Open Actively Recruiting

AFPᶜ³³²T in Advanced HCC

About

Brief Summary

The purpose of this study is to test the safety of genetically changed T cells, an investigational therapy, and find out what effects, if any, they have in subjects with liver cancer.

The subjects will have a procedure to filter blood through a machine. The machine will collect white blood cells and return everything else back into the bloodstream and may take up to 4 hours. The white blood cells will be sent to a lab where the T cells (also called T-lymphocytes) will be separated out and changed into the investigational drug, AFPc332T, the T cells intended to attack the cancer cells. Making the investigational drug from the subjects T cells will take about 1 month to complete.

Subjects will have 3 days of chemotherapy before they receive the investigational drug. Five (5) days after subjects finish chemotherapy, they will receive the investigational drug in the form of an infusion back into the bloodstream that will take about 15-30 minutes. Patients will be admitted for observation for 1 week after study drug administration.

Some study participants may be able to have a 2nd T cell infusion, if their cancer has gotten worse (disease progression), but they experienced an initial response to the cells.

Primary Purpose
Treatment
Study Type
Interventional
Phase
Phase I

Eligibility

Gender
All
Healthy Volunteers
No
Minimum Age
18 Years
Maximum Age
75 Years

Subjects between 18 and 75 years of age who have been diagnosed with liver cancer which cannot be treated with liver transplant, surgery or other procedures that reduce tumor size or your liver cancer has grown while you were receiving sorafenib, or you did not tolerate treatment or refused treatment with sorafenib.

For more information about the eligibility criteria for this trial, refer to the Health Professional version.

Key Inclusion Criteria:

  • Subject is ≥ 18 years and ≤ 75 years of age and has voluntarily agreed to participate by giving written informed consent in accordance with ICH GCP Guidelines and applicable local regulations.
  • Histologically confirmed HCC, not amenable to transplant, resection. Subjects may undergo loco-regional therapy after enrollment but not at time of lymphodepletion. Or Histologically confirmed diagnosis of another AFP expressing tumor (e.g. cholangiocarcinoma).
  • Measurable disease according to RECIST 1.1 criteria prior to lymphodepletion.
  • Progressive disease following or intolerant of or refuses standard of care systemic therapy prior to lymphodepletion.
  • Positive for any A*02:01 P group allele.
  • a) Group 1, 2, 3, (HCC) Subjects will be eligible for enrollment if they meet either one of these AFP expression criteria:
    • AFP expression of ≥1+ in ≥20% of tumor cells by immunohistochemistry and their non-cancerous liver tissue has ≤5% cells stained for AFP at any intensity by immunohistochemistry.
    • Serum AFP levels of ≥100ng/mL and their non-cancerous liver tissue has ≤5% cells stained for AFP at any intensity by immunohistochemistry.
  • b) Group 4 (other AFP expressing tumor types) Subjects will be eligible for enrollment if they meet either one of these AFP expression criteria: o Serum AFP levels of ≥100ng/mL and their non-cancerous liver tissue (if applicable) has ≤5% cells stained for AFP at any intensity by immunohistochemistry.
  • Life expectancy of > 4 months 8. Child-Pugh score ≤ 6 9. Eastern Cooperative Oncology Group (ECOG) 0-1 10. Subject must have adequate organ function as defined in the protocol.

Key Exclusion Criteria:

