Clinical Trials /

T Cells Expressing a Fully-Human Anti-CD30 Chimeric Antigen Receptor for Treating CD30-Expressing Lymphomas

NCT03049449

Description:

Background: - Improved treatments for a variety of treatment-resistant, CD30-expressing malignancies including Hodgkin lymphoma, anaplastic large cell lymphoma, and other CD30- expressing lymphomas are needed. - T cells can be genetically modified to express chimeric antigen receptors (CARs) that specifically target malignancy-associated antigens. - Autologous T cells genetically modified to express CARs targeting the B-cell antigen CD19 have caused complete remissions in a small number of patients with lymphoma. These results demonstrate that CAR-expressing T cells can have anti-lymphoma activity in humans. - CD30 expression can be easily detected by immunohistochemistry on lymphoma cells, which allows selection of CD30-expressing malignancies for treatment. - CD30 is not known to be expressed by normal cells except for a small number of activated lymphocytes. - We have constructed a novel fully-human anti-CD30 CAR that can specifically recognize CD30-expressing target cells in vitro and eradicate CD30-expressing tumors in mice. - This particular CAR has not been tested before in humans. - Possible toxicities include cytokine-associated toxicities such as fever, hypotension, and neurological toxicities. Elimination of a small number of normal activated lymphocytes is possible, and unknown toxicities are also possible. Objectives: Primary -Determine the safety and feasibility of administering T-cells expressing a novel fullyhuman anti-CD30 CAR to patients with advanced CD30-expresssing lymphomas. Eligibility: - Patients must have Hodgkin lymphoma, anaplastic large cell lymphoma, peripheral T-cell lymphoma not otherwise specified, diffuse large B-cell lymphoma not otherwise specified, primary mediastinal B-cell lymphoma, grey zone lymphoma, enteropathyassociated T-cell lymphoma, or extranodal NK/T-cell lymphoma, nasal type - Patients must have malignancy that is both measurable on a CT scan with a largest diameter of at least 1.5 cm and possessing increased metabolic activity detectable by PET scan. Alternatively patients with lymphoma detected by flow cytometry of bone marrow are eligible. - Patients must have a creatinine of 1.4 mg/dL or less and a normal cardiac ejection fraction. - An ECOG performance status of 0-1 is required. - No active infections are allowed including any history of HIV, hepatitis B, or hepatitis C. At the time of protocol enrollment patients must be seronegative for CMV by antibody testing or must have a negative blood CMV PCR. - Absolute neutrophil count greater than or equal to 1000/micro L, platelet count greater than or equal to 45,000/micro L, hemoglobin greater than or equal to 8g/dL - Serum ALT and AST less or equal to 3 times the upper limit of the institutional normal unless liver involvement by malignancy is demonstrated. - At least 14 days must elapse between the time of any prior systemic treatment (including corticosteroids) and initiation of protocol enrollment. - Clear CD30 expression must be detected on 75% or more of malignant cells from either bone marrow or lymphoma mass by flow cytometry or immunohistochemistry. The patient s malignancy will need to be assessed for CD30 expression by flow cytometry or immunohistochemistry performed at the NIH. If unstained, paraffin-embedded bone marrow or lymphoma sections are available from prior biopsies, these can be used to determine CD30 expression by immunohistochemistry; otherwise, patients will need to come to the NIH for a biopsy to determine CD30 expression. The sample for CD30 expression can come from a biopsy obtained at any time before enrollment, unless the patient has received a prior anti-CD30 monoclonal antibody, in which case the sample must come from a biopsy following completion of the most recent anti-CD30 monoclonal antibody treatment. - Eligible patients with Hodgkin lymphoma must fulfill one of the following criteria: 1) have received two prior therapies, one of which must be an autologous stem cell transplant, or 2) have received three prior lines of therapy. Eligible patients with any of the listed peripheral T cell lymphomas or non-Hodgkin lymphomas must have received two lines of prior therapy, at least one of which must contain cytotoxic chemotherapyPatients with diffuse large B-cell lymphoma or primary mediastinal B-cell lymphoma must have received 2 prior treatment regimens at least 1 of which included an anthracycline and an anti-CD20 monoclonal antibody. - Patients who have never had an allogeneic hematopoietic stem cell transplant as well as patients who have had an HLA-matched sibling or a 8/8 HLA-matched unrelated donor or 8/8-matched related (not HLA-identical) hematopoietic stem cell transplant are potentially eligible. - Women who are pregnant or plan to become pregnant will be excluded. Design...

