Phase 1/2 Clinical Study on Fully Human BCMA Chimeric Antigen Receptor Autologous T Cell Injection (CT103A) in the Treatment of Patients With Relapsed/Refractory Multiple Myeloma
Overview
- Phase
- Phase 1
- Intervention
- CT103A
- Conditions
- Multiple Myeloma
- Sponsor
- Nanjing IASO Biotechnology Co., Ltd.
- Enrollment
- 132
- Locations
- 14
- Primary Endpoint
- Phase 1: Laboratoty tests
- Last Updated
- 4 years ago
Overview
Brief Summary
This study is a single-armed, open-label, multicenter Phase 1/2 study to evaluate the efficacy and safety of CT103A in subjects with relapsed and refractory MM.
Detailed Description
Leukapheresis procedure will be performed to manufacture CT103A chimeric antigen receptor (CAR) modified T cells. Bridging therapy is allowed between PBMC collection and lymphodepletion. Lymphodepletion with fludarabine and cyclophosphamide was performed for three consecutive days. After 1-day rest, subjects will receive a single dose infusion of CT103A at 1.0 x 10\^6 CAR+ T cells/Kg. Subjects will be followed in the study for a minimum of 2 years after CT103A infusion. Long-term follow-up for lentiviral vector safety will be followed for up to 15 years after CT103A infusion.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Subjects must satisfy all the following criteria to be enrolled in the study:
- •age 18 to 70 years old, male or female.
- •Subjects with diagnosed relapsed or refractory MM according to IMWG criteria and have had at least 3 prior lines of therapy including chemotherapy based on proteasome inhibitors (PIs) and immunomodulatory agents (IMiDs). Disease progression must be documented during or within 12 months following the most recent anti-myeloma treatment.
- •Evidence of cell membrane BCMA expression, as determined by a validated immunohistochemistry (IHC) or flow cytometry of tumor tissue (e.g., bone marrow biopsies, or plasmacytoma).
- •The subjects should have measurable disease based on at least one of the following parameters:
- •The proportion of primitive immature or monoclonal plasma cells detected by bone marrow cytology, bone marrow biopsy, or flow cytometry is ≥ 5%.
- •Serum M-protein ≥ 0.5 g/dL.
- •Urine M-protein ≥ 200 mg/24 hrs.
- •For those whose Serum or Urine M-protein does not meet the measurable criteria but the light chain type, serum free light chain (sFLC): involved sFLC level ≥ 10 mg/dL (100 mg/L) provided serum FLC ratio is abnormal.
- •ECOG performance score 0-
Exclusion Criteria
- •The presence of any of the following will exclude a subject from enrollment:
- •Subjects who are known to have GVHD or need long-term immunosuppressive therapy.
- •Subjects have received an autologous hematopoietic stem cell transplantation (auto-HSCT) within 12 weeks before leukapheresis or have a previous history of two times of allo-HSCT or previous history of an allogeneic hematopoietic stem cell transplantation (allo-HSCT).
- •Insufficient mononuclear cells for CAR T cell production.
- •Subjects have received any anti-cancer treatment as follows: targeted therapies, epigenetic therapy or invasive experimental instruments therapy within 14 days or at least 5 half-lives before leukapheresis (according to the longer time), or monoclonal antibody for treating multiple myeloma within 21 days before leukapheresis, or cytotoxic therapy or proteasome inhibitors within 14 days before leukapheresis, or immunomodulatory agents within 7 days before leukapheresis.
- •Subjects who were receiving a used therapeutic dose of corticosteroid treatment (defined as prednisone or equivalent \> 20mg) within 7 days prior to screening, except for physiological alternatives, inhalation, or topical use.
- •Subjects with serious heart disease: including but not limited to unstable angina, myocardial infarction (within 6 months prior to screening), congestive heart failure (NYHA classification ≥III), and severe arrhythmias.
- •Subjects with systemic diseases that the investigator determined to be unstable include, but are not limited to, severe liver and kidney or metabolic diseases requiring medical treatment.
- •Subjects with second malignancies in addition to MM within the past 5 years before the screening, exceptions to this criterion: successfully treated cervical carcinoma in situ and non-metastatic basal or squamous cell skin carcinoma, local prostate cancer after radical surgery, and ductal carcinoma in situ of the breast after radical surgery.
- •Subjects with a history of organ transplantation.
Arms & Interventions
CT103A in relapsed and refractory multiple myeloma patients
CT103A autologous CAR-T cells will be infused at RP2D of 1.0 x 10\^6 CAR+ T cells after receiving lymphodepleting chemotherapy
Intervention: CT103A
Outcomes
Primary Outcomes
Phase 1: Laboratoty tests
Time Frame: Minimum of 2 years post CT103A infusion
Abnormal results of laboratoty tests
Phase 2: Overall response rate (ORR) evaluated by an Independent Review Committee (IRC)
Time Frame: 3 months post CT103A infusion
Percentage of subjects who achieved partial response (PR) or better according to IMWG Uniform Response Criteria for Multiple Myeloma as assessed by an IRC
Phase 1: Incidence and Severity of Adverse Events
Time Frame: Minimum of 2 years post CT103A infusion
An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.
Phase 1: Physical examination
Time Frame: Minimum of 2 years post CT103A infusion
Abnormal results of physical examination
Phase 1: Vital signs
Time Frame: Minimum of 2 years post CT103A infusion
Abnormal results of vital signs
Secondary Outcomes
- Pharmacokinetics - AUC0-90days(Minimum of 2 years post CT103A infusion)
- Duration of Response (DOR)(Minimum of 2 years post CT103A infusion)
- Overall response rate (ORR) evaluated by the investigators(3 months post CT103A infusion)
- Progression-free Survival (PFS)(Minimum of 2 years post CT103A infusion)
- Laboratoty tests(Minimum of 2 years post CT103A infusion)
- Overall Survival (OS)(Minimum of 2 years post CT103A infusion)
- Time to Response (TTR)(Minimum of 2 years post CT103A infusion)
- Vital signs(Minimum of 2 years post CT103A infusion)
- Minimal Residual Disease (MRD)(Minimum of 2 years post CT103A infusion)
- Pharmacokinetics - Tmax(Minimum of 2 years post CT103A infusion)
- Pharmacokinetics - AUC0-28days(Minimum of 2 years post CT103A infusion)
- soluble BCMA levels(Minimum of 2 years post CT103A infusion)
- Physical examination(Minimum of 2 years post CT103A infusion)
- Pharmacokinetics - Cmax(Minimum of 2 years post CT103A infusion)