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| ID | Type | Description | Link |
|---|---|---|---|
| OCR49765 | Other Identifier | University of Florida |
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This is a Phase I Study evaluating the safety and feasibility of IL-8 receptor-modified patient-derived activated CD70 CAR T cells in adult patients with brain metastases from primary cancer, with either newly diagnosed lesions or recurrent or progressive disease after prior therapy.
Adult patients with newly diagnosed or recurrent/progressive brain metastases will be screened. Consented patients will undergo screening procedures followed by tumor biopsy/surgery if clinically indicated, and may receive treatment for brain metastases, which include whole brain radiation therapy (WBRT), SRS treatment for new lesion(s) (SRS is permitted for recurrent disease only for newly developed brain lesion(s).
After enrollment, patients will be evaluated for cellular therapy suitability and undergo cell collection for the generation of 8R-70CAR T cells before initiation or up to two cycles while receiving standard-of-care chemoradiation. As part of screening, CD70 protein will be confirmed on primary tumor or lymph nodes biopsy. If the patient is eligible, they will receive FDA-approved standard of care therapy for their primary disease as a 2-4 cycles bridge while the 8R-70 CAR T cells are being manufactured. Following completion of standard of care therapy and prior to cellular therapy, patients will be evaluated to confirm disease stability. MRI of brain and CT imaging will be obtained within 28 days prior to CAR administration for disease staging.
If radiographic or clinical progression is identified, the treating physicians may consider initiating therapy for the primary disease prior to CAR administration. Upon completion of the additional line of therapy, eligibility for CAR administration will be reassessed at the discretion of the treating physicians based on overall clinical stability and disease control.
A single dose of 8R-70CAR T cells will be administered IV injection 2 to 6 months after study enrollment. Administration will be conducted in the hospital so the patient can be monitored for infusion-related toxicities.
After hospital discharge, patients will be required to remain within a 1-hour drive of UF Health for at least two weeks following infusion for safety monitoring. Patients receiving study treatment will be required to have a caregiver and advised to avoid driving for two weeks following product administration.
Patients will have post-infusion follow-up visits in the UF Health clinic 7 days, 2 weeks, 3 weeks, 4 weeks, 6 weeks, 8 weeks, and 12 weeks after CAR T administration.
Patients who continue to receive care at the University of Florida will be seen at the UF Health Neuro-oncology/Neurosurgery clinic every 2 months, for the first 12-24 months, then every 3 months for 12 months, then every 4 months or when clinically indicated for physical & neuro exam, interim medical history, until progressive disease and every 6 months thereafter.
Patients who transfer their care to an outside provider/institution will be contacted by phone at 3, 6, 12 months, and every 6 months thereafter for follow-up.
All patients who receive the 8R-70 CAR T cells investigational product will continue to be followed until death. Patients will also be followed up to 15 years in accordance with the guidance "Gene Therapy Clinical Trials - Observing Subjects for Adverse Events" to identify and mitigate the potential long-term risks to the patients receiving the investigational product.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IL-8 receptor-modified patient-derived activated CD70 CAR T cells | Experimental | Two dose levels Cohort 1 will receive 1 x 10^7 cells/kg; Cohort 2 will receive 1 x 10^8 cells/kg |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ex-Vivo expanded autologous IL-8 receptor (CXCR2) modified CD70 CAR (8R-70CAR) T cells | Biological | Single dose of 8R-70CAR T cells administered IV |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number and percentage of participants with dose-limiting toxicities after receiving 8R-70CAR T-cell therapy | Safety is defined as ≤ 1 DLT out of 6 patients is observed at the 1x10^8 cells/Kg dose. Dose-Limiting toxicity (DLT) will be defined as any adverse event attributable (possible, probable, or definite) to the administration of 8R-70CAR T cells and occurring from the time of infusion through 28 days post-infusion. Safety variables and variables that define the DLTs will be summarized using descriptive statistics by dose level. Number and percentage of patients with DLTs and its 95% confidence interval (CI) will be estimated based on the exact binomial distribution by dose level. | 28 days post-infusion |
| Proportion of participants who receive an infusion of 8R-70CAR T-cell therapy | Feasibility will be defined as the ability to infuse 8R-70CAR T-cell safely in 66.7 % of enrolled patients (patients who signed consent and were deemed eligible for the study). | enrollment up to 10 weeks |
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Inclusion Criteria:
Histological confirmation of primary cancers
Histologic confirmation of CD70 on primary tumor, lymph node, or BM biopsy
At least one recurrent or progressive metastatic lesion or new metastatic lesion(s).
KPS ≥ 70.
18 years or older.
Adequate bone marrow and organ function as defined below:
Adequate renal function as defined below:
Adequate hepatic function as defined below:
A diagnostic contrast-enhanced brain MRI must be performed within 28 days prior to study enrollment.
For females of childbearing potential, a negative serum pregnancy test at enrollment.
Women of childbearing potential (WOCBP) must be willing to use an acceptable contraceptive method to avoid pregnancy throughout the study and for at least 24 weeks after the last dose of study drug.
Males with female partners of childbearing potential must agree to practice adequate contraceptive methods throughout the study and should avoid conceiving children for 24 weeks following the last dose of the study drug.
Ability of the patient to understand and willingness to sign an IRB approved written informed consent document.
Steroid dose equivalent to dexamethasone dose of ≤ 6mg daily at the time of enrollment.
Patients treated on any other investigational therapy must discontinue that treatment prior to study entry.
Exclusion Criteria:
• Known immunosuppressive disease or human immunodeficiency virus (HIV) infection.
Rationale: The need to exclude patients with an immunosuppressive disease or human immunodeficiency virus infection is necessary because the management of potential toxicities from the study drug may involve treatment that is significantly immunosuppressive.
Participant has ongoing toxicity ≥ grade 2 per the CTCAE version 5.0 considered clinically significant and in the opinion of the investigator, attributable to prior antineoplastic therapies.
Participant has received any chemotherapy or other immunotherapy within 14 days prior to the first dose of study intervention.
Severe, active co-morbidity, defined as follows:
Pregnant or lactating women, due to possible adverse effects on the developing fetus or infant.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Taryn King, RN | Contact | 3522739000 | Wells-BTC@ufl.edu |
| Name | Affiliation | Role |
|---|---|---|
| Maryam Rahman, MD | University of Florida | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UF Health | Gainesville | Florida | 32610 | United States |
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| ID | Term |
|---|---|
| D001932 | Brain Neoplasms |
| ID | Term |
|---|---|
| D016543 | Central Nervous System Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D023063 | Receptors, Interleukin-8B |
| ID | Term |
|---|---|
| D053700 | Receptors, Interleukin-8 |
| D054387 | Receptors, CXCR |
| D019707 | Receptors, Chemokine |
| D043562 | Receptors, G-Protein-Coupled |
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|
| D001927 |
| Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D011956 | Receptors, Cell Surface |
| D008565 | Membrane Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D018121 | Receptors, Cytokine |
| D011971 | Receptors, Immunologic |
| D018123 | Receptors, Interleukin |