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This study is a phase I study of a cell based prostate cancer therapy, Autologous Lymphoid Effector Cells Specific Against Tumor-cells (ALECSAT). Safety and tolerability of a single dose has been shown in 13 prostate cancer patients. In this study 20 prostate cancer patients will receive 3 doses of the ALECSAT treatment. In this therapy specific cells from the patient's own immune system are isolated, activated and re-administered to the patient to boost a specific immune response against the cancer cells. The aim of the study is to show safety and tolerability for repeated dosing of this type of therapy. It is the hypothesis that the cells administered during the therapy will attack the tumor cells and in this way stop or slow down the progression of disease.
This study is a prospective open phase I study to investigate the safety and tolerability of administration of repeated doses of a cell based medicinal product (CBMP) ALECSAT.
ALECSAT is an autologous CBMP that is made from the patient's own blood cells. ALECSAT contains a large amount of tumour specific cytotoxic Lymphocytes (CTL) and Natural Killer (NK) cells that are isolated activated and amplified in number.
The CBMP is given as a slow i. v. injection to patients with prostate cancer. The patients are in the late stage of the disease where they have received hormone treatment but their disease is progressing.
The primary objective of the study is to observe if any side effects or tolerability issues occur as a consequence of the repeated administration of ALECSAT, secondarily it will be observed if changes in Prostate-Specific Antigen (PSA) levels or any positive anti tumor effect may be observed. The study has the purpose to investigate whether repeated treatment with ALECSAT in any way is toxic.
Trial Design: The study is an open, prospective phase I safety study of ALECSAT in prostate cancer patients.
A group consisting of 4 patients will be treated twice with ALECSAT according to the protocol. Then an interim analysis will be done. If there are no signs of significant toxicity related to the treatment, the study will continue to the third treatment for these patients and with 14 more patients that will be treated with ALECSAT according to the protocol. Thus this study will include a total of 20 patients.
The patients will after the first administration of ALECSAT be hospitalized for 2 days. Five and 10 weeks later the patients will be hospitalized for 1 day and receive the second and third administration of ALECSAT. Each patient will furthermore be followed closely for 12 weeks after the third treatment. During the course of the entire study the patients will be monitored by 11 planned study visits, by the investigators at Department of Urology, Fredrikssund Hospital, Denmark.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ALECSAT | Biological | Autologous activated CTL and NK-cells injected as three intravenous injections interspaced by 5 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Events | To show safety and tolerability patients was monitored closely after administration of ALECSAT and during the follow up period. Heart rate, temperature, blood pressure, Performance status was monitored. Blood samples analysed were: PSA, Alkaline Phosphatase (ALP), Lactate DeHydogenase (LDH), Creatinine (CREAT) and Standard haematology: Blood picture (complete blood count, haemogram), leucocytes, Differential count, electrolytes, renal function, and liver count (liver enzymes). AE and SAE was reported during the study period and the Investigator was urged to judge whether the event was related to the study product or not. | At planned study visit´s at study week 0, 4, 5, 6, 7, 9, 10, 11, 12, 14, 15, 16, 18, 21, 24 and at study visit week 25 |
| Blood Pressure, Pulse and Temperature | Blood pressure, pulse and temperature were monitored frequently during 48 hours post injection of the study product, and thereafter at each follow up visit. | At planned study visit´s at study week 0, 4, 5, 6, 7, 9, 10, 11, 12, 14, 15, 16, 18, 21, 24 and at study visit week 25 |
| Measure | Description | Time Frame |
|---|---|---|
| The Secondary Endpoint for This Study is to Establish if Any Indications of a Positive Therapeutic Effect on the Prostate Cancer May be Observed. | No significant conclusion of efficacy is possible due to the study design with only one group of patients. However by analyzing and comparing the outcome with the data the individual patient presented at baseline some trends of efficacy, defined as stable disease or partial response, are possible. Trends towards possible treatment response were measured by monitoring PSA, a potential marker for prostate cancer disease progression; by other blood markers; and by Quality of life questionnaire (EORTC QLQ-C30) and WHO/ECOG (Eastern Cooperative Oncology Group). Control of any bone metastases were followed by hotspots and bone scan index measured by skeletal scintigraphy. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hans-Henrik Meyhoff, MD | Department of Urology, Frederikssund Hospital, Frederikssundsvej 30, 3600 Frederikssund | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Urology | Frederikssund | DK-3600 | Denmark |
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The subjects was recruited consecutively. The subjects were hospitalized on the day ALECSAT was administered and also one day after the first administration. The overall study period for each participating patient was 25 weeks. The subjects were followed closely during 12 weeks after last treatment by planned study visits.
