P-BCMA-ALLO1 Allogeneic CAR-T Cells in the Treatment of Subjects With Multiple Myeloma
- Conditions
- Multiple Myeloma
- Interventions
- Biological: P-BCMA-ALLO1 CAR-T cells
- Registration Number
- NCT04960579
- Lead Sponsor
- Poseida Therapeutics, Inc.
- Brief Summary
Phase 1 study comprised of open-label, dose escalation, multiple cohorts of P-BCMA-ALLO1 allogeneic T stem cell memory (Tscm) CAR-T cells in subjects with relapsed / refractory Multiple Myeloma (RRMM).
- Detailed Description
Phase 1/1b study: Phase 1 Part 1 is a weight-based dose escalation following a 3+3 design of dose-escalating cohorts. Phase 1 Part 2 includes administration at fixed doses. After enrollment, subjects may receive a lymphodepletion therapy regimen before administration of allogeneic CAR-T cells, administered as a single or multiple dose(s). Treated subjects will undergo serial measurements of safety, tolerability and response. Rimiducid may be administered as indicated. Phase 1b of the study will undergo further expansion of cohorts/arms from Phase 1 Parts 1 or 2 or an intermediate dose between cohort levels.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 231
- Must have signed written, informed consent.
- Males or females, ≥18 years of age.
- Must have a confirmed diagnosis of active MM.
- Must have measurable MM.
- Must have relapsed / refractory MM, having received treatment with a proteasome inhibitor, immunomodulatory agent (IMiD), and anti-CD38 therapy.
- Must be willing to practice birth control from the time of Screening and throughout the first year of the study after P-BCMA-ALLO1 administration.
- Must have a negative serum pregnancy test at Screening and a negative urine pregnancy test within 3 days prior to initiating the lymphodepletion therapy regimen (females of childbearing potential).
- Must be at least 90 days since autologous stem cell transplant, if performed.
- Must have adequate vital organ function within pre-determined parameters.
- Must have recovered from toxicities due to prior therapies.
- Must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
- Is pregnant or lactating.
- Has inadequate venous access.
- Has active hemolytic anemia, plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome, disseminated intravascular coagulation, leukostasis, or amyloidosis.
- Has an active second malignancy (not disease-free for at least 5 years) in addition to MM, excluding low-risk neoplasms such as non-metastatic basal cell or squamous cell skin carcinoma.
- Has active autoimmune disease.
- Has a history of significant central nervous system (CNS) disease, such as stroke, epilepsy, etc.
- Has an active systemic infection.
- Has a history of hepatitis B, hepatitis C virus, human immunodeficiency virus (HIV), or human T-lymphotropic virus (HTLV) infection, or any immunodeficiency syndrome. Subjects with a history of treated hepatitis C can be enrolled if negative by Hepatitis C PCR on multiple occasions and with medical monitor approval.
- Is positive for cytomegalovirus (CMV) by PCR, CMV immunoglobulin M (IgM) antibody, or Coronavirus disease 2019 (COVID-19) by PCR.
- Has New York Heart Association (NYHA) Class III or IV heart failure, unstable angina, or a history of myocardial infarction or significant arrhythmia.
- Has any psychiatric or medical disorder that would preclude safe participation in and/or adherence to the protocol.
- Has received prior allogeneic cellular therapy or gene therapy.
- Has received anti-cancer medications within 2 weeks of the time of initiating conditioning LD therapy.
- Has received monoclonal antibody therapy within 4 weeks of initiating conditioning LD therapy.
- Has received immunosuppressive medications within 2 weeks of the time of administration of P-BCMA-ALLO1, and/or expected to require them while on study.
- Has received systemic corticosteroid therapy within 1 week or 5 half-lives (whichever is shorter) of the administration of P-BCMA-ALLO1 or is expected to require it during the course of the study.
- Has CNS metastases or symptomatic CNS involvement of their myeloma.
- Has a history of severe immediate hypersensitivity reaction to any of the agents used in this study.
- Has a history of having undergone allogeneic stem cell transplantation, or any other allogeneic or xenogeneic transplant, or has undergone autologous transplantation within 90 days.
- Arms R, RS, RP1, RP1.5 and RP2 Only: a) Has received a live vaccine within the last 28 days of the first administration of agents used in Arm R or RS, b) Has any known hypersensitivity or severe reactions or toxicity to agents used in Arms R or RS.
