This first time in human study is intended for men and women at least 18 years of age who have advanced lung cancer which has grown or returned after being treated. In particular, it is a study for subjects who have a blood test positive for HLA-A\*02:01 and/or HLA-A\*02:06 and a tumor test positive for MAGE A10 protein expression (protein or gene). This trial is a dose escalation trial that will evaluate 3 doses of transduced cells administered after a lymphodepleting chemotherapy regimen using a 3+3 dose escalation design .The study will take the subject's T cells, which are a natural type of immune cell in the blood, and send them to a laboratory to be modified. The changed T cells used in this study will be the subject's own T cells that have been genetically changed with the aim of attacking and destroying cancer cells. When the MAGE A10ᶜ⁷⁹⁶T cells are available, subjects will receive lymphodepleting chemotherapy with cyclophosphamide and fludarabine, followed by the T cell infusion. The purpose of this study is to test the safety of genetically changed T cells and find out what effects, if any, they have in subjects with lung cancer. The study will evaluate three different cell dose levels in order to find out the target cell dose. Once the target cell dose is determined, additional subjects will be enrolled to further test the safety and effects at this cell dose. Subjects will be seen frequently by the Study Physician right after receiving their T cells back and up to first 6 months. After that, subjects will be seen every three months. Subjects will be seen every 6 months by their Study Physician for the first 5 years after the T cell infusion. If the T cells are found in the blood at five years, then the subjects will continue to be seen once a year until the T cells are no longer found in the blood for a maximum of 15 years. If the T cells are no longer found in the blood at 5 years, then the subject will be contacted by the Study Physician for the next 10 years. Subjects who have a confirmed response or clinical benefit ≥4 weeks after the first T-cell infusion and whose tumor continues to express the appropriate antigen target may be eligible for a second infusion. All subjects, completing or withdrawing from the Interventional Phase of the study, will enter a 15-year long-term follow-up phase for observation of delayed adverse events. All subjects will continue to be followed for overall survival during the long-term follow-up phase.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
28
City of Hope
Duarte, California, United States
Stanford Cancer Center
Palo Alto, California, United States
University of Miami Sylvester Comprehensive Cancer Center
Miami, Florida, United States
H. Lee Moffitt Cancer Center
Tampa, Florida, United States
Winship Cancer Institute of Emory University
Atlanta, Georgia, United States
Indiana University Simon Cancer Center
Indianapolis, Indiana, United States
University of Maryland, Greenebaum Cancer Center
Baltimore, Maryland, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Washington University, School of Medicine
St Louis, Missouri, United States
Duke University Medical Center, Duke Cancer Institute
Durham, North Carolina, United States
...and 9 more locations
Number of subjects with dose-limiting toxicity (DLT) and adverse events (AE), including serious adverse events (SAE)
Determine if treatment with autologous genetically modified T cells, (MAGE A10ᶜ⁷⁹⁶T ) is safe and tolerable through assessment of DLTs, AEs, including SAEs; laboratory assessments, including chemistry, hematology, and coagulation; cardiac and pulmonary assessments, including ECG and troponin.
Time frame: 24 months
Proportion of subjects with a confirmed Complete Response (CR) or Partial Response (PR)
Evaluation of the efficacy of the treatment by assessment of the Overall Response Rate according to RECIST v1.1
Time frame: 24 months
Interval between the date of first T cell infusion dose and first documented evidence of CR or PR
Evaluation of the efficacy of the treatment by assessment of time to first response
Time frame: 24 months
Interval between the date of first documented evidence of CR or PR until first documented disease progression or death due to any cause
Evaluation of the efficacy of the treatment by assessment of duration of response
Time frame: 24 months
Interval between the date of first documented evidence of SD until first documented disease progression or death due to any cause
Evaluation of the efficacy of the treatment by assessment of duration of stable disease
Time frame: 24 months
Interval between the date of first T cell infusion and the earliest date of disease progression or death due to any cause
Evaluation of the efficacy of the treatment by assessment of progression-free survival
Time frame: 24 months
Interval between the date of first T cell infusion and date of disease progression or death due to any cause
Evaluation of the efficacy of the treatment by assessment of overall survival
Time frame: 24 months
Best Overall Response (BOR)
Best Overall Response (BOR), defined as the best response recorded from the date of T cell infusion until disease progression
Time frame: 24 months
To evaluate potential gene therapy-related delayed adverse events for 15 years post infusion.
Presence of any of the following LTFU AEs: * New malignancies * New incidence or exacerbation of a pre-existing neurologic disorder * New incidence or exacerbation of a prior rheumatologic or other autoimmune disorder * New incidence of a hematologic disorder * Opportunistic and/or serious infections * Unanticipated illness and/or hospitalization deemed related to gene modified cell therapy Persistence of MAGE-A10c796T and replication-competent lentivirus (RCL) over time.
Time frame: 15 years
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