B Cell Maturation Antigen（BMCA）-Targeted CAR-T for Refractory/Relapsed Multiple Myeloma

Phase 2

• Conditions: Multiple Myeloma
• Interventions: Biological: CAR-T treatment

• Registration Number: NCT03931421
• Lead Sponsor: First Affiliated Hospital of Zhejiang University

Brief Summary

It's a single arm, open label prospective study, in which the safety and efficacy of B Cell Maturation Antigen（BMCA）-targeted CAR-T thearpy are evaluated in refractory/relapsed multiple myeloma patients.

Detailed Description

In this trial, T cells are seperated from multiple myeloma patients, and engineered into BMCA-targeted CAR-T cells, these cells are then transfused back into the patients to elimimnate the myeloma cells. In this process, the safety and efficacy of this CAR-T treatment are closely monitored.

Study Timeline

• Study First Submitted: 2019-04-25
• Study First Submitted QC: 2019-04-25
• Study First Posted: 2019-04-30
• Status Verified: 2019-06
• Last Update Submitted: 2019-06-01
• Last Update Posted: 2019-06-04
• Study Start: 2019-07-31
• Primary Completion: 2022-11-30
• Study Completion: 2022-12-31

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• 1. Age≥18，male or female;
• 2. ECOG 0-3;
• 3. Clearly diagnosed as multiple myeloma (MM) [according to IMWG 2014 criteria];
• 4. Patients should have received 3 different regimens prior to enrollment (each regimen should last for at least one complete cycle, except for the case of disease progression);
• 5. Previously received one PI and IMiD treatment;
• 6. MM patients should fit one of the following: 1) disease progression; 2) relapsed after CR. The corresponding criteria is defined as follows: a, disease progression should satisfy at least 1 of the following: serum M protein ≥0.5g/dl, or urine M protein>200mg/24h, or FLC increasement >10mg/dl, or bone marrow plasma cell proportion >10%, or with new bone disease/plasmacytoma/original focus increased by 50% or more, or hypercalcemia ( corrected serum calcium level >11.5mg/dL(2.65mmol/L); b. relapse after CR, should satisfy one of the following: ①M protein in urine or blood; ②bone marrow plasma cell proportion≥5%; ③manifestation of disease progression, such as plasmacytoma, osteolytic lesions or hypercalcemia.
• 7. Peripheral blood mononucleated cell separation should be at least 2 weeks from chemo/radiotherapy;
• 8. Neutrophil count≥1000/ul, platelet count≥45000/ul, Hb>60g/l;
• 9. Cardiac, hepatic and renal function: Creatinin <1.5 times of normal maximum；ALT/AST level <2.5 times of the maximum of normal range; total bilirubin<1.5 times of ULN；cardiac ejection fraction≥ 50%; no pericardial effusion within 6 weeks prior to enrollment;
• 10. Being able to understand and willing to sign the written consent;
• 11. Fertile patients should agree to take contraceptive measures during the process of this trial.

Exclusion Criteria

• 1. History of other tumors other than multiple myeloma, except for the following: malignant tumor after radical surgery, and have been inactive for ≥3 years prior to enrollment; skin cancer (not melanoma) after sufficient treatment, no evidence of disease at enrollment;
• 2. History of the following treatment: received targeted therapy, epigenetic therapy or clinical trials, invasive operation within 14 days/5 half-time prior to enrollment. History of monoclonal antibody within 21 days prior to enrollment. History of cytotoxic medicine or proteasome treatment within 14 days prior to enrollment. History of immunomodulatory treatment within 7 days prior to enrollment;
• 3. History of >5mg/d systemic prednisone treatment (or other glucocorticoids of the equivalent dosage) within 2 weeks prior to peripheral mononucleated cell collection;
• 4. With CNS involvement or clinical manifestation of meningeal myeloma;
• 5. With active systemic infection;
• 6. With active HBV infection or HCV infection, or history of type C hepatitis;
• 7. With immunodeficiency, including HIV infection;
• 8. With the following heart condition: NYHA level III or IV congestive heart failure; myocardial infarction or CABG within 6 months prior to enrollment; clinically meaningful ventricular arrythmia, or history of idiopathic syncope (not caused by vascular-vagal disorder or dehydration), history of non-ischemic myopathy;
• 9. With active autoimmune disease;
• 10. History of autologous stem cell transplantation within 6 weeks prior to enrollment;
• 11. History of allogenic stem cell transplantation.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
experiment group	CAR-T treatment	In this arm, patients are treated with B Cell Maturation Antigen (BMCA)-targeted CAR-T cells and the safety and efficacy will be observed.

Primary Outcome Measures

Name	Time	Method
complete remission rate	at the time point 3 months after CAR-T cell transfusion	complete remission rate after treated by CAR-T therapy
incidence and severity of adverse events	from the date of the start of treatment to 36 months after last patient's enrollment	any unfavorable and unintended sign , symptom, or disease temporally associated with the use of a medical treatment or procedure that may or may not be considered related to the medical treatment or procedure; any unfavorable and unintended sign , symptom, or disease temporally associated with the use of a medical treatment or procedure that may or may not be considered related to the medical treatment or procedure; any unfavorable and unintended sign , symptom, or disease temporally associated with the use of a medical treatment or procedure that may or may not be considered related to the medical treatment or procedure

Secondary Outcome Measures

Name	Time	Method
progression free survival	from the day of treatment to the date of first documented progression，up to 36 months after the last patient's enrollment	from date of inclusion to date of progression, relapse, or death from any cause
overall survival	from the day of treatment to the date of first documented progression，up to 36 months after the last patient's enrollment	from the date of inclusion to date of death, irrespective of cause
duration of the CAR-T cells in the patients	from the date of re-transfusison to 36 months after last patient's enrollment	time from re-transfusion to date when the modified T cells become non-detectable

Trial Locations

Locations (1)

The first affiliated hospital of Zhejiang University; 🇨🇳 Hangzhou, Zhejiang, China