CT Antigen TCR-redirected T Cells for Ovarian Cancer.

Not Recruiting

Trial ID: NCT01567891

Purpose

This study, will take a subject's "T cells" and "teach" them to be able to recognize and attack the ovarian cancer cells. This is done by putting in a gene or genetic material that will change how a subject's T cells work and hopefully get them to attack and kill ovarian cancer cells. These new T cells are called "engineered T cells" because the new gene is causing them to become directed toward the ovarian cancer cells rather than their usual targets. These are also called "gene-modified T cells". For subjects who have the HLA A2 tissue-type marker, the T cells would be engineered to recognize a substance called "NY-ESO-1". After putting this new gene in T cells (a procedure called "gene therapy") the investigators will grow the cells in the laboratory and give these cells back to subjects.

Official Title

A Phase I/IIa, Open Label Clinical Trial Evaluating the Safety and Efficacy of Autologous T Cells Expressing Enhanced TCRs Specific for NY-ESO-1 in Patients With Recurrent or Treatment Refractory Ovarian Cancer.

Stanford Investigator(s)

Oliver Dorigo, M.D., Ph.D.
Oliver Dorigo, M.D., Ph.D.

Mary Lake Polan Professor

Eligibility


Inclusion Criteria:

   - Must have a diagnosis of recurrent epithelial ovarian, primary peritoneal or fallopian
   tube carcinoma with refractory or platinum resistant disease and/or have received ≥ 2
   lines of chemotherapy

   - Age ≥ 18 years of age

   - No significant immunodeficiency

   - Have been informed of other treatment options

   - Must be HLA A*0201, HLA-A*0205, and/or HLA-A*0206 positive by high resolution testing.

   - Patient's tumor must be positive by histological assay for NY-ESO-1ᶜ²⁵⁹T, according to
   the screening algorithm as described in Section 3.3.1. Positive expression is defined
   as ≥ 50% of cells that are 2+ and/or 3+ by immunohistochemistry

   - ECOG performance status of 0 or 1

   - Life expectancy of > 4 months

   - Prior therapies:

      1. prior immunotherapy, or prior investigational agents should be washed out 4 weeks
      before apheresis and must be completed 4 weeks prior to pre-infusion
      lymphodepletive chemotherapy.

      2. monoclonal antibody therapy must be completed at least 6 weeks prior to
      pre-infusion lymphodepletive chemotherapy

      3. All previous cytotoxic chemotherapy, monoclonal antibody therapy, immune therapy
      should be washed out 3 weeks before apheresis and must be completed at least 3
      weeks prior to pre-infusion lymphodepletive chemotherapy.

      4. Systemic corticosteroid or other immunosuppressive therapy should be washed out 2
      weeks before apheresis and must be completed at least 2 weeks prior to
      pre-infusion lymphodepletive chemotherapy

      5. Biologic or other approved molecular targeted small molecule inhibitors should be
      washed out 1 week before apheresis and must be completed at least 1 week prior to
      pre-infusion lymphodepletive chemotherapy.

      6. Any grade 3 or 4 -hematologic toxicity of previous therapy must have resolved to
      grade 2 or less prior to apheresis and any grade 3 or 4 toxicity must have
      resolved to grade 2 or less prior to pre-infusion lymphodepletive chemotherapy.

   - Must have measurable disease as defined by RECIST 1.1.

   - Must have adequate venous access for apheresis.

   - Women of childbearing potential are requested to use acceptable methods of birth
   control for the duration of the study and until persistence of the study drug is no
   longer detected in the patient. This may be a period of several years. Methods for
   acceptable birth control include: condoms, diaphragm or cervical cap with spermicide,
   intrauterine device, and hormonal contraception. It is recommended that a combination
   of two methods be used.

Patients must have normal organ and marrow function as defined below:

   - Leukocytes ≥ 3,000/mcL

   - Absolute Neutrophil Count ≥ 1,500/mcL

   - Platelets ≥ 100,000/mcL

   - Total bilirubin ≤ 1.5 ULN

   - AST(SGOT)/ALT(SGPT) ≤ 2.5 X institutional upper limit of normal

   - creatinine ≤ 2.0 mg/dL OR

   - creatinine clearance > 60 mL/min for patients with creatinine levels above
   institutional normal

   - Patient must understand the investigational nature of this study and sign an
   Independent Ethics Committee/Institutional Review Board approved written informed
   consent form prior to receiving any study related procedure.

Exclusion Criteria:

   - Currently receiving any other investigational agents

   - Patients with active brain metastases. Patients with prior history of brain metastasis
   who have undergone local therapy (i.e. metastatectomy and/or radiation) and show no
   evidence of local recurrence or progression over the past 6 months are eligible

   - History of allergic reactions attributed to compounds of similar chemical or biologic
   composition to cyclophosphamide or other agents used in the study

   - Prior malignancy (except non-melanoma skin cancer) within 18 months of study entry
   NOTE: Patients must be in complete remission from prior malignancy in order to be
   eligible to enter the study.

   - Uncontrolled intercurrent illness including, but not limited to, ongoing or active
   infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
   arrhythmia, or psychiatric illness/social situations that would limit compliance with
   study requirements

   - Use of chronic corticosteroids, hydroxyurea, or immunomodulating agents (e.g.
   interleukin-2, interferon-alpha or gamma, granulocyte colony stimulating factors,
   etc.) within 30 days prior to study entry. NOTE: Recent or current use of inhaled
   steroids is not exclusionary. If subjects are prescribed a brief course of oral
   corticosteroids, the use should be limited to less than 7 days. Use of steroids before
   apheresis and immune assessment blood draws should be discouraged as it will affect
   white blood cell function.

   - Active infection with HIV, HBV or HCV

   - Receipt of an experimental vaccine within 2 months or in the opinion of the
   Investigator is responding to an experimental vaccine given within 6 months, or has
   received any previous gene therapy using an integrating vector

   - History of severe autoimmune disease requiring steroids or other immunosuppressive
   treatments

   - Lack of availability of a patient for immunological and clinical follow-up assessment

   - Evidence or history of significant cardiac disease

Intervention(s):

biological: NYESO-1c259 T cells

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
CCTO
650-498-7061

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