A single arm, open-label pilot study is designed to determine the safety, efficacy and cytokinetics of CAR-BCMA T cells in patients with BCMA-positive refractory or relapsed multiple myeloma.
This study is designed to determine the safety, tolerability and engraftment potential of anti-BCMA lentivirus-transduced autologous T cells in patients with refractory or relapsed multiple myeloma. Primary objectives: 1. Determine the safety and tolerability of CAR-BCMA T cells (autologous T cells transduced with chimeric antigen receptors recognizing BCMA) in patients with refractory or relapsed multiple myeloma. 2. Observe the cytokinetics of CAR-BCMA T cells. Secondary objectives: 1. Observe the anti-tumor response of CAR-BCMA T cells to refractory or relapsed multiple myeloma (evaluated by diagnostic criteria International Myeloma Working Group (IMWG2014 version) as CR, sCR, ICR, MCR or VGPR). 2. Make an evaluation on the distribution and in vivo survival of CAR-BCMA T cells in peripheral blood, lymph node, and bone marrow. 3. Observe the immunogenicity of CAR-BCMA T cells, and determine if there is anti-BCMA scFv cellular immune response and anti-BCMA scFv humoral immune response. 4. Observe the changes of cell subsets of CAR-BCMA T cells against T cells (Tcm, central memory T lymphocytes; Tem, effector memory T lymphocytes; Treg, regulatory T lymphocytes).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Single dose of CAR-BCMA T cells will be infused, and classic "3+3" dose escalation will be applied.
Fludarabine is used for lymphodepletion.
Cyclophosphamide is used for lymphodepletion.
Xin Hua Hospital of Shanghai Jiao Tong University of Medicine
Shanghai, Shanghai Municipality, China
Number of participants with CAR-BCMA T cell therapy-related adverse events as assessed by CTCAE v4.03
Number of participants with study related adverse events which are defined as laboratory toxicities and clinical events that are possible, likely or definitely related to study treatment at any time from the infusion until week 24, including infusion related toxicity and any toxicity possibly related to CAR-BCMA T cells.
Time frame: 24 weeks
Engraftment
Duration of in vivo survival of CAR-BCMA T cells is defined as "engraftment". The primary engraftment endpoint is the number of CAR-BCMA DNA vector copies per mL blood of CAR-BCMA T cells at regular intervals from 24 hours after initial infusion through 2 years of last infusion. PCR for CAR-BCMA T vector sequences will be performed until any 2 sequential tests are negative, documented as engraftment of CAR-BCMA T cells.
Time frame: 2 years
Anti-tumor response of CAR-BCMA T cell infusion
Observe the anti-tumor response of CAR-BCMA T cells to refractory or relapsed multiple myeloma (evaluated by diagnostic criteria International Myeloma Working Group (IMWG2014 version) as CR, sCR, ICR, MCR or VGPR).
Time frame: 2 years
Statistical parameter of efficacy assessment#PFS
Statistical parameter#Progression-free Survival (PFS)
Time frame: 5 years
Statistical parameter of efficacy assessment#DCR
Statistical parameter:Disease Control Rate (DCR)
Time frame: 2 years
Statistical parameter of efficacy assessment#ORR
Statistical parameter:Objective Remission Rate (ORR)
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Time frame: 2 years
Statistical parameter of efficacy assessment#OS
Statistical parameter:Overall survival (OS)
Time frame: 5 years