Multiple MyelomaPhase 1NCT03399448
NY-ESO-1-redirected CRISPR (TCRendo and PD1) Edited T Cells (NYCE T Cells)
A Phase 1 study testing NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1, Cyclophosphamide and Fludarabine in people with Multiple Myeloma and Melanoma, run by University of Pennsylvania at 1 site in United States.
Trial summary
This is a first-in-human trial proposed to test HLA-A*0201 restricted NY-ESO-1 redirected T cells with edited endogenous T cell receptor and PD-1. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Multiple Myeloma, Melanoma, Synovial Sarcoma
- What is being tested?
- NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1, Cyclophosphamide and Fludarabine
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3 participants
- Where
- 1 siteUnited States
- Study dates
- 5 Sep 2018to 9 Oct 2020
- Phase
- Phase 1
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 1. Subjects with a confirmed diagnosis of relapsed refractory multiple myeloma (MM), melanoma, synovial sarcoma, or myxoid/round cell liposarcoma (MRCL) as follows:
- Multiple Myeloma i. Subjects must have a confirmed prior diagnosis of active MM as defined by the International Myeloma Working Group (IMWG) criteria.
- Subjects must have relapsed or refractory disease after either one of the following:
- At least 3 prior regimens, which must have contained an alkylating agent, proteasome inhibitor, and immunomodulatory agent (IMiD) OR
- At least 2 prior regimens if "double-refractory" to a proteasome inhibitor and IMiD, defined as progression on or within 60 days of treatment with these agents.
- Note: Induction therapy, stem cell transplant, and maintenance therapy, if given sequentially without intervening progression, should be considered as 1 "regimen".
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- Subjects must be at least 90 days since autologous stem cell transplant, if performed.
- Toxicities from prior therapies, with the exception of alopecia or peripheral neuropathy attributable to bortezomib, must have recovered to grade ≤ 2 according to the Common Toxicity Criteria (CTCAE) 4.0 criteria or to the subject's prior baseline.
- Subjects must have measurable disease per IMWG criteria on study entry, which must include at least 1 of the following:
- Serum M-spike ≥ 0.5 g/dL*
- 24 hour (hr) urine M-spike ≥ 200mg
- Involved serum free light chain (FLC) ≥ 50 mg/L with abnormal ratio
- Measurable plasmacytoma on exam or imaging
- Bone marrow plasma cells ≥ 20%
- Note: Patients with IgA myeloma in whom serum protein electrophoresis is deemed unreliable, due to co-migration of normal serum proteins with the paraprotein in the beta region, may be considered eligible as long as total serum IgA level is elevated above normal range.
- Melanoma i. Subjects must have a confirmed prior diagnosis of melanoma. ii. Progressed after at least 2 therapy lines. iii. Subjects with BRAF mutant tumors should have received and progressed through, or are intolerant to, BRAF/MEK inhibitor therapy prior to enrollment iv. Patients must have measurable disease per RECIST 1.1 in order to allow assessment of an anti-tumor response.
- Synovial Sarcoma or Myxoid/Round Cell Liposarcoma (MRCL) i. Subjects must have a confirmed prior diagnosis of synovial sarcoma or MRCL. ii. Patients with proven metastatic disease or surgically inoperable local recurrence that have failed first line treatment.
- Patients must have measurable disease per RECIST 1.1 in order to allow assessment of an anti-tumor response.
- 2. Provides written, informed consent. 3. Subjects ≥ 18 years of age. 4. Eastern Cooperative Oncology Group (ECOG) performance status of 0-2. 5. Documented NY-ESO-1 and/or LAGE-1 expression on tumor tissue. 6. HLA-A201 positive 7. Subjects of reproductive potential must agree to use acceptable birth control methods.
- 8. Adequate vital organ function as defined by:
- Serum creatinine ≤ 2.5 or estimated creatinine clearance ≥30 ml/min and not dialysis-dependent.
- Absolute neutrophil count ≥1000/μl and platelet count ≥50,000/μl (≥30,000/μl if bone marrow plasma cells are ≥50% of cellularity for MM patients).
- Serum glutamic oxaloacetic transaminase (SGOT) ≤ 3x the upper limit of normal and total bilirubin ≤ 2.0 mg/dl (except for patients in whom hyperbilirubinemia is attributed to Gilbert's syndrome).
- Left ventricular ejection fraction (LVEF) ≥ 45%. LVEF assessment must have been performed within 8 weeks of eligibility confirmation by physician-investigator.
Who cannot join
- 1. Pregnant or nursing (lactating) women.
- 2. Have inadequate venous access for or contraindications to leukapheresis.
- 3. Have any active and uncontrolled infection.
- 4. Active hepatitis B or hepatitis C
- 5. Human immunodeficiency virus (HIV) infection.
