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This is a single-arm, multi-site, single-dose, Phase 1/2 study to assess ST-400 in 6 subjects with transfusion-dependent β-thalassemia (TDT) who are ≥18 and ≤40 years of age. ST-400 is a type of investigational therapy that consists of gene edited cells. ST-400 is composed of the patient's own blood stem cells which are genetically modified in the laboratory using Sangamo's zinc finger nuclease (ZFN) technology to disrupt a precise and specific sequence of the enhancer of the BCL11A gene (which normally suppresses fetal hemoglobin production in erythrocytes). This process is intended to boost fetal hemoglobin (HbF), which can substitute for reduced or absent adult (defective) hemoglobin. ST-400 is then infused back into the patient after receiving conditioning chemotherapy to make room for the new cells in the bone marrow, with the aim of producing new erythrocytes with increased amounts of HbF. The primary objective is to understand safety and tolerability of ST-400, and secondary objectives are to assess the effects on HbF levels and transfusion requirements.
Once consented, study participants will progress through the following stages:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ST-400 Investigational product | Experimental | ST-400 Investigational product is composed of autologous CD34+ hematopoietic stem/progenitor cells that are genetically modified ex vivo at the erythroid-specific enhancer of the BCL11A gene |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ST-400 Investigational product | Genetic | Single dose of ST-400 following chemotherapy conditioning with busulfan |
|
| Measure | Description | Time Frame |
|---|---|---|
| Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) up to 156 Weeks After the ST-400 Infusion | Safety and tolerability assessed by number of participants with Adverse Events (AEs) and Serious Adverse Events (SAEs) up to 156 weeks after the ST-400 infusion | Up to 156 weeks after the ST-400 infusion |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical Laboratory Measurement of Hemoglobin (Hb) Fractions (A and F in g/dL) | Change from baseline clinical laboratory measurement of Hb fractions (A and F in g/dL) [Time Frame: Up to 156 weeks after ST-400 infusion] | Baseline, Weeks 26, 52, and 156 after ST-400 infusion |
| Clinical Laboratory Measurements of Percent (%) HbF |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Medical Monitor | Sangamo Therapeutics, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California, Los Angeles | Los Angeles | California | 90095-1678 | United States | ||
| UCSF Benioff Children's Hospital Oakland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34175041 | Derived | Brusson M, Miccio A. Genome editing approaches to beta-hemoglobinopathies. Prog Mol Biol Transl Sci. 2021;182:153-183. doi: 10.1016/bs.pmbts.2021.01.025. Epub 2021 Mar 1. |
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The original enrollment goal was six subjects were to be enrolled in the Phase 1/2 study ST-400-01, but 5 subjects were enrolled and dosed. One subject from the 5 dosed withdrew consent prior to completing the study. Subjects who received treatment with ST-400 were asked to participate in a separate observational long-term safety study.
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| ID | Title | Description |
|---|---|---|
| FG000 | ST-400 Investigational Product | ST-400 Investigational product is composed of autologous CD34+ hematopoietic stem/progenitor cells that are genetically modified ex vivo at the erythroid-specific enhancer of the BCL11A gene ST-400 Investigational product: Single dose of ST-400 following chemotherapy conditioning with busulfan |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Primary (ST-400 Infusion up to Week 52 ) |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Apr 9, 2021 | Aug 9, 2023 |
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Change from baseline percent (%) HbF [Time Frame: Up to 156 weeks after ST-400 infusion] |
| Baseline, Weeks 26, 52, and 156 after ST-400 infusion |
| Annualized Frequency of Packed RBC Transfusions | Calculation of annualized frequency and volume of packed red blood cell (PRBC) transfusions after ST-400 infusion transfusion support in the 2 years prior to screening | From Baseline (2 years prior to screening/consent), to ST-400 Infusion (Day 0), after hematopoietic reconstitution and up to 156 weeks (post ST-400 infusion) |
| Annualized Volume (mL) of Packed RBC Transfusions | Historical baseline defined as transfusion support in the 2 years prior to screening. | From Baseline (2 years prior to screening/consent), to ST-400 Infusion (Day 0), after hematopoietic reconstitution and up to 156 weeks (post ST-400 infusion) |
| Oakland |
| California |
| 94609 |
| United States |
| Children's Healthcare of Atlanta | Atlanta | Georgia | 30322 | United States |
| Dana-Farber Boston Children's Cancer and Blood Disorders Center | Boston | Massachusetts | 02116 | United States |
| University of Minnesota | Minneapolis | Minnesota | 55455 | United States |
| Children's Hospital of Philadelphia | Philadelphia | Pennsylvania | 19104 | United States |
| COMPLETED |
|
| NOT COMPLETED |
|
| Follow Up (Weeks 52-156 Post Infusion) |
|
|
The study population comprise male and non-pregnant, non-lactating female subjects with TDT between 18 and 40 years old, who are willing and able to undergo autologous HSCT.
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| ID | Title | Description |
|---|---|---|
| BG000 | ST-400 Investigational Product | ST-400 Investigational product is composed of autologous CD34+ hematopoietic stem/progenitor cells that are genetically modified ex vivo at the erythroid-specific enhancer of the BCL11A gene ST-400 Investigational product: Single dose of ST-400 following chemotherapy conditioning with busulfan |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||||
| Hemoglobin A (g/dL) at Baseline | Mean | Standard Deviation | g/dL |
| |||||||||||||||||
| Hemoglobin F (g/dL) at Baseline | Mean | Standard Deviation | g/dL |
| |||||||||||||||||
| Hemoglobin F Percentage at Baseline | Mean | Standard Deviation | Percentage |
|
| 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 | Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) up to 156 Weeks After the ST-400 Infusion | Safety and tolerability assessed by number of participants with Adverse Events (AEs) and Serious Adverse Events (SAEs) up to 156 weeks after the ST-400 infusion | All subjects who received the ST-400 infusion | Posted | Number | participants | Up to 156 weeks after the ST-400 infusion |
|
|
| |||||||||||||||||||||||||||||||||
| Secondary | Clinical Laboratory Measurement of Hemoglobin (Hb) Fractions (A and F in g/dL) | Change from baseline clinical laboratory measurement of Hb fractions (A and F in g/dL) [Time Frame: Up to 156 weeks after ST-400 infusion] | Hb fractions (A and F in g/dL) Change from Baseline to Week 26, Week 52 and Week 156 in Safety Population | Posted | Mean | Standard Deviation | g/dL | Baseline, Weeks 26, 52, and 156 after ST-400 infusion |
|
| |||||||||||||||||||||||||||||||||
| Secondary | Clinical Laboratory Measurements of Percent (%) HbF | Change from baseline percent (%) HbF [Time Frame: Up to 156 weeks after ST-400 infusion] | Change Percent (%) HbF from Baseline to Week 26, Week 52 and Week 156 in Safety Population | Posted | Mean | Standard Deviation | Percentage of Hemoglobin F | Baseline, Weeks 26, 52, and 156 after ST-400 infusion |
|
| |||||||||||||||||||||||||||||||||
| Secondary | Annualized Frequency of Packed RBC Transfusions | Calculation of annualized frequency and volume of packed red blood cell (PRBC) transfusions after ST-400 infusion transfusion support in the 2 years prior to screening | Annualized Frequency of Blood Product Transfusion in Safety Population | Posted | Mean | Standard Deviation | PRBC transfusions/year | From Baseline (2 years prior to screening/consent), to ST-400 Infusion (Day 0), after hematopoietic reconstitution and up to 156 weeks (post ST-400 infusion) |
|
| |||||||||||||||||||||||||||||||||
| Secondary | Annualized Volume (mL) of Packed RBC Transfusions | Historical baseline defined as transfusion support in the 2 years prior to screening. | Blood Product Annualized Total Volume Transfused in Safety Population | Posted | Mean | Standard Deviation | mL/year | From Baseline (2 years prior to screening/consent), to ST-400 Infusion (Day 0), after hematopoietic reconstitution and up to 156 weeks (post ST-400 infusion) |
|
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Participants with adverse events data collected from ICF signed through participant's last study visit, up to 156 weeks
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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 | ST-400 Investigational Product | ST-400 Investigational product is composed of autologous CD34+ hematopoietic stem/progenitor cells that are genetically modified ex vivo at the erythroid-specific enhancer of the BCL11A gene. Single dose of ST-400 following chemotherapy conditioning with busulfan. | 0 | 5 | 3 | 5 | 5 | 5 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Drug withdrawal syndrome | General disorders | Systematic Assessment |
| ||
| Hypersensitivity | Immune system disorders | Systematic Assessment |
| ||
| Pneumonia | Infections and infestations | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Febrile neutropenia | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Anaemia | Blood and lymphatic system disorders | Systematic Assessment |
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| Neutropenia | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Thrombocytopenia | Blood and lymphatic system disorders | Systematic Assessment |
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| Leukopenia | Blood and lymphatic system disorders | Systematic Assessment |
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| Sinus tachycardia | Cardiac disorders | Systematic Assessment |
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| Tachycardia | Cardiac disorders | Systematic Assessment |
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| Palpitations | Cardiac disorders | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | Systematic Assessment |
| ||
| Stomatitis | Gastrointestinal disorders | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Nausea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Abdominal pain | Gastrointestinal disorders | Systematic Assessment |
| ||
| Abdominal pain upper | Gastrointestinal disorders | Systematic Assessment |
| ||
| Gastrooesophageal reflux disease | Gastrointestinal disorders | Systematic Assessment |
| ||
| Haemoperitoneum | Gastrointestinal disorders | Systematic Assessment |
| ||
| COVID-19 | Infections and infestations | Systematic Assessment |
| ||
| Viral upper respiratory tract infection | Infections and infestations | Systematic Assessment |
| ||
| Bacterial sepsis | Infections and infestations | Systematic Assessment |
| ||
| Coxsackie viral infection | Infections and infestations | Systematic Assessment |
| ||
| Influenza | Infections and infestations | Systematic Assessment |
| ||
| Pneumonia | Infections and infestations | Systematic Assessment |
| ||
| Respiratory syncytial virus infection | Infections and infestations | Systematic Assessment |
| ||
| Sinusitis | Infections and infestations | Systematic Assessment |
| ||
| Upper respiratory tract infection | Infections and infestations | Systematic Assessment |
| ||
| Arthralgia | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Back pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Pain in extremity | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Flank pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Osteoporosis | Musculoskeletal and connective tissue disorders | Systematic Assessment |
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| Insomnia | Psychiatric disorders | Systematic Assessment |
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| Depression | Psychiatric disorders | Systematic Assessment |
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| Anxiety | Psychiatric disorders | Systematic Assessment |
| ||
| Fatigue | General disorders | Systematic Assessment |
| ||
| Non-cardiac chest pain | General disorders | Systematic Assessment |
