AzTrials
AzTrials

Cytomegalovirus InfectionsPhase 1NCT03950414

A Dose-Escalation Study Evaluating Safety and Tolerability of Viral-Specific T Cells Against CMV in Adult Solid Organ Transplant Recipients

A Phase 1 study testing CMV specific T-cells in people with Cytomegalovirus Infections and Solid Organ Transplant, run by University of Wisconsin, Madison at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

This study measures the tolerability of viral-specific T cells against Cytomegalovirus (CMV) in adult solid organ transplant (SOT) recipients. Participants are expected to be on study for 52 +/- 3 weeks. Read more about this study

Who is it for?
Ages 18 to 75 years
What is being tested?
CMV specific T-cells
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2 participants
Where
1 siteUnited States
Study dates
27 Sep 2019to 11 Jul 2022
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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult (age ≥ 18 and ≤75) patients suffering from CMV reactivation/infections following solid organ transplantation (e.g., liver, pancreas, lung, heart, and multi-solid organ)
  • CMV reactivation/viremia defined as positive (>250 copies/mL) CMV qPCR(quantitative polymerase chain reaction) AND/OR
  • Presence of symptoms secondary to CMV infection or evidence of invasive CMV infection (e.g. pneumonitis, colitis)
  • AND ONE OF THE FOLLOWING CRITERIA:
  • Absence of an improvement of viral load after ≥ 14 days of standard antiviral therapy with ganciclovir, valganciclovir or foscarnet (decrease by at least 1 log, i.e. 10-fold), or
  • New, persistent and/or worsening CMV-related symptoms, signs and/or markers of end organ compromise while on anti-viral therapy with medications such as ganciclovir, acyclovir, valganciclovir, foscarnet, cidofovir, IVIG(Intravenous immunoglobulin), and/or letermovir, or
Show all 10Show fewer
  • Have contraindications or experience adverse effects of anti-viral therapy with medications such as ganciclovir, acyclovir, valganciclovir, foscarnet, cidofovir, IVIG, and/or letermovir, or
  • Known resistance to the anti-viral medications ganciclovir, foscarnet and/or cidofovir based on molecular testing
  • Availability of eligible donor
  • Written informed consent given by patient

Who cannot join

  • Patient with acute rejection of allograft at time of T-cell transfer
  • Patient receiving steroids (>0.5 mg/kg body weight (BW) prednisone equivalent) at the time of T-cell transfer
  • Patient treated with Thymoglobulin (ATG), Alemtuzumab or T-cell immunosuppressive monoclonal antibodies within 28 days
  • Patients with CMV retinitis
  • Concomitant enrollment in another clinical trial interfering with endpoints of this study
  • Any medical condition which could compromise participation in the study according to the investigator's assessment
Show all 19Show fewer
  • Known HIV infection
  • Female patient who is pregnant or breast-feeding, or adult of reproductive potential not willing to use an effective method of birth control during study treatment Note: Women of childbearing potential must have a negative serum pregnancy test at study entry.
  • Patients unwilling or unable to comply with the protocol or unable to give informed consent
  • Donor Eligibility
  • Donor selection priority: The original donor will be the first choice as the source of T cells. If donation from the original organ donor is not possible (e.g., donor is unavailable or ineligible), then an alternative related donor will be selected, with preference for those who have full HLA matching in 6/6 loci over those with partial HLA matching (≥ 2/6 HLA loci). See Appendix 1 for patient and donor screening procedures.
  • ≥ 18 years old
  • Available and capable of undergoing a single standard 2 blood volume leukapheresis or donation of one unit of whole blood.
  • If the original transplant donor is not eligible, then an eligible fully matched or eligible partially matched family member will be used as the donor.
  • Related donors must be at least partially HLA compatible, matching with recipient in at least 2/6 HLA loci (HLA-A, HLA-B and HLA-DRB1 will be considered for this).
  • Donors must be CMV IgG seropositive.
  • Donors must show CMV T-cell activation after incubation with MACS GMP PepTivator Peptide Pools of CMV pp65 before undergoing leukapheresis.
  • Donor must meet the criteria for donor selection defined in the UWHC Hematopoietic Stem Cell Transplant Program SOP and FACT standards, which comply with 21 CFR 1271, subpart C.
  • Donor must provide written informed consent.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Wisconsin School of Medicine and Public Health

    Madison, Wisconsin, 53705

Other trials in United States

About this study

Official title: A Phase I Dose-Escalation Study Evaluating Safety and Tolerability of Viral-Specific T Cells Against CMV in Adult Solid Organ Transplant Recipients

This study measures the tolerability of viral-specific T cells against Cytomegalovirus (CMV) in adult solid organ transplant (SOT) recipients. Participants are expected to be on study for 52 +/- 3 weeks.

