The primary purpose of the Phase I portion of the study is to assess the therapeutic safety and preliminary efficacy of a hematopoietic cell-based gene therapy consisting of autologous CD34+ enriched cells transduced with the therapeutic lentiviral vector, Chim-CD18-WPRE, RP-L201. The primary objectives of the Phase II portion of the study are evaluation of survival, as determined by the proportion of subjects alive at age 2 (24 months) and at least 1-year post-infusion without allogeneic hematopoietic stem cell transplant (HSCT) and characterization of the safety and toxicity associated with the infusion.
This is a pediatric non-randomized open-label Phase I/II clinical trial. The Phase I portion will include a safety evaluation and preliminary assessment of the efficacy of hematopoietic gene therapy consisting of autologous CD34+ enriched cells transduced with a lentiviral vector carrying the ITGB2 gene in subjects with severe LAD-I. CD34+ cells will be transduced ex vivo with the therapeutic vector followed by cryopreservation. If the number of CD34+ cells that are available for infusion is at least 2x10e6 total CD34+ cells/kg, subjects will undergo myeloablative conditioning with intravenous busulfan. Subjects will then receive infusion of gene-corrected hematopoietic cells approximately 24 hours following the final busulfan dose. The active agent is a self-inactivating lentiviral vector carrying the therapeutic ITGB2 gene, encoding for the human CD18 receptor (β2 integrin subunit). The therapeutic product is the subject's autologous hematopoietic stem cells that have been transduced with the lentiviral vector.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
9
CD34+ enriched hematopoietic stem cells from subjects with severe LAD-I transduced ex vivo with lentiviral vector carrying the ITGB2 gene, Chim-CD18-WPRE.
University of California, Los Angeles
Los Angeles, California, United States
Hospital Infantil Universitario Niño Jesús (HIUNJ)
Madrid, Spain
University College London Great Ormond Street Institute of Child Health
London, United Kingdom
Phase I: Number of participants with treatment-related adverse events as assessed by United States (US) National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v.5.0
Evaluation of safety associated with treatment with RP-L201
Time frame: 2 years
Phase II: Survival following infusion of RP-L201
, as determined by the proportion of subjects alive at least 1-year post investigational product infusion without allogeneic HSCT and alive at age 2 (24 months) without allogeneic HSCT for subjects less than 1 year of age at study enrollment.
Time frame: 2 years
Phase II: Number of participants with treatment-related adverse events as assessed by CTCAE v.5.0
Evaluation of safety associated with treatment with RP-L201
Time frame: 2 years
CD18 expression after infusion of RP-L201
Determination of the percentage of subjects in whom infusion of RP-L201 results in a change in the percentage of neutrophils expressing CD18 to at least 10%
Time frame: 2 years
Genetic correction after infusion of RP-L201
Determination of the percentage of subjects in whom infusion of RP-L201 results in at least 10% of peripheral blood neutrophils carrying the therapeutic Chim-CD18-WPRE lentiviral vector provirus at 6 months post-infusion
Time frame: 2 years
Incidence of infections after infusion of RP-L201
Determination of the incidence of significant infections, infection-related hospitalizations, and prolonged infection-related hospitalizations, comparing the incidences prior to investigational product infusion and subsequent to hematopoietic reconstitution.
Time frame: 2 years
Assessment of LAD-I-associated neutrophilia after infusion of RP-L201
Evaluation of change to partially normal or to normal levels of LAD-I-associated neutrophilia
Time frame: 2 years
Assessment of LAD-I-associated leukocytosis after infusion of RP-L201
Evaluation of change to partially normal or to normal levels of LAD-I-associated leukocytosis
Time frame: 2 years
Assessment of skin rash or periodontal abnormalities after infusion of RP-L201
Evaluation of resolution (partial or complete) of any underlying skin rash or periodontal abnormalities
Time frame: 2 years
Assessment of overall survival after infusion of RP-L201
Assessment of event-free survival (EFS) defined as survival without graft failure (GF) and without acute graft-versus-host disease (aGVHD) grade 2 to 4.
Time frame: 2 years
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