Haplo / Allogeneic NKG2DL-targeting Chimeric Antigen Receptor-grafted γδ T Cells for Relapsed or Refractory Solid Tumour

Overview

This clinical trial is an open-label, single-centre, dose escalation, phase I study designed to investigate the safety and tolerability of Haploidentical / Allogeneic NKG2DL-targeting Chimeric Antigen Receptor-grafted Gamma Delta (γδ) T Cells (CTM-N2D) in Subjects with Relapsed or Refractory Solid Tumour. The study objectives of this phase I study are to determine the safety, activity and the safe dose of haploidentical or allogeneic NKG2DL-targeting chimeric antigen receptor-grafted γδ T cells given four times weekly in patients with relapsed or refractory solid tumors of different types.

Full Title of Study: “A Phase I Dose-escalation Trial to Evaluate Haploidentical / Allogeneic Natural Killer Group 2D Ligand (NKG2DL)-Targeting Chimeric Antigen Receptor-grafted Gamma Delta (γδ) T Cells (CTM-N2D) in Subjects With Relapsed or Refractory Solid Tumour”

Study Type

  • Study Type: Interventional
  • Study Design
    • Intervention Model: Sequential Assignment
    • Primary Purpose: Other
    • Masking: None (Open Label)
  • Study Primary Completion Date: September 1, 2020

Detailed Description

CTM-N2D-101 is a phase I dose-escalation study to evaluate the safety of CTM-N2D and the feasibility to produce CTM-N2D for three target dose levels between 3×10^8 – 3×10^9 per infusion will be tested. Four doses will be given at an interval of a week into subjects with relapsed or refractory solid tumors. A typical 3+3 design will be used to determine the safe regimen basing on the incidence of dose-limiting toxicity (DLT). The identified safe regimen will be used for further phase II studies for selected indications.

Interventions

  • Biological: Adoptive Cell Transfer of NKG2DL-targetting Chimeric Antigen Receptor-grafted Gamma Delta T cell
    • Adoptive Cell Transfer of Haploidentical / Allogeneic NKG2DL-targeting Chimeric Antigen Receptor-grafted γδ T Cells (CTM-N2D)

Arms, Groups and Cohorts

  • Experimental: CAR-T Cell Therapy Group
    • One arm study consisting of “3 + 3” dose escalation study design ranging from 3 x 10^8 – 3 x 10^9 cells CAR-γδ T cell. Each cycle of therapy will consist of 4 intravenous infusions, given 7 days apart.

Clinical Trial Outcome Measures

Primary Measures

  • Number of Patients with Dose Limiting Toxicity
    • Time Frame: 6 months
    • The primary endpoint of this dose-escalation study will be the occurrence of dose-limiting toxicities (DLTs) during 4 cycles of treatment and the week after treatment.

Secondary Measures

  • Occurence of adverse events during therapy
    • Time Frame: 6 months
    • A secondary outcome is to observe for the occurence of any adverse events (AEs) and serious adverse events (SAEs) during 4 cycles of treatment and the week after treatment
  • Observation of clinical efficacy
    • Time Frame: 6 months to 2 years
    • A secondary outcome is to observe for the occurrence of objective clinical response at d31, M3, M6, M9, M12, M18 and M24 after the start of 1st cycle of treatment (assessed according to RECIST criteria, version 1.1)
  • Observation for progression-free survival
    • Time Frame: up to 2 years
    • A secondary outcome is to observe for progression-free survival (PFS) and after the start of 1st cycle of treatment
  • Observation for duration of response
    • Time Frame: Up to 2 years
    • A secondary outcome is to observe the duration of response in patients with objective response up to M24, After the start of 1st cycle of treatment

Participating in This Clinical Trial

Inclusion Criteria

  • Men or women ≥18 years old. – Patient with specific cancer indications (see below). – Disease must be measurable according to the corresponding guidelines. – Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 or 2. – Patient with adequate bone marrow reserve (Haemoglobin ≥10g/dl, Absolute Neutrophil Count (ANC)≥1,500/mm3, Platelet≥100,000/mm3), hepatic function (Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) < 3x upper limit of normal), renal function (serum creatinine < 120 µmol/L) and cardiac function (Left ventricular ejection fraction of ≥50% by ECHO). – Patient must already have a previous tumour biopsy to confirm the disease. – Patient must agree to sign the informed consent form (ICF). Cancer-specific inclusion criteria of subject: – Colorectal cancer: A documented metastatic colorectal adenocarcinoma and having received, being intolerant to or being unfit for at least two prior standard cancer therapy regimens as part of their primary treatment regimen or part of their treatment for management of recurrent/persistent disease. – Breast cancer: A metastatic triple-negative breast cancer and having received at least two prior cancer therapy regimens as part of their treatment for management of recurrent/persistent disease. – Sarcoma, nasopharyngeal cancer, prostate cancer or gastric cancer: A metastatic cancer and having received at least two prior cancer therapy regimens as part of their treatment for management of recurrent/persistent disease. Exclusion Criteria:

  • Patients with a tumour metastasis in the central nervous system. – Patients who receive or are to receive any investigational product within the 4 weeks before the planned day for the first CTM-N2D administration. – Patients who receive or are to receive chemotherapy within the 8 weeks before the planned day for the first CTM-N2D administration. – Patients who are planned to receive concurrent growth factor, systemic steroid or other immunosuppressive therapy or cytotoxic agent. – Patients who underwent major surgery within 4 weeks before the planned day for the first CTM-N2D administration. – Patients who have active infections necessitating the use of antibiotics/antivirals treatment. – Patients with a history of autoimmune disease.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • CytoMed Therapeutics Pte Ltd
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Contact(s)
    • Peter Choo, +65 9732 8844, peterchoo@cytomed.sg

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