TCR-T Cell Therapy on Advanced Solid Tumors

Официальное название

A Prospective, One Arm Clinical Study on the Safety, Efficacy and Pharmacokinetics of KRAS Mutant Antigen Specific TCR-T Cells in the Treatment of Advanced Solid Tumors.

Обзор

The primary aim of this study is to evaluate the efficacy of KRAS mutant antigen specific TCR-T cells in the treatment of patients with advanced solid tumors. The secondary aim is to evaluate the pharmacokinetic/pharmacodynamic characteristics of TCR-T cell therapy in patients with advanced solid tumors and the survival of TCR-T cells. The investigators will evaluate the changes of tumor microenvironment after treatment of advanced solid tumors with KRAS mutant antigen specific TCR-T cells; Evaluating the correlation between cytokines and the occurrence of CRS and neurotoxicity

Подробное описание

1.This study is a prospective and single arm clinical study. In this trial, 18 patients with advanced solid tumors with KRAS G12V or G12D mutations and matching HLA-A subtypes are recruited for autologous Tumor-T Cell Receptor (TCR) -Mediated T Cells therapy(TCR-T) therapy.Within 3 - 5 days after pretreatment, subjects will receive a single TCR-T infusion with an infusion dose of about 1 × 10⁹～1 × 10¹⁰. Once every 12 hours within 24 hours after TCR-T cell infusion, recombinant human interleukin-2 will be injected intravenously for 5 days .

After 3 months of treatment, the patient's condition was evaluated. If the subject did not occur tumor progression and did not occur adverse events (AEs) of level 3 or higher, a second TCR-T cell reinfusion can be performed based on researcher's judgment (informed consent form needs to be signed again).

The study will evaluate the safety of TCR-T treatment by observing adverse events after cell therapy; evaluate the effectiveness of TCR-T compared to the results or historical data of the subject's own previous standard treatment regimen;and collect blood before and after cell infusion, measure the number and activity of TCR-T cells, and evaluate the pharmacokinetic (PK) characteristics of TCR-T.

Вмешательства

• Биопрепарат TCR-T therapy
  1.Preprocessing strategy： 1. Cyclophosphamide: 300-450mg/m², dissolved in 100ml 0.9% sodium chloride saline, intravenous drip for 60minutes, and 0.4g Mesna injected at 0hour, 4hours and 8 hours after cyclophosphamide,4days and 5 days before TCR-T cell infusion. 2. Fludarabine: 30mg/m² , dissolved in 100ml 0.9% sodium chloride saline, intravenous drip for 30minutes before 3 to 5days before TCR-T cell infusion. 2.Within 3-5 days after pretreatment, subjects will receive a single TCR-T reinfusion

Первичные конечные точки

• objective response rate（ORR） [Срок оценки: At 12months after the TCR-T cell infusion]

Вторичные конечные точки (12)

• Peak plasma concentration (Cmax) [Срок оценки: 1、3、7、14、28days and 2months、3 months、6 months、9 months、12months after the TCR-T cell infusion]
• Area under the plasma concentration versus time curve (AUC) [Срок оценки: 1、3、7、14、28days and 2months、3 months、6 months、9 months、12months after the TCR-T cell infusion]
• Peak time (Tmax) [Срок оценки: 1、3、7、14、28days and 2months、3 months、6 months、9 months、12months after the TCR-T cell infusion]
• Cell number of TCR-T cells in peripheral blood [Срок оценки: 1、3、7、14、28days and 2months、3 months、6 months、9 months、12months after the TCR-T cell infusion]
• Peak value of cytokines [Срок оценки: 1、3、7、14、28days and 2months、3 months、6 months、9 months、12months after the TCR-T cell infusion]
• Adverse events [Срок оценки: 12months after TCR-T infusion]
• duration of response(DOR) [Срок оценки: 12months after TCR-T infusion]
• The overall survival(OS) [Срок оценки: At 12months after the TCR-T cell infusion]
• Progression free survival (PFS) [Срок оценки: At 12months after the TCR-T cell infusion]
• Time to progression (TTP) [Срок оценки: 12months after the TCR-T cell infusion]
• Event free survival period [Срок оценки: At 12months after the TCR-T cell infusion]
• The disease-free survival period [Срок оценки: At 12months after the TCR-T cell infusion]

