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This is a phase I, open-label, non-randomized study that will enroll pediatric and young adult research participants with relapsed or refractory non-CNS solid tumors to evaluate the safety, feasibility, and efficacy of administering T cell products derived from the research participant's blood that have been genetically modified to express a B7H3-specific receptor (chimeric antigen receptor, or CAR) that will target and kill solid tumors that express B7H3. On Arm A of the study, research participants will receive B7H3-specific CAR T cells only. On Arm B of the study, research participants will receive CAR T cells directed at B7H3 and CD19, a marker on the surface of B lymphocytes, following the hypothesis that CD19+ B cells serving in their normal role as antigen presenting cells to T cells will promote the expansion and persistence of the CAR T cells. Arm A CAR T cells include the protein EGFRt and Arm B CAR T cells include the protein HER2tG. These proteins can be used to both track and destroy the CAR T cells in case of undue toxicity. The primary objectives of the study will be to determine the feasibility of manufacturing the cell products, the safety of the T cell product infusion, to determine the maximum tolerated dose of the CAR T cells products, to describe the full toxicity profile of each product, and determine the persistence of the modified cell in the participant's body on each arm. Participants will receive a single dose of T cells comprised of two different subtypes of T cells (CD4 and CD8 T cells) felt to benefit one another once administered to the research participants for improved potential therapeutic effect. The secondary objectives of this protocol are to study the number of modified cells in the patients and the duration they continue to be at detectable levels. The investigators will also quantitate anti-tumor efficacy on each arm. Participants who experience significant and potentially life-threatening toxicities (other than clinically manageable toxicities related to T cells working, called cytokine release syndrome) will receive infusions of cetuximab (an antibody commercially available that targets EGFRt) or trastuzumab (an antibody commercially available that targets HER2tG) to assess the ability of the EGFRt on the T cells to be an effective suicide mechanism for the elimination of the transferred T cell products.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SCRI-CARB7H3(s) | Experimental | Autologous CD4+ and CD8+ T-cells genetically modified to express an B7H3-specific CAR |
|
| SCRI-CARB7H3(s)x19 | Experimental | Autologous CD4+ and CD8+ T-cells genetically modified to a bispecific B7H3xCD19 CAR |
|
| SCRI-CARB7H3(s)x19 plus pembrolizumab | Experimental | Autologous CD4+ and CD8+ T-cells genetically modified to express a bispecific B7H3xCD19 CAR given in combination with pembrolizumab |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| second generation 4-1BBζ B7H3-EGFRt-DHFR | Biological | Autologous CD4+ and CD8+ T-cells lentivirally transduced to express a second generation 4-1BBζ B7H3-EGFRt-DHFR |
|
| Measure | Description | Time Frame |
|---|---|---|
| Assess the safety and tolerability of cellular immunotherapy utilizing ex-vivo expanded autologous T cells genetically modified to express B7H3-specific CAR (Arm A) | Type, frequency, severity, and duration of adverse events will be tabulated and summarized | 28 days |
| Assess the safety and tolerability of cellular immunotherapy utilizing ex-vivo expanded autologous T cells genetically modified to express a bispecific B7H3xCD19 CAR (Arm B) | Type, frequency, severity, and duration of adverse events will be tabulated and summarized | 28 days |
| To assess the safety and tolerability of cellular immunotherapy utilizing ex-vivo expanded autologous T cells genetically modified to express a bispecific B7H3xCD19 CAR given in combination with pembrolizumab (Arm C) | Type, frequency, severity, and duration of adverse events will be tabulated and summarized to determine maximal tolerated dose | 28 days |
| To determine the maximum tolerated dose (MTD) of B7H3-specific CAR (Arm A) | Type, frequency, severity, and duration of adverse events will be tabulated and summarized to determine maximal tolerated dose | 28 days |
| To determine the maximum tolerated dose of bispecific B7H3xCD19 CAR (Arm B) | Type, frequency, severity, and duration of adverse events will be tabulated and summarized | 28 days |
| To determine the feasibility of administration of pembrolizumab in combination with bispecific B7H3xCD19 CAR (Arm C) | Type, frequency, severity, and duration of adverse events will be tabulated and summarized |
| Measure | Description | Time Frame |
|---|---|---|
| Determine the duration of in vivo persistence of adoptively transferred T cells in the peripheral blood and compare engraftment between T cell products and treatment arms | Presence of CAR T cells in the peripheral blood will be assessed | 84 days |