| ||
| Peripheral swelling | General disorders | Systematic Assessment |
| ||
| Hypokalaemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Hypophosphataemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Iron overload | Metabolism and nutrition disorders | Systematic Assessment |
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| Decreased appetite | Metabolism and nutrition disorders | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | Systematic Assessment |
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| Fluid overload | Metabolism and nutrition disorders | Systematic Assessment |
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| Vitamin D deficiency | Metabolism and nutrition disorders | Systematic Assessment |
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| Headache | Nervous system disorders | Systematic Assessment |
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| Hyperaesthesia | Nervous system disorders | Systematic Assessment |
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| Migraine | Nervous system disorders | Systematic Assessment |
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| Restless legs syndrome | Nervous system disorders | Systematic Assessment |
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| Procedural pain | Injury, poisoning and procedural complications | Systematic Assessment |
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| Road traffic accident | Injury, poisoning and procedural complications | Systematic Assessment |
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| Infusion related reaction | Injury, poisoning and procedural complications | Systematic Assessment |
| ||
| Post-traumatic pain | Injury, poisoning and procedural complications | Systematic Assessment |
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| Transfusion reaction | Injury, poisoning and procedural complications | Systematic Assessment |
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| Traumatic haematoma | Injury, poisoning and procedural complications | Systematic Assessment |
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| Vaccination complication | Injury, poisoning and procedural complications | Systematic Assessment |
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| Platelet count decreased | Investigations | Systematic Assessment |
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| White blood cell count decreased | Investigations | Systematic Assessment |
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| Hepatic enzyme increased | Investigations | Systematic Assessment |
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| Lymphocyte count decreased | Investigations | Systematic Assessment |
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| Neutrophil count decreased | Investigations | Systematic Assessment |
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| Epistaxis | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Hypoxia | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Bradypnoea | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Laryngeal inflammation | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Alopecia | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Dry skin | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | Systematic Assessment |
| ||
| Skin hyperpigmentation | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Skin hypopigmentation | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Stasis dermatitis | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Dry eye | Eye disorders | Systematic Assessment |
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| Vision blurred | Eye disorders | Systematic Assessment |
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| Hypersensitivity | Immune system disorders | Systematic Assessment |
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| Hypertension | Vascular disorders | Systematic Assessment |
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| Hypotension | Vascular disorders | Systematic Assessment |
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| Cholelithiasis | Hepatobiliary disorders | Systematic Assessment |
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| Dysuria | Renal and urinary disorders | Systematic Assessment |
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| Ovarian cyst ruptured | Reproductive system and breast disorders | Systematic Assessment |
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| Leukocytosis | Blood and lymphatic system disorders | Systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | Systematic Assessment |
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| Incision site pain | Injury, poisoning and procedural complications | Systematic Assessment |
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| Vascular access site haemorrhage | Injury, poisoning and procedural complications | Systematic Assessment |
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| Vascular access site pain | Injury, poisoning and procedural complications | Systematic Assessment |
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| International normalised ratio increased | Investigations | Systematic Assessment |
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| Hyperglycaemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Hyperuricaemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Hypomagnesaemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Bone pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
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| Dysgeusia | Nervous system disorders | Systematic Assessment |
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| Haematuria | Renal and urinary disorders | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
Due to the limited sample size of 5 subjects, the study results presented are primarily descriptive in nature.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Medical Monitor | Sangamo Therapeutics, Inc. | (510) 307-7266 | clinicaltrials@sangamo.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Dec 20, 2021 | Aug 9, 2023 | SAP_001.pdf |
| ICF | No | No | Yes | Informed Consent Form | May 14, 2020 | Aug 9, 2023 | ICF_002.pdf |
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| ID | Term |
|---|---|
| D017086 | beta-Thalassemia |
| ID | Term |
|---|---|
| D013789 | Thalassemia |
| D000745 | Anemia, Hemolytic, Congenital |
| D000743 | Anemia, Hemolytic |
| D000740 | Anemia |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D006453 | Hemoglobinopathies |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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| Unknown or Not Reported |
|
| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
|
| More than one race |
|
| Unknown or Not Reported |
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