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TCR-T Cell Therapy on Advanced Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
TCR-T therapy
Sponsored by
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring Pancreatic Cancer, PK/PD, TCR-T, Safety, efficacy

Eligibility Criteria

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

Inclusion Criteria:

  1. Age greater than 18 years old;
  2. Pathological diagnosis of recurrent/metastatic pancreatic cancer and other solid tumors (except intracranial metastasis). Patients who have had prior therapy with at least one standard treatment regimen remain in stable or progressive disease states and refuse subsequent chemotherapy;
  3. Mutations in KRAS G12V or G12D and expression of matched HLA -A*11:01 subtypes are confirmed in previous tumor or biopsy tissues;
  4. Expected survival duration of more than 3 months;
  5. Eastern Cooperative Oncology Group( ECOG )score ≤2;
  6. All participants voluntarily participate in this study and sign an informed consent. And the subjects have good compliance and can cooperate with investigators follow-up study.
  7. Patients at least have had at least one measurable lesion as defined by RECIST v1.1 criteria;
  8. Female participants can not be pregnant or lactating and their serum or urine human chorionic gonadotropin tests must be negative within 72 hours prior to study enrollment;All subjects must be using a medically accepted means of contraception ( (e.g., oral contraceptives, intrauterine device) during the course of this study and for at least 3 months after completion of study therapy.
  9. Organ function and bone marrow reserve are in good condition, and the following requirements must be met:

1)Absolute neutrophil count≥1.5×10⁹/L;2)Platelet count≥50×10⁹/L;3)Hemoglobin≥90g/L;4)Bilirubin < 1.5 times upper limit of normal(Bile duct obstruction due to tumor compression were excluded);5)Serum creatinine ≤ 1.5 times the upper limit of normal range or creatinine clearance ≥ 60 mL/min.6)Serum alanine aminotransferase or aspartate aminotransferase is < 2.5 times the upper limit of the normal value (ULN) (if patients with liver metastasis, ≤5 times the ULN).7)Coagulation function normalised:INR≤1.5,PTT<1.2 times the upper limit of normal(Tumor - related anticoagulant therapy was excluded).

Exclusion Criteria:

  1. Use of immunosuppressants or glucocorticoids within 1 week before enrollment;
  2. Patients with moderate or severe hydrothorax need drain placement to relieve symptoms.
  3. Human immunodeficiency virus (HIV) positive;
  4. Active Hepatitis B or Hepatitis C infection;
  5. Pregnant women and lactating females;
  6. Previous or concurrent history of other malignant tumors. Exceptions include curatively treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy;
  7. Patients with central nervous metastases;
  8. Serious, uncontrolled comorbidities that may affect protocol compliance or interfere with interpretation of results,or any serious medical condition that may affect the safety of the subjects ;
  9. History of clinically significant respiratory diseases or other respiratory diseases that seriously affect Pulmonary function;
  10. Any active autoimmune disease,any condition requiring steroid hormones or immunosuppressive therapy( including but not limited to systemic lupus erythematosus, sjogren's syndrome, rheumatoid arthritis, psoriasis, multiple sclerosis, inflammatory bowel disease, etc., require > 10 mg/D of prednisone or equivalent hormone)
  11. A history of organ transplantation;
  12. A history of myocardial infarction and severe arrhythmia within six months;Ineligible also includes uncontrolled hypertension, coronary heart disease, stroke, liver cirrhosis, nephritis and other serious complications;
  13. Those who have a history of psychotropic drug abuse and cannot quit or have a history of psychiatric impairment;
  14. Participants with an allergic constitution, known sensitivity to human serum albumin, cyclophosphamide, fludarabine and interleukin 2;
  15. Those with bleeding or thromboembolic tendency:bleeding symptoms of clinical significance or a clear tendency to bleeding within 2 weeks prior to entering the study. And those with hereditary or acquired bleeding and thrombotic tendencies; serious arterial/venous thromboembolic events occurred in the previous 6 months;
  16. Other severe, acute or chronic medical or mental illnesses that in the investigator's judgement will might be increase the risk associated with the patient's participation in the study or interfere with interpretation of research results.

Sites / Locations

  • Sun Yat-sen Memorial HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TCR-T treatment group

Arm Description

Within 3 - 5 days after pretreatment, subjects will receive a single TCR-T infusion with an infusion dose of about 1 × 10⁹~1 × 10¹⁰.Once every 12 hours within 24 hours after TCR-T cell infusion, recombinant human interleukin-2 will be injected intravenously for 14 days .After 3 months of treatment, the patient's condition was evaluated. If the subject did not occur tumor progression and did not occur adverse events (AEs) of level 3 or higher, a second TCR-T cell reinfusion can be performed .

