Refractory or Relapsed Multiple MyelomaPhase 1NCT03716856
Clinical Study of CAR-BCMA T in Patients With Refractory or Relapsed Multiple Myeloma
A Phase 1 study testing CAR-BCMA T cells, Fludarabine and Cyclophosphamide in people with Refractory or Relapsed Multiple Myeloma, run by First Affiliated Hospital of Zhejiang University at 1 site in China.
Trial summary
A single arm, open-label pilot study is designed to determine the safety, efficacy and cytokinetics of CAR-BCMA T cells in patients with BCMA-positive refractory or relapsed multiple myeloma. Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Refractory or Relapsed Multiple Myeloma
- What is being tested?
- CAR-BCMA 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
- 11 participants
- Where
- 1 siteChina
- Study dates
- 23 Mar 2018to 23 Jun 2023
- 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 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients aged between 18 ~ 70 with relapsed or refractory multiple myeloma.
- Bone marrow sample is confirmed as BCMA-positive by flow cytometry or pathological examination.
- Patients with relapsed or refractory multiple myeloma who meet the following conditions:
- Curative efficacy is little or disease progressed after 2 courses of standard treatment regimen;
- Disease relapsed after chemotherapy or HSCT. Curative efficacy is little or disease progressed after 2 courses of original treatment regimen;
- More than 60 days between last treatment and disease progression;
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- Autologous or allogeneic SCT is not available at present, or patient refuses to receive SCT;
- No response to treatment is defined according to International Myeloma Working Group 2014 version as not achieving CR (including CR, sCR, ICR, MCR) or PR (including VGPR, PR, MR) after 2 consecutive cycles of treatment with current therapy, and the interval between the 2 cycles is no more than 60 days. Disease progression is defined as per 《Chinese Guidelines for Diagnosis and Treatment of Multiple Myeloma》 (Revision in 2015). At least one of the following conditions should be met:Serum M-protein increases ≥ 25% (absolute increase should be ≥ 5 g/L); If serum M protein is ≥ 50 g/L at baseline, increase of serum M protein can be ≥ 10 g/L; Urine M-protein increases ≥ 25% (absolute increase should be ≥ 200 mg/24 h); If the serum and urine M-protein are not detectable, a ≥ 25% increase in the difference between involved and uninvolved FLC levels is required (absolute increase should be ≥ 100 mg/L); Bone marrow plasma cell percentage increases ≥ 25% (absolute increase should be ≥ 10%); Size of existing bone lesions or soft tissue plasmacytomas increases by ≥ 25%, or development of new lytic bone lesions or soft tissue plasmacytomas; Development of hypercalcemia that can be attributed to plasma cell proliferative disorder (corrected calcium is > 2.8 mmol/L or 11.5 mg/dL); Disease progression must be confirmed by 2 sequential assessments.
- Expected survival > 12 weeks.
- Disease is measurable, and at least one of the following conditions should be satisfied:
- Serum M-protein is ≥ 10 g/L;
- 24-hour urine M-protein is ≥ 200 mg;
- Serum FLC is ≥ 5 mg/dL;
- Plasmacytomas that can be evaluated by tests or imaging;
- Bone marrow plasma cell percentage is ≥ 20%.
- ECOG scores 0 - 1.
- Adequate venous access for apheresis and venous blood sampling, and no other contraindications for leukapheresis.
- WBC ≥ 1.5×10^9/L;PLT ≥ 45×10^9/L; Hb≥9.0g/dL
- Serum creatinine ≤ 1.5 ULN.
- ALT ≤ 2.5 ULN;AST ≤ 2.5 ULN. The above lab results should not include those obtained from continuous supportive treatment that is ongoing.
Who cannot join
- Patients with any of the following conditions are not eligible for this study.
- Pregnant or lactating women.
- HIV positive, or HCV positive
- Uncontrolled active infection, including active tuberculosis and HBV DNA copies ≥ 1×10^3 copies/mL.
- Concurrent use of systemic steroids. Recent or current use of inhaled steroids is not exclusionary.
- Allergic to immunotherapies and related drugs.
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- Patients with heart disease for which treatment is needed or with poorly controlled hypertension.
- Hyponatremia: serum sodium level < 125 mmol/L.
- Baseline serum potassium < 3.5 mmol/L (taking potassium supplements before participating in the study to raise potassium level is acceptable).
- Previous treatment with chemoradiotherapy, local treatment ,immunotherapy and tumor-targeting drug conducted 2 weeks prior to participation in this study or blood collection.
- Patients have undertaken immunosuppressor for graft-versus-host disease (GVHD) within 4 weeks before participation in this study or blood collection, or the patient is diagnosed with acute or chronic GVHD.
- Other severe disease that may restrain patients from participating in this study (e.g. diabetes, severe cardiac dysfunction, myocardial infarction or unstable arrhythmias or unstable angina in recent 6 months, gastric ulcer, active autoimmune disease, etc.).
Trial locations and contacts
1 site in 1 country.
China1 site
First Affiliated Hospital of Zhejiang University
Hangzhou, Zhejiang, 310006,
About this study
Official title: Clinical Study of Redirected Autologous T Cells With a BCMA-targeted Chimeric Antigen Receptor in Patients With Refractory or Relapsed Multiple Myeloma
A single arm, open-label pilot study is designed to determine the safety, efficacy and cytokinetics of CAR-BCMA T cells in patients with BCMA-positive refractory or relapsed multiple myeloma.
Read the detailed description
This study is designed to determine the safety, tolerability and engraftment potential of anti-BCMA lentivirus-transduced autologous T cells in patients with refractory or relapsed multiple myeloma.
Primary objectives:
- Determine the safety and tolerability of CAR-BCMA T cells (autologous T cells transduced with chimeric antigen receptors recognizing BCMA) in patients with refractory or relapsed multiple myeloma.
- Observe the cytokinetics of CAR-BCMA T cells.
Secondary objectives:
- Observe the anti-tumor response of CAR-BCMA T cells to refractory or relapsed multiple myeloma (evaluated by diagnostic criteria International Myeloma Working Group (IMWG2014 version) as CR, sCR, ICR, MCR or VGPR).
- Make an evaluation on the distribution and in vivo survival of CAR-BCMA T cells in peripheral blood, lymph node, and bone marrow.
- Observe the immunogenicity of CAR-BCMA T cells, and determine if there is anti-BCMA scFv cellular immune response and anti-BCMA scFv humoral immune response.
- Observe the change of T cell subsets relative to CAR-BCMA T。 (Tcm, central memory T lymphocytes; Tem, effector memory T lymphocytes; Treg, regulatory T lymphocytes).
- Conditions
- Refractory or Relapsed Multiple Myeloma
- Being tested
- CAR-BCMA T cells, Fludarabine, Cyclophosphamide
- Medical subject headings
- Multiple Myeloma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CAR-BCMA T cellsGenetic
Also called BCMA-redirected autologous T cells
Single dose of CAR-BCMA T cells will be infused, and classic "3+3" dose escalation will be applied.
FludarabineDrug
Fludarabine is used for lymphodepletion.
CyclophosphamideDrug
Cyclophosphamide is used for lymphodepletion
| Study group | Role | What they receive |
|---|---|---|
| CAR-BCMA T cells | Experimental | In this study, autologous T cells transduced with a BCMA-targeted chimeric antigen receptor (CAR-BCMA T cells) are used to treat patients with refractory or relapsed multiple myeloma.
Route of administration: Intravenous injection.
Lymphodepletion conditioning:
Lymphodepletion will be conducted several days prior to CAR-BCMA T cells infusion.
A combination of fludarabine and cyclophosphamide will be used for lymphodepletion. Receives: Genetic: CAR-BCMA T cells; Drug: Fludarabine; Drug: Cyclophosphamide |
What is being measured
The primary outcome is the main question the study is designed to answer.
