Anti-CD7 CAR-Engineered T Cells for T Lymphoid Malignancies Malignancies
Study Details
Study Description
Brief Summary
This is a single-center, open-label, single-arm study to evaluate the primary safety and efficacy of anti-CD7 chimeric antigen receptor(CAR)-modified T cells(CAR7-Ts) in patients with relapsed or refractory T lymphoid malignancies.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 1 |
Detailed Description
Chimeric antigen receptor-T cells (CAR-T) have made breakthroughs in the treatment of B-cell tumors, especially refractory/relapsed acute B lymphocytes. CD7 is a transmembrane glycoprotein expressed by T cells and natural killer cells and their precursors; it is also expressed in >95% of lymphoblastic T-cell leukemias and lymphomas . CD7 was previously evaluated as a target for immunotoxin-loaded antibodies in patients with T-cell malignancies, but tumor responses were limited.
Enhancing the potency of CD7-directed cytotoxicity by substituting donor-derived CAR-T cells for a monoclonal antibody would augment the efficacy of CD7-targeted therapy in patients with T-cell malignancies. To prepare CAR7-T cells, CD7 expression is suppressed on donor-derived T cells by unique blocking technique, and CD7-negative T cells are transduced with a humanized anti-CD7-41BB-CD3ζ lentiviral vector.
This is an investigational study. The objectives are to evaluate the safety and efficacy of CAR7-T cells in patients with CD7+ T-cell malignancies.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Fludarabine + Cyclophosphamide + anti-CD7 CAR-T Cells Patients will received lymphodepletion with fludarabine (30 mg/kg) and cyclophosphamide (250 mg/kg) on day -5, -4, and -3, followed by the infusion of CAR7-T cells with the dose of 1×10^6/kg and 2×10^6/kg (with an allowance of ±20%). If no dose-limited toxicity (DLT) emerges in the group, then the subsequent higher dose will be used in the next group. If DLT emerges in a single subject in any dose level, 3 more subjects will be enrolled to the same dose level. The maximum dose could be extended. |
Drug: Fludarabine + Cyclophosphamide + CAR7-T Cells
fludarabine 30 mg/kg on day -5, -4, and -3; cyclophosphamide 250 mg/kg on day -5, -4, and -3; CAR7-T Cells on day 0.
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Outcome Measures
Primary Outcome Measures
- Incidence of Treatment-related Adverse Events [within 2 years after infusion]
Therapy-related adverse events will be recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0).
Secondary Outcome Measures
- Overall response rate(ORR) of administering CAR7-T cells in Relapsed/Refractory CD7+ T-cell hematological malignancies. [within 2 years after infusion]
ORR will be assessed from CAR T cell infusion to death or last follow-up (censored).
- Complete response rate(CRR) of administering CAR7-T cells in Relapsed/Refractory CD7+ T-cell hematological malignancies. [within 2 years after infusion]
CRR will be assessed from CAR T cell infusion to death or last follow-up (censored).
- Progress-free survival(PFS) of administering CAR7-T cells in Relapsed/Refractory CD7+ T-cell hematological malignancies. [within 2 years after infusion]
PFS will be assessed from CAR T cell infusion to death or last follow-up (censored).
- Duration of Response(DOR) of administering CAR7-T cells in Relapsed/Refractory CD7+ T-cell hematological malignancies. [within 2 years after infusion]
DOR will be assessed from CAR T cell infusion to death or last follow-up (censored).
- Overall survival(OS) of administering CAR7-T cells in Relapsed/Refractory CD7+ T-cell hematological malignancies. [within 2 years after infusion]
OS will be assessed from CAR T cell infusion to death or last follow-up (censored).
Other Outcome Measures
- In vivo expansion and survival of CAR7-T cells [within 2 years after infusion]
Quantity of CAR copies in bone marrow and peripheral blood will be determined by using quantitative polymerase chain reaction.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Aged from 14 to 70 years;
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Expected survival over 60 days;
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Eastern Cooperative Oncology Group score 0-2;
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Diagnosed as T-cell hematologic malignancies (including leukemia and lymphoma) according to WHO2016 criteria;
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Patients must relapse or be refractory after at least two lines of therapy.
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CD7 were positive in bone marrow or cerebrospinal fluid by immunohistochemistry or flow cytometry at screening, and one of the following conditions is satisfied:
- No remission was achieved after at least 2 lines of standard therapy; B. Relapse or progression after standard treatment; C. Relapse after autologous or allogeneic hematopoietic stem cell transplantation;
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Have no fertility requirements or plans for one year since enrollment in this clinical trial;
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Patient or his or her legal guardian voluntarily participates in and signs an informed consent form.
Exclusion Criteria:
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Complicated with central system leukemia/lymphoma with active intracranial lesions;
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Existing or preexisting CNS conditions, such as epileptic seizures, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or any CNS related autoimmune disease;
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Symptomatic heart failure or severe arrhythmias;
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Symptoms of severe respiratory failure;
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Complicated with other types of malignant tumors;
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Serum creatinine and/or urea nitrogen ≥ 1.5 times of normal value;
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Suffer from sepsis or other uncontrollable infections;
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Intracranial hypertension or brain consciousness disorder;
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Severe mental disorders;
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Have received organ transplantation (excluding bone marrow transplantation);
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Female patients (fertile patients) had positive blood HCG test;
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Hepatitis (including hepatitis B and C), AIDS and syphilis were screened positive;
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Patients with graft-versus-host disease (GVHD) or who require immunosuppressant treatment;
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The absolute value of lymphocytes was too low to manufacture CART cells;
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Other conditions considered inappropriate by the researcher.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Union Hospital, Huazhong University of Science and Technology | Wuhan | Hubei | China | 430022 |
Sponsors and Collaborators
- Wuhan Union Hospital, China
- Beijing GoBroad Hospital Management Co.,Ltd
- Shanghai YaKe Biotechnology Ltd.
Investigators
- Principal Investigator: Heng Mei, Wuhan Union Hospital, China
Study Documents (Full-Text)
None provided.More Information
Publications
- CAR7-T-cells