AzTrials
AzTrials

Glioma of Spinal CordPhase 1NCT04196413

GD2 CAR T Cells in Diffuse Intrinsic Pontine Gliomas (DIPG) & Spinal Diffuse Midline Glioma(DMG)

A Phase 1 study testing GD2 CAR T cells, Fludarabine and Cyclophosphamide in people with Glioma of Spinal Cord and Glioma of Brainstem, run by Stanford University at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The primary purpose of this study is to test whether CAR T cells targeting GD2 (GD2CART) can be successfully made and safely given to children and adults with H3K27M-mutant diffuse midline glioma (DMG). Read more about this study

Who is it for?
Ages 2 to 60 years
Conditions the study is for
Glioma of Spinal Cord, Glioma of Brainstem
What is being tested?
GD2 CAR T cells, Fludarabine and Cyclophosphamide
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
97 participants
Where
1 siteUnited States
Study dates
4 Jun 2020to 31 Jul 2043
Phase
Phase 1
Are there results?
Not yet: the study is under way

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 2 to 60 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Disease Status: Diagnosis of H3K27M mutant diffuse midline glioma (DMG)
  • H3K27M or H3K27I mutation. Confirmed by CLIA test.
  • Age: Greater than or equal to 2 year of age and less than or equal to 60 years of age.
  • Prior Therapy:
  • At least 4 weeks following completion of standard upfront radiation therapy.
  • At least 3 weeks post chemotherapy or 5 half-lives, whichever is shorter, must have elapsed since any prior systemic therapy, except for systemic inhibitory/stimulatory immune checkpoint therapy that requires 3 months.
Show all 20Show fewer
  • Dordaviprone (Modeyso), previously known as ONC201, may be taken as prior therapy but - just as with other anti-cancer medications - administration must cease at least 5 half-lives prior to enrollment
  • Performance Status:
  • Subjects > 16 years of age: Karnofsky ≥ 60% OR Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; Subjects ≤ 16 years of age: Lansky scale ≥ 60%.
  • Subjects who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score.
  • Normal Organ and Marrow Function (supportive care is allowed per institutional standards, i.e. filgrastim, transfusion) i. ANC ≥ 1000/uL ii. Platelet count ≥ 100,000/uL iii. Absolute lymphocyte count ≥ 150/uL iv. Hemoglobin ≥ 8 g/dL v. Adequate renal, hepatic, pulmonary and cardiac function defined as:
  • Creatinine within institutional norms for age (i.e.
  • ≤ 2 mg/dL in adults or according to table below in children <18 years) OR creatinine clearance (as estimated by Cockcroft Gault Equation) ≥ 60 mL/min
  • Serum ALT/AST ≤ 3.0 ULN (grade 1)
  • Total bilirubin ≤ 1.5 mg/dl, except in subjects with Gilbert's syndrome.
  • Cardiac ejection fraction ≥ 45%, no evidence of physiologically significant pericardial effusion as determined by an ECHO, and no clinically significant ECG findings
  • Baseline oxygen saturation > 92% on room air
  • Pregnancy Test Females of childbearing potential must have a negative serum or urine pregnancy test (females who have undergone surgical sterilization are not considered to be of childbearing potential) or NA
  • Contraception Subjects of child-bearing or child-fathering potential must be willing to practice birth control from the time of enrollment on this study and for four (4) months after receiving the preparative regimen or for as long as GD2CART cells are detectable in peripheral blood or CSF.
  • Ability to give informed consent. All subjects ≥ 18 years of age must be able to give informed consent. For subjects <18 years old their legal authorized representative (LAR) (i.e. parent or guardian) must give informed consent. Pediatric subjects will be included in age appropriate discussion and written assent will be obtained for those > 7 years of age, when appropriate. If a minor becomes of age during participation of this study, he/she will be asked to reconsent as an adult.

