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This is a single-arm, open-label, one center clinical study, to determine the safety and efficacy of infusion of autologous T cells engineered to express immune checkpoint antibodies (CTLA-4 and PD-1) and chimeric antigen receptor targeting MUC1 in adult patients with MUC1 positive, advanced recurrent or refractory malignant solid tumors.
This study will be conducted using a phase I/II trial design to assess the safety and efficacy of the CTLA-4 and PD-1 antibodies expressing MUC1-CAR-T for patients with MUC1 positive, advanced recurrent or refractory malignant solid tumors. MUC1-CAR-T can specificly and effectively kill the MUC1 positive cancer cells, CTLA4 and PD-1 antibodies are secreted from the CAR-T cells could improve immunosuppression microenvironment, new CAR-T cells contain the advantages of CAR-T and immune checkpoint inhibitor, which is a promising therapeutic method for advanced solid tumors.
The new CAR-T therapy is applied to clinical practice as bellow. T cells are prepared from peripheral blood mononuclear cells (PBMC) by leukapheresis, and then activated and engineered to express CTLA-4 and PD-1 antibodies and chimeric antigen receptor targeting MUC1. Cells are proliferated in culture and returned to the patients by venous transfusion. A total of 40 patients may be enrolled in the study. The total duration of the study is expected to be approximately 24 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Anti-CTLA-4/PD-1 expressing MUC1-CAR-T | Experimental | This study have only one arm that is anti-CTLA-4/PD-1 expressing MUC1-CAR-T group. All patients with advanced solid tumor will take part in the screening, who matching all the conditions will be chosen for the treatment using CTLA-4 and PD-1 antibodies expressing MUC1-targeted CAR-T cells. New CAR-T cells are cultured from PBMC and returned to the patients by venous transfusion. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Anti-CTLA-4/PD-1 expressing MUC1-CAR-T | Biological | Every cycle, peripheral blood mononuclear cells (PBMC) are collected on day 0, CAR-T cells are cultured in a GMP standard workshop. Patients are given a three-day regimen of chemotherapy consisting of cyclophosphamide aimed to deplete the lymphocytes before cells infusion. Then the patients will receive an i.v.gtt infusion of CTLA-4 and PD-1 antibodies expressing MUC1 targeted CAR-T cells at (2-5) ×10^7 cells/kg from day 18 to day 19 (±2 days). 2 cycles are regarded as a treatment period. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety of infusion of autologous CTLA-4 and PD-1 antibodies expressing MUC1-targeted CAR-T cells | Determine the toxicity profile of CTLA4 and PD-1 antibodies expressing MUC1-targeted CAR-T cells with Common Toxicity Criteria for Adverse Effects (CTCAE) version 4.0. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| The efficacy of the treatment using CTLA-4 and PD-1 antibodies expressing MUC1-CAR-T cells for advanced solid tumors | The efficacy of the treatment is assessed according to the response evaluation criteria in solid tumor version 1.1 (RECIST1.1), which is defined as complete remission (CR), partial remission (PR), stable disease (SD), or progressive disease (PD). | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Progression free survival | Progression free survival is defined as the time from the day in which the patient is enrolled to the date on which tumor progresses or the date on which the patient dies for any cause. | 2 years |
| Overall survival |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zhiwei Zhang, Ph.D | Contact | 0086-021-39595338 | zhangzw@shcell.com |
| Name | Affiliation | Role |
|---|---|---|
| Qijun Qian, Ph.D | Shanghai Cell Therapy Research Institute | Study Chair |
| Huajun Jin, Ph.D | Shanghai Cell Therapy Research Institute | Study Chair |
| Zhiwei Zhang, Ph.D |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ningbo No.5 Hospital (Ningbo Cancer Hospital) | Recruiting | Ningbo | Zhejiang | 315201 | China |
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| ID | Term |
|---|---|
| C563326 | Diabetes Mellitus, Insulin-Dependent, 12 |
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| ID | Term |
|---|---|
| D060908 | CTLA-4 Antigen |
| ID | Term |
|---|---|
| D000082102 | Immune Checkpoint Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D061025 | Costimulatory and Inhibitory T-Cell Receptors |
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Overall survival is defined as the time from the day in which the patient is enrolled to the date on which the patient dies for any cause.
| 2 years |
| Change of life quality | Life quality is assessed before and after the treatment. | 2 years |
| Proliferation and persistence of MUC1 specific CAR-T cells in peripheral blood of the patients after treatment | CAR-T proportion in peripheral blood of the patients is detected by flow cytometry assay to study the proliferation and persistence of MUC1 specific CAR-T cells. | 6 months |
| CTLA-4 and PD-1 antibodies level in peripheral blood of the patients after treatment | CTLA-4 and PD-1 antibodies level are detected by ELISA assay to asess the expressing level of CTLA4 and PD-1 antibodies from CAR-T cells. | 6 months |
| Shanghai Cell Therapy Research Institute |
| Study Director |
| Yan Sun | Shanghai Cell Therapy Research Institute | Study Director |
| Jiangtao Wang | Ningbo No.5 Hospital(Ningbo Cancer Hospital) | Principal Investigator |
| D011971 | Receptors, Immunologic |
| D011956 | Receptors, Cell Surface |
| D008565 | Membrane Proteins |
| D000945 | Antigens, Differentiation, T-Lymphocyte |
| D000943 | Antigens, Differentiation |
| D000954 | Antigens, Surface |
| D000941 | Antigens |
| D001685 | Biological Factors |
| D015415 | Biomarkers |