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The present study is a multi-center, single-arm, open, phase I/IIa clinical trial to evaluate the efficacy and safety of EBViNT Cell when administered to patients with Epstein-Barr (EBV) positive malignancies The present study investigates with 5 parts; Part1-phase I: IP single therapy on ENKL and solid tumors Part2-phase I: IP + lymphodepletion on solid tumors Part 3&5- Phase IIa: IP single therapy on each ENKL and solid tumors Part 4- Phase IIa: IP + lymphodepletion on solid tumors
The present study is a multi-center, single-arm, open, phase I/IIa clinical trial to evaluate the efficacy and safety of EBViNT Cell when administered to patients with Epstein-Barr (EBV) positive tumors
After proving the safety through Part 1 and part 2, the efficacy and safety would be studied through part 3~5.
If CTCAE grade 3 or higher adverse drug events (ADR) do not occur in the three subjects: Begin enrollment for phase IIa
If a CTCAE grade 3 or higher ADR occurs in one of the three subjects: Enroll three more subjects (up to six subjects in total) and assess whether any CTCAE grade 3 or higher ADR occurs
If a CTCAE grade 3 or higher ADR occurs in two of the three subjects: Begin enrollment for phase IIa at 7.0x10^8 cells, the maximum dose from phase I
Subjects participating in the present study will undergo 1) an EBV epitope screening test followed by 2) an eligibility assessment for clinical trial enrollment.
Subjects who are administered with the investigational product will be monitored until progressive disease (PD) is confirmed or for 24 weeks (main observation period of 4 weeks + monitoring for 20 weeks) to evaluate the product's safety and efficacy, and will undergo immunological assessment.
Radiological tests for tumor assessment will be conducted at the enrollment visit, 4 weeks, 8 weeks, 16 weeks, and 24 weeks and assessed by the Independent Radiology Review Committee (IRRC) using the Lugano criteria. To eliminate pseudo-progression, progressive disease (PD) will be determined by considering immunological tests, a quantitative EBV DNA assay, and intermediate response (IR) under LYRIC. Biopsies may be performed to achieve this.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EBViNT Cell | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EBViNT Cell | Biological |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Confirmed objective response rate (confirmed ORR) [assessed by IRRC] | up to 6 month from LPI |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of response (DoR) [assessed by IRRC and investigator] | up to 6 month from LPI | |
| Disease control rate (DCR) [assessed by IRRC and investigator] | up to 6 month from LPI | |
| Measure | Description | Time Frame |
|---|---|---|
| Immunological assessment | Plasma cytokine analysis (IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, TNF, IFN-γ, IL-17a) EBV LMP2a-specific cytokine production (IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, TNF, IFN-γ, IL-17a) Phenotypical analysis of CD8 T cells | up to 6 month |
| Quantitative EBV DNA assay |
Inclusion Criteria (Visit 1)
At least 19 years of age
Patients with lymphomas or solid tumors who have been found to be positive for EBV encoded RNA (EBER) by in situ hybridization (ISH) (previous test results may be used as evidence if available)
Patients who have given written consent to voluntarily participate in the epitope screening
Exclusion Criteria (Visit 1)
Enrollment Criteria (Visit 2)
Persons who have been found to be capable of production in the epitope screening test
Patients who have failed standard treatment or conventional chemotherapy and who meet any one of the following
Persons with evaluable lesions
Persons with appropriate liver, renal, and bone marrow function (two retests are permitted for borderline results, and corrections such as transfusion are permitted)
Exclusion criteria (Visit 2)
Where central nervous system (CNS) lymphoma or uncontrolled CNS metastasis is present (patients with brain metastasis that has been treated and is stable [stable for at least 30 days based on radiology records] may be enrolled)
Persons who have received surgery, radiotherapy, or chemotherapy in the 3 weeks prior to the investigational product administration