- 6. Any uncontrolled medical or psychiatric disorder that would preclude participation as outlined.
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- 7. New York Heart Association (NYHA) Class III or IV heart failure, unstable angina, or a history of recent (within 6 months) myocardial infarction or sustained (>30 seconds) ventricular tachyarrhythmias.
- 8. Received prior gene therapy or gene-modified cellular immunotherapy. Subject may have received, however, non-gene-modified autologous T-cells in association with an anti-myeloma vaccine (e.g., hTERT or MAGEA3) or vaccination against infectious agents (e.g., influenza or pneumococcus) as was performed on our previous studies.
- 9. Active auto-immune disease, including connective tissue disease, uveitis, sarcoidosis, inflammatory bowel disease, or multiple sclerosis, or have a history of severe (as judged by the principal investigator) autoimmune disease requiring prolonged immunosuppressive therapy.
- 10. Prior allogeneic stem cell transplant.
- 11. Prior or active central nervous system (CNS) involvement (e.g. leptomeningeal disease, parenchymal masses) with myeloma. Screening for this (e.g. with lumbar puncture) is not required unless suspicious symptoms or radiographic findings are present. Subjects with calvarial disease that extends intracranially and involves the dura will be excluded, even if cerebrospinal fluid (CSF) is negative for myeloma.
Trial locations and contacts
1 site in 1 country.
United States1 site
University of Pennsylvania
Philadelphia, Pennsylvania, 19104
About this study
Official title: Phase 1 Trial of Autologous T Cells Engineered to Express NY-ESO-1 TCR and CRISPR Gene Edited to Eliminate Endogenous TCR and PD-1 (NYCE T Cells)
This is a first-in-human trial proposed to test HLA-A*0201 restricted NY-ESO-1 redirected T cells with edited endogenous T cell receptor and PD-1.
- Being tested
- NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1, Cyclophosphamide, Fludarabine, NY-ESO-1 expression testing
- Medical subject headings
- Multiple Myeloma, Melanoma, Sarcoma, Synovial, Liposarcoma, Myxoid
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1Biological
Autologous T cells transduced with a lentiviral vector to express NY-ESO-1 and electroporated with CRISPR guide RNA to disrupt expression of endogenous TCRα, TCRβ and PD-1 (NYCE T Cells).
CyclophosphamideDrug
a cytotoxic chemotherapy agent used for lymphodepletion prior to NYCE T cells.
FludarabineDrug
a chemotherapy agent used for lymphodepletion prior to NYCE T cells.
NY-ESO-1 expression testingDevice
Testing to determine if NY-ESO-1 is expressed on tumor tissue.
| Study group | Role | What they receive |
|---|---|---|
| Multiple Myeloma (MM) | Experimental | Not described Receives: Biological: NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1; Drug: Cyclophosphamide; Drug: Fludarabine; Device: NY-ESO-1 expression testing |
| Synovial Sarcoma (SS) and Myxoid/Round Cell Liposarcoma (MRCL) | Experimental | Not described Receives: Biological: NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1; Drug: Cyclophosphamide; Drug: Fludarabine; Device: NY-ESO-1 expression testing |
| Melanoma | Experimental | Not Recruiting at the UPenn Site Receives: Biological: NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1; Drug: Cyclophosphamide; Drug: Fludarabine; Device: NY-ESO-1 expression testing |
What is being measured
The primary outcome is the main question the study is designed to answer.
Determine safety profile of a single infusion of NYCE T cells by monitoring the frequency and severity of adverse events assessed by the National Cancer Institute (NCI) - Common Toxicity Criteria (v4.03)
Measured: 5 years
Evaluate Manufacturing Feasibility of NYCE T Cells.
Evaluate the percentage of manufacturing products that do not meet release criteria for vector transduction efficiency, gene disruption T cell product purity, viability, sterility or due to tumor contamination.
Measured: 5 years
Secondary outcomes (5)
Percentage of patients achieving complete response (CR) before or at Month 6
Measured: 6 months
Overall survival (OS)
Measured: 5 years
Duration of remission (DOR)
Measured: 5 years
Progression- free survival (PFS)
Measured: 5 years
Cause of death (COD) when appropriate
Measured: 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Jan 2018
- Study start5 Sep 2018
- Primary completion29 Feb 2020
- Study completion9 Oct 2020
Why it stopped: Sponsor has terminated trial to pursue other targets.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Multiple MyelomaStudies of the same condition, open and under way.