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| ID | Title | Description |
|---|---|---|
| FG000 | ALECSAT | After inclusion in the ALECSAT trial, the subject donates 200 ml blood sample for the first ALECSAT product, and after 6 and 11 weeks the subject donated 200 ml again for the second and third product. ALECSAT was thereafter administered at week 4, 9, and week 14. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | ALECSAT |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Adverse Events | To show safety and tolerability patients was monitored closely after administration of ALECSAT and during the follow up period. Heart rate, temperature, blood pressure, Performance status was monitored. Blood samples analysed were: PSA, Alkaline Phosphatase (ALP), Lactate DeHydogenase (LDH), Creatinine (CREAT) and Standard haematology: Blood picture (complete blood count, haemogram), leucocytes, Differential count, electrolytes, renal function, and liver count (liver enzymes). AE and SAE was reported during the study period and the Investigator was urged to judge whether the event was related to the study product or not. | No formal statistical analysis plan was considered for this study. Any subject that received one administration of ALECSAT and a 6 week follow-up period will be considered as having received ALECSAT and be included in the efficacy part of the report. All patients that received at least one injection of ALECSAT was assessed for safety. | Posted | Number | Events | At planned study visit´s at study week 0, 4, 5, 6, 7, 9, 10, 11, 12, 14, 15, 16, 18, 21, 24 and at study visit week 25 |
|
At planned study visit´s at study week 0, 4, 5, 6, 7, 9, 10, 11, 12, 14, 15, 16, 18, 21, 24 and at study visit week 25
At each visit, the physician must assess whether any adverse events/reactions or side effects have occurred. Such events may either be reported by the subjects, be observed at the visits or discovered by the laboratory tests.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | ALECSAT |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Back pain radiating to legs | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Systematic Assessment | Pain in pelvis area radiating to leg. Not associated with the study product. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Allergic conjunctivitis | Eye disorders | MedDRA (12.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Christer Lundell-Ek, Project Manager - Clinical Development | CytoVac A/S | cle@cytovac.dk |
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| Within 12 weeks |
| Participants |
|
| Age, Continuous | Mean | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Description |
|---|
| OG000 | ALCESAT |
|
|
| Secondary | The Secondary Endpoint for This Study is to Establish if Any Indications of a Positive Therapeutic Effect on the Prostate Cancer May be Observed. | No significant conclusion of efficacy is possible due to the study design with only one group of patients. However by analyzing and comparing the outcome with the data the individual patient presented at baseline some trends of efficacy, defined as stable disease or partial response, are possible. Trends towards possible treatment response were measured by monitoring PSA, a potential marker for prostate cancer disease progression; by other blood markers; and by Quality of life questionnaire (EORTC QLQ-C30) and WHO/ECOG (Eastern Cooperative Oncology Group). Control of any bone metastases were followed by hotspots and bone scan index measured by skeletal scintigraphy. | Posted | Number | participants | Within 12 weeks |
|
|
|
| Primary | Blood Pressure, Pulse and Temperature | Blood pressure, pulse and temperature were monitored frequently during 48 hours post injection of the study product, and thereafter at each follow up visit. | Posted | Number | participants | At planned study visit´s at study week 0, 4, 5, 6, 7, 9, 10, 11, 12, 14, 15, 16, 18, 21, 24 and at study visit week 25 |