Read the detailed description

Viral infections, or their reactivation in the immunocompromised host, remain serious complications that adversely affect outcomes of transplantation. These infections may be refractory to pharmacologic treatment and result in increased morbidity and mortality after transplantation. Furthermore, the available pharmacologic therapies can result in severe toxicities.

Once an infection occurs, adequate immune reconstitution is decisive for recovery from viral disease after solid organ transplantation. The present trial will consist of the treatment of solid organ transplant recipients diagnosed with severe CMV infection when standard antiviral therapy is ineffective (disease progression on therapy, decline in viral load less than 10-fold in 2 weeks, known drug resistance), or toxic (end-organ damage), with virus-specific T cells using the CliniMACS® Prodigy System. These are the patients with the greatest unmet need and greatest risk or morbidity and allograft loss due to CMV infection. CMV-specific T cells will be isolated from donor leukapheresis products using the CliniMACS® Prodigy. Prior studies on transfer of CMV-specific T cells have been shown to be safe and efficacious in the treatment of CMV infections.

The primary objective of this Phase I trial is to evaluate the safety and tolerability of CMV-specific T-cell transfer in adult patients suffering from CMV infections following solid organ transplantation using a dose escalation design. The incubation with viral antigens (MACS GMP PepTivator) allows the enrichment of CMV-specific CD4+(Cluster of Differentiation 4) and CD8+(Cluster of Differentiation 8) T cells. Increasing evidence of the safety and efficacy of CMV-specific T-cell is available. Furthermore, the safety and efficacy of the specific manufacturing approach using the fully automated protocol of the ClinMACS® Prodigy for the isolation of CMV-specific T cells against CMV has been described and demonstrated that these cells retain their biological properties.

Being tested
CMV specific T-cells
Keywords
T-cell, immunotherapy
Medical subject headings
Cytomegalovirus Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CMV specific T-cellsBiological

    Naturally occurring, allogeneic donor lymphocytes derived from a leukapheresis or a whole blood product, enriched for CMV-specific CD4+ and CD8+ T cells Suspension of CMV-specific T cells in 10 mL of 0.9% NaCl with 2% Human Serum Albumin(HSA) via IV bolus injection

    • Low Dose Tier - Viral-Specific T cell infusion 5 x10^3 cells/kg body weight(BW)
    • Mid Dose Tier - Viral-Specific T cell infusion 1.25 x10^4 cells/kg BW
    • High Dose Tier - Viral-Specific T cell infusion 2.5 x10^4 cells/kg BW Product will be administered fresh intravenously to recipient within four hours of collection.
Study groups in NCT03950414
Study groupRoleWhat they receive
Tier 1Experimental3 participants enrolled at dose level 5x10^3 cells/kg of CMV viral specific T-cells
Receives: Biological: CMV specific T-cells

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety and Tolerability:Time of Occurence of Acute GVHD

    Time to occurrence of acute GVHD of any grade will be evaluated using the Kaplan-Meier method to assess incidence and severity of acute GVHD from day of T-cell transfer. The first day of GVHD onset at a certain grade will be used to calculate a cumulative incidence curve for that GVHD grade. Overall, cumulative incidence curves will be computed along with the 95% confidence intervals until Week 12 after T-cell transfer with death considered as a competing risk.

    Measured: up to 15 weeks

  2. Safety and Tolerability: Number of infusion-related adverse events

    Incidence of grades 3-5 infusion-related adverse events, grades 4-5 non-hematological adverse events within four weeks of the CMV-VST dose that are not due to the pre-existing infection or original malignancy or pre-existing co-morbidities

    Measured: up to 7 weeks

  3. Incidence of acute infusion-related toxicity

    Incidence of acute infusion-related toxicity as assessed by maximum toxicity on the day of T-cell transfer, evaluated by measuring vital signs prior to and at different times after the T-cell transfer and monitoring of specific adverse events (chills, nausea, vomiting, diarrhea, abdominal pain, allergic reactions, respiratory dysfunction or headache from T-cell transfer to 4 hours post injection)

    Measured: from T-cell transfer to 4 hours post injection, upto 3 weeks

  4. Severity of acute infusion-related toxicity as measured by Cytokine release syndrome (CRS) Grading criteria

    Severity of acute infusion-related toxicity will be assessed by CRS grading criteria.

    Grade 1 Symptoms are not life threatening and require symptomatic treatment only, (e.g., fever, nausea, fatigue, headache, myalgias, malaise) Grade 2 Symptoms require and respond to moderate intervention Grade 3 Symptoms require and respond to aggressive intervention Grade 4 Life-threatening symptoms Grade 5 Death

    Any grade 3 or greater occurrence of CRS will be considered a serious adverse event for this study.

