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Active, not recruitingNCT03301168Updated Jul 12, 2022

Study of Gene Modified Donor T-cells Following TCR Alpha Beta Positive Depleted Stem Cell Transplant

A Phase 1/2 interventional study of BPX-501 T cells and Rimiducid in Acute Lymphoblastic Leukemia, Leukemia, Acute Myeloid (AML), Child and Lymphoma, Non-Hodgkin, sponsored by Bellicum Pharmaceuticals. Active, not recruiting at 10 sites in United States. Open to participants aged 1 Month to 26 Years. Per ClinicalTrials.gov, last updated 2022-07-12.

Sponsored by Bellicum Pharmaceuticals · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
120
Allocation
Not applicable
Ages
1 Month to 26 Years
Sex
All
01

Study summary

This study will evaluate pediatric patients with malignant or non-malignant blood cell disorders who are having a blood stem cell transplant depleted of T cell receptor (TCR) alfa and beta cells that comes from a partially matched family donor. The study will assess whether immune cells, called T cells, from the family donor, that are specially grown in the laboratory and given back to the patient along with the stem cell transplant can help the immune system recover faster after transplant. As a safety measure these T cells have been programmed with a self-destruct switch so that they can be destroyed if they start to react against tissues (graft versus host disease).

Read the detailed description

This is a Phase 1/2 study evaluating the safety and feasibility of BPX-501 T cells infused after partially mismatched, related, TCR alpha beta T cell depleted hematopoietic stem cell transplant (HSCT) in pediatric patients. The purpose of this clinical trial is to determine whether BPX-501 infusion can enhance immune reconstitution in those patients with hematologic disorders, with the potential for reducing the severity and duration severe acute graft versus host disease (GvHD).

The trial will also evaluate the treatment of GvHD by the infusion of dimerizer drug (AP1903/rimiducid) in those subjects who present with GVHD that does not adequately respond to standard of care therapy.

02

Conditions studied

  • Acute Lymphoblastic Leukemia
  • Leukemia, Acute Myeloid (AML), Child
  • Lymphoma, Non-Hodgkin
  • Myelodysplastic Syndromes
  • Primary Immune Deficiency Disorder
  • Osteopetrosis
  • Cytopenia
  • Hemoglobinopathy in Children
  • Anemia, Aplastic

Keywords

  • ALL
  • AML
  • hematologic neoplasms
  • hematologic malignancies
  • primary immune deficiences
  • allogeneic stem cell transplant
03

Who can participate

Ages eligible
1 Month to 26 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age > 1 month and \< 26 years
  2. Life expectancy > 10 weeks
  3. Subjects deemed eligible for allogeneic stem cell transplantation.
  4. Subjects with life-threatening hematological malignancies (high-risk ALL in 1st CR, ALL in 2nd or subsequent CR, AML in 1st CR, AML in 2nd or subsequent CR, myelodysplastic syndromes, non-Hodgkin lymphomas in 2nd or subsequent CR, other hematologic malignancies eligible for stem cell transplantation per institutional standard);
  5. Non-malignant disorders amenable to cure by an allograft:

    1. primary immune deficiencies,
    2. severe aplastic anemia not responding to immune suppressive therapy,
    3. osteopetrosis,
    4. hemoglobinopathies, (thalassemias, and sickle cell anemia, and Diamond-Blackfan anemia among others)
    5. congenital/hereditary cytopenia, including Fanconi Anemia before any clonal malignant evolution (MDS, AML) Note: Subjects will be eligible if they meet either item 4 OR item 5.
  6. Lack of suitable conventional donor (HLA identical sibling or HLA phenotypically identical relative or 10/10 unrelated donor evaluated using high resolution molecular typing) or presence of rapidly progressive disease not permitting time to identify an unrelated donor
  7. A minimum genotypic identical match of 5/ 10 is required.
  8. The donor and recipient must be identical, as determined by high resolution typing, at least one allele of each of the following genetic loci: HLA-A, HLA-B, HLA-Cw, HLA- DRB1 and HLA-DQB1.
  9. Lansky/Karnofsky score > 50
  10. Signed written informed consent

