Myelodysplastic Syndromes (MDS) Clinical Trial
Official title:
Single Arm Phase I/II Study of the Safety and Efficacy of Gene-modified WT1 TCR Therapy in Patients With Myelodysplastic Syndrome (MDS) or Acute Myeloid Leukaemia (AML) Who Have Failed to Achieve or Maintain an IWG Response Following Hypomethylating Agent Therapy
This is a Phase I/II trial to determine safety, clinical efficacy and feasibility of a
gene-modified WT1 TCR therapy in patients with myelodysplastic syndrome (MDS) and acute
myeloid leukaemia (AML).
Patient's white blood cells (T cells) will be modified by transferring a gene which enables
them to make a new T cell receptor (TCR) that can recognize fragments of a protein called WT1
(Wilms' tumour 1) which is present at abnormally high levels on the surface of
myelodysplastic and leukaemic cells.
In this trial, approximately 25 participants with an Human Leukocyte Antigen A2 (HLA-A*0201)
tissue type who have failed to achieve or maintain an IWG defined response following
hypomethylating agent therapy will be recruited.
This is a Phase I/II trial to determine safety, clinical efficacy and feasibility of a
gene-modified WT1 TCR therapy. Following provision of informed consent, each subject will
undergo screening assessments, including HLA-A*0201 screening (if not already documented) and
a bone marrow aspirate/biopsy (BMA) to determine subject eligibility for the trial.
Subjects will undergo leukapheresis within 14 days of screening.
Once successful manufacture of the WT1 TCR-transduced T cells has been confirmed by the
Sponsor, each subject will be administered a lymphodepletive conditioning regimen for five
days consisting of fludarabine x 5 days 30mg/m2 intravenous (i.v.) and methylprednisolone x 1
day 500 mg i.v. Upon completion of the conditioning regimen, subjects will receive an
infusion of WT1 TCR-transduced T cells of ≤2 x 107/kg, followed by daily IL-2 subcutaneous
injections (1 x 106 units/m2 subcutaneous (s.c.) od) for 5 days.
If an IWG response has not been reported (one or more criteria met) at 3 months post-infusion
then, if agreed by both the Investigator and Sponsor, the subject will be offered to have a
repeat infusion of WT1 TCR-transduced T cells.
Following infusion, subjects will enter an intensive period of out-patient follow-up to
observe them for any acute complications and toxicities. Subjects will then be followed
monthly in the clinic for the first 6 months for routine safety and clinical evaluations,
including disease response evaluations. All subjects will be followed-up for a minimum of 12
months.
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