Related Conditions:
  • Anaplastic Large Cell Lymphoma
  • Diffuse Large B-Cell Lymphoma, Not Otherwise Specified
  • Enteropathy-Associated T-Cell Lymphoma
  • Hodgkin Lymphoma
  • Mature T-Cell and NK-Cell Lymphoma/Leukemia
  • Mediastinal Large B-Cell Lymphoma
  • Peripheral T-Cell Lymphoma, NOS
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: T Cells Expressing a Fully-Human Anti-CD30 Chimeric Antigen Receptor for Treating CD30-Expressing Lymphomas
  • Official Title: T Cells Expressing a Fully-Human Anti-CD30 Chimeric Antigen Receptor for Treating CD30-Expressing Lymphomas

Clinical Trial IDs

  • ORG STUDY ID: 170048
  • SECONDARY ID: 17-C-0048
  • NCT ID: NCT03049449

Conditions

  • Lymphoma, Large-Cell, Anaplasitc
  • Hodgkin Disease
  • Lymphoma, Hodgkins
  • Enteropathy-Associated T-Cell Lymphoma
  • Lymphoma, Extranodal NK-T-Cell

Interventions

DrugSynonymsArms
Anti-CD30-CAR T cells1
Cyclophosphamide1
Fludarabine1

Purpose

Background: - Improved treatments for a variety of treatment-resistant, CD30-expressing malignancies including Hodgkin lymphoma, anaplastic large cell lymphoma, and other CD30- expressing lymphomas are needed. - T cells can be genetically modified to express chimeric antigen receptors (CARs) that specifically target malignancy-associated antigens. - Autologous T cells genetically modified to express CARs targeting the B-cell antigen CD19 have caused complete remissions in a small number of patients with lymphoma. These results demonstrate that CAR-expressing T cells can have anti-lymphoma activity in humans. - CD30 expression can be easily detected by immunohistochemistry on lymphoma cells, which allows selection of CD30-expressing malignancies for treatment. - CD30 is not known to be expressed by normal cells except for a small number of activated lymphocytes. - We have constructed a novel fully-human anti-CD30 CAR that can specifically recognize CD30-expressing target cells in vitro and eradicate CD30-expressing tumors in mice. - This particular CAR has not been tested before in humans. - Possible toxicities include cytokine-associated toxicities such as fever, hypotension, and neurological toxicities. Elimination of a small number of normal activated lymphocytes is possible, and unknown toxicities are also possible. Objectives: Primary -Determine the safety and feasibility of administering T-cells expressing a novel fullyhuman anti-CD30 CAR to patients with advanced CD30-expresssing lymphomas. Eligibility: - Patients must have Hodgkin lymphoma, anaplastic large cell lymphoma, peripheral T-cell lymphoma not otherwise specified, diffuse large B-cell lymphoma not otherwise specified, primary mediastinal B-cell lymphoma, grey zone lymphoma, enteropathyassociated T-cell lymphoma, or extranodal NK/T-cell lymphoma, nasal type - Patients must have malignancy that is both measurable on a CT scan with a largest diameter of at least 1.5 cm and possessing increased metabolic activity detectable by PET scan. Alternatively patients with lymphoma detected by flow cytometry of bone marrow are eligible. - Patients must have a creatinine of 1.4 mg/dL or less and a normal cardiac ejection fraction. - An ECOG performance status of 0-1 is required. - No active infections are allowed including any history of HIV, hepatitis B, or hepatitis C. At the time of protocol enrollment patients must be seronegative for CMV by antibody testing or must have a negative blood CMV PCR. - Absolute neutrophil count greater than or equal to 1000/micro L, platelet count greater than or equal to 45,000/micro L, hemoglobin greater than or equal to 8g/dL - Serum ALT and AST less or equal to 3 times the upper limit of the institutional normal unless liver involvement by malignancy is demonstrated. - At least 14 days must elapse between the time of any prior systemic treatment (including corticosteroids) and initiation of protocol enrollment. - Clear CD30 expression must be detected on 75% or more of malignant cells from either bone marrow or lymphoma mass by flow cytometry or immunohistochemistry. The patient s malignancy will need to be assessed for CD30 expression by flow cytometry or immunohistochemistry performed at the NIH. If unstained, paraffin-embedded bone marrow or lymphoma sections are available from prior biopsies, these can be used to determine CD30 expression by immunohistochemistry; otherwise, patients will need to come to the NIH for a biopsy to determine CD30 expression. The sample for CD30 expression can come from a biopsy obtained at any time before enrollment, unless the patient has received a prior anti-CD30 monoclonal antibody, in which case the sample must come from a biopsy following completion of the most recent anti-CD30 monoclonal antibody treatment. - Eligible patients with Hodgkin lymphoma must fulfill one of the following criteria: 1) have received two prior therapies, one of which must be an autologous stem cell transplant, or 2) have received three prior lines of therapy. Eligible patients with any of the listed peripheral T cell lymphomas or non-Hodgkin lymphomas must have received two lines of prior therapy, at least one of which must contain cytotoxic chemotherapyPatients with diffuse large B-cell lymphoma or primary mediastinal B-cell lymphoma must have received 2 prior treatment regimens at least 1 of which included an anthracycline and an anti-CD20 monoclonal antibody. - Patients who have never had an allogeneic hematopoietic stem cell transplant as well as patients who have had an HLA-matched sibling or a 8/8 HLA-matched unrelated donor or 8/8-matched related (not HLA-identical) hematopoietic stem cell transplant are potentially eligible. - Women who are pregnant or plan to become pregnant will be excluded. Design...

