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Solid Tumor, AdultPhase 1NCT05631886

Combination of CAR-DC Vaccine and ICIs in Malignant Tumors

A Phase 1 study testing TP53-EphA-2-CAR-DC, Abraxane and Cyclophosphamide in people with Solid Tumor, Adult and Lymphoma, run by Chinese PLA General Hospital at 1 site in China.

Recruiting

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

Sites and contacts
Official record
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Trial summary

This is a pilot clinical trial for subjects with local advanced/metastatic solid tumors or relapsed/refractory (R/R) lymphomas to determine the safety, efficacy and immune response of autologous EphA2-targeting CAR-DC vaccine loaded with TP53 mutant peptide (TP53-EphA-2-CAR-DC) in combination with ICIs. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Solid Tumor, Adult, Lymphoma, EphA2 Overexpression
What is being tested?
TP53-EphA-2-CAR-DC, Abraxane and Cyclophosphamide
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteChina
Study dates
4 Jul 2023to 30 Dec 2026
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 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18-75 (inclusive).
  • ECOG performance status ≤2 and Estimated life expectancy of more than 3 months.
  • Local advanced/metastatic solid tumors or R/R lymphomas confirmed by histopathology or cytology with documentation of tumor EphA2 positive (≥20%) and TP53 mutation (R273H or R175H or R248Q or R249S) within 6 months prior to screening. The second malignancy is allowed.
  • No clinical response to standard frontline therapy or no standard therapy exists for solid tumors. Relapse after treatment with ≥2 lines systemic therapy or refractory disease for lymphomas. Patients who have declined standard therapy or have no access to standard therapy may be enrolled and the reasons for a lack of access need to be documented. Previous treatment with anti-PD-1/PD-L1 antibodies or anti-CTLA4 antibody are allowed, regardless of the level of PD-1/PD-L1 expression, dMMR and TMB.
  • At least one measurable lesion at baseline per RECIST version 1.1 or Lugano response criteria 2014.
  • Adequate organ function as defined by the following criteria: ANC ≥1000 cells/μL; Platelet count ≥80,000/μL; Hemoglobin ≥8.0 g/dL (hemocytopenia caused by lymphoma invasion of bone marrow is not subject to conditions); Serum AST and serum ALT, ≤3.0 x ULN (≤5 x ULN for patients with liver metastases); Total serum bilirubin ≤3.0 x ULN); Serum creatinine ≤2 x ULN or creatinine clearance of ≥45 mL/min.
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  • Willing to undergo either excised or large-needle lymph node or tissue biopsy, or provide formalin-fixed paraffin-embedded (FFPE) tumor tissue block or freshly cut unstained slides.
  • Willing to complete all scheduled visits and assessments at the institution administering the therapy.
  • Able to read, understand and provide written informed consent.

Who cannot join

  • Having TP53 (R273H or R175H or R248Q or R249S) germline mutation.
  • Active central nervous system disease involvement (but allow patients with prior brain metastases treated at least 4 weeks prior to enrollment that are clinically stable and do not require intervention), or prior history of NCI CTCAE Grade ≥3 drug-related CNS toxicity.
  • Prior organ allograft transplantations or allogeneic hematopoietic stem cell transplantation.
  • Evidence of active uncontrolled viral, bacterial, or systemic fungal infection.
  • Known positive test result for human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS).
  • Active infection of hepatitis B virus (HBV), or hepatitis C virus (HCV).
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  • Patients with history (within the last 5 years) or risk of autoimmune disease who have immunosuppressive medications or immunosuppressive doses of systemic corticosteroids (>10 mg/day prednisone or equivalent) within 28 days prior to enrollment. However, patients who received a short course of corticosteroids (eg, premedication prior to antibody drug) will be eligible for study entry.
  • Major trauma or major surgery within 4 weeks prior to enrollment.
  • Previous treatment involving TP53 mutant (R273H or R175H or R248Q or R249S) and EphA2.
  • Systemic chemotherapy and other intervene within 2 weeks prior to vaccination.
  • Being participating or withdrew any other trials within 4 weeks.
  • Any serious underlying medical (eg, pulmonary, renal, hepatic, gastrointestinal, or neurological) or psychiatric condition or any issue that would limit compliance with study requirements.
  • Vaccination within 30 days of study enrollment.
  • Pregnant, lactating, or breastfeeding females.
  • Researchers believe that other reasons are not suitable for clinical trials.

Trial locations and contacts

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

China1 site, 1 recruiting
  • Biotherapeutic Department of Chinsese PLA Gereral Hospital

    Beijing, Beijing Municipality, 100853

    Weidong Han, +86-010-66937463, hanwdrsw69@yahoo.com

    Recruiting

Other trials in China

About this study

Official title: A Pilot Clinical Trial of Autologous EphA-2-Targeting Chimeric Antigen Receptor Dendritic Cell Vaccine Loaded With TP53 Mutant Peptide Plus ICIs for Local Advanced/Metastatic Solid Tumors or Relapsed/Refractory Lymphomas.

This is a pilot clinical trial for subjects with local advanced/metastatic solid tumors or relapsed/refractory (R/R) lymphomas to determine the safety, efficacy and immune response of autologous EphA2-targeting CAR-DC vaccine loaded with TP53 mutant peptide (TP53-EphA-2-CAR-DC) in combination with ICIs. It aims to: assess the safety and antitumor effects of TP53-EphA-2-CAR-DC vaccine; detect T cell response against TP53 mutant peptide and tumor neoepitopes after the treatment with TP53-EphA-2-CAR-DC vaccine and ICIs.

Read the detailed description

Therapeutic cancer vaccines, especially DC-based vaccines, are extensively pursued immune approaches in addition to immune checkpoint blockade antibodies and chimeric antigen receptor T cells. DCs can engulf, process and present tumor antigens to T cells, thereby initiating a potent and tumor-specific immune response. However, clinical outcomes of therapeutic cancer vaccines still remain poor, with objective response rates that rarely exceed ~15%. The maturation and activation of DCs are necessary steps to trigger the antitumor responses. However, it is increasingly clear that tumor-infiltrating dendritic cells (TIDCs) usually have an immature or tolerated phenotype that plays central roles in developing tumor microenvironment (TME). As a consequence, malfunction of TIDCs could suppress the infiltration and function of tumor infiltrating T cells and convert them into immune suppressive regulatory T cells.

In our previous research, we constructed novel CAR-DCs (Chimeric antigen receptor engineered dendritic cells) containing a scFv domain targeting EphA2 antigen, CD8a transmembrane, tandem DC-specific activation domains. The engineered CAR-DCs were activated when contacting with tumor targets in TME, and consequently, augmented the cytotoxicity of antigen specific T cells in immune system humanized solid tumor mouse models. Our design of CAR-DCs provides an effective vaccine strategy for malignant tumors. Therefore, we designed an autologous CAR-DC vaccine engineered with anti-EphA2 CAR and TP53 mutant peptide (TP53-EphA-2-CAR-DC), which can suppress the growth of tumors expressing the correlated TP53 mutant in animal models. In addition, the combination of the immune checkpoint inhibitors could further reverse immunosuppressive TME and globally activate T cell responses. In this pilot study, we aim to assess the safety, efficacy and immune response of TP53-EphA-2-CAR-DC combined with anti-PD-1 antibody/anti-CTLA4 antibody in patients with local advanced/metastatic solid tumors or R/R lymphomas.

Being tested
TP53-EphA-2-CAR-DC, Abraxane, Cyclophosphamide, anti-PD-1 antibody, Anti-CTLA4 Monoclonal Antibody
Keywords
Local Advanced/Metastatic, Relapsed/refractory
Medical subject headings
Lymphoma, Neoplasm Metastasis, Recurrence

What participants receive

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

  • TP53-EphA-2-CAR-DCBiological

    5~10 × 10^6 CAR DCs per dose will be administered by intravenous injection.

  • AbraxaneDrug

    Also called Abraxane Injectable Product

    Intravenous abraxane 125 mg/m^2/day on day-5.

  • CyclophosphamideDrug

    Also called Cyclophosphamide for Injection

    Intravenous cyclophosphamide 300 mg/m^2/day on day -4.

  • anti-PD-1 antibodyDrug

    Also called PD-1 blocking antibody

    Intravenous anti-PD-1 antibody 200 mg/day.