- More trials run by University of PennsylvaniaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1
- Primary purpose
- Other
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 3 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Pennsylvania
- Sponsor type
- University, hospital or other
- Collaborators
- Parker Institute for Cancer Immunotherapy, Gilead Sciences
- Responsible party
- Sponsor
- Investigators
- Edward Stadtmauer, MD, Principal investigator, University of Pennsylvania
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03399448
- Sponsor's protocol ID
- UPCC# 25416; IRB #826672
- Status last verified
- Oct 2020
- First submitted
- 20 Dec 2017
- Last updated
- 22 Jun 2023
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- Yes
- Individual data sharing
- Undecided
Publications
Stadtmauer EA, Fraietta JA, Davis MM, Cohen AD, Weber KL, Lancaster E, Mangan PA, Kulikovskaya I, Gupta M, Chen F, Tian L, Gonzalez VE, Xu J, Jung IY, Melenhorst JJ, Plesa G, Shea J, Matlawski T, Cervini A, Gaymon AL, Desjardins S, Lamontagne A, Salas-Mckee J, Fesnak A, Siegel DL, Levine BL, Jadlowsky JK, Young RM, Chew A, Hwang WT, Hexner EO, Carreno BM, Nobles CL, Bushman FD, Parker KR, Qi Y, Satpathy AT, Chang HY, Zhao Y, Lacey SF, June CH. CRISPR-engineered T cells in patients with refractory cancer. Science. 2020 Feb 28;367(6481):eaba7365. doi: 10.1126/science.aba7365. Epub 2020 Feb 6.
PubMed 32029687Tsuchida CA, Brandes N, Bueno R, Trinidad M, Mazumder T, Yu B, Hwang B, Chang C, Liu J, Sun Y, Hopkins CR, Parker KR, Qi Y, Hofman L, Satpathy AT, Stadtmauer EA, Cate JHD, Eyquem J, Fraietta JA, June CH, Chang HY, Ye CJ, Doudna JA. Mitigation of chromosome loss in clinical CRISPR-Cas9-engineered T cells. Cell. 2023 Oct 12;186(21):4567-4582.e20. doi: 10.1016/j.cell.2023.08.041. Epub 2023 Oct 3.
PubMed 37794590Miah KM, Hyde SC, Gill DR. Emerging gene therapies for cystic fibrosis. Expert Rev Respir Med. 2019 Aug;13(8):709-725. doi: 10.1080/17476348.2019.1634547. Epub 2019 Jun 27.
PubMed 31215818
Study at a glance
From the registry record, last updated by the sponsor on 22 Jun 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase 1 Trial of Autologous T Cells Engineered to Express NY-ESO-1 TCR and CRISPR Gene Edited to Eliminate Endogenous TCR and PD-1 (NYCE T Cells)
- ClinicalTrials.gov ID
- NCT03399448
- Acronym / sponsor ID
- UPCC# 25416; IRB #826672
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Sponsor has terminated trial to pursue other targets.
- Enrolment
- 3 participants (actual)
- Lead sponsor
- University of PennsylvaniaUniversity, hospital or other
- Collaborators
- Parker Institute for Cancer Immunotherapy, Gilead Sciences
- Study start
- 5 Sep 2018 (actual)
- Primary completion
- 29 Feb 2020 (actual)
- Study completion
- 9 Oct 2020 (actual)
- First posted
- 16 Jan 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a first-in-human trial proposed to test HLA-A*0201 restricted NY-ESO-1 redirected T cells with edited endogenous T cell receptor and PD-1.
Study design
- Primary purpose
- Other
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Multiple Myeloma (MM) | Experimental | Biological: NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1, Drug: Cyclophosphamide, Drug: Fludarabine, Device: NY-ESO-1 expression testing |
| Synovial Sarcoma (SS) and Myxoid/Round Cell Liposarcoma (MRCL) | Experimental | Biological: NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1, Drug: Cyclophosphamide, Drug: Fludarabine, Device: NY-ESO-1 expression testing |
| Melanoma | Experimental | Biological: NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1, Drug: Cyclophosphamide, Drug: Fludarabine, Device: NY-ESO-1 expression testingNot Recruiting at the UPenn Site |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (24 listed)
- 1. Subjects with a confirmed diagnosis of relapsed refractory multiple myeloma (MM), melanoma, synovial sarcoma, or myxoid/round cell liposarcoma (MRCL) as follows:
- Multiple Myeloma i. Subjects must have a confirmed prior diagnosis of active MM as defined by the International Myeloma Working Group (IMWG) criteria.
- Subjects must have relapsed or refractory disease after either one of the following:
- At least 3 prior regimens, which must have contained an alkylating agent, proteasome inhibitor, and immunomodulatory agent (IMiD) OR
- At least 2 prior regimens if "double-refractory" to a proteasome inhibitor and IMiD, defined as progression on or within 60 days of treatment with these agents.
Key exclusion criteria (11 listed)
- 1. Pregnant or nursing (lactating) women.
- 2. Have inadequate venous access for or contraindications to leukapheresis.
- 3. Have any active and uncontrolled infection.