Detailed Description

      Background:

        -  Improved treatments for a variety of treatment-resistant, CD30-expressing malignancies
           including Hodgkin lymphoma, anaplastic large cell lymphoma, and other CD30- expressing
           lymphomas are needed.

        -  T cells can be genetically modified to express chimeric antigen receptors (CARs) that
           specifically target malignancy-associated antigens.

        -  Autologous T cells genetically modified to express CARs targeting the B-cell antigen
           CD19 have caused complete remissions in a small number of patients with lymphoma. These
           results demonstrate that CAR-expressing T cells can have anti-lymphoma activity in
           humans.

        -  CD30 expression can be easily detected by immunohistochemistry on lymphoma cells, which
           allows selection of CD30-expressing malignancies for treatment.

        -  CD30 is not known to be expressed by normal cells except for a small number of activated
           lymphocytes.

        -  We have constructed a novel fully-human anti-CD30 CAR that can specifically recognize
           CD30-expressing target cells in vitro and eradicate CD30-expressing tumors in mice.

        -  This particular CAR has not been tested before in humans.

        -  Possible toxicities include cytokine-associated toxicities such as fever, hypotension,
           and neurological toxicities. Elimination of a small number of normal activated
           lymphocytes is possible, and unknown toxicities are also possible.

      Objectives:

      Primary

      -Determine the safety and feasibility of administering T-cells expressing a novel fullyhuman
      anti-CD30 CAR to patients with advanced CD30-expresssing lymphomas.

      Eligibility:

        -  Patients must have Hodgkin lymphoma, anaplastic large cell lymphoma, peripheral T-cell
           lymphoma not otherwise specified, diffuse large B-cell lymphoma not otherwise specified,
           primary mediastinal B-cell lymphoma, grey zone lymphoma, enteropathyassociated T-cell
           lymphoma, or extranodal NK/T-cell lymphoma, nasal type

        -  Patients must have malignancy that is both measurable on a CT scan with a largest
           diameter of at least 1.5 cm and possessing increased metabolic activity detectable by
           PET scan. Alternatively patients with lymphoma detected by flow cytometry of bone marrow

      are eligible.

        -  Patients must have a creatinine of 1.4 mg/dL or less and a normal cardiac ejection
           fraction.

        -  An ECOG performance status of 0-1 is required.

        -  No active infections are allowed including any history of HIV, hepatitis B, or hepatitis
           C. At the time of protocol enrollment patients must be seronegative for CMV by antibody
           testing or must have a negative blood CMV PCR.

