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Pilot Immunotherapy Study With Letetresgene Autoleucel (Lete-cel, GSK3377794)T-cells Specific in NY-ESO-1/ LAGE-1a-positive Advanced Non-small Cell Lung Cancer (NSCLC) Either Alone or in Combination With Pembrolizumab

NCT03709706

Description:

This trial will evaluate safety and efficacy of letetresgene autoleucel (GSK3377794) with or without pembrolizumab in participants with non-small cell lung cancer.

Related Conditions:
  • Non-Small Cell Lung Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Pilot Immunotherapy Study With Letetresgene Autoleucel (Lete-cel, GSK3377794)T-cells Specific in NY-ESO-1/ LAGE-1a-positive Advanced Non-small Cell Lung Cancer (NSCLC) Either Alone or in Combination With Pembrolizumab
  • Official Title: A Phase 1b/2a Pilot Study to Evaluate the Safety and Tolerability of Autologous T-Cells Expressing Enhanced TCRs (T Cell Receptors) Specific for NY-ESO-1/LAGE-1a (GSK3377794) Alone, or in Combination With Pembrolizumab in HLA-A2+ Participants With NY-ESO-1- or LAGE-1a-Positive Advanced or Recurrent Non-Small Cell Lung Cancer

Clinical Trial IDs

  • ORG STUDY ID: 208471
  • NCT ID: NCT03709706

Conditions

  • Neoplasms

Interventions

DrugSynonymsArms
Lete-celArm A: lete-cel monotherapy
PembrolizumabArm A: lete-cel monotherapy

Purpose

This trial will evaluate safety and efficacy of letetresgene autoleucel (GSK3377794) with or without pembrolizumab in participants with non-small cell lung cancer.

Detailed Description

      New York esophageal antigen-1 (NY-ESO-1) and LAGE-1a antigens are tumor-associated proteins
      that have been found in several tumor types. Clinical trials using adoptively transferred
      T-cells directed against NY-ESO-1/LAGE-1a have shown objective responses. Letetresgene
      autoleucel (GSK3377794) is the first generation of NY-ESO-1 specific T-cell receptor (TCR)
      engineered T-cells. This protocol investigates Letetresgene autoleucel treatment in Human
      Leukocyte Antigen (HLA)-A*02+ participants with NY-ESO1+ advanced myxoid/round cell
      liposarcoma or high-grade myxoid liposarcoma.
    

Trial Arms

NameTypeDescriptionInterventions
Arm A: lete-cel monotherapyExperimentalIn Arm A, participants with NSCLC (lacking actionable genetic aberrations) will receive lete-cel monotherapy. Participants who subsequently progress by Week 25 will be offered pembrolizumab.
  • Lete-cel
  • Pembrolizumab
Arm B: lete-cel plus pembrolizumabExperimentalIn Arm B, participants with NSCLC (lacking actionable genetic aberrations) will receive lete-cel followed by pembrolizumab.
  • Lete-cel
  • Pembrolizumab
Arm C: lete-cel plus pembrolizumabExperimentalIn Arm C, participants with NSCLC (with actionable genetic aberrations) will receive lete-cel followed by pembrolizumab.
  • Lete-cel
  • Pembrolizumab

Eligibility Criteria

        Inclusion Criteria:

          -  Age >=18 years on the day of signing informed consent.

          -  Histologically or cytologically diagnosed unresectable Stage IIIb or Stage IV NSCLC.

          -  Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.

          -  Participant is positive for any of the following alleles: human leukocyte antigen
             (HLA)-A*02:01, HLA-A*02:05, and a) or HLA-A*02:06 by a validated test.

          -  Participant's tumor meets the pre-defined threshold for expression of NY-ESO-1 and/or
             LAGE-1a.

          -  Adequate organ function and blood cell counts, as defined in the protocol.

          -  Predicted life expectancy that is >=24 weeks from leukapheresis.

          -  Left ventricular ejection fraction >=45%.