Safety and effectivity - Incidence of study related adverse events
Incidence of study related adverse events which are defined as laboratory toxicities and clinical events that are possible, likely or definitely related to study treatment at any time from the infusion until week 24, including infusion related toxicity and any toxicity possibly related to CAR-BCMA T cells.
Measured: 24 weeks
Engraftment
Duration of in vivo survival of CAR-BCMA T cells is defined as "engraftment". After 24 hours of infusion, the CAR-BCMA DNA sequence was detected by PCR according to the follow-up time point, until the result of any two consecutive tests was negative and recorded as the "engraftment endpoint" of CAR-BCMA T cells.
Measured: 2 years
Secondary outcomes (4)
Statistical parameter of efficacy assessment:PFS
Statistical parameter:Progression-free Survival (PFS)
Measured: 5 years
Statistical parameter of efficacy assessment:DCR
Statistical parameter:Disease Control Rate (DCR)
Measured: 2 years
Statistical parameter of efficacy assessment:ORR
Statistical parameter:Objective Remission Rate (ORR)
Measured: 2 years
Statistical parameter of efficacy assessment:OS
Statistical parameter:Overall survival (OS)
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 posted23 Oct 2018
- Study start23 Mar 2018
- Primary completion23 Jun 2020
- Study completion23 Jun 2023 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Refractory or Relapsed Multiple MyelomaStudies of the same condition, open and under way.
- More trials run by First Affiliated Hospital of Zhejiang UniversityThe 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
- 11 participants (actual)
Sponsor and investigators
- Lead sponsor
- First Affiliated Hospital of Zhejiang University
- Sponsor type
- University, hospital or other
- Collaborators
- CARsgen Therapeutics Co., Ltd.
- Responsible party
- Sponsor
- Investigators
- Jie Jin, MD, Principal investigator, First Affiliated Hospital of Zhejiang UniversityHaitao Meng, MD, Principal investigator, First Affiliated Hospital of Zhejiang University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03716856
- Sponsor's protocol ID
- CG6003
- Status last verified
- Sep 2020
- First submitted
- 27 Sep 2018
- Last updated
- 8 Oct 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 Oct 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Clinical Study of Redirected Autologous T Cells With a BCMA-targeted Chimeric Antigen Receptor in Patients With Refractory or Relapsed Multiple Myeloma
- ClinicalTrials.gov ID
- NCT03716856
- Acronym / sponsor ID
- CG6003
- Conditions
- Refractory or Relapsed Multiple Myeloma
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 11 participants (actual)
- Lead sponsor
- First Affiliated Hospital of Zhejiang UniversityUniversity, hospital or other
- Collaborators
- CARsgen Therapeutics Co., Ltd.
- Study start
- 23 Mar 2018 (actual)
- Primary completion
- 23 Jun 2020 (actual)
- Study completion
- 23 Jun 2023 (estimated)
- First posted
- 23 Oct 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.
A single arm, open-label pilot study is designed to determine the safety, efficacy and cytokinetics of CAR-BCMA T cells in patients with BCMA-positive refractory or relapsed multiple myeloma.
Detailed description
This study is designed to determine the safety, tolerability and engraftment potential of anti-BCMA lentivirus-transduced autologous T cells in patients with refractory or relapsed multiple myeloma.
Primary objectives:
- Determine the safety and tolerability of CAR-BCMA T cells (autologous T cells transduced with chimeric antigen receptors recognizing BCMA) in patients with refractory or relapsed multiple myeloma.
- Observe the cytokinetics of CAR-BCMA T cells.
Secondary objectives:
- Observe the anti-tumor response of CAR-BCMA T cells to refractory or relapsed multiple myeloma (evaluated by diagnostic criteria International Myeloma Working Group (IMWG2014 version) as CR, sCR, ICR, MCR or VGPR).
