Donor-derived Anti-CD123-CART Cells for Recurred AML After Allo-HSCT

Adult Acute Myeloid Leukemia Clinical Trial

Official title:

Donor-derived Anti-CD123 Chimeric Antigen Receptors Modified T Cells for Recurred Acute Myeloid Leukaemia After Allogeneic Hematopoietic Stem Cell Transplantation

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03114670
• Other study ID #: 307-RV-CAR-123
• Status: Recruiting
• Phase: Phase 1
• First received: March 21, 2017
• Last updated: June 13, 2017
• Start date: March 25, 2017
• Est. completion date: March 18, 2021

Study information

• Verified date: June 2017
• Source: Affiliated Hospital to Academy of Military Medical Sciences
• Contact: Hu Chen, M.D., Ph.D.
• Phone: +86-010-6694-7108
• Email: chenhu217[@]aliyun.cn
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Patients with acute myeloid leukemia(AML) recurred after the allogeneic hematopoietic stem cell transplantation (allo-HSCT) have a dismal prognosis.The investigators developed donor-derived chimeric antigen receptor modified-T cell(CART) to target CD123 for the treatment of AML. The investigators start the Phase I study aimed to treat recurred post-transplantation AML patients using donor-derived CAR-T. The purpose of this study is to assess the safety and effectiveness of anti-CD123 CAR-T cells in patients.

Description:

Allo-HSCT is increasingly being used for AML, however, leukemia relapse remain a main problem for decades.Recently the investigators have witnessed great progresses in cancer therapy with chimeric antigen receptors modified T cells(CAR-T), especially for B-cell malignance. preclinical data about anti-CD123 CART have shown raised serious safety concerns of human anti-CD123 CAR-T for severe impairment of normal hematopoiesis in NSG mice.Patients with AML recurred after allo-HSCT have a dismal prognosis.The investigators developed donor-derived CART to target CD123 for the treatment of AML. The investigators start the Phase I study aimed to recurred post-transplantation AML patients using donor-derived CAR-T. The purpose of this study is to assess the safety and effectiveness of anti-CD123 CAR-T cells in patients.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 20
• Est. completion date: March 18, 2021
• Est. primary completion date: March 18, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Male and Female subjects with CD123+ acute myeloid leukemia as confirmed by immunohistochemistry and flow cytometry;

2. Patients must have received an allogenic stem cell transplantation(Allo-HSCT). The leukemia relapsed. There are available donor or enough cryopreserved donor-derived PBMCs for CART preparation and subsequent Allo-HSCT. In the previous case, the donor should have adequate venous access for apheresis.

3. Karnofsky score greater than 70%;

4. patients more than 18 years of age

5. Expected survival time >16 weeks;

6. Bilirubin <3.0 mg/dL,

7. Alanine aminotransferase(ALT)/ aspartate aminotransferase(AST)<3 fold normal.

8. Diffusing capacity of the lung for carbon monoxide(DLCO) and forced expiratory volume in one second(FEV1)>45% of predictive value.

9. At least received three kinds of medicines functioning by different mechanisms, including alkylating agents, protease inhibitors, and immunomodulators, and disease progressing within 60 days.

10. Important organs are well tolerated;

11. For post-transplantation patients, the apheresis would be undertaken only at least 2 weeks after immunosuppressive agents for GvHD withdrawal;

12. From very beginning of the test to 30 days after the withdrawal, men and women should adopt reliable contraceptive measures.

13. All research participants must have the ability to understand and willingness to sign a written informed consent.

Exclusion criteria:

1. Patients were diagnosed with APL M3:t(15; 17)(q22; q12);PML/RARa );

2. Symptomatic active central nervous system leukaemia;

3. Patients with HIV, hepatitis B or C infection;

4. Any concurrent active malignancies;

5. Other uncontrolled active illness that hinders participation in the trial;

6. Patients suffer from coronary heart disease, angina pectoris, myocardial infarction, arrhythmia, cerebral thrombosis, cerebral hemorrhage and other serious heart, cerebrovascular disease;

7. patients with poorly controlled hypertensive

8. patients with froward psychiatric history

9. anyone who the researchers think unsuitable to participate in the investigation;

10. anyone who long-term use of immunosuppressive agents for organ transplants or other reasons, or undertake inhaled corticosteroids therapy recently.

11. failed production release testing: CAR+ T cells <30% or T cell expansion less than 5-fold under the CD3/28 beads stimulation.

12. Pregnant, lactating or female patients planning to get pregnant within 2 months before treatment ends;

Related Conditions & MeSH terms

• Adult Acute Myeloid Leukemia
• Leukemia
• Leukemia, Myeloid
• Leukemia, Myeloid, Acute

Intervention

Biological:
• CD123CAR-41BB-CD3zeta-EGFRt-expressing T cells
a single dose of CD123CAR-41BB-CD3zeta-EGFRt-expressing T cells will be infusion after preconditioning.

Locations

Country	Name	City	State
China	Fengtai District	Beijing Shi

Sponsors (1)

Lead Sponsor	Collaborator
Affiliated Hospital to Academy of Military Medical Sciences

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence of adverse events related to treatment as assessed by NCI CTCAE version 4.03		15 years
Secondary	CART cells persistence in vivo		15 years
Secondary	CAR123-specific antibody level		15 years
Secondary	Overall survival		15 years
Secondary	Disease response(CR, CRi)		15 years