        -  Absolute neutrophil count greater than or equal to 1000/micro L, platelet count greater
           than or equal to 45,000/micro L, hemoglobin greater than or equal to 8g/dL

        -  Serum ALT and AST less or equal to 3 times the upper limit of the institutional normal
           unless liver involvement by malignancy is demonstrated.

        -  At least 14 days must elapse between the time of any prior systemic treatment (including
           corticosteroids) and initiation of protocol enrollment.

        -  Clear CD30 expression must be detected on 75% or more of malignant cells from either
           bone marrow or lymphoma mass by flow cytometry or immunohistochemistry. The patient s
           malignancy will need to be assessed for CD30 expression by flow cytometry or
           immunohistochemistry performed at the NIH. If unstained, paraffin-embedded bone marrow
           or lymphoma sections are available from prior biopsies, these can be used to determine
           CD30 expression by immunohistochemistry; otherwise, patients will need to come to the
           NIH for a biopsy to determine CD30 expression. The sample for CD30 expression can come
           from a biopsy obtained at any time before enrollment, unless the patient has received a
           prior anti-CD30 monoclonal antibody, in which case the sample must come from a biopsy
           following completion of the most recent anti-CD30 monoclonal antibody treatment.

        -  Eligible patients with Hodgkin lymphoma must fulfill one of the following criteria: 1)
           have received two prior therapies, one of which must be an autologous stem cell
           transplant, or 2) have received three prior lines of therapy. Eligible patients with any
           of the listed peripheral T cell lymphomas or non-Hodgkin lymphomas must have received
           two lines of prior therapy, at least one of which must contain cytotoxic

      chemotherapyPatients with diffuse large B-cell lymphoma or primary mediastinal B-cell
      lymphoma must have received 2 prior treatment regimens at least 1 of which included an
      anthracycline and an anti-CD20 monoclonal antibody.

        -  Patients who have never had an allogeneic hematopoietic stem cell transplant as well as
           patients who have had an HLA-matched sibling or a 8/8 HLA-matched unrelated donor or
           8/8-matched related (not HLA-identical) hematopoietic stem cell transplant are
           potentially eligible.

        -  Women who are pregnant or plan to become pregnant will be excluded.

      Design:

        -  This is a phase I dose-escalation trial.

        -  Patients will undergo leukapheresis.

        -  T cells obtained by leukapheresis will be genetically modified to express an anti-CD30
           CAR.

        -  Patients will receive a lymphocyte-depleting chemotherapy conditioning regimen with the
           intent of enhancing the activity of the infused anti-CD30 CAR-expressing T cells.

        -  A chemotherapy conditioning regimen of cyclophosphamide and fludarabine will be
           administered prior to all CAR T-Cell infusions. Fludarabine will be given on the same
           days as the cyclophosphamide.

        -  Two days after the chemotherapy ends, patients will receive an infusion of
           anti-CD30-CAR-expressing T cells.

        -  The initial dose level of this dose-escalation trial will be 0.3x10(6) CAR+ T cells/kg
           of recipient bodyweight for Cohort 1. The initial dose level will be 1 x 10 (6) CAR+T
           cells/kg for Cohort 2.

        -  The cell dose administered will be escalated until a maximum tolerated dose is
           determined.

        -  Following the T-cell infusion, there is a mandatory 9-day inpatient hospitalization to
           monitor for toxicity.

        -  Outpatient follow-up is planned for 2 weeks and 1, 2, 3, 4, 6, 9, and 12 months after
           the CAR T-cell infusion. Long-term gene-therapy follow-up consisting of yearly visits to
           a doctor near the patient s home for 4 more years and then yearly telephone contact for
           10 additional years will be required.

        -  As of Amendment E, repeat treatments consisting of the conditioning chemotherapy
           followed by a CAR T-cell infusion at the MTD for the patient s cohort are allowed for
           eligible patients with any best responses except continuing complete remission or
           progressive malignancy.

        -  Re-enrollment will be allowed for a small number of subjects.
    

