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TIL Therapy in Non-small-cell Lung Cancer (NSCLC) Patients

Phase 2
Not yet recruiting
Conditions
Non-Small Cell Lung Cancer
Interventions
Drug: Combination of TIL Transfer and low dose IL-2
Registration Number
NCT06455917
Lead Sponsor
University Hospital, Basel, Switzerland
Brief Summary

Aim of the study is to investigate the efficacy and safety of Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TILs) in NSCLC patients in a phase II clinical trial.

Detailed Description

Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TILs) is a personalized immunotherapy. In patients with advanced Non-Small Cell Lung Cancer (NSCLC), a phase I clinical trial has investigated TIL-ACT in patients who progressed during ICI-treatment.

For TIL-ACT, tumor-specific T cells are expanded from excised tumor samples and stimulated in cell culture with interleukin-2 (IL-2). The resulting autologous TILs are then re-infused to the patient after a non-myeloablative lymphodepleting chemotherapy with cyclophosphamide and fludarabine. Activation of TILs in the patient is then supported by IL-2 administration.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  1. Ability of the patient to understand the purpose of the study, provide signed and dated informed consent prior to performing any protocol-related procedures (including screening evaluations), and be able and willing to comply with the study procedures.
  2. Age ≥ 18 years.
  3. Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1 (cf. Appendix).
  4. Histologically confirmed NSCLC.
  5. Disease progression after at least one standard therapy and without any approved curative-intended treatment option.
  6. Accessible tumor lesion/metastasis for tumor collection.
  7. Willingness of the patient to undergo a surgical intervention (eg, surgical resection and/or biopsy) to collect one or more tumor lesions/metastases.
  8. Adequate organ function (pulmonary, cardiovascular, hematological, hepatic, and renal function) per investigator's judgment. Cardiac stress testing is required for all patients with underlying cardiac conditions and patients with age ≥ 50 years.
  9. Negative serum pregnancy test in women of childbearing potential, in peri-menopausal women and in women with less than 2 years of menopause.
Exclusion Criteria
  1. Active central nervous system (CNS) metastases. Patients with stable CNS metastases ≥ 1 month after definitive treatment (eg, surgery and/or radiotherapy) are eligible.
  2. Participants with an active second malignancy.
  3. Evidence of significant, uncontrolled concomitant diseases that could affect compliance with the protocol, including autoimmune or immunodeficient conditions, significant pulmonary disease, significant cardiac and/or vascular disease per investigator's judgment.
  4. Prior immune-related adverse events that would preclude re-challenge with an immune checkpoint inhibitor or immunomodulatory agent per investigator's judgment.
  5. Immunosuppressive treatment that would preclude the patient from any of the study therapies per investigator's judgment.
  6. Severe active infections or uncontrolled infectious conditions requiring treatment.
  7. Any other conditions/diseases, allergies, dysfunctions, and/or findings, that would contraindicate the use of any of the study interventions or therapies.
  8. Contraindication for any of the planned measures, interventions and/or treatments.
  9. Pregnant or breastfeeding women, or female subject who are not willing to use an acceptable, highly effective method of contraception until the End-of-Study visit.
  10. Known hypersensitivity to any of study therapies or drugs used for TIL production.
  11. Known human immunodeficiency virus (HIV) infection (or tests positive for HIV 1 or 2 at Screening).
  12. Known hepatitis B or hepatitis C infection.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Tumor-infiltrating lymphocyte product (TIL) transferCombination of TIL Transfer and low dose IL-2Tumor-specific T cells are expanded from excised tumor samples and stimulated in cell culture with interleukin-2 (IL-2). The resulting autologous TILs are then re-infused to the patient after a non-myeloablative lymphodepleting chemotherapy with cyclophosphamide and fludarabine. Activation of TILs in the patient is then supported by IL-2 administration. The transplant product will be produced in the Good Manufacturing Practice (GMP) facility of the University Hospital in Basel.
Primary Outcome Measures
NameTimeMethod
Progression-free rate at 6 months after Tumor-infiltrating lymphocytes transfer.5-7 months after TIL transfer

Progression-free rate (PFR) (RECIST v1.1 / iRECIST) at 6 months after TIL transfer, defined by the Kaplan-Meier estimator for progression-free survival (RECIST v1.1 / iRECIST) at 6 months (+/- 4 weeks as we allow this interval in the tumor assessment at 6 months).

Secondary Outcome Measures
NameTimeMethod
Duration of response (DOR)up to one year after TIL transfer

DOR is defined as the time from the first documented response and the date of the first documented tumor progression, death, or the last tumor assessment that occurred before subsequent therapy. DOR time for responders who have not progressed or died will be censored at the time of last tumor assessment

Frequency of adverse events (number)up to one year after TIL transfer

Frequency of adverse events (number) will be recorded to assess safety of combination of Tumor-infiltrating lymphocytes with IL-2

Incidence of adverse events (%)up to one year after TIL transfer

Incidence of adverse events (%) will be recorded to assess safety of combination of Tumor-infiltrating lymphocytes with IL-2

Objective response rate (ORR)up to one year after TIL transfer

ORR is defined as the proportion of patients with a best overall response of partial response or better (assessed by the local investigators

Severity of adverse events (CTCAE v5.0 criteria)up to one year after TIL transfer

Severity of adverse events (CTCAE v5.0 criteria) will be recorded to assess safety of combination of Tumor-infiltrating lymphocytes with IL-2

CTCAE (Common Terminology Criteria for Adverse Events): Grade 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, 5 = fatal.

Overall survival (OS)up to one year after TIL transfer

OS is defined as the time from registration to the date of death due to any cause

Progression-free survival (PFS)up to one year after TIL transfer

The progression-free survival (PFS) is defined as the time from registration to objective tumor progression (determined by local investigators), or death due to any cause, whichever occurred first. PFS time for patients who have not progressed or died will be censored at the time of the last tumor assessment

Trial Locations

Locations (1)

University Hospital Basel

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Basel, Basel-Stadt, Switzerland

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