Description:
Multi-center, open-label, Phase 1 study of the safety, tolerability and feasibility of dosing
patients harboring metastatic castration resistant prostate cancer (mCRPC) with genetically
modified autologous T cells (CART-PSMA-TGFβRDN cells) engineered to express a chimeric
antigen receptor (CAR) capable of recognizing the tumor antigen prostate-specific membrane
antigen (PSMA) and activating the T cell.
Title
- Brief Title: A Study of CART-PSMA-TGFβRDN in Patients With Metastatic Castration Resistant Prostate Cancer
- Official Title: A Phase 1 Open-Label, Multi-Center Study of PSMA Targeted Genetically Modified Chimeric Antigen Receptor T Cells in Patients With Metastatic Castration Resistant Prostate Cancer
Clinical Trial IDs
- ORG STUDY ID:
CART-PSMA-TGFβRDN-02
- NCT ID:
NCT04227275
Conditions
- Metastatic Castration-resistant Prostate Cancer
Interventions
Drug | Synonyms | Arms |
---|
CART-PSMA-TGFβRDN | | Dose Escalation |
Cyclophosphamide | | Dose Escalation |
Fludarabine | | Dose Escalation |
Anakinra | | Dose Escalation |
Purpose
Multi-center, open-label, Phase 1 study of the safety, tolerability and feasibility of dosing
patients harboring metastatic castration resistant prostate cancer (mCRPC) with genetically
modified autologous T cells (CART-PSMA-TGFβRDN cells) engineered to express a chimeric
antigen receptor (CAR) capable of recognizing the tumor antigen prostate-specific membrane
antigen (PSMA) and activating the T cell.
Detailed Description
This is a Phase 1 single-arm study designed to identify the dose and regimen of CART-PSMA-
TGFβRDN cells that can be safely administered intravenously following the lymphodepletion
(LD) regimen to patients with metastatic castration resistant prostate cancer (mCRPC).
Following Dose Escalation, a Cohort Expansion will enroll patients to further explore the
safety and tolerability of the selected dose and schedule.
It is anticipated that up to 50 patients will enroll in this study in both dose escalation
and cohort expansion.
Trial Arms
Name | Type | Description | Interventions |
---|
Dose Escalation | Experimental | Dose escalation of intravenous CART-PSMA-TGFβRDN cells for patients with metastatic castration resistant prostate cancer | - CART-PSMA-TGFβRDN
- Cyclophosphamide
- Fludarabine
- Anakinra
|
Eligibility Criteria
Inclusion Criteria:
- Confirmed histologic diagnosis of prostate cancer and have mCRPC, with castrate levels
of testosterone (<50 ng/mL)
- PSA measurable disease per Prostate Working Group 3 (PCWG3) criteria
- Prior therapies defined as at least 2 prior lines of systemic therapy for prostate
cancer, including at least one second generation androgen receptor inhibitor and/or
CYP17α inhibitor. At least one line of prior therapy must be in the mCRPC setting
- Estimated estimated glomerular filtration rate ≥ 60 mL/min by Modification of Diet in
Renal Disease criteria
- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5x the upper
limit of normal (ULN); patients with hepatic metastases ALT and AST ≤ 3.0 x ULN
- Serum total bilirubin < 1.5 mg/dL unless patient has known Gilbert's Syndrome, then
serum bilirubin ≤3 mg/dL
- Serum albumin ≥ 3.0 g/dL
- Left ventricular ejection fraction (LVEF) ≥ 50%. LVEF assessment must have been
performed within 8 weeks of enrollment
- Hemoglobin ≥ 8 g/dL
- Absolute neutrophil count ≥ 1000/μL
- Platelet count ≥ 75,000/μL
- Patients who have not undergone bilateral orchiectomy must be able to continue
gonadotropin-releasing hormone (GnRH) therapy during the study
- Eastern Cooperative Oncology Group (ECOG) score of 0 or 1
- Toxicities from any previous therapy must have recovered to Grade 1 or baseline
- Patients of reproductive potential agree to use of approved highly effective
contraceptive methods
Exclusion Criteria:
- Active invasive cancer, other than the proposed cancer included in the study, within 2
years prior to screening, unless treated with curative intent
- Current treatment with systemic corticosteroids (defined as a dose greater than the
equivalent of prednisone 10 mg/day)
- Active autoimmune disease (including connective tissue disease, uveitis, sarcoidosis,
inflammatory bowel disease or multiple sclerosis) or a history of severe autoimmune
disease requiring prolonged immunosuppressive therapy (any immunosuppressive therapy
within 6 weeks prior to screening visit)
- Current human immunodeficiency virus (HIV), hepatitis C virus, hepatitis B virus
infections; Patients who are hepatitis B core antigen positive, hepatitis B surface
antigen negative, should have a quantitative viral load measured; If viral load is
undetectable, the patient will not be excluded if hey are able to be treated with
anti-viral medication for at least 7 days prior to lymphodepletion until at least 6
months after infusion with viral load and ALT monitoring
- Active or uncontrolled medical or psychological condition that would preclude
participation
- History of seizure disorder
- Prior allogeneic stem cell transplant
- Central nervous system malignancy
- History of severe infusion reaction to monoclonal antibodies or biological therapies,
or to study product excipients that would preclude the patient safely receiving
CART-PSMA-TGFβRDN cells
- History of being previously treated with a J591 antibody-based therapy
- Ferritin levels ≥ 4x the upper limit of normal prior to apheresis or prior to the
start of lymphodepleting chemotherapy
- Active or recent (within the past 6 months prior to apheresis or lymphodepletion)
cardiovascular disease, defined as (1) New York Heart Association Class III or IV
heart failure, (2) unstable angina, (3) a history of recent (within 6 months)
myocardial infarction or sustained (> 30 second) ventricular tachyarrhythmias, or (4)
cerebrovascular accident
- Any active infection currently being treated or any infection within the last 6 weeks
that required 7 days or more of IV antibiotics or any active infection within the last
4 weeks that requires use of oral antibiotics. Patients may be eligible once these
timeframes elapse and with evidence that the infection has completely resolved
- Have inadequate venous access for or contraindications for the apheresis procedure
- Must agree not to participate in a conception process or must agree to a highly
effective method of contraception
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Male |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Dose Escalation: Dose Identification of CART-PSMA-TGFβRDN |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | Incidence of Dose Limiting Toxicity (DLT) |
Secondary Outcome Measures
Measure: | Preliminary efficacy of CART-PSMA-TGFβRDN as assessed by biochemical Objective Response Rate (ORR) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | ORR defined as the proportion of patients with maximal prostate-specific antigen (PSA) decline of greater than or equal to 50% at 12 weeks post infusion |
Measure: | Feasibility of CART-PSMA-TGFβRDN |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | Proportion of patients who did not receive CART-PSMA-TGFβRDN cells |
Measure: | Peripheral expansion and persistence of CART-PSMA-TGFβRDN |
Time Frame: | Up to 15 years |
Safety Issue: | |
Description: | Quantitative polymerase chain reaction (qPCR) |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Tmunity Therapeutics |
Trial Keywords
- Chimeric Antigen Receptor (CAR)
- T-cells
- Prostate-Specific Membrane Antigen (PSMA)
- Prostate Cancer
Last Updated
May 13, 2021