Who cannot join

  • For Dose Escalation: Bulky tumor involvement of cerebellar vermis or hemispheres (pontocerebellar peduncles involvement is acceptable), or thalamic lesions that in the investigator's assessment place the subject at unacceptable risk for herniation.
  • For Dose Expansion: Bulky disease that in the investigator's assessment place the subject at unacceptable risk for herniation. Thalamic DMG is permitted.
  • Clinically significant swallowing dysfunction/dysphagia or prominent medullary dysfunction, as determined by the clinical investigator; or primary cervical cord tumors above C6/7 that represent a high risk of respiratory compromise, as determined by the clinical investigator.
  • Current systemic corticosteroid therapy above physiologic replacement levels.
  • Ongoing use of dietary supplements, alternative therapies or extreme diet modifications or any medication not approved by the investigators
  • Prior CAR therapy.
Show all 20Show fewer
  • Prior immunomodulatory therapy, except for checkpoint inhibitor therapy after at least 3 month wash-out.
  • Uncontrolled fungal, bacterial, viral, or other infection. Previously diagnosed infection for which the patient continues to receive antimicrobial therapy is permitted if responding to treatment and clinically stable.
  • Diagnosed ongoing infection with:
  • HIV,
  • Hepatitis B (HBsAg positive) or
  • Hepatitis C virus (anti-HCV positive). A history of hepatitis B or hepatitis C is permitted if the viral load is undetectable per quantitative PCR and/or nucleic acid testing.
  • Clinically significant systemic illness or medical condition (e.g. significant cardiac, pulmonary, hepatic or other organ dysfunction), that in the judgement of the principal investigator is likely to interfere with assessment of safety or efficacy of the investigational regimen and its requirements.
  • Women who are pregnant or breastfeeding.
  • In the investigator's judgment, the subject is unlikely to complete all protocol-required study visits or procedures, including follow-up visits, or comply with the study requirements for participation.
  • Known sensitivity or allergy to any agents/reagents used in this study.
  • Primary immunodeficiency or history of autoimmune disease (e.g. Crohns, rheumatoid arthritis, systemic lupus) requiring systemic immunosuppression/systemic disease modifying agents within the last 2 years
  • All subject files must include supporting documentation to confirm subject eligibility.
  • The method of confirmation can include, but is not limited to, laboratory test results, radiology test results, subject self-report, and medical record review.
  • Anyone under 26, please contact Ashley Jacobs and anyone 26 and older, please contact Monica Reddy

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site, 1 recruiting
  • Lucile Packard Children's Hospital (LPCH)

    Stanford, California, 94304

    Ashley Jacobs, 650-497-7533, GD2CART@stanfordchildrens.org

    Monica Reddy, (650) 736-2690, secure-sci-cto-neuro-crcs-nio@lists.stanford.edu

    Recruiting

Other trials in United States

About this study

Official title: Phase 1 Clinical Trial of Autologous GD2 Chimeric Antigen Receptor (CAR) T Cells (GD2CART) for H3K27M-mutant Diffuse Midline Glioma (DMG)

The primary purpose of this study is to test whether CAR T cells targeting GD2 (GD2CART) can be successfully made and safely given to children and adults with H3K27M-mutant diffuse midline glioma (DMG). Eligible subjects may have DMG arising in the pons (called difuse intrinisic pontine glioma, DIPG), the spinal cord, or other areas of the brain such as a thalamus

Read the detailed description

Primary Objectives:

  • Determine the feasibility of manufacturing autologous T cells transduced with 14g2a-CD8-BBz-iCasp9 retroviral vector expressing GD2 Chimeric Antigen Receptor (GD2CART) for administration in subjects with H3K27M-mutant diffuse midline glioma (DMG) using a retroviral vector and dasatinib in the Miltenyi CliniMACS Prodigy® system.
  • Assess the safety and identify the maximum tolerated dose (MTD) and/or recommended phase 2 dose (RP2D), route and schedule of GD2CART and lymphodepleting chemotherapy in subjects with H3K27M-mutant DMG.
  • Assess the safety of the MTD/RP2D, route and schedule of GD2CART in expansion cohorts of subjects with H3K27M-mutant DMG.

Secondary Objectives:

  • In a preliminary manner, assess clinical benefit and Patient Reported Outcomes (PROs) of GD2CART at the RP2D in children and adults with H3K27M-mutant DMG.
  • Evaluate the safety and impact on clinical benefit of repeat intracerebroventricular (ICV) administrations of GD2CART according to Arms A, B, C or D.
  • If unacceptable toxicity occurs that is possibly, probably or likely related to GD2CART, assess the capacity for AP1903, a dimerizing agent, to mediate clearance of the genetically engineered cells and resolve toxicity.
Being tested
GD2 CAR T cells, Fludarabine, Cyclophosphamide, Rituximab

What participants receive

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

  • GD2 CAR T cellsDrug

    Autologous T-Cells transduced with retroviral vector (14g2a-CD8.BB.z.iCasp9) expressing GD2-chimeric antigen receptor

  • FludarabineDrug

    Fludarabine 30 mg/m2 per day IV for days -4, -3, -2

  • CyclophosphamideDrug

    Cyclophosphamide 500 mg/m2 per day IV for days -4, -3, -2

  • RituximabDrug

    First round: 750 mg/m2 per day IV for days -6 and -5. Subsequent rounds: 750 mg/m2 per day IV for day -5.

