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Phase I Study of IL-8 Receptor-modified CD70 CAR T Cell Therapy in CD70+ and MGMT-unmethylated Adult Glioblastoma (IMPACT) (IMPACT)

Primary Purpose

Glioblastoma Multiforme, Glioblastoma

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ex-Vivo expanded autologous IL-8 receptor (CXCR2) modified CD70 CAR (8R-70CAR) T cells
Sponsored by
University of Florida
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioblastoma Multiforme focused on measuring CAR T Cell, Brain Tumor, Brain Cancer, Glioblastoma Multiforme, Immunotherapy

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age ≥ 18 years
  • Newly-diagnosed de novo GBM based on the absence of previous history of brain tumor (WHO Grade IV glioma) by histopathology or molecular studies. (secondary GBM not eligible)
  • The tumor must have a supratentorial component
  • MGMT-unmethylated
  • CD70 positive (≥20%, 1+)

Tumor expression will be scored on a scale of 0 to 3 staining intensity:

0 = Negative

  1. = Low level
  2. = Moderate level
  3. = High level

    • The criteria for inclusion will be at least 20% of the cells scoring 1+ staining intensity (> 20%, 1+).

      • Surgical resection of tumors with less than 3cm x 3cm (9 cm2) residual enhancing tumor as a product of longest perpendicular planes by MRI. (biopsy only subjects are not eligible for this study)
      • Karnofsky Performance Status (KPS) of > 70%
      • CBC with differential with adequate bone marrow function as defined below:
    • Absolute neutrophil count (ANC) ≥ 1500 cells/mm3.
    • Platelet count ≥ 100,000 cells/mm3.
    • Hemoglobin ≥ 10 g/dl. (The use of transfusion or other intervention to achieve Hgb ≥ 10 g/dl is acceptable.)

      • Adequate renal function as defined below:

    • BUN ≤ 25 mg/dl
    • Creatinine ≤ 1.7 mg/dl

      • Adequate hepatic function as defined below:

    • Bilirubin ≤ 2.0 mg/dl
    • ALT ≤ 5 times institutional upper limits of normal for age
    • AST ≤ 5 times institutional upper limits of normal for age

      • Signed informed consent. If the patient's mental status precludes his/her giving informed consent, written informed consent may be given by the legally authorized representative.
      • For females of childbearing potential, a negative serum pregnancy test at enrollment.
      • Women of childbearing potential (WOCBP) must be willing to use an acceptable contraceptive method to avoid pregnancy throughout the study and for at least 24 weeks after the last dose of study drug.
      • Males with female partners of childbearing potential must agree to practice adequate contraceptive methods throughout the study and should avoid conceiving children for 24 weeks following the last dose of study drug.

Exclusion Criteria:

  • Prior invasive malignancy (except for non-melanomatous skin cancer) unless disease free for ≥ 3years. (In situ cancer are permissible)
  • Metastases detected below the tentorium or beyond the cranial vault and leptomeningeal involvement.
  • Recurrent or multifocal malignant gliomas.
  • The patient is not a candidate for cellular therapy as assessed by the study bone marrow transplant physician.
  • Known immunosuppressive disease or human immunodeficiency virus (HIV) infection.

Rationale: The need to exclude patients with the immunosuppressive disease or human

  • Severe, active co-morbidity, defined as follows:

    • Unstable angina and/or congestive heart failure requiring hospitalization.
    • Transmural myocardial infarction within the last 6 months.
    • Acute bacterial or fungal infection requiring intravenous antibiotics at the initiation of XRT/TMZ.
    • Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the initiation of XRT/TMZ.
    • Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects.
    • Patients with an autoimmune disease requiring medical management with immunosuppressants.
    • Major medical illnesses or psychiatric impairments that, in the investigator's opinion, will prevent administration or completion of protocol therapy.
    • Active connective tissue disorders such as lupus or scleroderma that, in the investigator's opinion, place the patient at high risk for radiation toxicity.
  • Pregnant or lactating women, due to possible adverse effects on the developing fetus or infant.
  • Patients treated on any other therapeutic clinical protocols within 30 days prior to enrollment.

Sites / Locations

  • University of Florida HealthRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

8R-70CAR T cells

Arm Description

Cohort 1 will receive 1 x 10^6 cells/kg. Cohort 2 will receive 1 x 10^7 cells/kg. Cohort 3 will receive 1 x 10^8 cells/kg. Cohort 4 will receive Cy/Flu + CAR T cells at established maximum tolerated dose.

Outcomes

Primary Outcome Measures

Safety of 8R-70CAR T-cell therapy in adult patients with de novo CD70+ GBM
Defined as ≤ 1 DLT out of 6 patients is observed at the 1x10^8 cells/Kg dose. Dose-Limiting toxicity (DLT) will be defined as any adverse event attributable (possible, probable, or definite) to the administration of 8R-70CAR T cells and occurring from the time of infusion through 28 days post-infusion.
Feasibility of 8R-70CAR T-cell therapy in adult patients with de novo CD70+ GBM
Feasibility will be defined as the ability to infuse 8R-70CAR T-cell safely in 66.7 % of enrolled patients (patients who signed consent and were deemed eligible for the study).

Secondary Outcome Measures

Full Information

First Posted
April 25, 2022
Last Updated
August 24, 2023
Sponsor
University of Florida
Collaborators
United States Department of Defense, AM Rosen Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT05353530
Brief Title
Phase I Study of IL-8 Receptor-modified CD70 CAR T Cell Therapy in CD70+ and MGMT-unmethylated Adult Glioblastoma (IMPACT)
Acronym
IMPACT
Official Title
Phase I Study -To Assess Safety and Feasibility of IL-8 Receptor Modified Patient-derived Activated CD70 CAR T Cell Therapy in CD70+ and MGMT-unmethylated Adult GBM
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 25, 2023 (Actual)
Primary Completion Date
December 2027 (Anticipated)
Study Completion Date
December 2042 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Florida
Collaborators
United States Department of Defense, AM Rosen Foundation

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 I study to assess the safety and feasibility of IL-8 receptor modified patient-derived activated CD70 CAR T cell therapy in CD70+ and MGMT-unmethylated adult glioblastoma.
Detailed Description
Newly diagnosed CD70 positive and MGMT-unmethylated adult GBM patients who have undergone surgery for maximal debulking will be enrolled in this 3+3 design dose-escalation clinical trial and undergo peripheral venipuncture for collection of PBMCs for generation of investigational 8R-70CAR T Cell vaccine. Patients will then undergo standard of care chemoradiation. Immunotherapy will begin 2 weeks (-7/+4 days) after completion of radiation. One single dose of 8R-70CAR T cells will be administered IV. The dose will depend on the enrolling cohort. Dose escalation will follow the traditional 3+3 design.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma Multiforme, Glioblastoma
Keywords
CAR T Cell, Brain Tumor, Brain Cancer, Glioblastoma Multiforme, Immunotherapy

