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Study on TIL for the Treatment of r/r Gynecologic Tumors

Primary Purpose

Gynecologic Cancer

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Tumor Infiltrating Lymphocytes (TIL)
Sponsored by
Shanghai 10th People's Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gynecologic Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Age: 18 years to 75 years;
  2. Histologically diagnosed as primary/relapsed/metastasized malignant tumors;
  3. Expected life-span more than 3 months;
  4. Karnofsky≥60% or ECOG score 0-2;
  5. Test subjects have failed standard treatment regimens, or there are no standard treatment regimens available.
  6. Test subjects must have tumor regions eligible for biopsy or resection, or malignant body fluid where TILs can be isolated;
  7. At least 1 evaluable tumor lesion;
  8. Absolute count of white blood cells≥2.5×10^9/L, absolute count of neutropils≥1.5×10^9/L, platelet count≥100×10^9, hemoglobin≥90 g/L;
  9. Serum creatinine clearance 50mL/min or higher; creatinine≤1.5×ULN; ALT/AST less than three times that of normal group, ALT/AST of test subjects with liver metastasis less than five times that of normal group; bilirubin≤1.5×ULN;
  10. Activated partial thromboplastin time (APTT) less than or equal to 1.5xULN; international normalized ratio (INR) less than or equal to 1.5xULN;
  11. Enough venous accessibility, no absolute or relative contraindications to operation or biopsy;
  12. Test subjects with child-bearing potential must be willing to practice approved highly effective methods of contraception at the time of informed consent, and continue within 1 year after the completion of lymphodepletion;
  13. Any malignant tumor-targeting therapies, including radiotherapy, chemotherapy and biologics must cease 28 days before obtaining TILs;
  14. Be able to understand and sign the informed consent document;
  15. Be able to stick to follow-up visit plan and other requirements in the agreement.

Exclusion Criteria:

  1. Need glucocorticoid treatment, and daily dose of Prednisone greater than 15mg (or equivalent doses of hormones);
  2. Autoimmune diseases requiring immunomodulatory treatment;
  3. Serum creatinine >1.5×ULN; serum glutamic-oxalacetic transaminase (SGOT) greater than 5×ULN; bilirubin >1.5×ULN;
  4. Forced expiratory volume in one second (FEV1) less than 2L, diffusing capacity of the lung for carbon monoxide (DLCO) (calibrated) less than 40%;
  5. Significant cardiovascular anomalies according to any of the following definition: New York Heart Association (NYHA) Grade III or IV congestive heart failure, clinically significant low blood pressure, uncontrollable symptomatic coronary artery diseases, or ejection fraction less than 35%; Severe cardiac rhythm and conduction anomaly, such as ventricular arrhythmia requiring clinical intervention, second-third degree atrio-ventricular conductive block, etc.
  6. Human immunodeficiency virus (HIV) infection or anti-HIV antibody positive, active HBV or HCV infection (HBsAg positive and/or anti-HCV positive), syphilis infection or Treponema pallidum antibody positive;
  7. Severe physical or mental diseases;
  8. Blood culture positive or imaging proof;
  9. Having been treated within a month or being treated now with other medicines, or other biologic therapy, chemo-or radiotherapy;
  10. History of allergy to chemical compound consisting of chemical and biologic substances resembling cell therapy;
  11. Having received immunotherapy and developed irAE level greater than Level 3;
  12. Previous anti-tumor treatment AE did not return to CTCAE5.0 version grade 1 or below (toxicity considered by the investigator as non-safety concerns like alopecia excluded);
  13. Females in pregnancy or lactation;
  14. Researchers considering the test subject as having a history of other severe systemic diseases, or other reasons inappropriate for the clinical study.

Sites / Locations

  • Shanghai Tenth People's HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Tumor Infiltrating Lymphocytes (TIL)

Arm Description

1x10^9-3x10^11 in vitro expanded autologous TILs will be infused i.v. to patients with relapsed/refractory malignant gynecological tumors after NMA lymphodepletion treatment with fludarabine and cyclophosphamide. PD-1 checkpoint inhibitor would be applied as combination treatment to those patients.

