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This study will evaluate the safety, tolerability, and efficacy of engineered donor grafts ("OrcaGraft"/"Orca-Q") in participants undergoing allogeneic hematopoietic cell transplant (alloHCT) transplantation for hematologic malignancies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm A | Experimental | Recipients with human leukocyte antigen (HLA)-identical related or unrelated or 1-allele mismatched (7/8 alleles) unrelated donor undergoing myeloablative conditioning (MAC); with single- or dual-agent graft-versus-host disease (GVHD) prophylaxis given |
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| Arm B | Experimental | Recipients with haploidentical-related donors undergoing MAC; with single- or dual-agent GVHD prophylaxis given |
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| Arm C | Experimental | Recipients with an HLA-identical related or unrelated donor undergoing MAC; no GVHD prophylaxis given |
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| Arm D | Experimental | Recipients with an HLA-identical related or unrelated donor undergoing non-myeloablative (NMA)/reduced intensity conditioning (RIC); with dual agent GVHD prophylaxis given |
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| Arm E | Experimental | Recipients with 1-allele mismatched (7/8 alleles) unrelated donor undergoing NMA/RIC; with dual-agent GVHD prophylaxis given |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| OrcaGraft (Orca-Q) | Biological | engineered donor allograft |
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| Measure | Description | Time Frame |
|---|---|---|
| Dose Limiting Toxicities through Day +28 (dose escalation) | Safety and tolerability of Orca-Q (formerly OrcaGraft) in adults undergoing myeloablative allogeneic hematopoietic cell transplantation (MA-alloHCT) will be evaluated by identification of the following dose limiting toxicities: Grade ≥ 3 infusion-related reaction or cytokine release syndrome, Grade ≥ 3 acute GVHD, Any Grade ≥ 3 treatment-related non-hematologic event not clearly related to the underlying malignancy, intercurrent infection, the HCT conditioning regimen, or other pre-existing medical condition | 28 Days after administration of Orca-Q/OrcaGraft |
| Primary Graft failure through Day +28 (dose expansion) | Primary graft failure in the dose expansion phase, defined as being alive without recovery of neutrophils during the evaluation period | 28 Days after administration of Orca-Q/OrcaGraft |
| Measure | Description | Time Frame |
|---|---|---|
| Neutrophil Engraftment through Day +28 | Neutrophil engraftment defined as an absolute neutrophil count of >/=500/mm3 for 3 consecutive days | 28 days after administration of Orca-Q/OrcaGraft |
| Platelet Engraftment through Day +50 |
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Key Inclusion Criteria:
Age at the time of enrollment:
Diagnosed acute myeloid, lymphoblastic or mixed phenotype leukemia, or high or very high risk myelodysplastic syndrome (MDS) either in complete remission (CR) or with ≤ 10 percent of blast cells in bone marrow (BM)
Indicated for allogeneic hematopoietic stem cell transplant (alloHCT)
Matched to a 8/8 or 7/8 related or unrelated donor, or to a related haploidentical donor
Estimated glomerular filtration rate (eGFR) > 50 mL/minute (MAC with tacrolimus) or > 30 mL/minute (NMA/RIC or MAC without tacrolimus)
Cardiac parameters: Cardiac ejection fraction ≥ 45 percent (MAC) or ≥ 40 percent (NMA/RIC)
Diffusing capacity of the lung for carbon monoxide (DLCO) (adjusted for hemoglobin) ≥ 50 percent for MAC or ≥ 40 percent for NMA/RIC
Liver function: Total bilirubin < 1.5 times upper limit of normal (ULN) (MAC) or < 3 times ULN (NMA/RIC); alanine transaminase (ALT)/aspartate transaminase (AST) < 3 times ULN (MAC) or < 5 times ULN (NMA/RIC)
Participants enrolling on NMA/RIC-alloHCT arms must be deemed unfit for a myeloablative alloHCT per assessment of the principal investigator (PI)
Key Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tamara Zharkevich, MD, PhD | Contact | 650-246-9601 | info@orcabiosystems.com | |
| James S McClellan, MD PhD | Contact | 650-246-9601 | info@orcabiosystems.com |