Persons who have been administered any other investigational product in the 3 weeks prior to the investigational product administration
Persons who have not recovered from the toxicity of any previous treatment to Grade 1 or lower based on NCI CTCAE v5.0 (however, clinically insignificant toxicities such as alopecia are excluded)
Patients who have received immunosuppressants, including steroids, in the 10 days prior to blood collection (Visit 2) for production of the study drug (however, local steroids and steroids for inhalers are permitted, and steroid equivalent to 20 mg/day of prednisolone may be administered at the investigator's discretion)
Patients with the following (but not limited to) clinically significant cardiovascular comorbidities as determined by the investigator
: Uncontrolled hypertension (i.e., systolic pressure > 180 mmHg and/or diastolic pressure > 100 mm/Hg), unstable angina, pulmonary embolism, cerebrovascular disease, valvular disease, congestive heart failure (NYHA severity classification Grade III or IV), or myocardial infarction or serious cardiac arrhythmia within the 24 weeks prior to the enrollment visit
Patients with findings of autoimmune or inflammatory disease, whose abnormal results from an autoimmune response test have been deemed clinically significant by an investigator
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sehee Hwang | Contact | +82-2-2071-3310 | hsh0820@eutilex.com |
| Name | Affiliation | Role |
|---|---|---|
| Hyeon Seok Eom, MD | National Cancer Center | Principal Investigator |
| Won Seog Kim, MD | Samsung Medical Center | Principal Investigator |
| Ho Jin Shin, MD |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samsung Medical Center | Not yet recruiting | Seoul | Gangnam-gu | 06351 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26938947 | Background | Eom HS, Choi BK, Lee Y, Lee H, Yun T, Kim YH, Lee JJ, Kwon BS. Phase I Clinical Trial of 4-1BB-based Adoptive T-Cell Therapy for Epstein-Barr Virus (EBV)-positive Tumors. J Immunother. 2016 Apr;39(3):140-8. doi: 10.1097/CJI.0000000000000113. | |
| 24714356 | Background | Choi BK, Lee SC, Lee MJ, Kim YH, Kim YW, Ryu KW, Lee JH, Shin SM, Lee SH, Suzuki S, Oh HS, Kim CH, Lee DG, Hwang SH, Yu EM, Lee IO, Kwon BS. 4-1BB-based isolation and expansion of CD8+ T cells specific for self-tumor and non-self-tumor antigens for adoptive T-cell therapy. J Immunother. 2014 May;37(4):225-36. doi: 10.1097/CJI.0000000000000027. |
| Label | URL |
|---|---|
| Web address | View source |
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|
| Objective response rate (ORR) [assessed by investigator] |
| up to 6 month from LPI |
| Complete response rate (CR rate) [assessed by IRRC and investigator] | up to 6 month from LPI |
| Partial response rate (PR rate) [assessed by IRRC and investigator] | up to 6 month from LPI |
| Partial response duration (PR duration) [assessed by IRRC and investigator] | up to 6 month from LPI |
| Progression-free survival (PFS) | up to 6 month from LPI |
| Overall survival (OS) | up to 6 month from LPI |
| up to 6 month |
| Pusan National University Hospital |
| Principal Investigator |
| Min-hee Ryu, MD | Asan Medical Cente | Principal Investigator |
| Won Sik Lee, MD | Inje University | Principal Investigator |
| Minsuk Kwon, MD | Ajou Univ. Hosp. | Principal Investigator |
| Hyo song Kim, MD | Severance Hosp | Principal Investigator |
| Jeeyun Lee, MD | Samsung Medical Center | Principal Investigator |
| National Cancer Center | Not yet recruiting | Goyang-si | Gyeonggi-do | 10408 | South Korea |
|
| Inje Univ. Hosp | Not yet recruiting | Pusan | South Korea |
|
| Pusan national Univ. Hosp. | Recruiting | Pusan | South Korea |
|
| Samsung Medical Center | Not yet recruiting | Seoul | South Korea |
|
| Seoul Asan Medical center | Not yet recruiting | Seoul | South Korea |
|
| Severance hosp. | Not yet recruiting | Seoul | South Korea |
|
| Ajou Univ Hosp. | Not yet recruiting | Suwon | South Korea |
|
| ID | Term |
|---|---|
| C562730 | Adenocarcinoma Of Esophagus |
| D008223 | Lymphoma |
| D013274 | Stomach Neoplasms |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D013272 | Stomach Diseases |
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