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
8R-70CAR T cells
Arm Type
Experimental
Arm Description
Cohort 1 will receive 1 x 10^6 cells/kg. Cohort 2 will receive 1 x 10^7 cells/kg. Cohort 3 will receive 1 x 10^8 cells/kg. Cohort 4 will receive Cy/Flu + CAR T cells at established maximum tolerated dose.
Intervention Type
Biological
Intervention Name(s)
Ex-Vivo expanded autologous IL-8 receptor (CXCR2) modified CD70 CAR (8R-70CAR) T cells
Other Intervention Name(s)
8R-70CAR T cells
Intervention Description
Single dose of 8R-70CAR T cells administered IV
Primary Outcome Measure Information:
Title
Safety of 8R-70CAR T-cell therapy in adult patients with de novo CD70+ GBM
Description
Defined as ≤ 1 DLT out of 6 patients is observed at the 1x10^8 cells/Kg dose. Dose-Limiting toxicity (DLT) will be defined as any adverse event attributable (possible, probable, or definite) to the administration of 8R-70CAR T cells and occurring from the time of infusion through 28 days post-infusion.
Time Frame
28 days post-infusion
Title
Feasibility of 8R-70CAR T-cell therapy in adult patients with de novo CD70+ GBM
Description
Feasibility will be defined as the ability to infuse 8R-70CAR T-cell safely in 66.7 % of enrolled patients (patients who signed consent and were deemed eligible for the study).
Time Frame
10 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Newly-diagnosed de novo GBM based on the absence of previous history of brain tumor (WHO Grade IV glioma) by histopathology or molecular studies. (secondary GBM not eligible) The tumor must have a supratentorial component MGMT-unmethylated CD70 positive (≥20%, 1+) Tumor expression will be scored on a scale of 0 to 3 staining intensity: 0 = Negative = Low level = Moderate level = High level The criteria for inclusion will be at least 20% of the cells scoring 1+ staining intensity (> 20%, 1+). Surgical resection of tumors with less than 3cm x 3cm (9 cm2) residual enhancing tumor as a product of longest perpendicular planes by MRI. (biopsy only subjects are not eligible for this study) Karnofsky Performance Status (KPS) of > 70% CBC with differential with adequate bone marrow function as defined below: Absolute neutrophil count (ANC) ≥ 1500 cells/mm3. Platelet count ≥ 100,000 cells/mm3. Hemoglobin ≥ 10 g/dl. (The use of transfusion or other intervention to achieve Hgb ≥ 10 g/dl is acceptable.) • Adequate renal function as defined below: BUN ≤ 25 mg/dl Creatinine ≤ 1.7 mg/dl • Adequate hepatic function as defined below: Bilirubin ≤ 2.0 mg/dl ALT ≤ 5 times institutional upper limits of normal for age AST ≤ 5 times institutional upper limits of normal for age Signed informed consent. If the patient's mental status precludes his/her giving informed consent, written informed consent may be given by the legally authorized representative. For females of childbearing potential, a negative serum pregnancy test at enrollment. Women of childbearing potential (WOCBP) must be willing to use an acceptable contraceptive method to avoid pregnancy throughout the study and for at least 24 weeks after the last dose of study drug. Males with female partners of childbearing potential must agree to practice adequate contraceptive methods throughout the study and should avoid conceiving children for 24 weeks following the last dose of study drug. Exclusion Criteria: Prior invasive malignancy (except for non-melanomatous skin cancer) unless disease free for ≥ 3years. (In situ cancer are permissible) Metastases detected below the tentorium or beyond the cranial vault and leptomeningeal involvement. Recurrent or multifocal malignant gliomas. The patient is not a candidate for cellular therapy as assessed by the study bone marrow transplant physician. Known immunosuppressive disease or human immunodeficiency virus (HIV) infection. Rationale: The need to exclude patients with the immunosuppressive disease or human Severe, active co-morbidity, defined as follows: Unstable angina and/or congestive heart failure requiring hospitalization. Transmural myocardial infarction within the last 6 months. Acute bacterial or fungal infection requiring intravenous antibiotics at the initiation of XRT/TMZ. Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the initiation of XRT/TMZ. Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects. Patients with an autoimmune disease requiring medical management with immunosuppressants. Major medical illnesses or psychiatric impairments that, in the investigator's opinion, will prevent administration or completion of protocol therapy. Active connective tissue disorders such as lupus or scleroderma that, in the investigator's opinion, place the patient at high risk for radiation toxicity. Pregnant or lactating women, due to possible adverse effects on the developing fetus or infant. Patients treated on any other therapeutic clinical protocols within 30 days prior to enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Phuong Deleyrolle, RN
Phone
352-273-9000
Email
phuong.deleyrolle@neurosurgery.ufl.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ashley Ghiaseddin, MD
Organizational Affiliation
University of Florida
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Florida Health
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Phuong Deleyrolle, RN
Phone
352-273-9000
Email
phuong.deleyrolle@neurosurgery.ufl.edu
First Name & Middle Initial & Last Name & Degree
Ashley Ghiaseddin, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase I Study of IL-8 Receptor-modified CD70 CAR T Cell Therapy in CD70+ and MGMT-unmethylated Adult Glioblastoma (IMPACT)

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