Clinical Trials /

T-Cell Infusion, Aldesleukin, and Utomilumab in Treating Patients With Recurrent Ovarian Cancer

NCT03318900

Description:

This phase I/Ib trial studies the side effects and best dose of utomilumab and how well it works with CD8-positive T-lymphocyte (T-cell infusion) and aldesleukin in treating patients with ovarian cancer that has come back. Aldesleukin may stimulate white blood cells to kill ovarian cancer cells. Giving white blood cells (T-cells) that have been activated by a vaccine with aldesleukin may kill more tumor cells. Immunotherapy with utomilumab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. Giving T-cell infusion with aldesleukin and utomilumab may work better in treating patients with ovarian cancer.

Related Conditions:
  • Ovarian Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: T-Cell Infusion, Aldesleukin, and Utomilumab in Treating Patients With Recurrent Ovarian Cancer
  • Official Title: Phase I/Ib Study of Adoptive Cellular Therapy Using Autologous IL-21-Primed CD8+ Tumor Antigen-Specific T Cells in Combination With Utomilumab (PF-05082566) in Patients With Platinum Resistant Ovarian Cancer

Clinical Trial IDs

  • ORG STUDY ID: 2016-0400
  • SECONDARY ID: NCI-2018-01034
  • SECONDARY ID: 2016-0400
  • SECONDARY ID: P30CA016672
  • NCT ID: NCT03318900

Conditions

  • COL6A3 Positive
  • HLA-A*0201 Positive Cells Present
  • PRAME Positive
  • Recurrent Ovarian Carcinoma

Interventions

DrugSynonymsArms
Aldesleukin125-L-Serine-2-133-interleukin 2, Proleukin, r-serHuIL-2, Recombinant Human IL-2, Recombinant Human Interleukin-2Treatment (T-cell infusion, aldesleukin, utomilumab)
CD8-Positive T-LymphocyteCD8 Cell, CD8 Lymphocyte, CD8 Lymphocytes, CD8+ T Cell, CD8+ T Lymphocyte, CD8+ T Lymphocytes, CD8+ T-Lymphocyte, CD8-Positive Lymphocyte, CD8-Positive Lymphocytes, CD8-Positive T-Lymphocytes, T8 Cell, T8 Cells, T8 Lymphocyte, T8 LymphocytesTreatment (T-cell infusion, aldesleukin, utomilumab)
Cyclophosphamide(-)-Cyclophosphamide, 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate, Carloxan, Ciclofosfamida, Ciclofosfamide, Cicloxal, Clafen, Claphene, CP monohydrate, CTX, CYCLO-cell, Cycloblastin, Cycloblastine, Cyclophospham, Cyclophosphamid monohydrate, Cyclophosphamidum, Cyclophosphan, Cyclophosphane, Cyclophosphanum, Cyclostin, Cyclostine, Cytophosphan, Cytophosphane, Cytoxan, Fosfaseron, Genoxal, Genuxal, Ledoxina, Mitoxan, Neosar, Revimmune, Syklofosfamid, WR- 138719Treatment (T-cell infusion, aldesleukin, utomilumab)
UtomilumabPF 05082566, PF 5082566, PF-05082566, PF-2566Treatment (T-cell infusion, aldesleukin, utomilumab)

Purpose

This phase I/Ib trial studies the side effects and best dose of utomilumab and how well it works with CD8-positive T-lymphocyte (T-cell infusion) and aldesleukin in treating patients with ovarian cancer that has come back. Aldesleukin may stimulate white blood cells to kill ovarian cancer cells. Giving white blood cells (T-cells) that have been activated by a vaccine with aldesleukin may kill more tumor cells. Immunotherapy with utomilumab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. Giving T-cell infusion with aldesleukin and utomilumab may work better in treating patients with ovarian cancer.

Detailed Description

      PRIMARY OBJECTIVES:

      I. Assess the safety and toxicity of adoptively transferred central memory-type CTL targeting
      ovarian cancer antigens administered alone, and in combination with, utomilumab, an agonistic
      anti-CD137 antibody, in patients with platinum-resistant ovarian cancer.

      II. Evaluate the functional and numeric in vivo persistence of adoptively transferred central
      memory-type CTL with and without utomilumab.

      SECONDARY OBJECTIVES:

      I. Evaluate the anti tumor effect of adoptively transferred central memory-type CTL targeting
      ovarian cancer antigens as measured by best overall response rate (BORR) and progression free
      survival (PFS).

      OUTLINE: This is a dose escalation study of utomilumab.