- Make an evaluation on the distribution and in vivo survival of CAR-BCMA T cells in peripheral blood, lymph node, and bone marrow.
- Observe the immunogenicity of CAR-BCMA T cells, and determine if there is anti-BCMA scFv cellular immune response and anti-BCMA scFv humoral immune response.
- Observe the change of T cell subsets relative to CAR-BCMA T。 (Tcm, central memory T lymphocytes; Tem, effector memory T lymphocytes; Treg, regulatory T lymphocytes).
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| CAR-BCMA T cells | Experimental | Genetic: CAR-BCMA T cells, Drug: Fludarabine, Drug: CyclophosphamideIn this study, autologous T cells transduced with a BCMA-targeted chimeric antigen receptor (CAR-BCMA T cells) are used to treat patients with refractory or relapsed multiple myeloma. Route of administration: Intravenous injection. Lymphodepletion conditioning: Lymphodepletion will be conducted several days prior to CAR-BCMA T cells infusion. A combination of fludarabine and cyclophosphamide will be used for lymphodepletion. |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (20 listed)
- Patients aged between 18 ~ 70 with relapsed or refractory multiple myeloma.
- Bone marrow sample is confirmed as BCMA-positive by flow cytometry or pathological examination.
- Patients with relapsed or refractory multiple myeloma who meet the following conditions:
- Expected survival > 12 weeks.
- Disease is measurable, and at least one of the following conditions should be satisfied:
Key exclusion criteria (12 listed)
- Patients with any of the following conditions are not eligible for this study.
- Pregnant or lactating women.
- HIV positive, or HCV positive
- Uncontrolled active infection, including active tuberculosis and HBV DNA copies ≥ 1×10^3 copies/mL.
- Concurrent use of systemic steroids. Recent or current use of inhaled steroids is not exclusionary.
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 |
|---|---|---|
| CAR-BCMA T cellsAlso: BCMA-redirected autologous T cellsSingle dose of CAR-BCMA T cells will be infused, and classic "3+3" dose escalation will be applied. | Genetic | CAR-BCMA T cells |
| FludarabineFludarabine is used for lymphodepletion. | Drug | CAR-BCMA T cells |
| CyclophosphamideCyclophosphamide is used for lymphodepletion | Drug | CAR-BCMA T cells |
Primary outcome
Safety and effectivity - Incidence of study related adverse events
Time frame: 24 weeks
Incidence of study related adverse events which are defined as laboratory toxicities and clinical events that are possible, likely or definitely related to study treatment at any time from the infusion until week 24, including infusion related toxicity and any toxicity possibly related to CAR-BCMA T cells.
Engraftment
Time frame: 2 years
Duration of in vivo survival of CAR-BCMA T cells is defined as "engraftment". After 24 hours of infusion, the CAR-BCMA DNA sequence was detected by PCR according to the follow-up time point, until the result of any two consecutive tests was negative and recorded as the "engraftment endpoint" of CAR-BCMA T cells.
4 secondary outcomes
Statistical parameter of efficacy assessment:PFS
Time frame: 5 years
Statistical parameter of efficacy assessment:DCR
Time frame: 2 years
Statistical parameter of efficacy assessment:ORR
Time frame: 2 years
Statistical parameter of efficacy assessment:OS
Time frame: 5 years
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Oct 2020.
- Individual participant dataSharing planned: No
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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.
Jie Jin, MD principal investigator
First Affiliated Hospital of Zhejiang University
Haitao Meng, MD principal investigator
First Affiliated Hospital of Zhejiang University
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 CAR-BCMA T cells, Fludarabine and Cyclophosphamide in people with Refractory or Relapsed Multiple Myeloma, run by First Affiliated Hospital of Zhejiang University at 1 site in China.
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 12 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: status not confirmed, as of the sponsor's last update on 8 Oct 2020. 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 China. 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?
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 effectivity - Incidence of study related adverse events (time frame: 24 weeks). 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 8 Oct 2020.