    Measured: from T-cell transfer to 4 hours post injection, upto 3 weeks

  5. Number of Participants of Newly Occurring Acute Rejection after T-cell Transfer

    Incidence and severity of acute rejection of the organ allograft will in part be measured by number of participants of newly occurring acute rejection after T-cell transfer

    Measured: up to 15 weeks

  6. Incidence of de novo Antibodies against Organ Allograft Donor (dnDSA) after T-cell Transfer

    Incidence and severity of acute rejection of the organ allograft will in part be measured by presence of de novo antibodies against organ allograft donor (dnDSA) after T-cell transfer

    Measured: up to 55 weeks

  7. Incidence of GVHD Grade ≥1

    Incidence and severity of Graft-versus-host disease (GVHD) will be measured by occurrence of acute GVHD grade ≥1 or aggravation of pre-existing acute GVHD after T-cell transfer

    Measured: up to 15 weeks

Secondary outcomes (10)
  1. Feasibility: Was production of CMV Virus specific T lymphocyte (VST) from donors accomplished?

    There is no minimum cell count required for the study as it can vary. Successful production of CMV Virus specific T lymphocyte (VST) from donors will be tracked by a Yes/No question.

    Production of cell accomplished: yes/no

    Measured: up to 3 weeks

  2. Feasibility: Participant Drop-out rate

    Evaluation of feasibility of CMV specific T cell transfer in adult patients suffering from severe CMV infection following solid organ transplantation in part will be measured by participant drop out rate

    Measured: up to 3 weeks

  3. Feasibility: Time from patient inclusion to administration of CMV-VST

    Evaluation of feasibility of CMV specific T cell transfer in adult patients suffering from severe CMV infection following solid organ transplantation in part will be measured by the amount of time from patient inclusion to administration of CMV-VST

    Measured: up to 21 days

  4. Efficacy: Percentage of patients with ≥1 log decrease in CMV viral load

    Evaluation of efficacy of CMV-specific T-cell transfer in adult patients suffering from severe CMV infection following solid organ transplantation in part will be measured in terms of percentage of patients with ≥1 log decrease in CMV viral load at Week 12

    Measured: up to 15 weeks

  5. Efficacy:Time to 1 log change in CMV viral load

    Evaluation of efficacy of CMV-specific T-cell transfer in adult patients suffering from severe CMV infection following solid organ transplantation in part will be measured in terms of time to 1 log change in CMV viral load

    Measured: up to 15 weeks

  6. Efficacy:Number of Participants with CMV clearance

    Efficacy evaluation in part will be measured by number of participants with CMV clearance. Either negative polymerase chain reaction (PCR) or <250 copies/mL will be considered as CMV clearance.

    Measured: up to 15 weeks

  7. Efficacy: Time of clearance of CMV

    Efficacy evaluation in part will be measured by number of days to achieve CMV clearance. Either negative polymerase chain reaction [PCR] or <250 copies/mL)will be considered as CMV clearance.

    Measured: up to 55 weeks

  8. Efficacy: Number of participants having CMV reactivation

    Efficacy in part will be measured by number of participants with CMV reactivations following initial viral clearance

    Measured: up to 55 weeks

  9. Efficacy: Overall Survival of Participant

    Overall survival rate of participants will be measured by time from T-cell transfer to death, graft loss, or last follow-up throughout the study

    Measured: up to 55 weeks

  10. Efficacy:Number of Participants with Clinical response/resolution of symptoms of underlying viral infection

    Efficacy in part will be measured by number of patients with resolution of clinical symptoms of underlying CMV infection from Day 7 (Week 1) to Week 12 after T-cell transfer as compared to Day 0

    Measured: up to 15 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 May 2019
  2. Study start27 Sep 2019
  3. Primary completion11 Jul 2022
  4. Study completion11 Jul 2022

Why it stopped: Insufficient Patient Population

Resources

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
Model description
3+3 dose-escalation, open label, non-randomized, non-placebo controlled, single group assignment study
Masking
None (open label)
Enrolment
2 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03950414
Sponsor's protocol ID
2019-0060
Other IDs
PACT VST-C-002, Protocol Version 11/1/2021
Status last verified
Feb 2024
First submitted
15 Apr 2019
Last updated
20 Feb 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing CMV specific T-cells in people with Cytomegalovirus Infections and Solid Organ Transplant, run by University of Wisconsin, Madison 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 10 inclusion and 19 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 20 Feb 2024. 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: Insufficient Patient Population). 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?

Safety and Tolerability:Time of Occurence of Acute GVHD (time frame: up to 15 weeks). The study lists 7 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 20 Feb 2024; AzTrials last refreshed its copy on 6 Nov 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in