      Patients undergo leukapheresis. Patients then receive cyclophosphamide intravenously (IV) on
      day -2, CD8-positive T-lymphocyte via infusion on day 0, and aldesleukin subcutaneously (SC)
      every 12 hours for 14 days. Beginning 24 hours after CD8-positive T-lymphocyte, patients also
      receive utomilumab IV over 90 minutes on days 1, 29, 57, 85, 113, and 141 in the absence of
      disease progression or unacceptable toxicity.

      After completion of study treatment, patients are followed up at days 3, 7, 14, 22, 28, 35,
      43, 49, 56, 64, 70, 77, 84, 112, and 140.
    

Trial Arms

NameTypeDescriptionInterventions
Treatment (T-cell infusion, aldesleukin, utomilumab)ExperimentalPatients undergo leukapheresis. Patients then receive cyclophosphamide IV on day -2, CD8-positive T-lymphocyte via infusion on day 0, and aldesleukin SC every 12 hours for 14 days. Beginning 24 hours after CD8-positive T-lymphocyte, patients also receive utomilumab IV over 90 minutes on days 1, 29, 57, 85, 113, and 141 in the absence of disease progression or unacceptable toxicity.
  • Aldesleukin
  • CD8-Positive T-Lymphocyte
  • Cyclophosphamide
  • Utomilumab

Eligibility Criteria

        Inclusion Criteria:

          -  Histopathologic documentation (must be performed or reviewed at MD Anderson) of
             recurrent high grade epithelial ovarian cancer.

          -  At least one prior line of platinum-based chemotherapy (subjects are eligible for
             enrollment and leukapheresis while still platinum-sensitive, however, they must have
             developed platinum resistant disease for treatment (turnstile 2).

          -  Tumor expressing PRAME and/or COL6A3.

          -  Expression of HLA-A*0201.

          -  Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.

          -  Expected survival of greater than 16 weeks.

          -  Willing and able to give informed consent.

          -  Hemoglobin >= 9.0 g/dL.

          -  Absolute neutrophil count (ANC) >= 1.0 x 10^9/L (>=1000 per mm^3).

          -  Platelet count >= 75 x 10^9/L (>=100,000 per mm^3).

          -  Serum bilirubin =< 1.5 x institutional upper limit of normal (ULN) unless diagnosed
             with Gilbert's syndrome.

          -  Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 x ULN
             unless liver metastases are present, in which case it must be =< 5x ULN.

          -  Serum creatinine clearance (CL) >40 mL/min by the Cockcroft-Gault formula or by
             24-hour urine collection for determination of creatinine clearance.

          -  Subjects must either be of non-reproductive potential (i.e., post-menopausal by
             history: >= 50 years old and no menses for >=1 year without an alternative medical
             cause; OR history of hysterectomy, OR history of bilateral tubal ligation, OR history
             of bilateral oophorectomy) or must have a negative serum pregnancy test upon study
             entry.

          -  Women of childbearing potential (WOCBP) must be using an adequate method of
             contraception to avoid pregnancy throughout the study in such a manner that the risk
             of pregnancy is minimized. Suggested precautions should be used to minimize the risk
             or pregnancy for at least 1 month before start of therapy, and while women are on
             study for up to 3 months after T cell infusion, and at least 8 weeks after the study
             drug is stopped.

          -  {Turnstile 2} Subjects must have platinum resistant disease (progression on a
             platinum-containing regimen or recurrence within 180 days of last dose of
             platinum-containing chemotherapy). Subjects that are not platinum resistant but are
             deemed not to be candidates for platinum-based chemotherapy due to prior significant
             allergic reaction may participate with principal investigator (PI) approval.

          -  {Turnstile 2} Bi-dimensionally measurable disease by radiographic imaging (magnetic
             resonance imaging [MRI] or computed tomography [CT] scan).

          -  {Turnstile 2} At least 4 weeks must have elapsed since the last chemotherapy,
             immunotherapy, radiotherapy or major surgery. At least 6 weeks for bevacizumab.

          -  {Turnstile 2} Toxicity related to prior therapy must either have returned to =< grade
             1, baseline, or been deemed irreversible.

        Exclusion Criteria:

          -  Clinically significant pulmonary dysfunction, as determined by medical history and
             physical exam. Patients so identified will undergo pulmonary functions testing and
             those with forced expiratory volume in one second (FEV1) < 60% of normal or carbon
             monoxide diffusing capacity (DLco) (corrected [corr] for hemoglobin [Hgb]) < 55% will
             be excluded.