Критерии участия

Inclusion Criteria：

• Age greater than 18 years old；
• Subjects with advanced solid tumors confirmed by histology/cytology who have failed standard treatment, are intolerant to standard treatment, or for whom no standard treatment exists. . Non-small cell lung cancer: Recurrent/metastatic non-small cell lung cancer previously treated with platinum-based chemotherapy and/or immunotherapy and/or anti-angiogenic therapy; ii. Pancreatic cancer: Recurrent/metastatic pancreatic cancer that has failed at least one prior systemic therapy; iii. Colorectal cancer: Recurrent/metastatic colorectal cancer that has failed at least two prior systemic therapies (including oxaliplatin, irinotecan, fluoropyrimidine-based agents, anti-angiogenic drugs, etc.); iiii. Other tumors: Other advanced solid tumors that have failed standard treatment, are intolerant to standard treatment, or for which no standard treatment exists;
• Previous tissue pathology or peripheral blood testing confirmed the presence of KRAS G12V or G12D mutations with matching HLA subtypes；
• Expected survival duration of more than 3 months；
• Eastern Cooperative Oncology Group( ECOG )score ≤2；
• All participants voluntarily participate in this study and sign an informed consent. And the subjects have good compliance and can cooperate with investigators follow-up study.
• Patients at least have had at least one measurable lesion as defined by RECIST v1.1 criteria；
• Female participants can not be pregnant or lactating and their serum or urine human chorionic gonadotropin tests must be negative within 72 hours prior to study enrollment；All subjects must be using a medically accepted means of contraception ( (e.g., oral contraceptives, intrauterine device) during the course of this study and for at least 3 months after completion of study therapy.
• Organ function and bone marrow reserve are in good condition, and the following requirements must be met:

1)Absolute neutrophil count≥1.5×10⁹/L, Absolute lymphocyte count ≥0.5×10⁹/L；2)Platelet count≥50×10⁹/L；3)Hemoglobin≥90g/L；4)Bilirubin < 1.5 times upper limit of normal（Bile duct obstruction due to tumor compression were excluded)；5)Serum creatinine ≤ 1.5 times the upper limit of normal range or creatinine clearance ≥ 60 mL/min.6)Serum alanine aminotransferase or aspartate aminotransferase is < 2.5 times the upper limit of the normal value (ULN) (if patients with liver metastasis, ≤5 times the ULN).7)Coagulation function normalised：INR≤1.5，PTT<1.2 times the upper limit of normal（Tumor - related anticoagulant therapy was excluded).

Критерии исключения

• Intracranial metastasis or Patients with moderate or severe hydrothorax need drain placement to relieve symptoms.
• Active pulmonary tuberculosis
• Human immunodeficiency virus (HIV) positive；
• Active Hepatitis B or Hepatitis C infection；
• Pregnant women and lactating females；
• Previous or concurrent history of other malignant tumors. Exceptions include curatively treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy;
• Patients with central nervous metastases；
• Serious, uncontrolled comorbidities that may affect protocol compliance or interfere with interpretation of results，or any serious medical condition that may affect the safety of the subjects ;
• History of clinically significant respiratory diseases or other respiratory diseases that seriously affect Pulmonary function;
• Any active autoimmune disease,any condition requiring steroid hormones or immunosuppressive therapy( including but not limited to systemic lupus erythematosus, sjogren's syndrome, rheumatoid arthritis, psoriasis, multiple sclerosis, inflammatory bowel disease, etc., require > 10 mg/D of prednisone or equivalent hormone）
• A history of organ transplantation；
• A history of myocardial infarction and severe arrhythmia within six months；Ineligible also includes uncontrolled hypertension, coronary heart disease, stroke, liver cirrhosis, nephritis and other serious complications;
• Those who have a history of psychotropic drug abuse and cannot quit or have a history of psychiatric impairment；
• Participants with an allergic constitution, known sensitivity to human serum albumin, cyclophosphamide, fludarabine and interleukin 2;
• Those with bleeding or thromboembolic tendency：bleeding symptoms of clinical significance or a clear tendency to bleeding within 2 weeks prior to entering the study. And those with hereditary or acquired bleeding and thrombotic tendencies； serious arterial/venous thromboembolic events occurred in the previous 6 months;
• Other severe, acute or chronic medical or mental illnesses that in the investigator's judgement will might be increase the risk associated with the patient's participation in the study or interfere with interpretation of research results.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Не применимо

Модель

Одна группа

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Китай · 1 центр

• Sun Yat-sen Memorial Hospital — Гуанчжоу

Публикации

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Идентификаторы

NCT: NCT05438667 · [2022]01-01

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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