| Determine the magnitude of in vivo persistence of adoptively transferred T cells in the peripheral blood and compare engraftment between T cell products |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate for the presence of B7H3 CAR T cells in tumor tissue and/or normal tissue if a tissue biopsy, tumor biopsy, or resection is clinically indicated post-treatment | Tumor tissue, when obtained, will be assessed for the presence of adoptively transferred CAR T cells | 84 days |
| Evaluate B7H3 antigen expression in tumor tissue and/or normal tissue if a tissue biopsy, tumor biopsy, or resection is available |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Catherine Albert, MD | Seattle Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seattle Children's Hospital | Seattle | Washington | 98105 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39255444 | Derived | Pinto N, Albert CM, Taylor MR, Ullom HB, Wilson AL, Huang W, Wendler J, Pattabhi S, Seidel K, Brown C, Gustafson JA, Rawlings-Rhea SD, Cheeney SHE, Burleigh K, Gustafson HH, Orentas RJ, Vitanza NA, Gardner RA, Jensen MC, Park JR. STRIvE-02: A First-in-Human Phase I Study of Systemically Administered B7-H3 Chimeric Antigen Receptor T Cells for Patients With Relapsed/Refractory Solid Tumors. J Clin Oncol. 2024 Dec 10;42(35):4163-4172. doi: 10.1200/JCO.23.02229. Epub 2024 Sep 10. |
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| second generation 4-1BBζ B7H3-EGFRt-DHFR(selected) and a second generation 4-1BBζ CD19-Her2tG | Biological | Autologous CD4+ and CD8+ T-cells lentivirally transduced to express a second generation 4-1BBζ B7H3-EGFRt-DHFR(selected) and a second generation 4-1BBζ CD19-Her2tG |
|
| Pembrolizumab | Drug | SCRI-CARB7H3(s)x19 plus pembrolizumab |
|
| 28 days |
| To assess the dose limiting toxicities (DLTs) and describe the full toxicity profile for each study arm | Type, frequency, severity, and duration of adverse events will be tabulated and summarized | 28 days |
| To assess the feasibility of manufacturing B7H3 specific CARs from patient-derived lymphocytes | Type, frequency, severity, and duration of adverse events will be tabulated and summarized | 28 days |
| To assess the feasibility of manufacturing B7H3xCD19 bispecific CARs from patient-derived lymphocytes | Type, frequency, severity, and duration of adverse events will be tabulated and summarized | 28 days |
Number of CAR T cells in the peripheral blood will be assessed |
| 84 days |
| Quantitate anti-tumor responses by measuring changes in tumor burden using disease-specific evaluations | Presence of CAR T cells in the peripheral blood will be assessed | 84 days |
| Describe the relative expansion and persistence of the CAR T cell product and retention of function for B7H3xCD19 bispecific CARs determined by maintenance of B cell aplasia (BCA) with and without pembrolizumab | Presence of CAR T cells in the peripheral blood will be assessed | 84 days |
Tumor tissue, when obtained, will be assessed for the presence of B7H3 antigen |
| 84 days |
| Analyze blood, bone marrow, CSF, normal tissue, and/or tumor tissue for biomarkers of safety and/or anti-tumor activity | If a tissue biopsy, tumor biopsy, or resection is clinically indicated post-treatment, pathology will be assessed for the presence of B7H3 CAR T cells | 84 days |
| Assess the efficacy of infusional cetuximab and/or trastuzumab in ablating transferred T cells and ameliorating acute toxicities in treated participants | Biologic specimens, when obtained, will be assessed for biomarkers of safety and/or anti-tumor efficacy | 84 days |
| ID | Term |
|---|---|
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D012175 | Retinoblastoma |
| D018197 | Hepatoblastoma |
| D009396 | Wilms Tumor |
| D018335 | Rhabdoid Tumor |
| D002277 | Carcinoma |
| D012516 | Osteosarcoma |
| D012512 | Sarcoma, Ewing |
| D012208 | Rhabdomyosarcoma |
| D013584 | Sarcoma, Synovial |
| D018227 | Sarcoma, Clear Cell |
| D018319 | Neurofibrosarcoma |
| D058405 | Desmoplastic Small Round Cell Tumor |
| D012509 | Sarcoma |
| D009447 | Neuroblastoma |
| D008545 | Melanoma |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |
| D019572 | Retinal Neoplasms |
| D005134 | Eye Neoplasms |
| D009371 | Neoplasms by Site |
| D015785 | Eye Diseases, Hereditary |
| D005128 | Eye Diseases |
| D012164 | Retinal Diseases |
| D018193 | Neoplasms, Complex and Mixed |
| D007680 | Kidney Neoplasms |
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009386 | Neoplastic Syndromes, Hereditary |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D018213 | Neoplasms, Bone Tissue |
| D009372 | Neoplasms, Connective Tissue |
| D018204 | Neoplasms, Connective and Soft Tissue |
| D009217 | Myosarcoma |
| D009379 | Neoplasms, Muscle Tissue |
| D005354 | Fibrosarcoma |
| D018218 | Neoplasms, Fibrous Tissue |
| D009455 | Neurofibroma |
| D018317 | Nerve Sheath Neoplasms |
| D010524 | Peripheral Nervous System Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009422 | Nervous System Diseases |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D018241 | Neuroectodermal Tumors, Primitive, Peripheral |
| D018242 | Neuroectodermal Tumors, Primitive |
| D018358 | Neuroendocrine Tumors |
| D018326 | Nevi and Melanomas |
| D012878 | Skin Neoplasms |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| C582435 | pembrolizumab |
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