years
Title
Event-Free Survival
Description
From the date of enrollment in the clinical trial until the failure of treatment, relapse or death.
Time Frame
Up to 2 years
Title
Duration of Response
Description
The time from the start of the first assessment of CR or PR to the first assessment as disease recurrence or progression or death
Time Frame
Up to 2 years
Title
Relapse-Free Survival
Description
Relapse-free survival is the time from study enrollment until documented disease relapse, or death from any cause.
Time Frame
Up to 2 years
Title
Overall Survival
Description
From the date of entry into the clinical study until death from any cause.
Time Frame
Up to 5 years

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: Voluntarily sign an ICF and expect to complete the study procedures for follow-up examinations and treatment. Aged 18 to 70 years (including cut-offs), regardless of gender. Accordance with the diagnostic criteria of AML in the 2016 WHO staging and meeting the diagnostic criteria of relapsed and refractory in the Chinese Guidelines for the Treatment of Relapsed/Refractory Acute Myeloid Leukemia (2017 edition). Diagnostic criteria for Relapsed AML: reappearance of leukemic cells in peripheral blood or >5% primitive/naive cells in bone marrow after CR (except for other causes such as bone marrow regeneration after consolidation chemotherapy) or extra-marrow infiltration of leukemic cells. Diagnostic criteria for refractory AML: primary refractory disease that has not achieved complete remission after two courses of induction chemotherapy with a standard regimen (containing cytarabine and an anthracycline or anthraquinone). The patient has recovered from the toxicity of the prior treatment, i.e., less than a grade 2 CTCAE toxicity rating (unless the abnormality is tumor-related). ECOG score 0 to 1. Appropriate organ function, and accordance with the following criteria within 7 days prior to lymphodepleting chemotherapy. Glutathione aminotransferase (AST) ≤ 3 times the upper limit of normal (ULN) Glutamic aminotransferase (ALT) ≤ 3 times ULN. Total bilirubin ≤ 1.5 times ULN, unless the patient has documented Gilbert syndrome. Patients with Gilbert-Meulengracht syndrome with total bilirubin ≤ 3.0 times ULN and direct bilirubin ≤ 1.5 times ULN may be included. Serum creatinine ≤ 1.5 times ULN or a creatinine clearance ≥ 60 ml/min. Hemoglobin ≥ 60 g/L or hemoglobin maintained at that level following transfusion. Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L. A platelet count ≥ 30 x 10^9/L or a platelet count maintained at that level following a platelet transfusion Left ventricular ejection fraction (LVEF) ≥ 45%. Female patients with of childbearing potential should have a negative pregnancy test during the screening period. Any male and female patients of childbearing potential must agree to use an effective contraception method for at least six months from the time that they sign the informed consent form until the end of the cell infusion. Female patients without childbearing potential (meeting at least 1 of the following criteria) is described below. Have undergone a hysterectomy or bilateral oophorectomy Medically recognized as ovarian failure. Medically recognized as post-menopausal (at least 12 consecutive months of menopause without pathological or physiological cause). Exclusion Criteria: A diagnosis of acute promyelocytic leukemia. Patients with extramedullary infiltration of leukemia. Evidence or history of central nervous system invasion or cranial neuropathy. Patients with positive hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and peripheral blood hepatitis B virus (HBV) DNA titration assay not within the normal reference range, positive hepatitis C virus (HCV) antibody and peripheral blood HCV RNA ,positive for human immunodeficiency virus (HIV), or positive for cytomegalovirus (CMV) DNA, or positive syphilis test. Persons with hypersensitivity to excipients of RC1012 injection (e.g., human albumin) or other drugs recommended in the study protocol (e.g., lymphodepleting treatment, Tocilizumab). Serious cardiac disease, including but not limited to severe arrhythmia, unstable angina, massive heart attack, New York Heart Association class III or IV cardiac insufficiency, refractory hypertension. Persons who have previously received an organ transplant or are preparing to receive an organ transplant (except for hematopoietic stem cell transplantation) Persons with acute and chronic graft-vs-host disease (GVHD) Those who have received a hematopoietic stem cell transplant within 2 months prior to screening tests. Active neurological autoimmune or inflammatory diseases (e.g. Guillain-Barre Syndrome (GBS), Amyotrophic lateral sclerosis (ALS)) and clinically significant active cerebrovascular disease (e.g. cerebral oedema, Posterior Reversible Encephalopathy Syndrome (PRES)). Patients with a life expectancy of less than 3 months Patients have been involved in other clinical studies within 3 months prior to screening. Patients, in the judgement of the investigator and/or clinical criteria, are contraindicated to any study procedure or have other medical conditions that may place them at unacceptable risk.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zhen Cai, MD, PhD
Phone
+086-0571-56734707
Email
caizhen1@sina.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jingsong He, MD, PhD
Phone
086-13600547247
Email
hejingsong@zju.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhen Cai, MD, PhD
Organizational Affiliation
First Affiliated Hospital of Zhejiang University
Official's Role
Principal Investigator
Facility Information:
Facility Name
First Affiliated Hospital of Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Huili Zhou, MD, PhD
Phone
086-0571-87236685
Email
1482055406@qq.com

12. IPD Sharing Statement

Learn more about this trial

Phase I Clinical Trial of RC1012 Injection in Patients With r/r AML

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