Trial Arms

NameTypeDescriptionInterventions
1ExperimentalAll patients will be receiving starting dose: 0.3x106 CAR+ T cells/kg (weight based dosing)(up to a maximum dose of 18x106 CAR+ T cells /kg)infuse on day 0 and Cyclophosphamide: 300 mg/m2 IV infusion over 30 minutes on days -5, -4 and -3 and Fludarabine: 30 mg /m2 IV infusion over 30 minutes administered immediately following the cyclophosphamid on days -5, -4,and -3
  • Anti-CD30-CAR T cells
  • Cyclophosphamide
  • Fludarabine

Eligibility Criteria

        -  INCLUSION CRITERIA:

        Malignancy Criteria:

          -  Patients must have Hodgkin lymphoma, anaplastic large cell lymphoma, peripheral T-cell
             lymphoma not otherwise specified, diffuse large B-cell lymphoma not otherwise
             specified, primary mediastinal B-cell lymphoma, grey zone lymphoma,
             enteropathy-associated T-cell lymphoma, or extranodal NK/T-cell lymphoma, nasal type

          -  Clear CD30 expression must be detected on 75% or more of malignant cells from either
             bone marrow or lymphoma mass by flow cytometry or immunohistochemistry. The patient s
             malignancy will need to be assessed for CD30 expression by flow cytometry or
             immunohistochemistry performed at the NIH. If unstained, paraffin-embedded bone marrow
             or lymphoma sections are available from prior biopsies, these can be used to determine
             CD30 expression by immunohistochemistry; otherwise, patients will need to come to the
             NIH for a biopsy to determine CD30 expression. The sample for CD30 expression can come
             from a biopsy obtained at any time before enrollment, unless the patient has received
             a prior anti-CD30 monoclonal antibody, in which case the sample must come from a
             biopsy following completion of the most recent anti-CD30 monoclonal antibody
             treatment.

          -  Eligible patients with Hodgkin lymphoma must fulfill one of the following criteria: 1)
             have received two prior therapies, one of which must be an autologous stem cell
             transplant, or 2) have received three prior lines of therapy. Eligible patients with
             any of the listed peripheral T- cell lymphomas or non-Hodgkin lymphomas must have
             received two lines of prior therapy, at least one of which must contain cytotoxic
             chemotherapy. Patients with diffuse large B-cell lymphoma or primary mediastinal
             B-cell lymphoma must have received 2 prior treatment regimens at least 1 of which
             included an anthracycline and an anti-CD20 monoclonal antibody.

          -  Patients must have measurable malignancy as defined by at least one of the criteria
             below.

          -  Lymphoma mass that is measurable (minimum 1.5 cm in largest diameter) by CT scan is
             required unless bone marrow lymphoma is detectable.

          -  For a lymphoma mass to count as measurable malignancy, it must have abnormally
             increased metabolic activity when assessed by positron emission tomography (PET) scan.

          -  For lymphoma with only bone marrow involvement, no mass is necessary, but if a mass is
             not present, bone marrow malignancy must be detectable by flow cytometry.

        Other Inclusion Criteria:

          -  Greater than or equal to 18 years of age and less than or equal to age 73.

          -  Able to understand and sign the Informed Consent Document.

          -  Clinical performance status of ECOG 0-1

          -  Room air oxygen saturation of 92% or greater

          -  Male patients and must be willing to practice birth control from the time of
             enrollment on this study and for four months following the final CAR T-cell infusion.
             Pre-menopausal patients (female patients who have had a menstrual period within the
             last year) must be willing to practice birth control from the time of enrollment and
             for one year following the final CAR T cell infusion.

          -  Seronegative for HIV antibody. (The experimental treatment being evaluated in this
             protocol depends on an intact immune system. Patients who are HIV seropositive can
             have decreased immune -competence and thus are less responsive to the experimental
             treatment and more susceptible to its toxicities.)

          -  Patients with a known history of hepatitis B or hepatitis C are not eligible due to
             the risk of re-activation of hepatitis after possible immunosuppression due to
             anti-CD30 CAR T-cells and chemotherapy administered on this protocol.

          -  Seronegative for HTLV-1.

          -  Negative for hepatitis B surface antigen. Positive hepatitis B tests can be further
             evaluated by confirmatory tests; and if confirmatory tests are negative, the patient
             can be enrolled. Patients with a known history of hepatitis B are not eligible.

          -  Seronegative for hepatitis C antibody unless antigen negative. If hepatitis C antibody
             test is positive, then patients must be tested for the presence of RNA by RT-PCR and
             be HCV RNA negative. Patients with a known history of hepatitis C are not eligible.