Outcomes

Primary Outcome Measures

The overall survival(OS)
The overall survival period refers to the time of the TCR-T infusion to the death of the patient for any cause.
Progression free survival (PFS)
Progression free survival refers to the time from TCR-T infusion to the first occurrence of disease or death from any cause.According to RECIST version 1.1, the tumor evaluation of all subjects will be evaluated within 12 months after TCR-T treatment.
Time to progression (TTP)
Time to progression (TTP) refers to the time from TCR-T infusion to objective tumor progression.According to RECIST version 1.1, the tumor evaluation of all subjects will be evaluated within 12 months after TCR-T treatment.
Event free survival period
The event free survival period (until the time of treatment failure) refers to the time from entering the trial to any treatment failure, including disease progression or cessation of treatment for any reason (such as disease progression, toxic reactions, subject willingness, initiation of new treatment without clear progression, or death).According to RECIST version 1.1, the tumor evaluation of all subjects will be evaluated within 12 months after TCR-T treatment.
The disease-free survival period
The disease-free survival period refers to the time from obtaining disease-free status or reaching complete response until recurrence or death due to acute toxicity of tumors or treatment.
The duration of efficacy
The duration of efficacy refers to the time from reaching the treatment effectiveness (i.e. CR or PR) standard until the first definite recurrence or progression is achieved.

Secondary Outcome Measures

Peak plasma concentration (Cmax)
Peak plasma concentration (Cmax) refers to the maximum concentration of TCR-T cells in peripheral blood after the TCR-T cells infusion.
Area under the plasma concentration versus time curve (AUC)
Area under the plasma concentration versus time curve (AUC) is used to access the absorbed TCR-T cells dose into human blood circulation after TCR-T cells injection.
Peak time (Tmax)
Peak time (Tmax) refers to the time when the blood concentration reaches the peak after TCR-T cells injection.
Cell number of TCR-T cells in peripheral blood
Cell numbers of TCR-T cells after the injection of TCR-T cells
Peak value of cytokines
The peak value of cytokines within 1 month after TCR-T cell infusion .
Adverse events
The type, incidence and severity of adverse events include abnormal laboratory examination results with clinical significance after treatment, abnormal physical examination and blood examination results, bone marrow examination results, etc. Clinical and laboratory adverse events will be classified according to the National Cancer Institute general terminology standard for adverse events (NCI CTCAE) version 5.0.

Full Information

First Posted
June 7, 2022
Last Updated
July 16, 2023
Sponsor
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
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1. Study Identification

Unique Protocol Identification Number
NCT05438667
Brief Title
TCR-T Cell Therapy on Advanced Pancreatic Cancer
Official Title
A Prospective, One Arm Clinical Study on the Safety, Efficacy and Pharmacokinetics of KRAS Mutant Antigen Specific TCR-T Cells in the Treatment of Advanced Pancreatic Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 7, 2022 (Actual)
Primary Completion Date
June 30, 2025 (Anticipated)
Study Completion Date
May 30, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary aim of this study is to evaluate the efficacy of KRAS mutant antigen specific TCR-T cells in the treatment of patients with advanced pancreatic cancer. The secondary aim is to evaluate the pharmacokinetic/pharmacodynamic characteristics of TCR-T cell therapy in patients with advanced pancreatic cancer and the survival of TCR-T cells. The investigators will evaluate the changes of tumor microenvironment after treatment of advanced pancreatic cancer with KRAS mutant antigen specific TCR-T cells; Evaluating the correlation between cytokines and the occurrence of CRS and neurotoxicity
Detailed Description
1.This study is a prospective and single arm clinical study. In this trial, 18 patients with advanced pancreatic cancer with KRAS G12V or G12D mutations and matching HLA-A*11:01 subtypes are recruited for autologous Tumor-T Cell Receptor (TCR) -Mediated T Cells therapy(TCR-T) therapy.Within 3 - 5 days after pretreatment, subjects will receive a single TCR-T infusion with an infusion dose of about 1 × 10⁹~1 × 10¹⁰.Once every 12 hours within 24 hours after TCR-T cell infusion, recombinant human interleukin-2 will be injected intravenously for 14 days . After 3 months of treatment, the patient's condition was evaluated. If the subject did not occur tumor progression and did not occur adverse events (AEs) of level 3 or higher, a second TCR-T cell reinfusion can be performed (informed consent form needs to be signed again). The study will evaluate the safety of TCR-T treatment by observing adverse events after cell therapy; evaluate the effectiveness of TCR-T compared to the results or historical data of the subject's own previous standard treatment regimen;and collect blood before and after cell infusion, measure the number and activity of TCR-T cells, and evaluate the pharmacokinetic (PK) characteristics of TCR-T.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
Pancreatic Cancer, PK/PD, TCR-T, Safety, efficacy