|
|
|
| 7 |
| 21 |
| 20 |
| 21 |
|
| Increased blood Creatinine | Renal and urinary disorders | MedDRA (12.0) | Systematic Assessment | Hospitalization due to elevated Serum Creatinine. Not associated with the study product. |
|
| Leg pain | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Systematic Assessment | Increased thigh pain bilateral. Withdrawn by PI due to skeletal metastasis. Referred to external radiotherapy. Not associated with the study product. |
|
| Ureter obstruction | Renal and urinary disorders | MedDRA (12.0) | Systematic Assessment | Stone in urethra BEFORE first dose of the study product. Not associated with the study product. |
|
| General physical health deterioration | General disorders | MedDRA (12.0) | Systematic Assessment | Shortness of breath and blurred vision. Thorax scanning verifies vertebral metastasis in the lung level. Withdrawn from the study due to progressive disease. Not associated with the study product. |
|
| Femoral artery bypass | Vascular disorders | MedDRA (12.0) | Systematic Assessment | Femoral bypass due to thrombosis. Not associated with the study product. |
|
| Hip fracture | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Systematic Assessment | Fracture due to accidental fall. Not associated with the study product. |
|
| Malignant melanoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (12.0) | Systematic Assessment | Elective surgery/excision of malignant melanoma performed at three times due to node metastasis. Not associated with the study product. |
|
| Paroysmal atrial fibrillation | Cardiac disorders | MedDRA (12.0) | Systematic Assessment |
|
| Noose bleed | Vascular disorders | MedDRA (12.0) | Systematic Assessment |
|
| Bronchitis | Respiratory, thoracic and mediastinal disorders | MedDRA (12.0) | Systematic Assessment |
|
| Dizziness | General disorders | MedDRA (12.0) | Systematic Assessment |
|
| Dyspnea | Respiratory, thoracic and mediastinal disorders | MedDRA (12.0) | Systematic Assessment |
|
| Fever | General disorders | MedDRA (12.0) | Systematic Assessment |
|
| Gastroenteritis | Gastrointestinal disorders | MedDRA (12.0) | Systematic Assessment |
|
| Warm but no fever | General disorders | MedDRA (12.0) | Systematic Assessment |
|
| Hematoma | Vascular disorders | MedDRA (12.0) | Systematic Assessment |
|
| Hydronephros | Renal and urinary disorders | MedDRA (12.0) | Systematic Assessment |
|
| Flu | General disorders | MedDRA (12.0) | Systematic Assessment |
|
| Lip sore/cold | Skin and subcutaneous tissue disorders | MedDRA (12.0) | Systematic Assessment |
|
| Micturition disorder | Renal and urinary disorders | MedDRA (12.0) | Systematic Assessment |
|
| Pain | General disorders | MedDRA (12.0) | Systematic Assessment |
|
| Tiredness | General disorders | MedDRA (12.0) | Systematic Assessment |
|
| Traumatic injury | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Systematic Assessment |
|
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA (12.0) | Systematic Assessment |
|
| Blurred visison | Eye disorders | MedDRA (12.0) | Systematic Assessment |
|
| Cold | Respiratory, thoracic and mediastinal disorders | MedDRA (12.0) | Systematic Assessment |
|
| Gout | Renal and urinary disorders | MedDRA (12.0) | Systematic Assessment |
|
| Increased creatinine level | Renal and urinary disorders | MedDRA (12.0) | Systematic Assessment |
|
| Knee surgery | Musculoskeletal and connective tissue disorders | MedDRA (12.0) | Systematic Assessment | Elective knee surgery |
|
| Malignant melanom | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (12.0) | Systematic Assessment | elective surgery; removal of glandulae |
|
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| Title | Measurements |
|---|---|
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