Description:
Chimeric antigen receptor (CAR)-modified T cells can mediate long-term durable remissions in
recurrent or refractory CD19+ B cell malignancies, and are a promising therapy to treat
glioblastoma, which is the most dangerous and aggressive form of brain cancer. EGFRvIII
mutation (epidermal growth factor receptor variant III, EGFRvIII) is the results of tumor
specific gene rearrangement naturally happened in about 30% of glioblastoma patients and
produces a mutated protein with neo-antigen that is tumor specific and is not expressed in
normal human tissues. Therefore, EGFRvIII is an attractive target for CAR T cell therapy. We
have constructed a lentiviral vector that contains a chimeric antigen receptor that
recognizes the EGFRvIII tumor antigen. A truncated EGFR (tEGFR) which lacks of the ligand
binding domain and cytoplasmic kinase domain of wildtype EGFR is incorporated into the CAR
vector and is used for in vivo tracking and ablation of CAR T cells in necessary. This pilot
study is to determine the safety and efficacy of autologous anti-EGFRvIII CAR T cells in
patients with recurrent glioblastoma.
Title
- Brief Title: Pilot Study of Autologous Anti-EGFRvIII CAR T Cells in Recurrent Glioblastoma Multiforme
- Official Title: A Safety and Efficacy Study of Autologous Chimeric Antigen Receptor Engineered T Cells Redirected to EGFRvIII in Patients With Recurrent Glioblastoma Multiforme
Clinical Trial IDs
- ORG STUDY ID:
SBNK-2016-015-01
- NCT ID:
NCT02844062
Conditions
Interventions
Drug | Synonyms | Arms |
---|
anti-EGFRvIII CAR T cells | | anti-EGFRvIII CAR T cells |
cyclophosphamide | | anti-EGFRvIII CAR T cells |
Fludarabine | | anti-EGFRvIII CAR T cells |
Purpose
Chimeric antigen receptor (CAR)-modified T cells can mediate long-term durable remissions in
recurrent or refractory CD19+ B cell malignancies, and are a promising therapy to treat
glioblastoma, which is the most dangerous and aggressive form of brain cancer. EGFRvIII
mutation (epidermal growth factor receptor variant III, EGFRvIII) is the results of tumor
specific gene rearrangement naturally happened in about 30% of glioblastoma patients and
produces a mutated protein with neo-antigen that is tumor specific and is not expressed in
normal human tissues. Therefore, EGFRvIII is an attractive target for CAR T cell therapy. We
have constructed a lentiviral vector that contains a chimeric antigen receptor that
recognizes the EGFRvIII tumor antigen. A truncated EGFR (tEGFR) which lacks of the ligand
binding domain and cytoplasmic kinase domain of wildtype EGFR is incorporated into the CAR
vector and is used for in vivo tracking and ablation of CAR T cells in necessary. This pilot
study is to determine the safety and efficacy of autologous anti-EGFRvIII CAR T cells in
patients with recurrent glioblastoma.
Trial Arms
Name | Type | Description | Interventions |
---|
anti-EGFRvIII CAR T cells | Experimental | Patients will receive lymphodepletion chemotherapy consisting of fludarabine and cyclophosphamide, followed by intravenous infusion of autologous anti-EGFRvIII CAR T cells. A standard 3+3 escalation approach will be used to obtain the safe dosage of CAR T cells. The tested CAR T cell dosage ranges from 5×10^4 /kg to 1×10^7 /kg | - anti-EGFRvIII CAR T cells
- cyclophosphamide
- Fludarabine
|
Eligibility Criteria
Inclusion Criteria:
1. abilities to understand and the willingness to provide written informed consent;
2. patients are ≥ 18 and ≤ 70 years old;
3. recurrent glioblastoma patients with measurable tumors. Patients have received
standard care of medication, such as Gross Total Resection with concurrent
Radio-chemotherapy (~54 - 60 Gy, TMZ). Patients must either not be receiving
dexamethasone or receiving ≤ 4 mg/day at the time of leukopheresis;
4. Malignant cells are EGFRvIII positive confirmed by IHC, quantitative PCR or
sequencing;
5. karnofsky performance score (KPS) ≥ 60;
6. life expectancy >3 months;
7. satisfactory bone marrow, liver and kidney functions as defined by the following:
absolute neutrophile count ≥ 1500/mm^3; hemoglobin > 10 g/dL; platelets > 100000
/mm^3; Bilirubin < 1.5×ULN; alanine aminotransferase (ALT) or aspartate
aminotransferase (AST) < 2.5×ULN; creatinine < 1.5×ULN;
8. peripheral blood absolute lymphocyte count must be above 0.8×10^9/L;
9. satisfactory heart functions;
10. patients must be willing to follow the orders of doctors;
11. women of reproductive potential (between 15 and 49 years old) must have a negative
pregnancy test within 7 days of study start. Male and female patients of reproductive
potential must agree to use birth control during the study and 3 months post study.
Exclusion Criteria:
1. a prior history of gliadel implantation 4 weeks before this study start or antibody
based therapies;
2. HIV positive;
3. hepatitis B infection or hepatitis C infection;
4. history of autoimmune disease, or other diseases require long-term administration of
steroids or immunosuppressive therapies;
5. history of allergic disease, or allergy to CAR T cells or study product excipients;
6. patients already enrolled in other clinical study;
7. patients, in the opinion of investigators, may not be eligible or not able to comply
with the study.
Maximum Eligible Age: | 70 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Safety of infusion of autologous anti-EGFRvIII CAR T cells with cyclophosphamide and fludarabine as lymphodepleting chemotherapy in patients with recurrent glioblastoma using the NCI CTCAE V4.0 criteria. |
Time Frame: | 2 years |
Safety Issue: | |
Description: | incidents of treatment related adverse events as assessed by CTCAE V4.0. |
Secondary Outcome Measures
Measure: | Treatment Responses Rate |
Time Frame: | 4 weeks |
Safety Issue: | |
Description: | defined as the proportion of patients who achieved complete remission (CR), partial remission (PR), stable disease (SD), or progressive disease (PD). |
Measure: | Overall Survival Rate |
Time Frame: | 2 years |
Safety Issue: | |
Description: | |
Measure: | Progression-free Survival Rate |
Time Frame: | 2 years |
Safety Issue: | |
Description: | |
Measure: | Persistence of CAR T cells in patients |
Time Frame: | 2 years |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Unknown status |
Lead Sponsor: | Beijing Sanbo Brain Hospital |
Last Updated
July 26, 2016