          -  At time of protocol enrollment, the patient should be negative for CMV by antibody
             testing or by PCR. In case of disagreement between these 2 CMV tests, the tests will
             be repeated and Dept. of Laboratory Medicine consulted.

          -  Absolute neutrophil count greater than or equal to 1000/mm3 without the support of
             filgrastim or other growth factors.

          -  Platelet count greater than or equal to 55,000/mm3 without transfusion support

          -  Hemoglobin greater than 8.0 g/dl.

          -  Less than 5% malignant cells in the peripheral blood leukocytes

          -  Serum ALT and AST less or equal to 3 times the upper limit of the institutional normal
             unless liver involvement by malignancy is demonstrated.

          -  Serum creatinine less than or equal to 1.4 mg/dL.

          -  Total bilirubin less than or equal to 2.0 mg/dl.

          -  At least 14 days must have elapsed since any prior systemic therapy prior to apheresis
             and prior to the initiation of chemotherapy (including systemic corticosteroids at any
             dose). Because this protocol requires collection of autologous blood cells by
             leukapheresis in order to prepare CAR T cells, systemic anti-malignancy therapy
             including systemic corticosteroid therapy of any dose is not allowed within 14 days
             prior to the required leukapheresis. NOTE: Because of the long half-life and potential
             to affect CAR T-cells, 30 days must elapse from the time of administration of
             anti-PD-1 or anti-PD-L1 antibodies or other agents that in the opinion of the PI can
             stimulate immune activity and infusion of CAR T-cells.

          -  Normal cardiac ejection fraction (greater than or equal to 50% by echocardiography)
             and no evidence of hemodynamically significant pericardial effusion as determined by
             an echocardiogram within 4 weeks of the start of the treatment protocol.

          -  Patients must not take corticosteroids including prednisone, dexamethasone or any
             other corticosteroid for 14 days before apheresis and CAR T-cell infusion. Patients
             must also not take corticosteroids at doses higher than 5 mg/day of prednisone or
             equivalent at any

        time after the CAR T cell infusion except to treat CAR T-cell toxicity.

          -  Patients must be willing to undergo endotracheal intubation, mechanical ventilation,
             dialysis, CPR, and electrical defibrillation. Patients must be willing to receive
             vasopressor drugs and all other standard intensive care unit interventions. Any living
             will must be amended to allow these interventions or the patient will not eligible.

          -  Patients who have been treated on other protocols of genetically-modified T-cells at
             the NIH only are potentially eligible under these conditions:

               -  At least 6 months have elapsed since the last genetically-modified T-cell therapy
                  that the patient received and there is no evidence of replication-competent
                  retroviruses (evidence must be provided from prior NIH gene-therapy protocol
                  Principal Investigator) and persisting genetically-modified T cells are not
                  detectable in the patient s blood (evidence must be provided by prior NIH
                  gene-therapy protocol Principal Investigator).

        Additional Inclusion Criteria Pertinent Only for Patients with Prior Allogeneic
        Transplantation:

          -  Recipients must have received an HLA-identical sibling allogeneic hematopoietic stem
             cell transplant, or an 8/8-matched (HLA-A, B, C, DR) other-than-sibling related
             donors, or a 8/8-matched (HLA-A, B, C, DR) unrelated donor (URD) allo-HSCT for an
             eligible CD30+ lymphoma

          -  Donor T cell engraftment after allo-HSCT (>90% donor chimerism of the T-cell
             compartment).

          -  Patients must be at least 90 days post-transplant.

          -  Patients must be off all systemic immunosuppressive drugs including corticosteroids at
             any dose for at least 28 days prior to protocol enrollment and must remain off
             immunosuppressive drugs while enrolled on the protocol. Patients must not be taking
             any systemic steroids at all for 14 days prior to apheresis and initiation of
             chemotherapy. Topical corticosteroid preparations applied to the skin such as
             solutions, creams, and ointments are allowed. Inhaled corticosteroids are allowed, and
             corticosteroid eye drops are allowed.

          -  Prior DLIs are not necessary.

