A Phase 1 Dose Escalation and Expansion Study of Orca-Q, an Engineered Donor Graft Derived From Mobilized Peripheral Blood, in Recipients Undergoing Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancies
试验速览
- 阶段
- 1 期
- 状态
- 招募中
- 入组人数
- 300
- 试验地点
- 19
- 主要终点
- Primary Graft failure through Day +28 (dose expansion)
研究概览
简要总结
This study will evaluate the safety, tolerability, and efficacy of engineered donor grafts ("OrcaGraft"/"Orca-Q") in participants undergoing allogeneic hematopoietic cell transplant (alloHCT) transplantation for hematologic malignancies.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 12 Years 至 78 Years(Child, Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age at the time of enrollment:
- •For MAC with fully matched donor (Arm A with 8/8 donor and Arm C) and NMA/RIC: Age ≥ 12 and ≤ 78 years
- •For MAC with mismatched donors (Arm A with 7/8 donor and Arm B): Age ≥ 12 and ≤ 65 years
- •Diagnosed acute myeloid, lymphoblastic or mixed phenotype leukemia, or high or very high risk myelodysplastic syndrome (MDS) either in complete remission (CR) or with ≤ 10 percent of blast cells in bone marrow (BM)
- •Indicated for allogeneic hematopoietic stem cell transplant (alloHCT)
- •Matched to a 8/8 or 7/8 related or unrelated donor, or to a related haploidentical donor
- •Estimated glomerular filtration rate (eGFR) > 50 mL/minute (MAC with tacrolimus) or > 30 mL/minute (NMA/RIC or MAC without tacrolimus)
- •Cardiac parameters: Cardiac ejection fraction ≥ 45 percent (MAC) or ≥ 40 percent (NMA/RIC)
- •Diffusing capacity of the lung for carbon monoxide (DLCO) (adjusted for hemoglobin) ≥ 50 percent for MAC or ≥ 40 percent for NMA/RIC
- •Liver function: Total bilirubin < 1.5 times upper limit of normal (ULN) (MAC) or < 3 times ULN (NMA/RIC); alanine transaminase (ALT)/aspartate transaminase (AST) < 3 times ULN (MAC) or < 5 times ULN (NMA/RIC)
- •Participants enrolling on NMA/RIC-alloHCT arms must be deemed unfit for a myeloablative alloHCT per assessment of the principal investigator (PI)
排除标准
- •Prior alloHCT
- •Currently receiving corticosteroids or other immunosuppressive therapy except for approved disease-specific therapy for the patient's underlying hematologic malignancy. Topical corticosteroids or oral systemic corticosteroid doses less than or equal to 10 mg/day are allowed
- •Planned donor lymphocyte infusion (DLI)
- •Planned pharmaceutical in vivo or ex vivo T cell depletion, e.g., post-transplant cyclophosphamide (Cy) or alemtuzumab
- •Positive anti-donor HLA antibodies against a mismatched allele in the selected donor
- •Low performance score: For MAC: Karnofsky Performance Score (KPS) < 70 percent, For NMA/RIC: <60 percent
- •High HCT-specific Comorbidity Index (HCT-CI): For MAC > 4, For NMA/RIC >6
- •Uncontrolled bacterial, viral or fungal infections (currently taking antimicrobial therapy and with progression or no clinical improvement) at time of enrollment
- •Seropositive for human immunodeficiency virus (HIV)-1 or -2, human T-lymphotropic virus (HTLV)-1 or -2 or Hepatitis B surface antigen (HbsAg) or anti-Hepatitis C virus (HCV) antibody (Ab)
- •Any uncontrolled autoimmune disease requiring active immunosuppressive treatment
- •Concurrent malignancies or active disease within 1 year, except non-melanoma skin cancers that have been curatively resected. Patients with concurrent indolent hematologic malignancies that do not require active treatment and are under active surveillance only (such as CLL, low-grade lymphomas, smoldering MM, MZL) may be included with the approval of Medical Monitor