          -  Prior therapies prior to lymphodepletion: a) All participants with NSCLC lacking
             actionable genetic aberrations, per National Comprehensive Cancer Network (NCCN)
             guidelines (Arms A and B), need to have received at least one line of programmed death
             protein 1/programmed death protein 1 ligand (PD-1/PD-L1) checkpoint blockade therapy.
             For participants in the metastatic setting, PD-1/PD-L1 checkpoint blockade therapy
             must have been received either alone, in combination or sequentially with
             platinum-containing chemotherapy. OR b) All participants with NSCLC with actionable
             genetic aberrations, per NCCN guidelines (Arm C only), should have received
             appropriate targeted therapy following NCCN or equivalent country-level guidelines.

          -  Disease progression at time of treatment, as defined in the protocol.

          -  Measurable disease at time of treatment per response evaluation criteria in solid
             tumors (RECIST) version 1.1 as assessed by local site investigator/radiology.

        Exclusion Criteria:

          -  Prior gene therapy using an integrating vector.

          -  Prior allogeneic/autologous bone marrow or solid organ transplantation.

          -  History of allergic reactions attributed to compounds of similar chemical or biologic
             composition to cyclophosphamide, fludarabine, dimethylsulfoxide (DMSO) or other agents
             used in the study

          -  Severe hypersensitivity (>= Grade 3) to pembrolizumab and/or any of its excipients.

          -  Active autoimmune disease that has required systemic treatment in past 2 years.

          -  History of chronic or recurrent (within the last year prior to enrollment) severe
             autoimmune or active immune-mediated disease requiring steroids or other
             immunosuppressive treatments.

          -  Uncontrolled intercurrent illness.

          -  Participant has active infection with human immunodeficiency virus (HIV), hepatitis B
             virus (HBV), hepatitis C virus (HCV), Epstein Barr virus (EBV), cytomegalovirus (CMV),
             syphilis, or human T lymphotropic virus (HTLV), as defined in protocol.

          -  Known psychiatric or substance abuse disorders.

          -  Symptomatic or untreated central nervous system (CNS) metastases.

          -  Radiotherapy meeting any of the following criteria: a. >=50 Gray (Gy) to a significant
             volume of the pelvis, long bones or spine, or a cumulative dose of radiation that, in
             the investigator's opinion would predispose patients to prolonged cytopenia after
             lymphodepletion. b. Radiotherapy to the target lesions within 3 months before
             lymphodepletion. A lesion with unequivocal progression may be considered a target
             lesion regardless of time from last radiotherapy dose.

          -  Other protocol-defined inclusion/exclusion criteria may apply.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of participants with adverse events (AEs), serious adverse events (SAEs) and AEs of special interest (AESIs) based on severity
Time Frame:Up to 106 weeks
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Progression-Free Survival (PFS)
Time Frame:Up to 106 weeks
Safety Issue:
Description:
Measure:Disease Control Rate (DCR)
Time Frame:Up to 106 weeks
Safety Issue:
Description:
Measure:Duration of Response (DoR)
Time Frame:Up to 106 weeks
Safety Issue:
Description:
Measure:Time to Response (TTR)
Time Frame:Up to 106 weeks
Safety Issue:
Description:
Measure:Maximum transgene expansion (Cmax) for lete-cel
Time Frame:Up to 106 weeks post-dose
Safety Issue:
Description:
Measure:Time to Cmax (Tmax) for lete-cel
Time Frame:Up to 106 weeks post-dose
Safety Issue:
Description:
Measure:Area under the time curve from zero to time t (AUC[0 to t]) of GSK3377794
Time Frame:Up to 106 weeks post-dose
Safety Issue:
Description:

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:GlaxoSmithKline

Trial Keywords

  • GSK3377794
  • Pembrolizumab
  • T Cell Receptors
  • Adoptive T-cell therapy
  • Non-Small Cell Lung Cancer
  • Immuno-oncology
  • NY-ESO-1
  • LAGE-1a
  • Leukapheresis
  • Letetresgene autoleucel

Last Updated

August 9, 2021