Leukocyte Adhesion Defect - Type IPhase 1NCT03825783
A Gene Therapy Trial to Evaluate the Safety and Efficacy of RP-L201 in Subjects With Leukocyte Adhesion Deficiency-I
A Phase 1 study testing RP-L201 in people with Leukocyte Adhesion Defect - Type I, run by Rocket Pharmaceuticals Inc. at 1 site in Spain.
Trial summary
The primary purpose of the Phase I portion of the study is to determine the safety profile and preliminary evidence of efficacy associated with infusion of autologous gene-corrected hematopoietic stem cells. Read more about this study
- Who is it for?
- Ages 3 months and older
- Conditions the study is for
- Leukocyte Adhesion Defect - Type I
- What is being tested?
- RP-L201
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 0 participants
- Where
- 1 siteSpain
- Study dates
- 15 Apr 2019to Oct 2021
- 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 3 months and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- A confirmed diagnosis of severe LAD-I as demonstrated by flow cytometry indicating CD18 expression on <2% neutrophils (polymorphonuclear neutrophils [PMNs]). (Patients in which CD18+ PMNs are >2% will be considered eligible with <2% CD11a or CD11b expressing PMNs and if there is a documented ITGB2 mutation and clinical history consistent with LAD-I (or known family history).
- At least one (1) prior significant bacterial or fungal infection (US National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE], v5.0, Grade ≥2). This criteria is not required for patients with documented family history who meet the above inclusion criteria.
- Age ≥3 months.
- Considered to be an appropriate candidate for autologous transplantation of HSCs.
- A competent custodial parent with legal capacity to execute an Ethics Committee (EC)-approved consent form must be available to participate in the consent process. (Informed assent will be sought from capable patients, in accordance with the directive of the EC and with local requirements.)
- Ability to comply with trial procedures including investigational therapy and follow-up evaluations.
Who cannot join
- Availability of a medically-eligible human leukocyte antigen (HLA)-identical sibling donor transplant. Patients may not be included in this trial as an alternative to a clinically-indicated and feasible HLA-matched sibling donor HSC transplant. If an HLA-identical sibling is identified, but mobilized peripheral blood or bone marrow HSC collection is not feasible (for example: donor is in utero, is a newborn from whom cord blood was not collected, or is unable to undergo donation procedure because of medical impairments), then inclusion may be permitted per the Principal Investigator discretion.
- Hepatic dysfunction as defined by either:
- Bilirubin > 1.5 × the upper limit of normal (ULN) or
- Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >2.5×ULN
- Pulmonary dysfunction as defined by either:
- Need for supplemental oxygen during the prior 2 weeks (in absence of acute infection).
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- Oxygen saturation (by pulse oximetry) <90%.
- Evidence of active metastatic or locoregionally advanced malignancy (including hematologic malignancy) for which survival is anticipated to be less than 3 years.
- Serious infections with persistent bloodstream pathogens at time of trial entry. (Patients with active infections [e.g., unresolved ulcerative lesions, skin or oral infections] are permitted as long as appropriate antibiotic therapy has been [or is being] administered).
- Any medical or other contraindication for both leukopheresis and bone marrow harvest procedure, as determined by the treating investigator.
- Any medical or other contraindication for the administration of conditioning therapy, as determined by the treating investigator.
- Significant medical conditions, including documented human immunodeficiency virus (HIV) infection, poorly-controlled diabetes, poorly-controlled hypertension, poorly-controlled cardiac arrhythmia or congestive heart failure; or arterial thromboembolic events (including stroke or myocardial infarction) within the 6 prior months.
- Any medical or psychiatric condition that in the opinion of the Principal Investigator renders the patient unfit for trial participation or at higher than acceptable risk for participation.
- Patients who are evaluated for the trial and determined ineligible may be subsequently evaluated and declared eligible if the criteria by which they were considered ineligible is reversible (for example: bloodstream infection, transient increase in liver enzymes) and there is documented and plausible evidence of its resolution in the opinion of the Principal Investigator.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Gene Therapy for Leukocyte Adhesion Deficiency-I (LAD-I): A Phase I Clinical Trial to Evaluate the Safety and Efficacy of the Infusion of Autologous Hematopoietic Stem Cells Transduced With a Lentiviral Vector Encoding the ITGB2 Gene.
The primary purpose of the Phase I portion of the study is to determine the safety profile and preliminary evidence of efficacy associated with infusion of autologous gene-corrected hematopoietic stem cells.
Read the detailed description
The study is a pediatric non-randomized open-label Phase I clinical trial. This 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 Leukocyte Adhesion Deficiency-I (LAD-I). Subjects will undergo mobilization and collection of peripheral blood hematopoietic stem cells (HSCs) with granulocyte-colony stimulating factor (G-CSF) and plerixafor or bone marrow harvest in select circumstances.