Study groups in NCT04196413
Study groupRoleWhat they receive
ARM AExperimentalGD2CART will be administered on Day 0 in hospitalized subjects with either DIPG or spinal DMG Intravenously, after conditioning lymphodepletion chemotherapy regimen with cyclophosphamide and fludarabine * Dose Level -1: 3x10^5 transduced T cells/kg(± 20%) * Dose Level 1: 1x10^6 transduced T cells/kg (± 20%) * Dose Level 2: 3x10^6 transduced T cells/kg (± 20%)
Receives: Drug: GD2 CAR T cells; Drug: Fludarabine; Drug: Cyclophosphamide
ARM BExperimentalGD2CART will be administered on Day 0 in hospitalized subjects with either DIPG or spinal DMG Intracerebroventricularly, without conditioning lymphodepletion chemotherapy * Dose Level -1: 10x10^6 transduced T cells (±20%) * Dose Level 1: 30x10^6 transduced T cells (±20%) * Dose Level 2: 50x10^6 transduced T cells (±20%) * Dose Level 3: 100x10^6 transduced T cells (±20%)
Receives: Drug: GD2 CAR T cells
ARM CExperimentalGD2CART will be administered in escalating doses on Day 0 in hospitalized subjects with either DIPG or spinal DMG Intracerebroventricularly after administration of conditioning lymphodepletion chemotherapy regimen with cyclophosphamide and fludarabine * Dose Level -1: 10x10^6 transduced T cells (±20%) * Dose Level 1: 30x10^6 transduced T cells (±20%) * Dose Level 2: 50x10^6 transduced T cells (±20%)
Receives: Drug: GD2 CAR T cells; Drug: Fludarabine; Drug: Cyclophosphamide
ARM DExperimentalGD2CART will be administered in escalating doses on Day 0 in hospitalized subjects with either DIPG, spinal DMG, or high risk features. Intracerebroventricularly after administration of conditioning lymphodepletion chemotherapy regimen with rituximab, cyclophosphamide and fludarabine * Dose Level -1: 10x10^6 transduced T cells (±20%) * Dose Level 1: 30x10^6 transduced T cells (±20%) * Dose Level 2: 50x10^6 transduced T cells (±20%)
Receives: Drug: GD2 CAR T cells; Drug: Fludarabine; Drug: Cyclophosphamide; Drug: Rituximab

What is being measured

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

  1. Rate of successful manufacture of GD2CART using a retroviral vector in the Miltenyi CliniMACS Prodigy system

    The percentage of apheresis samples (fresh or frozen) will be determined for each dose cohort.

    Measured: 14 days after apheresis

  2. Safety of the dose, route and schedule of GD2CART and lymphodepleting chemotherapy in subjects with H3K27M-mutant DMG

    Incidence and severity of dose limiting toxicities (DLTs) after initial dose of GD2.BB.z.iCasp9-CAR T cells (GD2CART) in each Arm, at each dose level tested by disease cohort

    Measured: 28 days after infusion

  3. Safety of GD2CART at RP2D, route and schedule of GD2CART in expansion cohorts of subjects with H3K27M-mutant DMG

    Suspected adverse events and serious adverse events following chemotherapy preparative regimen and infusion of GD2CART."

    Measured: 28 days after infusion

Secondary outcomes (5)
  1. Radiographic Response Rate

    Radiographic Response will be evaluated using the RANO 2.0 tumor response criteria.

    Measured: Time Frame: Day 28, 3 months, 6 months, 9 months and 12 months and 24 months post CAR T cell infusion.

  2. Overall Survival (OS)

    Overall survival (OS) is defined as the time from date of initial diagnosis to date of death from any cause. Treatment OS is defined as the time from Cycle 1 Day 0 to date of death from any cause.

    Measured: Time Frame: Day 28, 3 months, 6 months, 9 months and 12 months and 24 months post CAR T cell infusion.

  3. Progression-Free Survival (PFS)

    PFS is defined as the time from the start of the lymphodepleting chemotherapy preparative regimen to the date of radiographic progression or death from any cause.

    Measured: Time Frame: Day 28, 3 months, 6 months, 9 months and 12 months and 24 months post CAR T cell infusion

  4. Post-progression survival (PPS)

    PPS is measured for each subject with DIPG as OS minus PFS, and for each patient with recorded progression as OS minus Time to Progression (TTP)

    Measured: ime Frame: Day 28, 3 months, 6 months, 9 months and 12 months and 24 months post CAR T cell infusion

  5. Measure resolution of toxicity

    Resolution of toxicity ≤ grade2, in the event unacceptable toxicity considered possibly, probably or definitely related to GD2CART cells within 72 hours

    Measured: 72 hours of administration of AP1903

Timeline

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

  1. First posted12 Dec 2019
  2. Study start4 Jun 2020
  3. Primary completion31 Jul 2028 (estimated)
  4. Study completion31 Jul 2043 (estimated)

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
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
97 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04196413
Sponsor's protocol ID
IRB-52934
Other IDs
PEDSCCT6005, NCI-2020-05891, 5R01CA263500-05
Status last verified
Dec 2025
First submitted
10 Dec 2019
Last updated
26 Jan 2026
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 GD2 CAR T cells, Fludarabine and Cyclophosphamide in people with Glioma of Spinal Cord and Glioma of Brainstem, run by Stanford University 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 20 inclusion and 20 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: looking for participants now, as of the sponsor's last update on 26 Jan 2026. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Ashley Jacobs, RN, BSN (650-497-7533, gd2cart@stanfordchildrens.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rate of successful manufacture of GD2CART using a retroviral vector in the Miltenyi CliniMACS Prodigy system (time frame: 14 days after apheresis). The study lists 3 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 26 Jan 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