Outcomes

Primary Outcome Measures

Objective Response Rate (ORR)
To evaluate the efficacy of TIL infusion in patients as determined by objective response rate (ORR), which contains complete response (CR) and partial response (PR), using the RECIST v1.1, as assessed by the Investigator. ( CT Scan at 4-6 weeks after TIL infusion, and than every 4-6 weeks for 1 year, and then every six months after that for up to 3 years)
Disease Control Rate (DCR)
Percentage of patients that meet CR, PR and SD criteria set in this study according to RECIST 1.1
Duration of Response (DOR)
The time length between the first confirmed objective response per RECIST 1.1 to the treatment and the subsequent disease progression per RECIST 1.1
Progression-Free Survival (PFS)
The time length between TIL infusion and confirmed subsequent disease progression according to RECIST 1.1
Overall Survival (OS)
The length of time from the date of the start of TIL treatment that the patients are still alive

Secondary Outcome Measures

Complete Response(CR)
Patients with complete response per RECIST 1.1 to TIL treatment
Partial Response (PR)
Percentage of patients with partial response per RECIST 1.1 to TIL treatment
Stable Disease (SD)
Patients with stable disease per RECIST 1.1 to TIL treatment
Progressive Disease (PD)
Patients with progressive disease per RECIST 1.1 to TIL treatment
Change in Quality of Life
Comparison of patients' quality of life before and after TIL treatment

Full Information

First Posted
February 19, 2021
Last Updated
November 12, 2021
Sponsor
Shanghai 10th People's Hospital
Collaborators
Shanghai Juncell Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT04766320
Brief Title
Study on TIL for the Treatment of r/r Gynecologic Tumors
Official Title
A Clinical Safety and Efficacy Study on TIL for the Treatment of r/r Gynecologic Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Recruiting
Study Start Date
January 4, 2021 (Actual)
Primary Completion Date
January 31, 2023 (Anticipated)
Study Completion Date
January 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shanghai 10th People's Hospital
Collaborators
Shanghai Juncell Therapeutics

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 study is to investigate the safety and efficacy of tumor infiltrating lymphocyte (TIL) therapy in patients with malignant refractory/relapsed gynecologic tumors. Autologous TILs are expanded from tumor resections or biopsies and infused i.v. into the patient after NMA lymphodepletion treatment with fludarabine and cyclophosphamide.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gynecologic Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Tumor Infiltrating Lymphocytes (TIL)
Arm Type
Experimental
Arm Description
1x10^9-3x10^11 in vitro expanded autologous TILs will be infused i.v. to patients with relapsed/refractory malignant gynecological tumors after NMA lymphodepletion treatment with fludarabine and cyclophosphamide. PD-1 checkpoint inhibitor would be applied as combination treatment to those patients.
Intervention Type
Biological
Intervention Name(s)
Tumor Infiltrating Lymphocytes (TIL)
Intervention Description
Adoptive transfer of 1x10^9-3x10^11 autologous TILs to patients i.v. in 30-120 minutes.
Primary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
To evaluate the efficacy of TIL infusion in patients as determined by objective response rate (ORR), which contains complete response (CR) and partial response (PR), using the RECIST v1.1, as assessed by the Investigator. ( CT Scan at 4-6 weeks after TIL infusion, and than every 4-6 weeks for 1 year, and then every six months after that for up to 3 years)
Time Frame
Up to 36 months
Title
Disease Control Rate (DCR)
Description
Percentage of patients that meet CR, PR and SD criteria set in this study according to RECIST 1.1
Time Frame
Up to 36 months
Title
Duration of Response (DOR)
Description
The time length between the first confirmed objective response per RECIST 1.1 to the treatment and the subsequent disease progression per RECIST 1.1
Time Frame
Up to 36 months
Title
Progression-Free Survival (PFS)
Description
The time length between TIL infusion and confirmed subsequent disease progression according to RECIST 1.1
Time Frame
Up to 36 months
Title
Overall Survival (OS)
Description
The length of time from the date of the start of TIL treatment that the patients are still alive
Time Frame
Up to 36 months
Secondary Outcome Measure Information:
Title
Complete Response(CR)
Description
Patients with complete response per RECIST 1.1 to TIL treatment
Time Frame
Up to 36 months
Title
Partial Response (PR)
Description
Percentage of patients with partial response per RECIST 1.1 to TIL treatment
Time Frame
Up to 36 months
Title
Stable Disease (SD)
Description
Patients with stable disease per RECIST 1.1 to TIL treatment
Time Frame
Up to 36 months
Title
Progressive Disease (PD)
Description
Patients with progressive disease per RECIST 1.1 to TIL treatment
Time Frame
Up to 36 months
Title
Change in Quality of Life
Description
Comparison of patients' quality of life before and after TIL treatment
Time Frame
Up to 36 months