  • Anti-CTLA4 Monoclonal AntibodyDrug

    Also called Ipilimumab

    Intravenous anti-CTLA4 antibody 1 mg/kg/day

Study groups in NCT05631886
Study groupRoleWhat they receive
TP53-EphA-2-CAR-DC plus anti-PD-1 antibody/anti-CTLA4 antibodyExperimentalIn the priming phase, a conditioning chemotherapy regimen of Abraxane and cyclophosphamide is administered three days before vaccination, and TP53-EphA-2-CAR-DC vaccine is infused on Day 0 and Day 7 in Week 1. In the boost phase, TP53-EphA-2-CAR-DC vaccine is infused one dose every 8 weeks since Week 5. Anti-PD-1 antibody and anti-CTLA4 antibody are administered 2 days after the first dose of TP53-EphA-2-CAR-DC vaccine in the boost phase (Day 3 in Week 5) and every 3 weeks afterwards for four doses, followed by anti-PD-1 antibody once every 3 weeks, until: 1. Unacceptable toxicity occurred or disease progression; or 2. Reactive T cells are undetected repeatedly after the last vaccine dose; or 3. Vaccine exhaustion.
Receives: Biological: TP53-EphA-2-CAR-DC; Drug: Abraxane; Drug: Cyclophosphamide; Drug: anti-PD-1 antibody; Drug: Anti-CTLA4 Monoclonal Antibody

What is being measured

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

  1. Incidence of treatment related adverse events (AEs)

    Determining the safety profile following the initiation of treatment and grading these toxicities by CTCAE v5.0. AEs such as cytokine release syndrome (CRS) and immune cell-associated neurotoxicity syndrome (ICANS) were graded according to American Society for Transplantation and Cellular Therapy (ASTCT) criteria.

    Measured: 2 years

  2. Clinical Response

    Clinical Response will be determined by iRECIST criteria. Response rate is the proportion of patients that achieve CR or PR.

    Measured: 2 years

  3. Immune Response

    Immune response will be evaluated by phenotype and functional analysis of vaccine-reactive T cells and Neoantigen-reactive T cells as well as other immune cells in peripheral blood and tumor samples. Response is defined by ≥3 folds increase relative to pre-vaccination.

    Measured: Peripheral blood: baseline, weekly before Week 9, prior to each vaccination after Week 9 until last vaccine and 1 year after last vaccine. Tumor tissue: baseline, Week 3, and following timing will be performed according to subject's condition.

Secondary outcomes (6)
  1. Progression Free Survival (PFS)

    PFS is defined as the time from TP53-EphA-2-CAR-DCs infusion to documented disease progression or death.

    Measured: 2 years

  2. Overall Survival (OS)

    OS is defined as the time from TP53-EphA-2-CAR-DCs infusion to the date of death.

    Measured: 2 years

  3. Time to response (TTR)

    TTR is defined as the time from TP53-EphA-2-CAR-DCs infusion to first assessed CR or PR by investigators and based on the iRECIST criteria.

    Measured: 2 years

  4. Duration of response (DOR)

    DOR is defined as the time from objective response (OR) until documented tumor progression date among responders.

    Measured: 2 years

  5. Number and copy number of TP53-EphA-2-CAR-DCs

    Number and copy number of TP53-EphA-2-CAR-DCs were assessed by the number in peripheral blood and tumor tissue.

    Measured: Peripheral blood samples are collected on days 0, 3, 7, 10, 22, the day before each vaccination until last vaccination and 1 year after last vaccine. Tumor tissues are collected at baseline, the day before Week 5, and after combination.

  6. The level of cytokines in serum

    The cytokines mainly include IL-1, IL-2, IL-6, IL-8, IL-10, IL-12 (p70), TNF-α

    Measured: Peripheral blood samples are collected on days 0, 3, 7, 10, 22, the days before each vaccination until last vaccination and 1 year after last vaccine. Tumor tissues are collected at baseline, the day before Week 5, and after combination.

Timeline

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

  1. First posted30 Nov 2022
  2. Study start4 Jul 2023
  3. Primary completion30 Dec 2025 (estimated)
  4. Study completion30 Dec 2026 (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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
10 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05631886
Sponsor's protocol ID
CHN-PLAGH-BT-075
Status last verified
Aug 2023
First submitted
21 Nov 2022
Last updated
28 Aug 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing TP53-EphA-2-CAR-DC, Abraxane and Cyclophosphamide in people with Solid Tumor, Adult and Lymphoma, run by Chinese PLA General Hospital 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 9 inclusion and 15 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 28 Aug 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 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?

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 Weidong Han, Ph.D (010-66937231 ext. +86, hanwdrsw@sina.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of treatment related adverse events (AEs) (time frame: 2 years). 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 28 Aug 2023.

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