Phase I Study of Autologous CAR T-Cells Targeting the CD138 Antigen for Relapsed or Refractory Multiple Myeloma
试验速览
- 阶段
- 1 期
- 状态
- 进行中（未招募）
- 入组人数
- 25
- 试验地点
- 1
- 主要终点
- Proportion of participants with dose limiting toxicities as a measure of maximum tolerated dose of CAR138 T cells
研究概览
简要总结
The body has different ways of fighting infection and disease. No single way seems perfect for fighting cancer. This research study combines two different ways of fighting disease: antibodies and T cells. Antibodies are proteins that protect the body from disease caused by bacteria or toxic substances. Antibodies work by binding those bacteria or substances, which stops them from growing and causing bad effects. T cells, also called T lymphocytes, are special infection-fighting blood cells that can kill other cells, including tumor cells or cells that are infected. Both antibodies and T cells have been used to treat subjects with cancers. They both have shown promise, but neither alone has been sufficient to cure most subjects. This study is designed to combine both T cells and antibodies to create a more effective treatment. The treatment that is being researched is called autologous T lymphocyte chimeric antigen receptor cells targeted against the CD138 antigen (CAR138 T cells).
In previous studies, it has been shown that a new gene can be put into T cells that will increase their ability to recognize and kill cancer cells. A gene is a unit of DNA. Genes make up the chemical structure carrying the subject's genetic information that may determine human characteristics (i.e., eye color, height and sex). The new gene that is put in the T cells in this study makes a piece of an antibody called anti-CD138. This antibody floats around in the blood and can detect and stick to cancer cells called multiple myeloma cells because they have a substance on the outside of the cells called CD138. Anti-CD138 antibodies have been used to treat people with multiple myeloma, but have not been strong enough to cure most subjects. For this study, the anti-CD138 antibody has been changed so that instead of floating free in the blood part of it is now joined to the T cells. Only the part of the antibody that sticks to the multiple myeloma cells is attached to the T cells instead of the entire antibody. When an antibody is joined to a T cell in this way it is called a chimeric receptor. These CD138 chimeric (combination) receptor-activated T cells seem to kill some of the tumor, but they do not last very long in the body and so their chances of fighting the cancer are unknown.
详细描述
Cell Procurement Up to 300 mL total of peripheral blood (up to 3 collections) will be obtained from subjects for cell procurement. In subjects with a low CD3 count in the peripheral blood (less than 200/μl by flow cytometry), a leukopheresis may be performed to isolate sufficient T-cells. The parameters for pheresis will be 2 blood volumes.
CAR138 T-cell Administration Autologous CAR138 T-cells will be administered 2-14 days following lymphodepletion. The lymphodepletion regimen will consist of Cyclophosphamide 300 mg/m^2 and Fludarabine 30 mg/m^2 IV each given daily over 3 consecutive days.
Duration of Therapy Autologous CAR138 T-cells will be administered 2-14 days following lymphodepletion with cyclophosphamide and fludarabine by a licensed provider (oncology registered nurse or physician) via intravenous injection over 5-10 minutes through either a peripheral or central line. The expected volume is 1-50cc.
Treatment with one infusion will be administered unless:
- The subject decides to withdraw from the study, OR
- General or specific changes in the subject's condition render the subject unacceptable for further treatment in the judgment of the investigator.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
研究组 & 干预措施
CAR138 T cells
The first 3 subjects enrolled in the study will receive 5x10^6 CAR138 T-cells/m^2 via infusion. The number of cells for the infusion will be increased to 1x10^7 CAR138 T-cells/m^2 and then, 2.5x10^7 CAR138 T-cells/m^2, 5x10^7 CAR138 T-cells/m^2, 1x10^8 CAR138 T-cells/m^2 and 2x10^8 CAR138 T-cells/m^2 in subsequent cohorts of 3 subjects provided no dose limiting toxicities (DLTs) are observed within 4 weeks of the cell infusion. Cohort enrollment will be staggered, requiring each subject to complete at least 2 weeks of safety monitoring following CAR138 T-cell infusion at the designated dose level for the cohort before another subject is allowed to enroll in the cohort.
干预措施: CAR138 T Cells (Drug)
结局指标
主要结局
Proportion of participants with dose limiting toxicities as a measure of maximum tolerated dose of CAR138 T cells
时间窗: 4 weeks from infusion of the CAR138 T cells
The maximum tolerated dose will be determined through assessment of dose limiting toxicity (DLT) experienced during the safety evaluation period. Severity and categorization of adverse events will be determined in accordance with the National Cancer Institute's Common Terminology for Adverse Events (CTCAE, version 5.0). A DLT is defined as any of the following that may, after consultation with the FDA, be considered possibly, probably, or definitely related to the study cellular products: Grade 3 and 4 cytokine release syndrome (CRS) that persists beyond 72 hours, or any Grade 5 CRS event; Grade 4 neutropenia or thrombocytopenia lasting more than 28 days from the time of CAR138 T-cell infusion. Any other ≥ Grade 3 non- hematologic toxicity (exceptions include: alopecia; grade 3 electrolyte abnormalities, hyperglycemia, diarrhea, or nausea and vomiting that can be managed with supportive care and do not persist as Grade 3 toxicities for \> 72 hours)).
次要结局
- Overall response rate (ORR) as defined as the percentage of subjects achieving a confirmed partial response or better based on the International Myeloma Working Group (IMWG) response criteria.(15 years)
- Survival of CAR138 T cells in vivo as assessed by PCR and flow cytometry(15 years)
- Overall survival after infusion of CAR138 T cells(15 years)
- Progression free survival after infusion of CAR138 T cells(15 years)