7. Study Design

Primary Purpose
Treatment
Study Phase
Early 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
TCR-T treatment group
Arm Type
Experimental
Arm Description
Within 3 - 5 days after pretreatment, subjects will receive a single TCR-T infusion with an infusion dose of about 1 × 10⁹~1 × 10¹⁰.Once every 12 hours within 24 hours after TCR-T cell infusion, recombinant human interleukin-2 will be injected intravenously for 14 days .After 3 months of treatment, the patient's condition was evaluated. If the subject did not occur tumor progression and did not occur adverse events (AEs) of level 3 or higher, a second TCR-T cell reinfusion can be performed .
Intervention Type
Biological
Intervention Name(s)
TCR-T therapy
Intervention Description
1.Preprocessing strategy: Cyclophosphamide: 500mg/m², dissolved in 100ml 0.9% sodium chloride saline, intravenous drip for 60minutes, and 0.4g Mesna injected at 0hour, 4hours and 8 hours after cyclophosphamide,4days and 5 days before TCR-T cell infusion. Fludarabine: 30mg/m² , dissolved in 100ml 0.9% sodium chloride saline, intravenous drip for 30minutes before 3 to 5days before TCR-T cell infusion. 2.Within 3 - 5 days after pretreatment, subjects will receive a single TCR-T reinfusion with an infusion dose of about 1 × 10⁹~1 × 10¹⁰. 3.Once every 12 hours within 24 hours after TCR-T cell infusion, recombinant human interleukin-2 (injection unit: 500000 units /m², once every 12 hours, subcutaneous injection) will be injected intravenously for 14 days (24 times in total). 4.After 3 months of treatment, If the subject did not occur tumor progression and did not occur adverse events (AEs) of level 3 or higher, a second TCR-T cell reinfusion can be performed .
Primary Outcome Measure Information:
Title
The overall survival(OS)
Description
The overall survival period refers to the time of the TCR-T infusion to the death of the patient for any cause.
Time Frame
At 12months after the TCR-T cell infusion
Title
Progression free survival (PFS)
Description
Progression free survival refers to the time from TCR-T infusion to the first occurrence of disease or death from any cause.According to RECIST version 1.1, the tumor evaluation of all subjects will be evaluated within 12 months after TCR-T treatment.
Time Frame
At 12months after the TCR-T cell infusion
Title
Time to progression (TTP)
Description
Time to progression (TTP) refers to the time from TCR-T infusion to objective tumor progression.According to RECIST version 1.1, the tumor evaluation of all subjects will be evaluated within 12 months after TCR-T treatment.
Time Frame
12months after the TCR-T cell infusion
Title
Event free survival period
Description
The event free survival period (until the time of treatment failure) refers to the time from entering the trial to any treatment failure, including disease progression or cessation of treatment for any reason (such as disease progression, toxic reactions, subject willingness, initiation of new treatment without clear progression, or death).According to RECIST version 1.1, the tumor evaluation of all subjects will be evaluated within 12 months after TCR-T treatment.
Time Frame
At 12months after the TCR-T cell infusion
Title
The disease-free survival period
Description
The disease-free survival period refers to the time from obtaining disease-free status or reaching complete response until recurrence or death due to acute toxicity of tumors or treatment.
Time Frame
At 12months after the TCR-T cell infusion
Title
The duration of efficacy
Description
The duration of efficacy refers to the time from reaching the treatment effectiveness (i.e. CR or PR) standard until the first definite recurrence or progression is achieved.
Time Frame
At 12months after the TCR-T cell infusion
Secondary Outcome Measure Information:
Title
Peak plasma concentration (Cmax)
Description
Peak plasma concentration (Cmax) refers to the maximum concentration of TCR-T cells in peripheral blood after the TCR-T cells infusion.
Time Frame
12months after the TCR-T cell infusion
Title
Area under the plasma concentration versus time curve (AUC)
Description
Area under the plasma concentration versus time curve (AUC) is used to access the absorbed TCR-T cells dose into human blood circulation after TCR-T cells injection.
Time Frame
12months after the TCR-T cell infusion
Title
Peak time (Tmax)
Description
Peak time (Tmax) refers to the time when the blood concentration reaches the peak after TCR-T cells injection.
Time Frame
12months after the TCR-T cell infusion
Title
Cell number of TCR-T cells in peripheral blood
Description
Cell numbers of TCR-T cells after the injection of TCR-T cells
Time Frame
12months after the TCR-T cell infusion
Title
Peak value of cytokines
Description
The peak value of cytokines within 1 month after TCR-T cell infusion .
Time Frame
1 month after TCR-T cell infusion
Title
Adverse events
Description
The type, incidence and severity of adverse events include abnormal laboratory examination results with clinical significance after treatment, abnormal physical examination and blood examination results, bone marrow examination results, etc. Clinical and laboratory adverse events will be classified according to the National Cancer Institute general terminology standard for adverse events (NCI CTCAE) version 5.0.
