To Evaluate the Safety and Efficacy of Human Derived Anti-BCMA CAR-T Injection for Subjects With R/R MM
Primary Purpose
Multiple Myeloma
Status
Recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
Human Derived anti-BCMA CAR-T Injection
Sponsored by
About this trial
This is an interventional treatment trial for Multiple Myeloma focused on measuring BCMA, CAR-T, multiple myeloma, Relapsed /Refractory
Eligibility Criteria
Inclusion Criteria:
Subjects must meet all of the following criteria to be enrolled:
- Subjects volunteer to participate in clinical trails, understand and inform the trials and sign informed consent form, be willing to complete all the trial procedures;
- 18 to 75 years old (including cut-off value), Male and female;
- Expected survival > 12 weeks;
- Previously diagnosed as multiple myeloma by IMWG updated criteria (2014);
One of the following indicators is satisfied:
- Serum M protein: for immunoglobulin G (IgG) type , M protein≥ 10 g/L, or for immunoglobulin A (IgA) type , M protein > 5g/L, or for immunoglobulin D (IgD) type , M protein, IgD exceeds upper limit of normal range.
- Urine M protein ≥ 200 mg/24h;
- Serum free light chain ≥ 100 mg/L and Serum free light chain ratio is abnormal ;
- Patients with relapsed/refractory multiple myeloma. Relapsed is defined as: Patients have disease progression after at least three-line treatment regimens. Patients previously received at least 3 different mechanisms treatment regimens for multiple myeloma, including protease inhibitors and immunomodulators; Refractory is defined as: Patients who achieved minimal response(MR) or above was never achieved in previous treatment; MR or above was achieved in previous treatment, but disease progression occurred during subsequent treatment or within 60 days after the last treatment.
- ECOG score 0-2;
Liver, kidney and cardiopulmonary functions meet the following requirements:
- Creatinine clearance (estimated by Cockcroft Gault formula) ≥ 40 mL/min;
- Left ventricular ejection fraction >50%;
- Baseline peripheral oxygen saturation >95%;
- Total bilirubin ≤ 2×ULN; Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 × ULN;
- The venous access required for collection can be established and leukepheresis can be carriedaccording to the judgement of investigators.
Exclusion Criteria:
Any one of the following conditions cannot be selected as a subject:
- Accompanied by other uncontrolled malignancies;
- Subjects with positive Hepatitis B surface antigen (HBsAg) or Hepatitis B core antibody (HBcAb) and peripheral blood Hepatitis B virus(HBV) DNA titer is ≥500IU/mL; hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; human immunodeficiency virus(HIV) antibody positive; syphilis primary screening antibody positive;
- Any instability of systemic disease, including but not limited to unstable angina, cerebrovascular accident, or transient cerebral ischemic (within 6 months prior to screening), myocardial infarction (within 6 months prior to screening), congestive heart failure (New York heart association (NYHA) classification ≥ III), need drug therapy of severe arrhythmia, liver, kidney, or metabolic disease;
- Patients who are accounted to be not appropriate for this trail by investigator;
- Pregnant or lactating woman, and female subject who plans to have a pregnancy within 1 year after cell transfusion, or male subject whose partner plans to have a pregnancy within 1 year after cell transfusion;
- Received CAR-T treatment or other gene therapies before enrollment;
- Those who failed to sign informed consent form or comply with the research procedures; Unwilling or unable to comply with research requirements;
- Have had severe immediate hypersensitivity reactions to any drugs used in this research;
- Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment;
- In the past two years, the terminal organ was damaged due to autoimmune diseases (such as Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus), or the systemic use of immunosuppressive or other systemic disease control drugs was required;
- Patients with symptoms of central nervous system.
