In this study, a combination of two T-cell directed antibodies both conjugated to a cell-killing toxin will be evaluated. Previous in vitro studies have demonstrated that this so-called immunotoxin-combination (IT-combination) acts synergistically in eliminating T cells. In a subsequent clinical pilot-study, the IT-combination has generated encouraging results when applied as third line therapy. Extensive biological and clinical responses could be noted in the absence of severe acute toxicities. Building on this experience, the current study aims at evaluating the characteristics of the IT-combination when administered in an earlier phase of the disease, i.e. as second line instead of as third line therapy.
"The experimental design is a non-controlled multicentric fixed-dose Phase I/II study. A total of 12 evaluable patients will be enrolled in 4 transplant centers throughout the Netherlands, in a 9 to 12 months period. The treatment consists of a standard dose of 4 infusions IT-combination (4 mg/m2), given 48-hours apart over a 4-hour period. The intended follow-up period is 12 months. The patient will also be asked to participate in additional research aiming at determining the presence and evolution of biomarkers suggestive for the extent to which the IT-combination 'resets the T-cell compartment, induces clinical tolerance, and/or enhances the risk of over-immunosuppression."
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
The treatment consists of a standard dose of 4 infusions of IT-combination (4 mg/m2), given 48-hours apart over a 4-hour period. The IT-combination is a combination of two immunotoxins. One immunotoxin is a mAb anti-CD3 conjugated to recombinant ricin A chain and the other immunotoxin is a mAb anti-CD7 conjugated to recombinant ricin A chain.
Department of Hematology Radboud University Nijmegen (RUN)
Nijmegen, Netherlands
Department of Hematology Erasmus MC/Daniel den Hoed Cancer CenterGroene Hilledijk
Rotterdam, Netherlands
L.F. , Department of HematologyUMC Utrecht
Utrecht, Netherlands
The acute GVHD response rate on study Day 29
Time frame: Day 29
The safety and tolerability of the IT-combination, as determined by the number and intensity of adverse and serious adverse events during 12 months
Time frame: 12 months
The acute GVHD relapse rate
Time frame: 12 months
The incidence of chronic GVHD during 12 months
Time frame: 12 months
The overall survival and progression free survival during 12 months
Time frame: 12 months
The kinetics of treatment-induced T cell and Natural Killer (NK) cell depletion
Time frame: 12 months
The pharmacokinetic profile of the IT-combination
Time frame: day 9
The occurrence and extent of humoral responses against the IT-combination
Time frame: 12 months
The occurrence of any treatment-induced cytokine release
Time frame: day 7
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