Safety and Clinical Activity of QEL-001 in A2-mismatch Liver Transplant Patients

Phase 1

Recruiting

• Conditions: Liver Failure; Rejection; Transplant, Liver; Liver Diseases
• Interventions: Drug: QEL-001

• Registration Number: NCT05234190
• Lead Sponsor: Quell Therapeutics Limited

Brief Summary

The purpose of this study is to evaluate the safety and tolerability of QEL-001 in the prevention of liver transplant rejection following immunosuppression withdrawal. QEL-001 is a product made from a patients own cells, which are genetically modified and designed to help the transplant recipient's body accept their donated liver and prevent their immune system from rejecting it once immune suppression is withdrawn.

Detailed Description

This study is a multicenter, first-in-human, open-label, single-arm study of an autologous CAR T regulatory (CAR-Treg) in HLA-A2 mismatched liver transplant recipients. The aim is for the CAR-Tregs to be activated on recognition of HLA-A2 antigens present on the donated liver and subsequently induce and maintain immunological tolerance to the organ.

Study Timeline

• Study Start: 2022-01-21
• Study First Submitted: 2022-02-01
• Study First Submitted QC: 2022-02-01
• Study First Posted: 2022-02-10
• Status Verified: 2024-04
• Last Update Submitted: 2024-04-22
• Last Update Posted: 2024-04-23
• Primary Completion: 2025-09
• Study Completion: 2040-03

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 33

Inclusion Criteria

• Written informed consent.
• Subject who are HLA A2/A28 negative who have received HLA A2-mismatch liver transplant 12 months to 5 years prior to study entry.
• Able and willing to use contraception.
• Be on stable maintenance of immunosuppression for at least 12 weeks prior to study entry.

Exclusion Criteria

• Severe cardiac, respiratory disease or any other major organ dysfunction.

• Subjects with prior non-liver solid organ or hematopoietic stem cell transplant.

• Known hypersensitivity to study medication ingredients, protocol defined immunosuppressive medications, or a significant allergic reaction to any drug.

• Positive serology for human immunodeficiency virus (HIV), active or latent tuberculosis (TB) or other clinically active local or systemic infection.

• Use of investigational agents within 3 months of screening.

• Subjects with history of autoimmune disease requiring use of immunosuppression or biologics within 24 months prior to study entry.

• Subject with history of malignancy in the past 5 years.

• Medical or social condition that is not compatible with adequate study follow-up and any other reason that, in the opinion of the Site Investigator or Medical Monitor, would render the subject unsuitable for participation in the study.

• Protocol defined laboratory value for the following parameters:

  • Alanine aminotransferase (ALT) and either alkaline phosphatase (ALP) or gamma-glutamyl transferase (GGT),
  • Kidney function e.g. eGFR,
  • White blood cells,
  • Hemoglobin,
  • Platelets.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Treatment group	QEL-001	-

Primary Outcome Measures

Name	Time	Method
Safety and Tolerability	28 Days post infusion	Incidence of protocol defined Dose Limiting Toxicities (DLTs).
Long-term safety	Day of infusion through to Week 82 and up to 15 years post infusion	Incidence and grade of treatment-emergent adverse events (TEAEs), including serious adverse events (SAEs) according to CTCAE V5.0.

Secondary Outcome Measures

Name	Time	Method
Tolerance related outcome	1 year following immune suppression withdrawal	Ability to achieve operational tolerance as measured by the proportion of subjects meeting the clinical, biochemical and histological operational tolerance criteria at one year following IS withdrawal.
Immunosuppression related outcome	2 months and 1 year post withdrawal of immune suppression	Ability to withdraw immunosuppression (IS) as measured by the percentage of subjects who have stable Liver Function Tests and are IS free at two months and at one year following IS withdrawal.
Composite efficacy failure outcome	1 year following immune suppression withdrawal	Proportion of subjects with composite event: acute rejection (AR), biopsy proven acute rejection (BPAR), reintroduction of IS or graft loss.

Trial Locations

Locations (10)

H. Saint Luc; 🇧🇪 Brussels, Belgium

King's College Hospital NHS Foundation Trust; 🇬🇧 London, United Kingdom

G. Gergorio Maranon; 🇪🇸 Madrid, Spain

Hospital Reina Sofia; 🇪🇸 Córdoba, Spain

H. Clinic Barcelona; 🇪🇸 Barcelona, Spain

Cambridge University Hospitals NHS Foundation Trust; 🇬🇧 Cambridge, United Kingdom

Queen Elizabeth Hospital; 🇬🇧 Birmingham, United Kingdom

Hopital Erasme; 🇧🇪 Brussels, Belgium

UZ Leuven; 🇧🇪 Leuven, Belgium

Royal Free London NHS Foundation Trust; 🇬🇧 London, United Kingdom