10. Eligibility

Sex
Female
Gender Based
Yes
Gender Eligibility Description
This study is biologically possible only for females regardless of self-recognition of gender identity.
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age: 18 years to 75 years; Histologically diagnosed as primary/relapsed/metastasized malignant tumors; Expected life-span more than 3 months; Karnofsky≥60% or ECOG score 0-2; Test subjects have failed standard treatment regimens, or there are no standard treatment regimens available. Test subjects must have tumor regions eligible for biopsy or resection, or malignant body fluid where TILs can be isolated; At least 1 evaluable tumor lesion; Absolute count of white blood cells≥2.5×10^9/L, absolute count of neutropils≥1.5×10^9/L, platelet count≥100×10^9, hemoglobin≥90 g/L; Serum creatinine clearance 50mL/min or higher; creatinine≤1.5×ULN; ALT/AST less than three times that of normal group, ALT/AST of test subjects with liver metastasis less than five times that of normal group; bilirubin≤1.5×ULN; Activated partial thromboplastin time (APTT) less than or equal to 1.5xULN; international normalized ratio (INR) less than or equal to 1.5xULN; Enough venous accessibility, no absolute or relative contraindications to operation or biopsy; Test subjects with child-bearing potential must be willing to practice approved highly effective methods of contraception at the time of informed consent, and continue within 1 year after the completion of lymphodepletion; Any malignant tumor-targeting therapies, including radiotherapy, chemotherapy and biologics must cease 28 days before obtaining TILs; Be able to understand and sign the informed consent document; Be able to stick to follow-up visit plan and other requirements in the agreement. Exclusion Criteria: Need glucocorticoid treatment, and daily dose of Prednisone greater than 15mg (or equivalent doses of hormones); Autoimmune diseases requiring immunomodulatory treatment; Serum creatinine >1.5×ULN; serum glutamic-oxalacetic transaminase (SGOT) greater than 5×ULN; bilirubin >1.5×ULN; Forced expiratory volume in one second (FEV1) less than 2L, diffusing capacity of the lung for carbon monoxide (DLCO) (calibrated) less than 40%; Significant cardiovascular anomalies according to any of the following definition: New York Heart Association (NYHA) Grade III or IV congestive heart failure, clinically significant low blood pressure, uncontrollable symptomatic coronary artery diseases, or ejection fraction less than 35%; Severe cardiac rhythm and conduction anomaly, such as ventricular arrhythmia requiring clinical intervention, second-third degree atrio-ventricular conductive block, etc. Human immunodeficiency virus (HIV) infection or anti-HIV antibody positive, active HBV or HCV infection (HBsAg positive and/or anti-HCV positive), syphilis infection or Treponema pallidum antibody positive; Severe physical or mental diseases; Blood culture positive or imaging proof; Having been treated within a month or being treated now with other medicines, or other biologic therapy, chemo-or radiotherapy; History of allergy to chemical compound consisting of chemical and biologic substances resembling cell therapy; Having received immunotherapy and developed irAE level greater than Level 3; Previous anti-tumor treatment AE did not return to CTCAE5.0 version grade 1 or below (toxicity considered by the investigator as non-safety concerns like alopecia excluded); Females in pregnancy or lactation; Researchers considering the test subject as having a history of other severe systemic diseases, or other reasons inappropriate for the clinical study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jing Guo, PHd
Phone
+86 21 66307151
Email
jguo12@foxmail.com
Facility Information:
Facility Name
Shanghai Tenth People's Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200040
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jing Guo, PHD
Phone
+86 21 66307151
Email
jguo12@foxmail.com

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35177415
Citation
Guo J, Luo N, Ai G, Yang W, Zhu J, Li C, Chen R, Zhang C, Liu S, Jin H, Cheng Z. Eradicating tumor in a recurrent cervical cancer patient with autologous tumor-infiltrating lymphocytes and a modified lymphodepleting regimen. J Immunother Cancer. 2022 Feb;10(2):e003887. doi: 10.1136/jitc-2021-003887.
Results Reference
derived

Learn more about this trial

Study on TIL for the Treatment of r/r Gynecologic Tumors

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