Time Frame
12months after TCR-T infusion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age greater than 18 years old; Pathological diagnosis of recurrent/metastatic pancreatic cancer (except intracranial metastasis). Patients who have had prior therapy with at least one standard treatment regimen remain in stable or progressive disease states and refuse subsequent chemotherapy; Mutations in KRAS G12V or G12D and expression of matched HLA -A*11:01 subtypes are confirmed in previous tumor or biopsy tissues; Expected survival duration of more than 3 months; Eastern Cooperative Oncology Group( ECOG )score ≤2; All participants voluntarily participate in this study and sign an informed consent. And the subjects have good compliance and can cooperate with investigators follow-up study. Patients at least have had at least one measurable lesion as defined by RECIST v1.1 criteria; Female participants can not be pregnant or lactating and their serum or urine human chorionic gonadotropin tests must be negative within 72 hours prior to study enrollment;All subjects must be using a medically accepted means of contraception ( (e.g., oral contraceptives, intrauterine device) during the course of this study and for at least 3 months after completion of study therapy. Organ function and bone marrow reserve are in good condition, and the following requirements must be met: 1)Absolute neutrophil count≥1.5×10⁹/L;2)Platelet count≥50×10⁹/L;3)Hemoglobin≥90g/L;4)Bilirubin < 1.5 times upper limit of normal(Bile duct obstruction due to tumor compression were excluded);5)Serum creatinine ≤ 1.5 times the upper limit of normal range or creatinine clearance ≥ 60 mL/min.6)Serum alanine aminotransferase or aspartate aminotransferase is < 2.5 times the upper limit of the normal value (ULN) (if patients with liver metastasis, ≤5 times the ULN).7)Coagulation function normalised:INR≤1.5,PTT<1.2 times the upper limit of normal(Tumor - related anticoagulant therapy was excluded). Exclusion Criteria: Intracranial metastasis or Patients with moderate or severe hydrothorax need drain placement to relieve symptoms. Active pulmonary tuberculosis Human immunodeficiency virus (HIV) positive; Active Hepatitis B or Hepatitis C infection; Pregnant women and lactating females; Previous or concurrent history of other malignant tumors. Exceptions include curatively treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy; Patients with central nervous metastases; Serious, uncontrolled comorbidities that may affect protocol compliance or interfere with interpretation of results,or any serious medical condition that may affect the safety of the subjects ; History of clinically significant respiratory diseases or other respiratory diseases that seriously affect Pulmonary function; Any active autoimmune disease,any condition requiring steroid hormones or immunosuppressive therapy( including but not limited to systemic lupus erythematosus, sjogren's syndrome, rheumatoid arthritis, psoriasis, multiple sclerosis, inflammatory bowel disease, etc., require > 10 mg/D of prednisone or equivalent hormone) A history of organ transplantation; A history of myocardial infarction and severe arrhythmia within six months;Ineligible also includes uncontrolled hypertension, coronary heart disease, stroke, liver cirrhosis, nephritis and other serious complications; Those who have a history of psychotropic drug abuse and cannot quit or have a history of psychiatric impairment; Participants with an allergic constitution, known sensitivity to human serum albumin, cyclophosphamide, fludarabine and interleukin 2; Those with bleeding or thromboembolic tendency:bleeding symptoms of clinical significance or a clear tendency to bleeding within 2 weeks prior to entering the study. And those with hereditary or acquired bleeding and thrombotic tendencies; serious arterial/venous thromboembolic events occurred in the previous 6 months; Other severe, acute or chronic medical or mental illnesses that in the investigator's judgement will might be increase the risk associated with the patient's participation in the study or interfere with interpretation of research results.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Meng Zhang, MD
Phone
+86 02034071785
Email
sysmhqkyxkek@mail.sysu.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Zhifen Zeng, MD
Phone
+86 02034071785
Email
sysmhqkyxkek@mail.sysu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Meng Zhang, MD
Organizational Affiliation
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Official's Role
Study Chair
Facility Information:
Facility Name
Sun Yat-sen Memorial Hospital
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Meng zhang, MD
Phone
+86 02034071785
Email
sysmhqkyxkek@mail.sysu.edu.cn

12. IPD Sharing Statement

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TCR-T Cell Therapy on Advanced Pancreatic Cancer

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