HSCs will then be transduced with the therapeutic vector (Chim.hCD18-LV), with the intent of enabling stable integration of the provirus in the genome of stem and progenitor cells.
If the number of CD34+ cells that are cryopreserved is at least 4×10E6 total CD34+ cells/kg, subjects will receive myeloablative conditioning with intravenous busulfan. The gene-modified CD34+ cells will be then transplanted back into the subject.
Once engrafted, it is anticipated that the gene-modified stem and progenitor cells will enable hematopoiesis, generating blood cells in which the integrated therapeutic gene (ITGB2) will be transcribed and translated to produce the therapeutic CD18 protein with a preferential high expression in mature myeloid cells. Leukocytes expressing a functional CD18 will have the capability to arrest on endothelial surfaces and extravasate to infectious sites, enabling a competent antimicrobial response and reversing the clinical disorder.
- Conditions
- Leukocyte Adhesion Defect - Type I
- Being tested
- RP-L201
- Keywords
- Leukocyte Adhesion Deficiency- Type I, LAD-I
- Medical subject headings
- Leukocyte adhesion deficiency type 1
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RP-L201Biological
CD34+ enriched hematopoietic stem cells from subjects with severe LAD-I transduced ex vivo with lentiviral vector carrying the ITGB2 gene, Chim-CD18-WPRE.
| Study group | Role | What they receive |
|---|---|---|
| RP-L201 | Experimental | RP-L201 is a gene therapy product containing autologous genetically modified CD34+ hematopoietic stem cells transduced with Chim-CD18-WPRE lentiviral vector administered as a single infusion in subjects with severe LAD-I Receives: Biological: RP-L201 |
What is being measured
The primary outcome is the main question the study is designed to answer.
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
Measured: 2 years
Survival following infusion of RP-L201
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
Measured: 2 years
Secondary outcomes (6)
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% in 2 years
Measured: 2 years
Genetic correction after infusion of RP-L201
Determination of whether infusion of RP-L201 results in vector copy number/cell of at least 0.1 in peripheral blood neutrophils carrying the therapeutic Chim.hCD18-LV provirus at 6 months post-infusion
Measured: 6 months
Incidence of infections after infusion of RP-L201
Determination of the incidence and severity of bacterial or other infections (subsequent to hematopoietic reconstitution)
Measured: 2 years
Assessment of number of participants with a change in LAD-I-associated neutrophilia after infusion of RP-L201
Evaluation of change to partially normal or to normal levels of LAD-I-associated neutrophilia
Measured: 2 years
Assessment of number of participants with a change in skin lesions or periodontal abnormalities after infusion of RP-L201
Evaluation of resolution (partial or complete) of any underlying skin lesions or periodontal abnormalities
Measured: 2 years
Assessment of overall survival after infusion of RP-L201
Evaluation of overall survival (beyond age 2 years and beyond the initial year subsequent to investigational therapy)
Measured: 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted31 Jan 2019
- Study start15 Apr 2019
- Primary completionOct 2021 (estimated)
- Study completionOct 2021 (estimated)
Why it stopped: Patients were enrolled under global Phase 1/2 protocol RP-L201-0318.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Leukocyte Adhesion Defect - Type IStudies of the same condition, open and under way.
- More trials run by Rocket Pharmaceuticals Inc.The 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
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- Rocket Pharmaceuticals Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Julián Sevilla Navarro, MD, PhD, Principal investigator, Hospital Infantil Universitario Niño Jesús (HIUNJ)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03825783
- Sponsor's protocol ID
- RP-L201-0218
- Status last verified
- Nov 2021
- First submitted
- 25 Jan 2019
- Last updated
- 7 Dec 2021
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 7 Dec 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Gene Therapy for Leukocyte Adhesion Deficiency-I (LAD-I): A Phase I Clinical Trial to Evaluate the Safety and Efficacy of the Infusion of Autologous Hematopoietic Stem Cells Transduced With a Lentiviral Vector Encoding the ITGB2 Gene.
- ClinicalTrials.gov ID
- NCT03825783
- Acronym / sponsor ID
- RP-L201-0218
- Conditions
- Leukocyte Adhesion Defect - Type I
- Keywords
- Leukocyte Adhesion Deficiency- Type I, LAD-I
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- WithdrawnReason stopped: Patients were enrolled under global Phase 1/2 protocol RP-L201-0318.
- Enrolment
- 0 participants (actual)
- Lead sponsor
- Rocket Pharmaceuticals Inc.Industry (pharma, biotech, devices)
- Study start
- 15 Apr 2019 (actual)
- Primary completion
- Oct 2021 (estimated)
- Study completion
- Oct 2021 (estimated)
- First posted
- 31 Jan 2019 (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.
The primary purpose of the Phase I portion of the study is to determine the safety profile and preliminary evidence of efficacy associated with infusion of autologous gene-corrected hematopoietic stem cells.