Sites / Locations
- Shanghai Changzheng HospitalRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Human Derived anti-BCMA CAR-T Injection
Arm Description
Single administration:1.0×10^6 CAR+T, 3.0×10^6 CAR+T, 6.0×10^6 CAR+T
Outcomes
Primary Outcome Measures
Dose limited toxicity(DLT)
Safety Indicator
Secondary Outcome Measures
Pharmacokinetics parameters - Maximum CAR level in blood and CAR level in bone marrow(Cmax)
Effectiveness Metrics
Pharmacokinetics parameters -Time to peak CAR level in blood (Tmax)
Effectiveness Metrics
Pharmacokinetics parameters - 28-day Area under the curve of the CAR level in blood(AUC0-28)
Effectiveness Metrics
Pharmacodynamics characteristics - Cytokines Concentrations,cytokines level in blood
Effectiveness Metrics
Pharmacodynamics characteristics -Clonal bone marrow plasma cells level
Effectiveness Metrics
Overall Response Rate (ORR) at 3 month post infusion
ORR defined as proportion of subjects who achieved Partial remission(PR) or better according to the International Myeloma Working Group response criteria (2016) (IMWG 2016) as determined by an Investigator assessment at 3 month post infusion.
Percentage of Subjects With Negative Minimal Residual Disease (MRD)
MRD negative rate is defined as the proportion of subjects who achieve MRD negative status
Duration of Subjects With Negative Minimal Residual Disease (MRD)
MRD duration will calculated among MRD negative responders fom the date of initial MRD negative to the date of first documented evidence of MRD positive, as defined in the IMWG criteria (2016).
Number of Subjects with Adverse Events
Adverse event is any untoward medical event that occurs in a subject administered an investigational drug.
Change from Baseline in Perform Status as Measured by Eastern Cooperative Oncology Group(ECOG)Score(0-4)
Eastern Cooperative Oncology Group(ECOG) Performance Status Score(0-4) will be assessed by the inverstigator at baseline and the respective time point, higher scores mean a worse performance status.
Change from Baseline in complete blood count with differential and blood biochemical examination
complete blood count with differential and blood biochemical examination will be assessed by the investigator at the respective time point.
Change from Baseline in Physical Exam
physical exam will be assessed by the inverstigator at the respective time poin.
Progression-free Survival (PFS)
PFS defined as time from date of initial infusion of CAR-T to date of first disease progression according to IMWG criteria (2016) , or death due to any cause, whichever occurs first.
Overall Survival (OS)
OS is measured from the date of the initial infusion of CAR-T to the date of the subject's death.
Duration of Response (DOR)
DOR will be calculated among responders (with a PR or better response) from the date of initial response (PR or better) to the date of first documented evidence of progressive disease, as defined in the IMWG criteria (2016).
Full Information
NCT ID
NCT05302648
First Posted
March 3, 2022
Last Updated
March 27, 2022
Sponsor
Hrain Biotechnology Co., Ltd.
Collaborators
Shanghai Changzheng Hospital
1. Study Identification
Unique Protocol Identification Number
NCT05302648
Brief Title
To Evaluate the Safety and Efficacy of Human Derived Anti-BCMA CAR-T Injection for Subjects With R/R MM
Official Title
A Early Phase 1 Clinical Trial To Evaluate the Safety and Efficacy of Human Derived Anti-BCMA CAR-T Injection for Subjects With Relapsed/Refractory Multiple Myeloma
Study Type
Interventional
2. Study Status
Record Verification Date
March 2022
Overall Recruitment Status
Recruiting
Study Start Date
February 9, 2022 (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
Hrain Biotechnology Co., Ltd.
Collaborators
Shanghai Changzheng Hospital
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 a single-arm, open-label, dose-escalation trial to explore the safety, tolerability and pharmacokinetic/pharmacodynamics characteristics of Human Derived anti-BCMA CAR-T Injection , and to preliminarily observe the efficacy of the trial drug in patients with relapsed/refractory multiple myeloma.
