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| Name | Class |
|---|---|
| UTC Therapeutics Inc. | INDUSTRY |
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The goal of this clinical trial is to study the safety, efficacy, and pharmacokinetics of mRNA-engineered anti-Mesothelin (MESO) Chimeric Antigen Receptor T-Cell (CAR-T cells) therapy in patients with mesothelin expression-positive, advanced solid tumors that have failed at least first-line or second-line therapy.
This phase I study is being conducted to establish safety, pharmacokinetics, and preliminary efficacy of intravenous (IV) mRNA electroporated fully-humanized anti-MESO re-directed autologous T cell administration in patients with chemotherapy-refractory metastatic solid tumors.
The study will adopt the "3+3" dose escalation design exploring two doses of 1×109 and 3×109. The administration is planned to infuse 3 times a week for 2 consecutive weeks.
• The subjects will receive a total dose of 1x109 RNA transduced anti-MESO CAR-T cells in the first week, following lymphodepleting chemotherapy with cyclophosphamide 300 mg/m2/day and fludarabine 30 mg/m2/day given over 3 days by intravenous infusion. If there is no obvious dose-limiting toxicity (DLT) after the first week of infusion, three times consecutive infusions of 1x109 anti-MESO CAR-T cells each time is planned in the second week. Each subject needs to be observed for at least 2 weeks (14 days) after completing the last infusion. Lymphodepleting chemotherapy will not be repeated prior to additional infusions of anti-MESO CAR-T cells.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| anti-MESO CAR-T cells | Experimental | The subjects in this arm will receive Cyclophosphamide 300mg/m2/d and Fludarabine 30mg/m2/d from day-4 to day-2. Subjects will be treated with six administrations of anti-MESO CAR-T cells three times weekly (Monday-Wednesday-Friday) for two weeks. In the first week, total 1×109 or 3×109 will be infused, the second week is to plan three times consecutive infusions of 1x109 or 3×109 anti-MESO CAR-T cells each time. Subjects will be enrolled serially. For subject safety, the preceding subject must have completed therapy and be 28 days from their last infusion before the next subject can be treated. Interventions:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| anti-MESO CAR T cells | Biological | Autologous genetically modified anti-MESO CAR T cells |
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| Measure | Description | Time Frame |
|---|---|---|
| TEAEs | Incidence of Treatment Emergent Adverse Event | 4 weeks after the last infusion |
| TRAEs | Incidence of Treatment Related Adverse Events | 4 weeks after the last infusion |
| SIAEs and SAEs | Incidence of AEs of Special Interest and Serious Adverse Events | 4 weeks after the last infusion |
| DLTs | Incidence of dose-limiting toxicities | 4 weeks after the last infusion |
| Measure | Description | Time Frame |
|---|---|---|
| TEAEs,TRAEs, SIAEs and SAEs | Incidence of Treatment Emergent Adverse Event, Treatment Related adverse events, AEs of special interest and serious adverse events | 12 weeks after the last infusion |
| ORR by IR |
| Measure | Description | Time Frame |
|---|---|---|
| mesothelin expression and efficacy | Immunohistochemical method to detect the expression of mesothelin, CT or magnetic resonance image(MRI) evaluation efficacy, statistical method (SPSS 24.0) to assess the correlation between mesothelin expression level and efficacy | 12 weeks after the last infusion |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jun Zhang, MD, PhD | Contact | 0086-13818332497 | junzhang10977@sjtu.edu.cn | |
| Yan Shi, MD, PhD | Contact | 0086-13810561979 | sy_rjh@aliyun.com |
| Name | Affiliation | Role |
|---|---|---|
| Jun Zhang, MD, PhD | Ruijin Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Oncology, Ruijin Hospital | Recruiting | Shanghai | 200025 | China |
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Objective response rate based on investigator's evaluation
| 12 weeks after the last infusion |
| ORR by IRC | ORR based on independent review committee evaluation | 12 weeks after the last infusion |
| DCR by IR | Disease control rate based on the investigator's evaluation | 12 weeks after the last infusion |
| DCR by IRC | DCR based on IRC evaluation | 12 weeks after the last infusion |
| DOR by IR | Duration of Remission based on the investigator's evaluation | 12 weeks after the last infusion |
| TTR by IR | Time to remission based on the investigator's evaluation | 12 weeks after the last infusion |
| PFS by IR | Progression-free survival (PFS) based on the investigator's evaluation | 24 weeks after the last infusion |
| PFS by IRC | PFS based on IRC evaluation | 24 weeks after the last infusion |
| OS | Overall survival | 52 weeks after the last infusion |
| QOL | According to the EUROPEAN Organization for Research and Treatment of Cancer, Eortc, Quality of Life QuestionNare-Core 3, QOQ-C30), ERTC QLQ-C30, evaluated subject's quality of life. | 12 weeks after the last infusion |
| Cmax | the highest concentration (Cmax) of anti-human MESO T cells in the peripheral blood after CAR T cell infusion | 4 weeks after the last infusion |
| AUC | the area under the curve of 28 days of anti-human MESO T cells in the peripheral blood after CAR T cell infusion | 4 weeks after the last infusion |
| HACA | Positive rate of Human Anti-CAR Antibodies after CAR T cell infusion | 4 weeks after the last infusion |