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Limited enrollment.
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This study is an open-label, single arm phase 1b safety study of CAR2 Anti-CEA CAR-T cell hepatic arterial infusions for pancreatic carcinoma patients with carcinoembryonic antigen positive (CEA+) liver metastases resistant to standard therapy who meet all other eligibility criteria.
Patients will receive weekly 3 doses of CAR2 Anti-CEA CAR-T cells in each 28-day cycle by hepatic arterial infusions using a Pressure Enhanced Delivery Device (PEDD) with low dose systemic IL-2 support. Patients may receive up to 3 cycles of CAR2 Anti-CEA CAR-T cell hepatic arterial infusions, per discretion of the investigator.
All patients who receive investigational CAR-T therapy will be included in the analyses and summaries of safety, efficacy, pharmacokinetic, and pharmacodynamic assessments.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CAR2 Anti-CEA CAR-T cell | Experimental | 3 doses of CAR2 Anti-CEA CAR-T cells for each cycle; up to 3 additional cycles received per investigator discretion |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CAR2 Anti-CEA CAR-T cells | Biological | doses will be delivered by hepatic arterial infusions using pressure enhanced delivery device (PEDD) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Assess preliminary efficacy by overall survival | As a measure of activity, Overall Survival (OS) will be assessed. The events for the assessment of OS are death events. Time to event endpoints will be estimated using Kaplan-Meier methods. Point estimates and 95% confidence intervals will be provided where applicable. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Assess preliminary efficacy by radiographic response rate using Response Evaluation Criteria in Solid Tumors (RECIST) | As a measure of activity, overall response rate will be assessed by radiographic scans using RECIST criteria. Response will be assessed for each patient over a 6-month timeframe during the treatment and observation phases of the protocol. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Assess if serum cytokine levels correlate with response and/or toxicity to hepatic arterial infusions. | As an exploratory analysis, serum cytokine levels will be measured by ELISA to determine if increases in cytokines predict response and/or toxicity to liver arterial infusions. | 6 months |
| Assess if neutrophil:lymphocyte ratios correlate with response |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Steven C Katz, MD | Roger Williams Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Roger Williams Medical Center | Providence | Rhode Island | 02908 | United States |
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| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
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Three doses of CAR2 Anti-CEA CAR T Cells 1 x 10e10 cells by hepatic artery infusion (on Days 1, 8, and 15) of each 28-day cycle in the Treatment Period using the HITM method and Surefire device, with IL-2 systemic infusion. Patient may receive up to three 28-day cycles of CAR-T therapy in the Treatment Period.
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|
| Assess preliminary efficacy by metabolic response rate using PET Response Criteria in Solid Tumors (PERCIST) | As a measure of activity, overall response rate will be assessed by radiographic scans using PERCIST criteria. Response will be assessed for each patient over a 6-month timeframe during the treatment and observation phases of the protocol. | 6 months |
| Assess preliminary efficacy by response rate using Immune-related Response Criteria (irRC) | As a measure of activity, overall response rate will be assessed by radiographic scans using irRC. Response will be assessed for each patient over a 6-month timeframe during the treatment and observation phases of the protocol. | 6 months |
| Assess preliminary efficacy by histologic response rate using pathologic response in biopsy specimens | As a measure of activity, overall response rate will be assessed by pathologic criteria using biopsies of the liver metastases and measuring necrosis and fibrosis. REsponse rates will be assess for each patient over a 6-month timeframe during the treatment and observation phases of the protocol. | 6 months |
| Assess preliminary efficacy by serologic response rates by CEA levels | As a measure of activity, overall response rate will be assessed by serologic CEA levels. Response will be assess for each patient over a 6-month timeframe during the treatment and observation phases of the protocol. | 6 months |
| Assess preliminary efficacy by serologic response rates by CA 19-9 levels | As a measure of activity, overall response rate will be assessed by serologic CA 19-9 levels. Response will be assess for each patient over a 6-month timeframe during the treatment and observation phases of the protocol. | 6 months |
| Assess preliminary efficacy by duration of response in accordance with RECIST criteria | As a measure of activity, duration of response will be measured using radiologic scans and assessed according to RECIST criteria. This will be assess for each patient over a 6-month timeframe during the treatment and observation phases of the protocol. | 6 months |
| Assess preliminary efficacy by in-liver progression free survival (PFS) | As a measure of activity, in-liver PFS will be assessed. The events for the assessment of PFS are disease progression and death events. This time to event endpoint will be estimated using Kaplan-Meier methods. Point estimate estimates and 95% confidence intervals will be provided where appropriate. | 6 months |
As an exploratory analysis, neutrophil:lymphcyte ratios will be calculated to determine if they correlate with response and/or toxicity. |
| 6 months |
| Assess the persistence of CAR-T cells circulating in blood over time | As an exploratory analysis, circulating CAR-T cells will be analyzed to assess persistence of CAR-T cells during the treatment and observation phases of the study. | 6 months |
| Assess the persistence of CAR-T cells in liver tumor biopsies over time | As an exploratory analysis, the engraftment of CAR-T cells in planned liver tumor biopsies will be analyzed to assess persistence of CAR-T cells during the treatment and observation phases of the study. | 6 months |
| Assess if circulating tumor cells (CTC) correlate with response | As an exploratory analysis, levels of circulating tumor cells (CTC) will be determined to investigate if decreases in CTC levels correlate with response. | 6 months |
| D004066 |
| Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |