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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00730613
Other study ID # 01020
Secondary ID P30CA033572CHNMC
Status Completed
Phase Phase 1
First received August 7, 2008
Last updated October 6, 2017
Start date February 2002
Est. completion date August 2011

Study information

Verified date October 2017
Source City of Hope Medical Center
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

RATIONALE: Cellular adoptive immunotherapy may stimulate the immune system in different ways and stop cancer cells from growing.

PURPOSE: This clinical trial is studying the side effects of cellular adoptive immunotherapy using genetically modified T-lymphocytes and to see how well it works in treating patients with recurrent or refractory high-grade malignant glioma.


Description:

OBJECTIVES:

Primary

- To assess the feasibility and safety of cellular immunotherapy utilizing ex vivo expanded autologous CD8-positive T-cell clones genetically modified to express the IL-13 zetakine chimeric immunoreceptor and the Hy/TK selection/suicide fusion protein in patients with recurrent or refractory, high-grade malignant glioma.

Secondary

- To evaluate the antitumor activity of adoptively transferred clones in these patients.

- To screen for the development of anti-IL13 zetakine and anti-HyTK immune responses in these patients.

- To evaluate the efficacy of ganciclovir administration for ablating transferred clones in vivo should toxicity be encountered.

OUTLINE:

- Leukapheresis and therapy preparation: Patients undergo leukapheresis to obtain peripheral blood mononuclear cells. T-cells isolated from the peripheral blood are then genetically modified, hygromycin-resistant cloned, expanded ex vivo, and cryopreserved until the first clinical or radiographic evidence of recurrence or progression. Patients with documented disease recurrence or progression undergo re-biopsy or re-resection of the tumor and placement of a reservoir-access device (Rickham shunt) into the tumor resection cavity prior to autologous T-cell clone infusion therapy.

- Autologous T-cell clone infusion: Patients receive an infusion of autologous antigen-specific CD8+ cytotoxic T-lymphocyte clones over 5-10 minutes on days 1, 3, and 5 of weeks 1 and 2. Treatment repeats every 3 weeks for a total of 2 courses in the absence of disease progression or unacceptable toxicity. Patients achieving tumor regression with residual disease by MRI after 4 courses of study therapy may receive up to 2 additional courses in the absence of disease progression, unacceptable toxicity, or a complete response.

Patients undergo blood, cerebrospinal fluid, and tissue sample collection periodically for correlative studies. Samples are assessed for IL13Rα2 expression levels, susceptibility to redirected T-cell effector mechanisms, and other tumor and T-cell activation markers.

After completion of study treatment, patients will be followed monthly for 3 months, then every 3 months for two years, and then annually for at least 15 years.


Recruitment information / eligibility

Status Completed
Enrollment 3
Est. completion date August 2011
Est. primary completion date August 2011
Accepts healthy volunteers No
Gender All
Age group 18 Years to 70 Years
Eligibility DISEASE CHARACTERISTICS:

- Histologically confirmed malignant glioma at original diagnosis

- Grade III or IV disease

- Refractory or recurrent disease

- Unifocal site of original disease in cerebral cortex

- No clinical evidence of progressive encephalopathy

- Has not undergone recent re-resection of recurrent or progressive disease

- No communication between the tumor resection cavity and the ventricles and deep cerebrospinal fluid pathways as documented by post-operative MRI scan

PATIENT CHARACTERISTICS:

- Karnofsky performance status 70-100%

- Life expectancy > 3 months

- WBC = 2,000/dL

- ANC > 1,000/dL

- Platelet count = 100,000/dL (unsupported by transfusion or growth factor)

- Creatinine < 1.6 mg/dL

- Bilirubin < 1.5

- SGOT and SGPT < 2 times upper limit of normal

- Not pregnant

- Negative pregnancy test

- Fertile patients must use effective contraception

- Able to understand protocol basic elements and/or risks/benefits of participating in this pilot study

- No requirement for supplemental oxygen to keep saturation > 95% that is not expected to resolve within 2 weeks

- No uncontrolled cardiac arrhythmia

- No hypotension requiring pressor support

- No renal dialysis dependency

- No refractory seizure disorder

- No concurrent non-malignant illness that is poorly controlled with treatment or is of such severity the investigators deem it unwise to enter the patient on protocol

- No severe infection for which patient is being treated

- No history of ganciclovir and/or Prohance contrast allergy or intolerance

- No HIV positivity within the past 3 months

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- Must have recovered from major surgery

- At least 4 weeks since primary therapy and no steroid dependence

- At least 2 weeks since prior adjuvant cytotoxic chemotherapy and recovered

- No concurrent systemic corticosteroids, except for use in managing T-cell therapy toxicity

- No concurrent immunotherapy (i.e., interferons, vaccines, or other cellular products)

- No concurrent pentoxifylline

- No other concurrent investigative agents

- No concurrent ganciclovir or ganciclovir derivative

- No concurrent acyclovir for non-life threatening herpes virus infection

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
therapeutic autologous lymphocytes
Cycles of escalating cell dose infusions up to the target cell dose of 10(8)
Genetic:
gene expression analysis
At the time of excess pathology samples documenting response/relapse
Other:
laboratory biomarker analysis
CSF generated at the time of each T-cell dose

Locations

Country Name City State
n/a

Sponsors (2)

Lead Sponsor Collaborator
City of Hope Medical Center National Cancer Institute (NCI)

Outcome

Type Measure Description Time frame Safety issue
Primary Feasibility 1 year after the end of treatment on study
Primary Safety 1 year after the end of treatment on study
Secondary Anti-tumor activity of adoptively transferred clones 1 year after the end of treatment on study
Secondary Anti-IL 13 zetakine and anti-HyTK immune response in patients 1 year after the end of treatment on study
Secondary Efficacy of ganciclovir for clone ablation (in the event of toxicity) 1 year after the end of treatment on study
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