Detailed Description
Subjects withe relapsed/refractory multiple myeloma can participate if all eligibility criteria are met. Tests required to determine eligibility including disease assessments, a physical exam, Electrocardiograph, Computed tomography(CT)/Magnetic Resonance Imaging(MRI)/Positron Emission Tomography(PET),liver/renal function tests, complete blood count with differential and complete metabolic profile and etc.. Subjects will receive precondtioning chemotherapy prior to the infusion of BCMA CAR- T cells. After the infusion, subjects will be followed for adverse events pharmacokinetic/pharmacodynamics characteristics, efficacy, of BCMA CAR-T cells. Study procedures may be performed while hospitalized.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
BCMA, CAR-T, multiple myeloma, Relapsed /Refractory
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
Human Derived anti-BCMA CAR-T Injection
Arm Type
Experimental
Arm Description
Single administration:1.0×10^6 CAR+T, 3.0×10^6 CAR+T, 6.0×10^6 CAR+T
Intervention Type
Drug
Intervention Name(s)
Human Derived anti-BCMA CAR-T Injection
Other Intervention Name(s)
BCMA CAR-T
Intervention Description
Autologous genetically modified anti-BCMA CAR transduced T cells
Primary Outcome Measure Information:
Title
Dose limited toxicity(DLT)
Description
Safety Indicator
Time Frame
28 days post infusion
Secondary Outcome Measure Information:
Title
Pharmacokinetics parameters - Maximum CAR level in blood and CAR level in bone marrow(Cmax)
Description
Effectiveness Metrics
Time Frame
2 years post infusion
Title
Pharmacokinetics parameters -Time to peak CAR level in blood (Tmax)
Description
Effectiveness Metrics
Time Frame
2 years post infusion
Title
Pharmacokinetics parameters - 28-day Area under the curve of the CAR level in blood(AUC0-28)
Description
Effectiveness Metrics
Time Frame
2 years post infusion
Title
Pharmacodynamics characteristics - Cytokines Concentrations,cytokines level in blood
Description
Effectiveness Metrics
Time Frame
2 years post infusion
Title
Pharmacodynamics characteristics -Clonal bone marrow plasma cells level
Description
Effectiveness Metrics
Time Frame
2 years post infusion
Title
Overall Response Rate (ORR) at 3 month post infusion
Description
ORR defined as proportion of subjects who achieved Partial remission(PR) or better according to the International Myeloma Working Group response criteria (2016) (IMWG 2016) as determined by an Investigator assessment at 3 month post infusion.
Time Frame
3 month post infusion
Title
Percentage of Subjects With Negative Minimal Residual Disease (MRD)
Description
MRD negative rate is defined as the proportion of subjects who achieve MRD negative status
Time Frame
2 years post infusion
Title
Duration of Subjects With Negative Minimal Residual Disease (MRD)
Description
MRD duration will calculated among MRD negative responders fom the date of initial MRD negative to the date of first documented evidence of MRD positive, as defined in the IMWG criteria (2016).
Time Frame
2 years post infusion
Title
Number of Subjects with Adverse Events
Description
Adverse event is any untoward medical event that occurs in a subject administered an investigational drug.
Time Frame
2 years post infusion
Title
Change from Baseline in Perform Status as Measured by Eastern Cooperative Oncology Group(ECOG)Score(0-4)
Description
Eastern Cooperative Oncology Group(ECOG) Performance Status Score(0-4) will be assessed by the inverstigator at baseline and the respective time point, higher scores mean a worse performance status.
Time Frame
2 years post infusion
Title
Change from Baseline in complete blood count with differential and blood biochemical examination
Description
complete blood count with differential and blood biochemical examination will be assessed by the investigator at the respective time point.
Time Frame
2 years post infusion
Title
Change from Baseline in Physical Exam
Description
physical exam will be assessed by the inverstigator at the respective time poin.
Time Frame
2 years post infusion
Title
Progression-free Survival (PFS)
Description
PFS defined as time from date of initial infusion of CAR-T to date of first disease progression according to IMWG criteria (2016) , or death due to any cause, whichever occurs first.
Time Frame
2 years post infusion
Title
Overall Survival (OS)
Description
OS is measured from the date of the initial infusion of CAR-T to the date of the subject's death.
Time Frame
2 years post infusion
Title
Duration of Response (DOR)
Description
DOR will be calculated among responders (with a PR or better response) from the date of initial response (PR or better) to the date of first documented evidence of progressive disease, as defined in the IMWG criteria (2016).
Time Frame
2 years post infusion
Other Pre-specified Outcome Measures:
Title
Distribution of CAR-T
Description
CAR level in extramedullary lesions, pleural effusion, ascites, cerebrospinal fluid, etc, if appropriate.
Time Frame
2 years post infusion
Title
Cytokines Concentrations
Description
Cytokine levels in pleural effusion, ascites, cerebrospinal fluid, etc.if appropriate.