          -  Significant cardiovascular abnormalities including any one of the following:
             Congestive heart failure, Clinically significant hypotension, symptoms of coronary
             artery disease, presence of cardiac arrhythmias on electrocardiography (EKG) requiring
             drug therapy; or patients with a history of cardiovascular disease. (Patients with the
             above will undergo a cardiac evaluation which can include a stress test and/or
             echocardiography. Results of this evaluation will be considered before excluding
             patients on the basis of cardiovascular abnormalities). Subjects with evidence of
             stress-induced cardiac ischemia or ejection fraction less than 55% will be excluded.

          -  History of central nervous system (CNS) metastasis.

          -  Autoimmune disease: patients with a history of inflammatory bowel disease are excluded
             from this study, as are patients with a history of autoimmune disease (e.g. systemic
             lupus erythematosus, vasculitis, infiltrating lung disease) whose possible progression
             during treatment would be considered by the Investigator to be unacceptable.

          -  {Turnstile 2} Participation in another clinical study with an investigational product
             administered during the last 28 days.

          -  {Turnstile 2} Receipt of the last dose of previous chemotherapy, hormonal, or biologic
             treatment for ovarian, fallopian tube, or primary peritoneal cancer in the last 28
             days (in the last 6 weeks for bevacizumab).

          -  {Turnstile 2} Current or prior use of immunosuppressive medication within 28 days
             before enrollment, with the exceptions of intranasal and inhaled corticosteroids or
             systemic corticosteroids at physiological doses, which are not to exceed 10 mg/day of
             prednisone, or an equivalent corticosteroid.

          -  {Turnstile 2} Any prior grade >= 3 immune-related adverse event (irAE) while receiving
             any previous immunotherapy agent, or any unresolved irAE > grade 1.

          -  History of allogeneic organ transplant.

          -  Unresolved partial or complete small or large bowel obstruction.

          -  {Turnstile 2} Receipt of live attenuated vaccination within 30 days prior to
             enrollment or within 30 days of planned lymphodepletion.

          -  Any underlying medical or psychiatric condition, which in the opinion of the
             investigator, will make the administration of study drug hazardous or obscure the
             interpretation of adverse events.

          -  Active viral hepatitis.

          -  Confirmed human immunodeficiency virus (HIV) infection.
      
Maximum Eligible Age:75 Years
Minimum Eligible Age:18 Years
Eligible Gender:Female
Healthy Volunteers:No

Primary Outcome Measures

Measure:Dose Limiting Toxicity Summary associated with Utomilumab Dose Escalation
Time Frame:Up to 6-8 weeks
Safety Issue:
Description:Safety and toxicity of adoptively transferred central memory-type CTL targeting ovarian cancer antigens administered alone, and in combination with, an Utomilumab, an agonistic anti-CD137 antibody, in patients with platinum resistant ovarian cancer reported at each dose level. Safety and toxicity will be assessed using the latest version of Common Terminology Criteria for Adverse Events (CTCAE).

Secondary Outcome Measures

Measure:Best overall response rate (BORR)
Time Frame:12 weeks up to 1 year
Safety Issue:
Description:BORR is defined as the total number of participants who's BOR is complete response (CR) or partial response (PR), divided by the total number of participants. Radiographic imaging and clinical assessment of residual disease will be compared with pre-infusion baseline assessment according to modified RECIST 1.1 for response: complete response (CR) defined as total regression of all tumor, a partial response (PR) as 30% or greater decrease in sum of longest diameter of target lesions and progressive disease (PD) as 20% increase in sum of longest diameter of target lesions (modified world health organization criteria or mWHO). Assessment at 6 and 12 weeks following T cell infusion and then every 8 weeks (+/- 1 week) until disease progression or intervening therapy. The overall response rate (OR) will be after 1 cycle (12) weeks.
Measure:Progression free survival (PFS)
Time Frame:6 months after the T cell infusion
Safety Issue:
Description:PFS is defined as the time between T cell infusion date and the date of progression or death. A participant who dies without reported prior progression will be considered to have progressed on the date of death. For those who remain alive and have not progressed, PFS will be censored on the date of last tumor assessment. For participants who have PD prior to Week 12 and a subsequent assessment of SD, PR or CR, the date of PD following response (where available) will be used in the analysis of PFS; otherwise these participants will be censored on the date of their last tumor assessment. PFS is estimated for each arm using the Kaplan-Meier product limit method.

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:M.D. Anderson Cancer Center

Last Updated

March 12, 2020