| Name | Affiliation | Role |
|---|---|---|
| James S McClellan, MD, PhD | Orca Biosystems, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| City of Hope | Recruiting | Duarte | California | 91010 | United States |
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| Arm F | Experimental | Recipients with haploidentical-related donors undergoing NMA/RIC; with dual-agent GVHD prophylaxis given |
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Platelet engraftment is defined as achieving a platelet count > 20,000/mm3 for 3 consecutive days without platelet transfusion in the preceding 7 days, by Day +50
| 50 days after administration of Orca-Q/OrcaGraft |
| Secondary Graft Failure through Day +100 | Secondary graft failure is defined as neutrophil engraftment followed by subsequent decline in absolute neutrophil counts < 500 cells/μL, unresponsive to growth factor therapy, by Day +100 | 100 days after administration of Orca-Q/OrcaGraft |
| Acute GVHD through Day +100 | Acute GVHD will be staged and graded per Mount Sinai Acute GvHD International Consortium (MAGIC) Standardization criteria | 100 days after administration of Orca-Q/OrcaGraft |
| Chronic GVHD through Day +365 | Chronic GVHD will be diagnosed per 2014 International NIH Chronic GVHD Diagnosis and Staging Consensus Working Group criteria | 365 days after administration of Orca-Q/OrcaGraft |
| Incidence of Non-relapse Mortality (NRM) through Day +365 | NRM is defined as death without evidence of disease recurrence | 365 days after administration of Orca-Q/OrcaGraft |
| Incidence of Disease Relapse through Day +365 | Recurrence of primary disease for transplant | 365 days after administration of Orca-Q/OrcaGraft |
| GVHD-free and Relapse-free Survival (GRFS) through Day +365 | Survival free from GVHD and relapse | 365 days after administration of Orca-Q/OrcaGraft |
| Disease-free Survival (DFS) through Day +365 | DFS is the time from date of transplant to death or relapse, whichever comes first. | 365 days after administration of Orca-Q/OrcaGraft |
| Overall Survival through Day +365 | OS is defined as the time from the date of transplant to the date of death from any cause or, for surviving patients, to the date of last follow-up. | 365 days after administration of Orca-Q/OrcaGraft |
| UC Davis | Recruiting | Sacramento | California | 95817 | United States |
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| Stanford Health Care | Recruiting | Stanford | California | 94305 | United States |
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| Moffitt Cancer Center | Recruiting | Tampa | Florida | 33612 | United States |
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| Emory University | Active, not recruiting | Atlanta | Georgia | 30322 | United States |
| The University of Kansas Hospital | Withdrawn | Kansas City | Kansas | 66160 | United States |
| John Theurer Cancer Center at Hackensack University Medical Center | Recruiting | Hackensack | New Jersey | 07601 | United States |
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| Memorial Sloan Kettering Cancer Center | Recruiting | New York | New York | 10065 | United States |
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| Ohio State University | Active, not recruiting | Columbus | Ohio | 43210 | United States |
| University of Texas MD Anderson Cancer Center | Recruiting | Houston | Texas | 77054 | United States |
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| Fred Hutchinson Cancer Center | Recruiting | Seattle | Washington | 98109 | United States |
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| Froedtert Memorial Lutheran Hospital | Withdrawn | Milwaukee | Wisconsin | 53226 | United States |
| ID | Term |
|---|---|
| D015470 | Leukemia, Myeloid, Acute |
| D009190 | Myelodysplastic Syndromes |
| D015456 | Leukemia, Biphenotypic, Acute |
| D054198 | Precursor Cell Lymphoblastic Leukemia-Lymphoma |
| ID | Term |
|---|---|
| D007951 | Leukemia, Myeloid |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D001855 | Bone Marrow Diseases |
| D007945 | Leukemia, Lymphoid |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
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