T Cell Receptor-transduced T Cells Targeting NY-ESO-1 for Treatment of Patients With NY-ESO-1- Expressing Malignancies

• Status: Unknown status
• Trial end date: 2019-12-01
• Target enrollment: 0
• Participant gender: All

Summary

Background:

Autologous T cells engineered to express a T cell receptor (TCR) targeting NY-ESO-1 will be infused back to patients with NY-ESO-1- expressing malignancies. The patients pretreated with a lymphodepleting preconditioning regimen will be monitored after infusion of anti-NY-ESO-1 TCR-transduced T cells for adverse events, persistence of anti-NY-ESO-1 TCR-transduced T cells and treatment efficacy.

Objectives:

To evaluate the safety and the efficacy of anti-NY-ESO-1 TCR-transduced T cell-based immunotherapy for patients with NY-ESO-1- expressing malignancies.

Eligibility:

Patients older than one year of age, who have relapsed or refractory malignancies that express both NY-ESO-1 and human leukocyte antigen (HLA)-A2 molecules.

Patients must have adequate organ functions.

Design:

• Peripheral blood from patients will be collected for isolation of peripheral blood mononuclear cells (PBMCs), which will be transduced with a lentiviral or retroviral vector encoding an HLA-A2 restricted anti-NY-ESO-1 TCR gene.

• Patients will receive a lymphodepleting preconditioning regimen to prepare their immune system to accept modified T cells.

• Patients will receive an infusion of their own modified T cells. They will remain in the hospital to be monitored for adverse events until they have recovered from the treatment.

• Patients will have frequent follow-up visits to monitor the persistence of modified T cells and efficacy of the treatment.

• Phase: Phase 1
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Shenzhen Second People's Hospital
• Collaborator: Shenzhen Institute for Innovation and Translational Medicine
• Treatments: Cyclophosphamide; Fludarabine; Fludarabine phosphate

Criteria

• Inclusion Criteria:

1. Must be pathology or cytology confirmed cancer patients with age of one year old and over；

2. Must be HLA-A2 positive, and cancer tissues express NY-ESO-1；

3. There is at least one measurable disease: diameter ≥20mm or spiral CT≥10mm；

4. Willing to sign a durable power of attorney；

5. Able to understand and sign the Informed Consent Document；

6. Performance status：ECOG 0-2；

7. Life expectancy：More than 3 months；

8. Patients must be willing to practice birth control for four months after receiving a lymphodepleting preconditioning regimen；

9. Patients with no pregnancy and lactation；

10. Hematopoietic： (1) Absolute neutrophil count > 1000/mm3 without support of filgrastim； (2) Platelet count > 100,000/mm3； (3) Hemoglobin > 8.0 g/dL； (4) lymphocyte count >500/mm3； (5) WBC > 3,000/mm3；

11. Chemistry： (1) AST and ALT < 2.5 times upper limit of normal； (2) Serum creatinine≤1.6 mg/dl； (3) Bilirubin ≤1.5 mg/dL（3.0 mg/dL in patients with Gilbert's syndrome）；

12. Seronegative for hepatitis B and C viruses；

13. Seronegative for human immunodeficiency virus (HIV) antibody；

14. More than four weeks must have elapsed since any prior systemic therapy at the time of randomization, and patients' toxicities must have recovered to a grade 1 or less (except for alopecia or vitiligo). Patients may have undergone minor surgical procedures within the past 3 weeks, as long as all toxicities have recovered to grade 1 or less or as specified in the eligibility criteria；

15. Six weeks must have elapsed since any prior anti-CTLA4 antibody therapy to allow antibody levels to decline. Patients who have previously received any anti-CTLA4 antibody and have documented gastrointestinal (GI) toxicity must have a normal colonoscopy with normal colonic biopsies.

• Exclusion Criteria:

1. Any form of primary immunodeficiency (such as Severe Combined Immunodeficiency Disease)；

2. Active systemic infections；

3. Coagulation disorders or other major medical illnesses of the cardiovascular, respiratory or immune system；

4. Concurrent use of systemic steroids；

5. History of severe immediate hypersensitivity reaction to any of the agents used in this study；

6. There are obvious dysfunctions in heart , liver，kidney and other vital organs

7. T cell lymphoma and leukemia patients；

8. HIV positive；

9. History of coronary revascularization or ischemic symptoms；

10. Documented Left Ventricular Ejection Fraction (LVEF) of less than or equal to 45 percent tested in patients with: Clinically significant atrial and/or ventricular arrhythmias including but not limited to: atrial fibrillation, ventricular tachycardia, second or third degree heart block；

11. Documented forced expiratory volume 1 (FEV1) less than or equal to 60 percent predicted tested in patients with a prolonged history of cigarette smoking (20 pk/yrs of smoking) or symptoms of respiratory dysfunction；

12. Bronchial lesions (probably shifted obstructive pneumonia or intracranial hemorrhage risk)