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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2014-01211 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| RP110553-P4 | |||
| RM1012-012-1 | |||
| 2012-0758 | Other Identifier | M D Anderson Cancer Center |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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This pilot phase I trial studies the side effects and best dose of genetically modified T-cells followed by aldesleukin in treating patients with stage III-IV melanoma. T-cells are a type of white blood cell that help the body fight infections. Genes that may help the T-cells recognize melanoma cells are placed into the T-cells in the laboratory. Adding these genes to the T cells may help them kill more tumor cells when they are put back in the body. Aldesleukin may enhance this effect by stimulating white blood cells to kill more melanoma cells.
PRIMARY OBJECTIVES:
Primary for Cohort A:
I. To assess the feasibility and safety of autologous transforming growth factor beta (TGFb) resistant (DNRII transduced) and NGFR transduced tumor infiltrating lymphocytes (TIL) in patients with metastatic melanoma.
Primary for Cohort B:
I. To assess the feasibility and safety of autologous TGBβ resistant (DNRII transduced) TIL in patients with metastatic melanoma. Feasibility will be defined as the production of virally transduced T cells and treatment of patients with these cells
SECONDARY OBJECTIVES:
Secondary for Cohort A:
I. To determine the survival and immune function of TGFb resistant (DNRII transduced) TIL in vivo.
II. To assess the anti-tumor effects of TGFb resistant (DNRII transduced) TIL.
Secondary for Cohort B:
I. To determine the survival and immune function of TGFβ resistant (DNRII transduced) TIL in vivo
II. To assess the anti-tumor effects of TGFβ resistant (DNRII transduced) TIL.
OUTLINE:
Patients receive cyclophosphamide intravenously (IV) over 2 hours on days -7 and -6, fludarabine phosphate IV daily over 15-30 minutes on days -5 to -1, and TGFb DNRII-transduced autologous TIL and NGFR-transduced autologous T lymphocytes IV over up to 4 hours on day 0. Patients then receive high-dose aldesleukin IV over 15 minutes every 8-16 hours on days 1-5 (up to 15 doses) and 22-26 (up to 15 doses).
After completion of study treatment, patients are followed up at 6 and 12 weeks, every 3 months for 1 year and then yearly for 10 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment (chemotherapy, autologous T-cell immunotherapy) | Experimental | Patients receive cyclophosphamide IV over 2 hours on days -7 and -6, fludarabine phosphate IV daily over 15-30 minutes on days -5 to -1, and TGFb DNRII-transduced autologous TIL and NGFR-transduced autologous T lymphocytes IV over up to 4 hours on day 0. Patients then receive high-dose aldesleukin IV over 15 minutes every 8-16 hours on days 1-5 (up to 15 doses) and 22-26 (up to 15 doses). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Aldesleukin | Biological | Given IV |
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| Measure | Description | Time Frame |
|---|---|---|
| (Cohort A) Generation of TGF alpha (TGFa)-DNRII and NGFR transduced tumor infiltrating lymphocytes (TILs) | Feasibility of generating TGFa-DNRII and NGFR transduced TILs and safety of treating patients with genetically modified T cells will be assessed. Feasibility will be defined as the production of virally transduced T cells and treatment of patients with these cells. | Up to 5 years |
| (Cohort B) The primary endpoint of growing enough TIL for patient treatment and sample size is 15 patients. | The primary endpoint is feasibility (F) of growing enough TIL for patient treatment and sample size is 15 patients.) If you assume that Prob(F) follows 2s a non-informative beta (0.50, 0.50)prior, which has mean = 0.50 and effective sample size =1, then for example, if you observe 5/15 patients for whom F occurred and 10/15 for whom it did not, then a posterior 95% credible interval for Prob(F) would have lower and upper limits 0.14 to 0.58. | Up to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| (Cohort A) Response | Will be defined following immune-related response criteria as a 50% or greater decrease in the tumor's linear dimension post treatment compared to baseline. | Up to 24 months |
| (Cohort A) Number of DNRII transduced cells |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rodabe N Amaria | M.D. Anderson Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| M D Anderson Cancer Center | Houston | Texas | 77030 | United States |
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| Label | URL |
|---|---|
| MD Anderson Cancer Center | View source |
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| Cyclophosphamide | Drug | Given IV |
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| Fludarabine Phosphate | Drug | Given IV |
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| Laboratory Biomarker Analysis | Other | Correlative studies |
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| NGFR-transduced Autologous T Lymphocytes | Biological | Given IV |
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| TGFbDNRII-transduced Autologous Tumor Infiltrating Lymphocytes | Biological | Given IV |
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A linear regression model will be used to test the hypothesis that the DNRII cells are more likely to survive longer in the tumor environment than the NGFR (control) cells. Dose will be included as a covariate. Separate analyses will be performed at each post-treatment time point (6 weeks, 12 weeks, 6 months, 12 months, and 24 months), with the 6-month time point considered primary. If there is evidence of a linear relationship over time, a generalized linear mixed model (GLMM) approach may be used to model the DNRII/NGFR ratio over time.
| 6 months |
| (Cohort A) Number of NGFR transduced cells at infusion | A linear regression model will be used to test the hypothesis that the DNRII cells are more likely to survive longer in the tumor environment than the NGFR (control) cells. Dose will be included as a covariate. Separate analyses will be performed at each post-treatment time point (6 weeks, 12 weeks, 6 months, 12 months, and 24 months), with the 6-month time point considered primary. If there is evidence of a linear relationship over time, a GLMM approach may be used to model the DNRII/NGFR ratio over time. | Day 0 |
| (Cohort A) Number of NGFR transduced cells based on tumor biopsy | A linear regression model will be used to test the hypothesis that the DNRII cells are more likely to survive longer in the tumor environment than the NGFR (control) cells. Dose will be included as a covariate. Separate analyses will be performed at each post-treatment time point (6 weeks, 12 weeks, 6 months, 12 months, and 24 months), with the 6-month time point considered primary. If there is evidence of a linear relationship over time, a GLMM approach may be used to model the DNRII/NGFR ratio over time. | Up to 24 months |
| ID | Term |
|---|---|
| D008545 | Melanoma |
| ID | Term |
|---|---|
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D012878 | Skin Neoplasms |
| D009371 | Neoplasms by Site |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| C082598 | aldesleukin |
| D003520 | Cyclophosphamide |
| C042382 | fludarabine phosphate |
| ID | Term |
|---|---|
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
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