Time Frame
2 years post infusion
Title
Different Expression Genes (DEGs) in Plasma Cells for Relapse Subjects as Measured by Single-cell Ribonucleic Acid (RNA) Sequencing.
Description
Single-cell Ribonucleic Acid (RNA) Sequencing will be performed in relapsed subjects if appropriate. The different expression genes (DEGs) in plasma cells before and after relapse will be assessed by single-cell RNA sequencing, DEGs cutoff was adjusted p-value < 0.05 (Wilcoxon Rank Sum test) and the fold change >2.
Time Frame
2 years post infusion
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:
Subjects must meet all of the following criteria to be enrolled:
Subjects volunteer to participate in clinical trails, understand and inform the trials and sign informed consent form, be willing to complete all the trial procedures;
18 to 75 years old (including cut-off value), Male and female;
Expected survival > 12 weeks;
Previously diagnosed as multiple myeloma by IMWG updated criteria (2014);
One of the following indicators is satisfied:
Serum M protein: for immunoglobulin G (IgG) type , M protein≥ 10 g/L, or for immunoglobulin A (IgA) type , M protein > 5g/L, or for immunoglobulin D (IgD) type , M protein, IgD exceeds upper limit of normal range.
Urine M protein ≥ 200 mg/24h;
Serum free light chain ≥ 100 mg/L and Serum free light chain ratio is abnormal ;
Patients with relapsed/refractory multiple myeloma. Relapsed is defined as: Patients have disease progression after at least three-line treatment regimens. Patients previously received at least 3 different mechanisms treatment regimens for multiple myeloma, including protease inhibitors and immunomodulators; Refractory is defined as: Patients who achieved minimal response(MR) or above was never achieved in previous treatment; MR or above was achieved in previous treatment, but disease progression occurred during subsequent treatment or within 60 days after the last treatment.
ECOG score 0-2;
Liver, kidney and cardiopulmonary functions meet the following requirements:
Creatinine clearance (estimated by Cockcroft Gault formula) ≥ 40 mL/min;
Left ventricular ejection fraction >50%;
Baseline peripheral oxygen saturation >95%;
Total bilirubin ≤ 2×ULN; Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 × ULN;
The venous access required for collection can be established and leukepheresis can be carriedaccording to the judgement of investigators.
Exclusion Criteria:
Any one of the following conditions cannot be selected as a subject:
Accompanied by other uncontrolled malignancies;
Subjects with positive Hepatitis B surface antigen (HBsAg) or Hepatitis B core antibody (HBcAb) and peripheral blood Hepatitis B virus(HBV) DNA titer is ≥500IU/mL; hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; human immunodeficiency virus(HIV) antibody positive; syphilis primary screening antibody positive;
Any instability of systemic disease, including but not limited to unstable angina, cerebrovascular accident, or transient cerebral ischemic (within 6 months prior to screening), myocardial infarction (within 6 months prior to screening), congestive heart failure (New York heart association (NYHA) classification ≥ III), need drug therapy of severe arrhythmia, liver, kidney, or metabolic disease;
Patients who are accounted to be not appropriate for this trail by investigator;
Pregnant or lactating woman, and female subject who plans to have a pregnancy within 1 year after cell transfusion, or male subject whose partner plans to have a pregnancy within 1 year after cell transfusion;
Received CAR-T treatment or other gene therapies before enrollment;
Those who failed to sign informed consent form or comply with the research procedures; Unwilling or unable to comply with research requirements;
Have had severe immediate hypersensitivity reactions to any drugs used in this research;
Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment;
In the past two years, the terminal organ was damaged due to autoimmune diseases (such as Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus), or the systemic use of immunosuppressive or other systemic disease control drugs was required;
Patients with symptoms of central nervous system.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xuedong Sun, Doctor
Phone
+8615811287219
Email
sunxuedong@dashengbio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Juan Du, Doctor
Organizational Affiliation
Shanghai Changzheng Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shanghai Changzheng Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200005
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Juan Du, Doctor
Phone
021-81885423
Email
juan_du@live.com
First Name & Middle Initial & Last Name & Degree
Juan Du, Doctor
12. IPD Sharing Statement
Learn more about this trial
To Evaluate the Safety and Efficacy of Human Derived Anti-BCMA CAR-T Injection for Subjects With R/R MM
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