Description:
Patients with relapsed or refractory leukemia often develop resistance to chemotherapy and
some patients who relapse following CD19 directed therapy relapse with CD19 negative
leukemia. For this reason, the investigators are attempting to use T-cells obtained directly
from the patient, which can be genetically modified to express two chimeric antigen receptors
(CARs). One is to recognize CD19 and the other is to recognize CD22, both of which are
proteins expressed on the surface of the leukemic cell in patients with CD19+CD22+ leukemia.
The CAR enables the T-cell to recognize and kill the leukemic cell through recognition of
CD19 and CD22. This is a phase 1 study designed to determine the safety of the CAR+ T-cells
and the feasibility of making enough to treat patients with CD19+CD22+ leukemia.
Title
- Brief Title: A Feasibility and Safety Study of Dual Specificity CD19 and CD22 CAR-T Cell Immunotherapy for CD19+CD22+ Leukemia
- Official Title: Pediatric and Young Adult Leukemia Adoptive Therapy (PLAT)-05: A Phase 1 Feasibility and Safety Study of Dual Specificity CD19 and CD22 CAR-T Cell Immunotherapy for CD19+CD22+ Leukemia
Clinical Trial IDs
- ORG STUDY ID:
PLAT-05
- NCT ID:
NCT03330691
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Patient-derived CD19- and CD22 specific CAR | | Patient-derived CD19- and CD22 specific CAR v1 |
Purpose
Patients with relapsed or refractory leukemia often develop resistance to chemotherapy and
some patients who relapse following CD19 directed therapy relapse with CD19 negative
leukemia. For this reason, the investigators are attempting to use T-cells obtained directly
from the patient, which can be genetically modified to express two chimeric antigen receptors
(CARs). One is to recognize CD19 and the other is to recognize CD22, both of which are
proteins expressed on the surface of the leukemic cell in patients with CD19+CD22+ leukemia.
The CAR enables the T-cell to recognize and kill the leukemic cell through recognition of
CD19 and CD22. This is a phase 1 study designed to determine the safety of the CAR+ T-cells
and the feasibility of making enough to treat patients with CD19+CD22+ leukemia.
Trial Arms
Name | Type | Description | Interventions |
---|
Patient-derived CD19- and CD22 specific CAR v1 | Experimental | Patient-derived CD19-specific CAR also expressing an HER2t and CD22-specific CAR T-cells also expressing an EGFRt | - Patient-derived CD19- and CD22 specific CAR
|
Patient-derived CD19- and CD22 specific CAR v2 | Experimental | Patient-derived CD19-specific CAR also expressing an HER2t and CD22-specific CAR T-cells also expressing an EGFRt | - Patient-derived CD19- and CD22 specific CAR
|
Eligibility Criteria
Inclusion Criteria:
- First 2 subjects: male and female subjects age ≥18 and < 27 years (as of 2/16/18 the
first 2 subjects were enrolled and treated); subsequent subjects <31 years.
- Diagnosis of CD19+22+ leukemia
- Disease status:
- If post allogeneic HCT: Confirmed CD19+CD22+ leukemia recurrence defined as at
least 0.01% disease following allogeneic HCT
- If relapse/refractory status with no prior history of allogeneic HCT, one of the
following:
- Second or greater marrow relapse, with or without extramedullary disease
- First marrow relapse at end of first month or re-induction with marrow having at
least 0.01 % blasts by morphology and/or MPF
- Primary refractory as defined as greater than 5% blasts by multi-parameter flow
after at least 2 separate induction regimens.
- Subject has indication for HCT but has been deemed ineligible, inclusive of
persistent MRD prior to HCT
- Asymptomatic from CNS involvement, if present, and in the opinion of the Principal
Investigator with a reasonable expectation that disease burden can be controlled in
the interval between enrollment and T-cell infusion. Subjects with significant
neurologic deterioration will not be eligible for T-cell infusion until stabilized.
- Free from active GVHD and off immunosuppressive GVHD therapy for 4 weeks prior to
enrollment
- Lansky or Karnofsky performance score of at least 50
- Life expectancy of at least 8 weeks
- Recovered from acute toxic effects of all prior chemotherapy, immunotherapy, and
radiotherapy
- At least 7 days post last chemotherapy administration (excluding intrathecal
maintenance chemotherapy)
- At least 7 das post last systemic corticosteroids administration (unless physiologic
replacement dosing)
- No prior genetically modified cell therapy that is still detectable or virotherapy
- Adequate organ function
- Adequate laboratory values
- Willing to participate in long-term follow-up for up to 15 years, if enrolled in the
study and receive T cell infusion
- Patients of childbearing/fathering potential must agree to use highly effective
contraception from the time of initial T cell infusion through 12 months following the
last T cell infusion
Exclusion Criteria:
- Presence of active clinically significant CNS dysfunction
- Pregnant or breast-feeding
- Unable to tolerate apheresis procedure
- Presence of active malignancy other than CD19+CD22+ leukemia
- Presence of active severe infection
- Presence of any concurrent medical condition that, in the opinion of the Principal
Investigator, would prevent the patient from undergoing protocol-specified therapy
Maximum Eligible Age: | 30 Years |
Minimum Eligible Age: | N/A |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | The adverse events associated with one or multiple CAR T-cell product infusions will be assessed |
Time Frame: | 30 days |
Safety Issue: | |
Description: | Type, frequency, severity, and duration of adverse events will be summarized |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Seattle Children's Hospital |
Trial Keywords
Last Updated
May 24, 2021