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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 target mesothelin and express PD-1 antibodies in adult patients with advanced recurrent or refractory malignant solid tumors, which were positive expression of mesothelin.
This study will be conducted using a phase I/II trial design to assess the safety and efficacy of the PD-1 antibody expressing mesoCAR-T for patients with mesothelin positive, advanced recurrent or refractory malignant solid tumors. MesoCAR-T can specifically and effectively kill the mesothelin positive cancer cells, PD-1 antibody 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 chimeric antigen receptors (CARs) targeting mesothelin and PD-1 antibody. Cells are proliferated in culture and returned to the patients by venous transfusion therapy. A total of 50 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 |
|---|---|---|---|
| PD-1 antibody expressing mesoCAR-T cells | Experimental | Patients will receive two cycles of PD-1 antibody expressing mesoCAR-T cells treatment. Every cycle, peripheral blood mononuclear cells (PBMC) are collected on day -18, CAR-T cells are cultured in a GMP standard workshop. Patients are given a three-day regimen of chemotherapy consisting of fludarabine and cyclophosphamide aimed to deplete the lymphocytes before cells infusion. Then the patients will receive an i.v.gtt infusion of PD-1 antibody expressing mesoCAR-T cells from day 1 to day 3 (±3days). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PD-1 antibody expressing mesoCAR-T cells | Biological | Patients with mesothelin positive cancer will be infused the PD-1 antibody expressing mesoCAR-T cells. The modified mesoCAR-T cells can specifically kill mesothelin positive cancer cells and secrete PD-1 antibody, which could enhance the cytotoxicity of mesoCAR-T cells and activate the tumor infiltrating lymphocytes. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of treatment-related adverse events of infusion of autologous PD-1 antibody expressing mesothelin-targeted CAR-Tcells | Incidence of treatment-related adverse events are assessed using the NCI CTCAE V4.0 criteria. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Objective response rate (ORR) of the treatment using PD-1 antibody expressing mesoCAR-T cells for advanced solid tumors | Objective response rate (ORR) of the treatment is assessed according to the response evaluation criteria in solid tumor version 1.1 (RECIST1.1), which contains complete response (CR) and partial response (PR). | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Proliferation and persistence of mesothelin specific CAR-T cells in peripheral blood of the patients | CAR-T proportionin in peripheral blood of the patients is detected by flow cytometry assay to study the proliferation and persistence of mesothelin specific CAR-T cells. | 6 months |
| PD-1 antibody level in peripheral blood of the patients after treatment |
Inclusion Criteria:
Exclusion Criteria:
(1) The withdrawal time of chemotherapy before enrollment was shorter than the treatment cycle of chemotherapy.
(2) The use of anti-tumor therapy within 4 weeks before the study or less than 5 times of the half-life period of the drugs (including radiation therapy, chemotherapy, small molecules and biological therapy or immunotherapy), the shortest period of time was as the criterion (but the shortest time should not be less than 21 days).
7. Women patients in pregnancy period or suckling period.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zhiwei Zhang, PhD | Contact | 0086-021-59593168 | 8008 | zhangzw@shcell.com |
| Name | Affiliation | Role |
|---|---|---|
| Qijun Qian, PhD | Shanghai Cell Therapy Research Institute | Study Chair |
| Huajun Jin, PhD | Shanghai Cell Therapy Research Institute | Study Chair |
| Qing Xu, PhD |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| China | Recruiting | Shanghai | Shanghai Municipality | 200072 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33589520 | Derived | Fang J, Ding N, Guo X, Sun Y, Zhang Z, Xie B, Li Z, Wang H, Mao W, Lin Z, Qin F, Yuan M, Chu W, Qin H, Qian Q, Xu Q. alphaPD-1-mesoCAR-T cells partially inhibit the growth of advanced/refractory ovarian cancer in a patient along with daily apatinib. J Immunother Cancer. 2021 Feb;9(2):e001162. doi: 10.1136/jitc-2020-001162. |
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| ID | Term |
|---|---|
| C565324 | Parkinson Disease 4, Autosomal Dominant Lewy Body |
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|
| 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 | 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 |
PD-1 antibody level are detected by ELISA assay to assess the expressing level of PD-1 antibody from CAR-T cells. |
| 6 months |
| Shanghai 10th People's Hospital |
| Principal Investigator |
| Zhiwei Zhang, PhD | Shanghai Cell Therapy Research Institute | Study Director |
| Yan Sun | Shanghai Cell Therapy Research Institute | Study Director |
| Huimei Li, PhD | Shanghai Cell Therapy Research Institute | Study Director |
| Juemin Fang, PhD | Shanghai 10th People's Hospital | Principal Investigator |
| Song Gao, PhD | Shanghai 10th People's Hospital | Principal Investigator |
| Xianling Guo | Shanghai 10th People's Hospital | Principal Investigator |
| Hui Wang | Shanghai 10th People's Hospital | Principal Investigator |
| Zhongzheng Zhu | Shanghai 10th People's Hospital | Principal Investigator |
| Jianhua Chen | Shanghai 10th People's Hospital | Principal Investigator |