A Phase I Trial of Memory T Cells Expressing an NKG2D Chimeric Antigen Receptor in Children, Adolescents and Young Adults With Advanced Sarcoma — CAR4SAR  

Advanced Sarcoma Clinical Trial

Official title: A Phase I Trial of Memory T Cells Expressing an NKG2D Chimeric Antigen Receptor in Children, Adolescents and Young Adults With Advanced Sarcoma

Status Recruiting

Clinical Trial Summary

Phase I, open label, prospective, single-center, non-randomized, dose escalation clinical trial aiming to determine the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of systemic transduced donor-derived NKG2D-CAR memory T cell infusions (Arm A), and of dual treatment, with both systemic and locally transduced donor-derived NKG2D-CAR memory T cell infusions (Arm B).

Clinical Trial Description

Childhood cancer is considered a rare disease based on prevalence. Despite this, in developed countries, cancer is the most common cause of disease-related death in the pediatric population. Sarcomas are a rare and heterogeneous group of malignant tumors of mesenchymal origin representing around 10% of pediatric cancers. For patients with standard-risk and localized disease, survival is 70-80%. However, for those patients with high-risk disease, or those who relapse or develop metastases, the survival rate is only 30%. Current treatment consisting in local surgery, radiotherapy and poly-chemotherapy remains ineffective in advanced stages or relapse and is associated with acute and chronic adverse effects which compromise survival and quality of life. Thus, there is an urgent need to find new therapeutic alternatives in order to improve the outcome in sarcoma patients. Different groups have described the importance of NKG2D receptor and NKG2D ligands (NKG2DL) in sarcoma immunosurveillance. Tumor cells are recognized and eliminated by the immune surveillance system. A master key receptor called NKG2D is critical to induce cancer control. Recently, this group has published how this receptor can recognize and target most childhood cancers including sarcoma. Although different cells from the surveillance system possess this receptor, cancer cells can block their ability to recognize and eliminate the tumor cells. NKG2D CAR receptor induces tumor-specific lysis, is safe to normal cells and provides effector cells the ability to bypass the mechanisms of resistance induced by tumor cells. In the present study the investigators aim to analyze the safety of an NKG2D-CAR T cell therapy in pediatric, adolescent and young adult (AYA) patients suffering from advanced sarcoma. In a recent preclinical study developed by this group, the investigators demonstrated the efficacy and safety of an NKG2D-CAR T cell-based therapy for osteosarcoma. Furthermore, in this hospital, NKG2D-CAR T cells have been already produced in a GMP-environment and infused in two pediatric patients as compassionate use, and no signs of treatment-related toxicity have been observed. In the present study, the investigators aim to develop a dose escalation Phase I trial of NKG2D chimeric antigen receptor-T cells (NKG2D-CAR T) to assess the safety and clinical activity in pediatric patients with advanced sarcoma. This clinical trial proposal is the continuation of a previous research project funded by the Asociación Española Contra el Cáncer (AECC) in 2016, which was the first AECC funded project on CAR T cell therapy in children with metastatic disease. ;

Related Conditions & MeSH terms

• Advanced Sarcoma
• Sarcoma

• NCT number: NCT06087341
• Study type: Interventional
• Source: Instituto de Investigación Hospital Universitario La Paz
• Contact: Antonio Pérez Martínez
• Phone: 917 27 75 76
• Email: aperezmartinez@salud.madrid.org
• Status: Recruiting
• Phase: Phase 1
• Start date: January 10, 2024
• Completion date: April 2028