This is a non-randomised, open-label phase I study of an investigational medicinal product (IMP) consisting of a HLA-A\*02:01 restricted HA-1H T cell receptor transduced T cell (MDG1021) immunotherapy for relapsed or persistent hematologic malignancies after allogeneic hematopoietic stem cell transplantation. The aim of the study is to determine the recommended phase II dose of MDG1021.
This phase I is designed to assess the safety and feasibility of a HLA-A\*02:01 restricted, HA-1H T cell receptor (TCR) transduced patient-derived T cell (MDG1021) immunotherapy, with secondary endpoints including preliminary efficacy, in patients with relapsed or persistent hematologic malignancies after allogeneic hematopoietic stem cell transplantation. In the dose-escalation part of the study, at least 9 patients will be treated with MDG1021 at 3 different doses to assess the safety and the maximum tolerated dose using a standard 3+3 cohort design. Thereafter, the selected optimal MDG1021 dose will be assessed for safety and preliminary efficacy in 20 additional patients during the dose-expansion part of the study. Manufacturing feasibility will be determined. MDG1021 will be administered by single intravenous infusion. HA-1H is exclusively expressed on cells of the hematopoietic system. If the patient's blood-cells, and thus lymphoma or leukemic cells, carry the immunogenic version of the HA-1H antigen on their surface and the donor stem cells do not, MDG1021 immunotherapy could eradicate the patient's cancer cells and allow the donor stem cells to repopulate the patient's blood forming system.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
3 patients to receive dose1: target dose of 0.3x10\^6 HA-1H TCR transduced T cells/kg BW ±20% in 100 mL
3 patients to receive dose 2: target dose of 1x10\^6 HA-1H TCR transduced T cells/kg BW ±20% in 100 mL
3 patients to receive dose 3: target dose of 3x10\^6 HA-1H TCR transduced T cells/kg BW +20% in 100 mL
Leiden University Medical Centre
Leiden, South Holland, Netherlands
Safety and tolerability of HA-1H TCR transduced T cells: incidence and severity of adverse events
To assess the incidence and severity of adverse events during the dose escalation part of the study according to the NCI CTCAE v5.0
Time frame: up to 28 days after T cell infusion
Maximum tolerated dose (MTD) of HA-1H TCR transduced T cells
To asses the maximum tolerated dose (MTD) of MDG1021 as determined by dose-limiting toxicities (DLTs)
Time frame: up to 28 days after T cell infusion
Recommended phase 2 dose (RP2D) of HA-1H TCR transduced T cells
To asses the recommended phase II dose (RP2D) of MDG1021
Time frame: up to 28 days after T cell infusion
Safety and tolerability of HA-1H TCR transduced T cells at recommended phase II dose: incidence and severity of adverse events
To assess the incidence and severity of adverse events of MDG1021 at the RP2D during the expansion part of the study according to the NCI CTCAE v5.0
Time frame: up to 28 days after T cell infusion
Safety and tolerability (both parts of the study): incidence and severity of adverse events
To assess the incidence and severity of AEs ≥ grade 3 (NCI CTCAE v5.0)
Time frame: Up to 12 months after T cell infusion
Overall response rate
To assess the overall response rate defined as the proportion of patients with a best overall response of complete response (CR), partial response (PR), and/or their disease specific subcategories
Time frame: Up to 12 months after T cell infusion
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20 patients to receive the selected optimal dose
Overall survival
To assess the overall survival (OS) defined as the time from the date of signing the informed consent until the documented date of death.
Time frame: Up to 12 months afterT cell infusion
Progression free survival
To assess the progression-free survival (PFS) defined as the time from the date of signing the date of signed informed consent until progressive disease/relapse or death, whichever occurs first.
Time frame: Up to 12 months afterT cell infusion
Duration of response
To assess the duration of response (DoR) defined as time from the date of the first documented response to the first documented progression of disease or death due to underlying cancer.
Time frame: Up to 12 months afterT cell infusion
Quality of life (EQ-5D-5L)
The quality of life will be assessed by using the EQ-5D-5L questionnaire, consisting of 5 questions. Higher scores correspond to higher quality of life.
Time frame: Up to 12 months afterT cell infusion
Quality of life (VAS)
The quality of life will be assessed by a visual analog scale (EuroQoL), having a range of 0 ot 100, with higher scores corresponding to better quality of life.
Time frame: Up to 12 months afterT cell infusion