This is one center, single-arm, open-label investigator initiated trial to assess the safety and efficacy of enhanced autologous PSMA chimeric antigen receptor T cells in the treatment for patients with refractory castration resistant prostate cancer, and the sample size is set to 7-18 subjects.
This is one center, single-arm, open-label investigator initiated trial to assess the safety and efficacy of enhanced autologous PSMA chimeric antigen receptor T cells in the treatment for patients with refractory castration resistant prostate cancer, and the sample size is set to 7-18 subjects. Based on the "3 + 3" dose escalation design principle, subjects will be divided into 3 groups from low dose to high dose in sequence (Group A; Group B; Group C). Additional subjects will be enrolled into the RP2D group to ensure that 6-9 efficacy-evaluable subjects are available in the RP2D group before entering the phase II study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
3 escalated dosing cohorts are designed to explore safety and efficacy of enhanced autologous PSMA-CAR T: cohort A: CART-PSMA cells 0.25×106/kgBW, following lymphodepleting chemotherapy with cyclophosphamide 300 mg/m2/day and fludarabine 30 mg/m2/day given according to protocol; cohort B: CART-PSMA cells 0.75×106/kgBW,following lymphodepleting chemotherapy with cyclophosphamide 300 mg/m2/day and fludarabine 30 mg/m2/day given according to protocol; cohort C: CART-PSMA cells 2×106/kgBW,following lymphodepleting chemotherapy with cyclophosphamide 300 mg/m2/day and fludarabine 30 mg/m2/day given according to protocol;
Changzheng hospital
Shanghai, Shanghai Municipality, China
DLT
The number and severity of dose-limiting toxicity (DLT) events
Time frame: Within 28 Days After Enhanced autologous PSMA-CAR T Infusion
The National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE V5.0)
Safety assessment: toxicity profile
Time frame: Through 6 months after CAR-T cell infusion
Cytokine Release Syndrome (CRS) grading post CAR T cell infusion
Safety assessment: toxicity profile
Time frame: Through 6 months after CAR-T cell infusion
Efficacy assessment: PSA changes
Prostate-Specific Antigen (PSA) changes assessed by serum PSA measurement (ng/ml).
Time frame: 6 months after CAR-T cell infusion
Efficacy assessment: radiographic Progression-Free Survival (rPFS)
rPFS is defined as the time between treatment with study drug and the development of imaging progression or death from any cause, whichever occurs first, with imaging progression encompassing the evaluation of progression of primary lesions, non-regional lymph node invasion, soft tissue metastases, and bone metastatic lesions according to RECIST 1.1 and PCWG3 criteria.
Time frame: 3 months after CAR-T cell infusion
Pharmacokinetics (PK) assessment: expansion of CAR-T cells
With the day of the first infusion of the cellular preparation recorded as DO, the monitoring phase of the pharmacokinetic study started from 1 day before the first infusion (D-1). Expansion of CAR T cells will be assessed by concentration profile of CAR-T cells in peripheral blood after CAR-T infusion.
Time frame: From Day 1 till at least 3 months after CAR-T cell infusion
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Pharmacokinetics (PK) assessment: persistence of CAR T cells
With the day of the first infusion of the cellular preparation recorded as DO, the monitoring phase of the pharmacokinetic study started from 1 day before the first infusion (D-1). Persistence of CAR T cells will be assessed by T-cell survival time (area under the curve AUCO-28 at 28 days and area under the curve AUCO-90 at 90 days);
Time frame: From Day 1 till at least 3 months after CAR-T cell infusion
Pharmacodynamics (PD) assessment eg. (Level of IL-6)
Pharmacokinetic (PD) endpoints is assessed by changes in serum cytokine levels (eg.IL-6) after CAR-T infusion.
Time frame: From Day 1 till at least 3 months after CAR-T cell infusion