  • Positive for any of the HLA-A02 allele other than HLA-A02:01 P Group, HLA-A02:03 P group or null alleles or positive for the following alleles: HLA-C04:04 or HLA-B*51:03.
  • Prior liver transplant
  • Received the following prior to leukapheresis:
    • Cytotoxic chemotherapy, immune therapy and biological therapy within 3 weeks
    • Corticosteroids or any other immunosuppressive therapy within 2 weeks. NOTE: Use of inhaled or topical steroids is not exclusionary
    • Sorafenib/Regorafenib/Lenvatinib within 1 week
    • Cabozantinib within 2 weeks
    • Duration of treatment free intervals for any other anti-cancer therapies must be discussed with Adaptimmune Study Physician.
  • Received the following prior to lymphodepleting chemotherapy :
    • Cytotoxic chemotherapy or loco-regional therapy within 3 weeks, liver directed radiation therapy within three months.
    • Corticosteroids or any other immunosuppressive therapy within 2 weeks. NOTE: Use of inhaled or topical steroids is not exclusionary
    • Bone/soft tissue directed palliative radiotherapy within 4 weeks.
    • Investigational treatment or clinical trial within 4 weeks.
    • Sorafenib/Regorafenib/Lenvatinib within 1 week.
    • Cabozantinib within 2 weeks
    • Prior cancer-directed immunotherapy within 4 weeks, including monoclonal antibodies against PD-1 receptor or ligand.
    • Use of an experimental vaccine within 2 months in the absence of tumor response. The subject should be excluded if their disease is responding to an experimental vaccine given within 6 months
    • Any previous gene therapy using an integrated vector
    • Duration of treatment free intervals for any other anti-cancer therapies must be discussed with Adaptimmune Study Physician.
  • Toxicity persisting from previous anti-cancer therapy of ≥ Grade 2 (except for non-clinically significant toxicities, e.g., alopecia, vitiligo). Subjects with Grade 2 toxicities that are deemed stable or irreversible (e.g. peripheral neuropathy) can be enrolled on a case-by-case basis with prior consultation and agreement with the Sponsor Study Physician.
  • Major surgery within 4 weeks prior to lymphodepletion; subjects should have been fully recovered from any surgical related toxicities.
  • Bleeding ≥ Grade 2 in the past 3 months prior to lymphodepletion
  • Therapeutic anticoagulation from lymphodepletion until platelet count recovery (prophylactic heparin allowed)
  • Clinically or radiographically detectable ascites (beyond trace/rim of ascites) or ascites requiring medication
  • Clinically detectable hepatic encephalopathy or hepatic encephalopathy requiring medication
  • Active viral hepatitis Subjects positive for hepatitis B surface antigen not on antiviral treatment/prophylaxis or subjects with detectable hepatitis B DNA
    • Subjects with resolved (surface antigen negative, core antibody positive) or chronic stable (surface antigen positive) hepatitis B on antiviral treatment/prophylaxis with DNA levels of ≤100 IU/mL are allowed with HBV DNA monitoring after treatment
    • Subjects with hepatitis C allowed provided they meet all other eligibility criteria
  • Positive serology for HIV
  • Positive serology for HTLV 1 or 2
  • History of chronic or recurrent (within the last year) severe autoimmune or immune mediated disease requiring steroids or other immunosuppressive treatments. Subjects with history of idiopathic autoimmune hepatitis are excluded. Subjects who experienced hepatitis during treatment with check point inhibiting antibodies are not excluded.
  • Subject has brain metastases.
  • Other active malignancy besides HCC or other eligible AFP expressing tumor types within 3 years.
  • Electrocardiogram (ECG) showing clinically significant abnormality at Screening or showing a QTc interval ≥450 msec in males and ≥470 msec in females (≥480 msec for subjects with Bundle Branch Block (BBB) over consecutive ECGs).
  • Bacterial or opportunistic infection within 3 months of treatment (upper respiratory infection and uncomplicated urinary tract infection allowed)
  • Uncontrolled intercurrent illness considered by the Investigator to add appreciable risk to study participation, including but not limited to:
    • Clinically significant cardiac disease defined by CHF New York Heart Association (NYHA) > Class 1; uncontrolled clinically significant arrhythmia in last 6 months; Acute Coronary Syndrome (ACS) (angina or myocardial infarction) in last 6 months.
    • Oxygen dependent lung disease.
    • Clinically significant psychiatric illness/social situations that would limit compliance with study requirements.
    • History of stroke or central nervous system bleeding; transient ischemic attack (TIA) or reversible ischemic neurologic deficit (RIND) in last 6 months.
  • Pregnant or breastfeeding
  • Alcohol or illicit drug dependency
  • Known contraindication to cyclophosphamide, fludarabine, mesna, G-CSF or other agents associated with study treatment.

Join this Trial

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Study Stats
Protocol No.
16-001401
Category
Hematology-Oncology
Oncology
Contact
Shenetra Walker
Location
  • UCLA Westwood
For Providers
NCT No.
NCT03132792
For detailed technical eligibility, visit ClinicalTrials.gov.