          -  Either no evidence of GVHD or minimal clinical evidence of acute GVHD and chronic GVHD
             while off of systemic immunosuppressive therapy for at least 28 days. Minimal clinical
             evidence of acute GVHD defined as grade 0 to I acute GVHD 109 Minimal evidence of
             chronic GVHD is defined as mild global score chronic GVHD (as defined by the 2005 NIH
             consensus project) or no chronic GVHD .107 Subjects with disease that is controlled to
             stage I acute GVHD or to mild global score chronic GVHD with local topical cutaneous
             steroids will be eligible for enrollment.

        EXCLUSION CRITERIA:

          -  Patients that require urgent therapy due to tumor mass effects or spinal cord
             compression.

          -  Patients with lymphoma masses 10.0 cm or larger in longest diameter will not be
             eligible.

          -  Patients that have active hemolytic anemia.

          -  Patients who are currently taking any medications for systemic anticoagulation other
             than aspirin will not be eligible.

          -  Patients with second malignancies in addition to their lymphoma are not eligible if
             the second malignancy has required treatment (including maintenance therapy) within
             the past 4 years or is not in complete remission. There are two exceptions to this
             criterion:

        successfully treated non-metastatic basal cell or squamous cell skin carcinoma.

          -  Women of child-bearing potential who are pregnant or breastfeeding because of the
             potentially dangerous effects of the preparative chemotherapy on the fetus or infant.
             Women of child-bearing potential are defined as all women except women who are
             postmenopausal or who have had a hysterectomy. Postmenopausal will be defined as women
             over the age of 55 who have not had a menstrual period in at least 1 year.

          -  Active uncontrolled systemic infections (defined as infections causing fevers and
             infections requiring intravenous antibiotics when the intravenous antibiotics have
             been administered for less than 72 hours); active coagulation disorders or other major
             uncontrolled medical illnesses of the cardiovascular, respiratory, endocrine, renal,
             gastrointestinal, genitourinary or immune system; history of myocardial infarction;
             history of ventricular tachycardia or ventricular fibrillation; active cardiac
             arrhythmias (Active atrial fibrillation is not allowed, but resolved atrial
             fibrillation is allowed.); active obstructive or restrictive pulmonary disease; or
             active autoimmune diseases such as rheumatoid arthritis.

          -  Patients will not be seen for screening appointments or enrolled on the protocol if
             they have been hospitalized within the 7 days prior to the screening appointment or
             the date of protocol enrollment.

          -  Any form of primary immunodeficiency (such as Severe Combined Immunodeficiency
             Disease).

          -  Systemic corticosteroid therapy of any dose is not allowed within 14 days prior to the
             required leukapheresis, or the initiation of the conditioning chemotherapy regimen.
             Corticosteroid creams, ointments, and eye drops are allowed.

          -  History of severe immediate hypersensitivity reaction to any of the agents used in
             this study.

          -  Patients with current CNS involvement by malignancy (either by imaging or
             cerebrospinal fluid involvement or biopsy-proven).

          -  Patients currently taking anticoagulants.
      
Maximum Eligible Age:73 Years
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Determine the safety and feasibility of administering T cells expressing a novel fully-human anti-CD30 CAR to patients with advanced CD30-expresssing lymphomas.
Time Frame:4-5 weeks after first dose
Safety Issue:
Description:List of adverse event frequency

Secondary Outcome Measures

Measure:Assess the immunogenicity of the CAR used in this protocol
Time Frame:5 years
Safety Issue:
Description:Amount of anti-CD30-CAR transduced T cells in the blood of patients after infusion.
Measure:Evaluate the in vivo persistence and peak blood levels of anti-CD30 CAR T cells after initial and repeated CAR T-cell infusions
Time Frame:5 years
Safety Issue:
Description:Amount of anti-CD30-CAR transduced T cells in the blood of patients after infusion.
Measure:Assess for evidence of antilymphoma activity by anti-CD30 CAR T cells
Time Frame:5 years
Safety Issue:
Description:Evidence of anti-lymphoma activity in the blood after anti-CD30 infusion

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:National Cancer Institute (NCI)

Trial Keywords

  • Gene Therapy
  • Adoptive T Cell Therapy
  • T-cell infusion
  • Allogeneic Stem Cell Transplantation
  • Immunohistochemistry

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