- Has received radiation within 1 week of initiating conditioning LD therapy.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description P-BCMA-ALLO1 CAR-T cells (Arm RS) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen RS. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm S) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen S. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm R) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen R. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm RP1.5) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen RP1.5. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm CP1.5) P-BCMA-ALLO1 CAR-T cells Cyclic weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen CP1.5. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm P1.5) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen P1.5. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm S) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen S. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm R) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen R. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm480) P-BCMA-ALLO1 CAR-T cells Single fixed dose IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen S, P1, P1.5 or P2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm P1.5) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen P1.5. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm F) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen F. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm P2) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen P2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm C) P-BCMA-ALLO1 CAR-T cells Cyclic weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen C. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm480) Rimiducid Single fixed dose IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen S, P1, P1.5 or P2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm F) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen F. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm P1) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen P1. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm P2) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen P2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm160) P-BCMA-ALLO1 CAR-T cells Single fixed dose IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen S, P1, P1.5 or P2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm N) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm P1) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen P1. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm CP2) Rimiducid Cyclic weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen CP2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm RP1.5) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen RP1.5. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm CP1) Rimiducid Cyclic weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen CP1. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm RP1) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen RP1. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm RP2) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen RP2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm RP1) P-BCMA-ALLO1 CAR-T cells Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen RP1. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm RP2) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen RP2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm CP1) P-BCMA-ALLO1 CAR-T cells Cyclic weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen CP1. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm CP2) P-BCMA-ALLO1 CAR-T cells Cyclic weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen CP2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm N) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm RS) Rimiducid Single weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen RS. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm C) Rimiducid Cyclic weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen C. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm160) Rimiducid Single fixed dose IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen S, P1, P1.5 or P2. Rimiducid may be administered as indicated. P-BCMA-ALLO1 CAR-T cells (Arm CP1.5) Rimiducid Cyclic weight-based IV administration of P-BCMA-ALLO1 following conditioning chemotherapy regimen CP1.5. Rimiducid may be administered as indicated.
- Primary Outcome Measures
Name Time Method Phase 1 Part 2: Assess the safety and tolerability of P-BCMA-ALLO1 when administered as a fixed dose of cells. Baseline through 36 months Frequency and severity of adverse events, including cytokine release syndrome.
Phase 1b: The effect of cell dose and study arm to guide selection of Recommended Phase 2 Dose (RP2D). Baseline through 36 months Incidence and severity of cytokine release syndrome (CRS) events graded using American Society for Transplantation and Cellular Therapy (ASTCT) criteria (Lee, 2019).
Phase 1 Part 1: Assess the safety and maximum tolerated dose (MTD) of P-BCMA-ALLO1 based on dose limiting toxicities (DLT) Baseline through Day 28 Rate of dose limiting toxicities (DLT)
- Secondary Outcome Measures
Name Time Method The safety of P-BCMA-ALLO1 Baseline through 15 years Incidence and severity of treatment-emergent adverse events
The anti-Myeloma effect of P-BCMA-ALLO1 (DOR) Baseline through 15 years According to the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma: Duration of Response - Time from complete response (CR), very good partial response (VGPR), or partial response (PR) to progressive disease
The anti-Myeloma effect of P-BCMA-ALLO1 (OS) Baseline through 15 years According to the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma: Overall Survival (OS) - Duration of survival from time of treatment with P-BCMA-ALLO1
The anti-myeloma effect of P-BCMA-ALLO1 (ORR) in Phase 1 Parts 1 and 2 Baseline through 15 years According to the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma: Overall Response Rate (ORR) - Percentage of patients with complete response (CR), very good partial response (VGPR), or partial response (PR)
The anti-Myeloma effect of P-BCMA-ALLO1 (PFS) Baseline through 15 years According to the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma: Progression Free Survival (PFS) - Time from P-BCMA-ALLO1 treatment to progressive disease
The anti-myeloma effect of P-BCMA-ALLO1 (TTR) Baseline through 15 years According to the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma: Time to Response (TTR) - Time to complete response (CR), very good partial response (VGPR), or partial response (PR) to progressive disease
Trial Locations
- Locations (20)
Blood Marrow and Transplant Group of Georgia
🇺🇸Atlanta, Georgia, United States
City of Hope
🇺🇸Chicago, Illinois, United States
University of California San Diego
🇺🇸San Diego, California, United States
University of California San Francisco
🇺🇸San Francisco, California, United States
Emory University
🇺🇸Atlanta, Georgia, United States
Advocate Aurora Health
🇺🇸Park Ridge, Illinois, United States
University of Iowa
🇺🇸Iowa City, Iowa, United States
University of Kansas Medical Center
🇺🇸Kansas City, Kansas, United States
University of Maryland Greenebaum Comprehensive Cancer Center
🇺🇸Baltimore, Maryland, United States
Wayne State - Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Roswell Park Comprehensive Cancer Center
🇺🇸Buffalo, New York, United States
University of North Carolina at Chapel Hill
🇺🇸Chapel Hill, North Carolina, United States
University of Cincinnati
🇺🇸Cincinnati, Ohio, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
University of Oklahoma, Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States
University of Pennsylvania
🇺🇸Philadelphia, Pennsylvania, United States
Vanderbilt University Medical Center
🇺🇸Nashville, Tennessee, United States
Sarah Cannon Research Institute - St. David's South Austin Medical Center
🇺🇸Austin, Texas, United States
Houston Methodist Research Institute
🇺🇸Houston, Texas, United States
Sarah Cannon Research Institute - Methodist Healthcare
🇺🇸San Antonio, Texas, United States