Detailed description
The study is a pediatric non-randomized open-label Phase I clinical trial. This 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 Leukocyte Adhesion Deficiency-I (LAD-I). Subjects will undergo mobilization and collection of peripheral blood hematopoietic stem cells (HSCs) with granulocyte-colony stimulating factor (G-CSF) and plerixafor or bone marrow harvest in select circumstances.
HSCs will then be transduced with the therapeutic vector (Chim.hCD18-LV), with the intent of enabling stable integration of the provirus in the genome of stem and progenitor cells.
If the number of CD34+ cells that are cryopreserved is at least 4×10E6 total CD34+ cells/kg, subjects will receive myeloablative conditioning with intravenous busulfan. The gene-modified CD34+ cells will be then transplanted back into the subject.
Once engrafted, it is anticipated that the gene-modified stem and progenitor cells will enable hematopoiesis, generating blood cells in which the integrated therapeutic gene (ITGB2) will be transcribed and translated to produce the therapeutic CD18 protein with a preferential high expression in mature myeloid cells. Leukocytes expressing a functional CD18 will have the capability to arrest on endothelial surfaces and extravasate to infectious sites, enabling a competent antimicrobial response and reversing the clinical disorder.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| RP-L201 | Experimental | Biological: RP-L201RP-L201 is a gene therapy product containing autologous genetically modified CD34+ hematopoietic stem cells transduced with Chim-CD18-WPRE lentiviral vector administered as a single infusion in subjects with severe LAD-I |
Who may qualify
- Ages
- 3 months and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (6 listed)
- A confirmed diagnosis of severe LAD-I as demonstrated by flow cytometry indicating CD18 expression on <2% neutrophils (polymorphonuclear neutrophils [PMNs]). (Patients in which CD18+ PMNs are >2% will be considered eligible with <2% CD11a or CD11b expressing PMNs and if there is a documented ITGB2 mutation and clinical history consistent with LAD-I (or known family history).
- At least one (1) prior significant bacterial or fungal infection (US National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE], v5.0, Grade ≥2). This criteria is not required for patients with documented family history who meet the above inclusion criteria.
- Age ≥3 months.
- Considered to be an appropriate candidate for autologous transplantation of HSCs.
- A competent custodial parent with legal capacity to execute an Ethics Committee (EC)-approved consent form must be available to participate in the consent process. (Informed assent will be sought from capable patients, in accordance with the directive of the EC and with local requirements.)
Key exclusion criteria (14 listed)
- Availability of a medically-eligible human leukocyte antigen (HLA)-identical sibling donor transplant. Patients may not be included in this trial as an alternative to a clinically-indicated and feasible HLA-matched sibling donor HSC transplant. If an HLA-identical sibling is identified, but mobilized peripheral blood or bone marrow HSC collection is not feasible (for example: donor is in utero, is a newborn from whom cord blood was not collected, or is unable to undergo donation procedure because of medical impairments), then inclusion may be permitted per the Principal Investigator discretion.
- Hepatic dysfunction as defined by either:
- Pulmonary dysfunction as defined by either:
- Evidence of active metastatic or locoregionally advanced malignancy (including hematologic malignancy) for which survival is anticipated to be less than 3 years.
- Serious infections with persistent bloodstream pathogens at time of trial entry. (Patients with active infections [e.g., unresolved ulcerative lesions, skin or oral infections] are permitted as long as appropriate antibiotic therapy has been [or is being] administered).
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 |
|---|---|---|
| RP-L201CD34+ enriched hematopoietic stem cells from subjects with severe LAD-I transduced ex vivo with lentiviral vector carrying the ITGB2 gene, Chim-CD18-WPRE. | Biological | RP-L201 |
Primary outcome
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
Time frame: 2 years
Evaluation of safety associated with treatment with RP-L201
Survival following infusion of RP-L201
Time frame: 2 years
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
6 secondary outcomes
CD18 expression after infusion of RP-L201
Time frame: 2 years
Genetic correction after infusion of RP-L201
Time frame: 6 months
Incidence of infections after infusion of RP-L201
Time frame: 2 years
Assessment of number of participants with a change in LAD-I-associated neutrophilia after infusion of RP-L201
Time frame: 2 years
Assessment of number of participants with a change in skin lesions or periodontal abnormalities after infusion of RP-L201
Time frame: 2 years
Assessment of overall survival after infusion of RP-L201
Time frame: 2 years
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Dec 2021.
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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.
Julián Sevilla Navarro, MD, PhD principal investigator
Hospital Infantil Universitario Niño Jesús (HIUNJ)
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 RP-L201 in people with Leukocyte Adhesion Defect - Type I, run by Rocket Pharmaceuticals Inc. at 1 site in Spain.
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 6 inclusion and 14 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: withdrawn, as of the sponsor's last update on 7 Dec 2021. 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 Spain. 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 withdrawn before enrolling participants, so there are no results.
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?
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 (time frame: 2 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?
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 7 Dec 2021.