- •History of idiopathic or secondary myelofibrosis
- •Women who are pregnant or breastfeeding
研究组 & 干预措施
Arm B
Recipients with haploidentical-related donors undergoing MAC; with single- or dual-agent GVHD prophylaxis given
干预措施: OrcaGraft (Orca-Q) (Biological)
Arm C
Recipients with an HLA-identical related or unrelated donor undergoing MAC; no GVHD prophylaxis given
干预措施: OrcaGraft (Orca-Q) (Biological)
Arm D
Recipients with an HLA-identical related or unrelated donor undergoing non-myeloablative (NMA)/reduced intensity conditioning (RIC); with dual agent GVHD prophylaxis given
干预措施: OrcaGraft (Orca-Q) (Biological)
Arm E
Recipients with 1-allele mismatched (7/8 alleles) unrelated donor undergoing NMA/RIC; with dual-agent GVHD prophylaxis given
干预措施: OrcaGraft (Orca-Q) (Biological)
Arm F
Recipients with haploidentical-related donors undergoing NMA/RIC; with dual-agent GVHD prophylaxis given
干预措施: OrcaGraft (Orca-Q) (Biological)
Arm A
Recipients with human leukocyte antigen (HLA)-identical related or unrelated or 1-allele mismatched (7/8 alleles) unrelated donor undergoing myeloablative conditioning (MAC); with single- or dual-agent graft-versus-host disease (GVHD) prophylaxis given
干预措施: OrcaGraft (Orca-Q) (Biological)
结局指标
主要结局
Primary Graft failure through Day +28 (dose expansion)
时间窗: 28 Days after administration of Orca-Q/OrcaGraft
Primary graft failure in the dose expansion phase, defined as being alive without recovery of neutrophils during the evaluation period
Dose Limiting Toxicities through Day +28 (dose escalation)
时间窗: 28 Days after administration of Orca-Q/OrcaGraft
Safety and tolerability of Orca-Q (formerly OrcaGraft) in adults undergoing myeloablative allogeneic hematopoietic cell transplantation (MA-alloHCT) will be evaluated by identification of the following dose limiting toxicities: Grade ≥ 3 infusion-related reaction or cytokine release syndrome, Grade ≥ 3 acute GVHD, Any Grade ≥ 3 treatment-related non-hematologic event not clearly related to the underlying malignancy, intercurrent infection, the HCT conditioning regimen, or other pre-existing medical condition
Primary Graft failure through Day +28 (dose expansion)
时间窗: 28 Days after administration of Orca-Q/OrcaGraft
Primary graft failure in the dose expansion phase, defined as being alive without recovery of neutrophils during the evaluation period
次要结局
- Neutrophil Engraftment through Day +28(28 days after administration of Orca-Q/OrcaGraft)
- Platelet Engraftment through Day +50(50 days after administration of Orca-Q/OrcaGraft)
- Secondary Graft Failure through Day +100(100 days after administration of Orca-Q/OrcaGraft)
- Acute GVHD through Day +100(100 days after administration of Orca-Q/OrcaGraft)
- Chronic GVHD through Day +365(365 days after administration of Orca-Q/OrcaGraft)
- Incidence of Non-relapse Mortality (NRM) through Day +365(365 days after administration of Orca-Q/OrcaGraft)
- Incidence of Disease Relapse through Day +365(365 days after administration of Orca-Q/OrcaGraft)
- GVHD-free and Relapse-free Survival (GRFS) through Day +365(365 days after administration of Orca-Q/OrcaGraft)
- Disease-free Survival (DFS) through Day +365(365 days after administration of Orca-Q/OrcaGraft)
- Overall Survival through Day +365(365 days after administration of Orca-Q/OrcaGraft)
- Neutrophil Engraftment through Day +28(28 days after administration of Orca-Q/OrcaGraft)
- Acute GVHD through Day +100(100 days after administration of Orca-Q/OrcaGraft)
- Chronic GVHD through Day +365(365 days after administration of Orca-Q/OrcaGraft)