- 4. Active hepatitis B or hepatitis C
- 5. Human immunodeficiency virus (HIV) infection.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1Autologous T cells transduced with a lentiviral vector to express NY-ESO-1 and electroporated with CRISPR guide RNA to disrupt expression of endogenous TCRα, TCRβ and PD-1 (NYCE T Cells). | Biological | Melanoma, Multiple Myeloma (MM), Synovial Sarcoma (SS) and Myxoid/Round Cell Liposarcoma (MRCL) |
| Cyclophosphamidea cytotoxic chemotherapy agent used for lymphodepletion prior to NYCE T cells. | Drug | Melanoma, Multiple Myeloma (MM), Synovial Sarcoma (SS) and Myxoid/Round Cell Liposarcoma (MRCL) |
| Fludarabinea chemotherapy agent used for lymphodepletion prior to NYCE T cells. | Drug | Melanoma, Multiple Myeloma (MM), Synovial Sarcoma (SS) and Myxoid/Round Cell Liposarcoma (MRCL) |
| NY-ESO-1 expression testingTesting to determine if NY-ESO-1 is expressed on tumor tissue. | Device | Melanoma, Multiple Myeloma (MM), Synovial Sarcoma (SS) and Myxoid/Round Cell Liposarcoma (MRCL) |
Primary outcome
Determine safety profile of a single infusion of NYCE T cells by monitoring the frequency and severity of adverse events assessed by the National Cancer Institute (NCI) - Common Toxicity Criteria (v4.03)
Time frame: 5 years
Evaluate Manufacturing Feasibility of NYCE T Cells.
Time frame: 5 years
Evaluate the percentage of manufacturing products that do not meet release criteria for vector transduction efficiency, gene disruption T cell product purity, viability, sterility or due to tumor contamination.
5 secondary outcomes
Percentage of patients achieving complete response (CR) before or at Month 6
Time frame: 6 months
Overall survival (OS)
Time frame: 5 years
Duration of remission (DOR)
Time frame: 5 years
Progression- free survival (PFS)
Time frame: 5 years
Cause of death (COD) when appropriate
Time frame: 5 years
Results and safety
The study was stopped early (reason given: Sponsor has terminated trial to pursue other targets.). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jun 2023.
- Results publication: PubMed 32029687Stadtmauer EA, Fraietta JA, Davis MM, Cohen AD, Weber KL, Lancaster E, Mangan PA, Kulikovskaya I, Gupta M, Chen F, Tian L, Gonzalez VE, Xu J, Jung IY, Melenhorst JJ, Plesa G, Shea J, Matlawski T, Cervini A, Gaymon AL, Desjardins S, Lamontagne A, Salas-Mckee J, Fesnak A, Siegel DL, Levine BL, Jadlowsky JK, Young RM, Chew A, Hwang WT, Hexner EO, Carreno BM, Nobles CL, Bushman FD, Parker KR, Qi Y, Satpathy AT, Chang HY, Zhao Y, Lacey SF, June CH. CRISPR-engineered T cells in patients with refractory cancer. Science. 2020 Feb 28;367(6481):eaba7365. doi: 10.1126/science.aba7365. Epub 2020 Feb 6.
- Derived from this study: PubMed 37794590Tsuchida CA, Brandes N, Bueno R, Trinidad M, Mazumder T, Yu B, Hwang B, Chang C, Liu J, Sun Y, Hopkins CR, Parker KR, Qi Y, Hofman L, Satpathy AT, Stadtmauer EA, Cate JHD, Eyquem J, Fraietta JA, June CH, Chang HY, Ye CJ, Doudna JA. Mitigation of chromosome loss in clinical CRISPR-Cas9-engineered T cells. Cell. 2023 Oct 12;186(21):4567-4582.e20. doi: 10.1016/j.cell.2023.08.041. Epub 2023 Oct 3.
- Derived from this study: PubMed 31215818Miah KM, Hyde SC, Gill DR. Emerging gene therapies for cystic fibrosis. Expert Rev Respir Med. 2019 Aug;13(8):709-725. doi: 10.1080/17476348.2019.1634547. Epub 2019 Jun 27.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Edward Stadtmauer, MD principal investigator
University of Pennsylvania
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing NY-ESO-1 redirected autologous T cells with CRISPR edited endogenous TCR and PD-1, Cyclophosphamide and Fludarabine in people with Multiple Myeloma and Melanoma, run by University of Pennsylvania at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 24 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 22 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was stopped early (reason given: Sponsor has terminated trial to pursue other targets.). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Determine safety profile of a single infusion of NYCE T cells by monitoring the frequency and severity of adverse events assessed by the National Cancer Institute (NCI) - Common Toxicity Criteria (v4.03) (time frame: 5 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03399448, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jun 2023.