Exclusion criteria

Exclusion Criteria:

  1. Greater than Grade II acute GVHD or chronic extensive GVHD due to a previous allograft at the time of inclusion
  2. Subject receiving an immunosuppressive treatment for GVHD treatment due to a previous allograft at the time of inclusion
  3. Dysfunction of liver (ALT/AST > 5 times normal value, or bilirubin > 3 times normal value), or of renal function (creatinine clearance \< 30 mL / min)
  4. Severe cardiovascular disease (arrhythmias requiring chronic treatment, congestive heart failure or left ventricular ejection fraction \< 40%)
  5. Current active infectious disease (including positive HIV serology or viral RNA)
  6. Serious concurrent uncontrolled medical disorder
  7. Pregnant or breastfeeding subject
  8. For subjects who have received more than 1 x 10E5 alpha/beta T cells/kg with the graft infusion the clinical trial site must contact the sponsor for approval to be eligible to receive BPX-501 infusion.
04

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
120 participants (estimated)

Study arms

  • Experimental
    BPX-501 T cells and Rimiducid

    TCR alpha beta depleted graft infusion with addback of BPX-501 T cells. Rimiducid: Dimerizer drug administered to subjects who present with Grade I-IV acute GVHD with inadequate response to steroids within 48 hours of treatment or mild to severe chronic GVHD with inadequate response to steroids within 7 days of treatment.

    Biological: BPX-501 T cells · Drug: Rimiducid

Interventions

  • BiologicalBPX-501 T cells

    T cells transduced with CaspaCIDe® safety switch

    Also known as: rivogenlecleucel

  • DrugRimiducid

    administered to inactivate BPX-501 cells in the event of GVHD

    Also known as: AP1903

05

What researchers measure

Primary outcomes

  1. Adverse Event

    Demonstrate safety of BPX-501 MTD

    Time frame: Month 24

  2. TRM/NRM

    Assess the cumulative incidence of non-relapse/transplant related mortality

    Time frame: Day 180, Month 12

Secondary outcomes

  1. Disease-free survival

    Disease-free survival rates after transplantation

    Time frame: Month 24

  2. Relapse

    Cumulative incidence of relapse

    Time frame: Month 12

  3. Engraftment

    Cumulative incidence of neutrophil and platelet engraftment, primary \& secondary graft failure

    Time frame: Month 24

  4. GvHD

    Cumulative incidence and severity of acute and chronic GvHD

    Time frame: Month 24

  5. Rimiducid Efficacy

    Time to resolution of acute or chronic GvHD after administration of rimiducid

    Time frame: Month 24

  6. Infection

    Rate of infectious complications

    Time frame: Month 24

  7. Hospitalizations

    Duration of hospitalization and rehospitalization

    Time frame: Month 24

06

Study locations

10 sites
  • Children's Hospital Los Angeles
    Los Angeles, California 90027, United States
  • Stanford University - Division of Pediatric Stem Cell Transplant & Regenerative Medicine
    Palo Alto, California 94304, United States
  • Children's National Medical Center
    Washington, District of Columbia 20010, United States
  • Children's Healthcare of Atlanta
    Atlanta, Georgia 30322, United States
  • Dana-Farber Boston Children's Cancer and Blood Disorders Center
    Boston, Massachusetts 02215, United States
  • Children's Hospital at Montefiore
    Bronx, New York 10467, United States
  • Oregon Health Sciences University - Doernbecher Children's Hospital
    Portland, Oregon 97239, United States
  • University of Texas Southwestern-Children's Medical Center
    Dallas, Texas 77390, United States
  • Baylor College of Medicine/ Texas Children's Hospital
    Houston, Texas 77030, United States
  • Fred Hutchinson Cancer Research Center
    Seattle, Washington 98109, United States
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03301168
Lead sponsor
Bellicum Pharmaceuticals
Responsible party
Sponsor
First posted
Oct 4, 2017
Start date
Apr 2014
Primary completion
May 11, 2021
Completion
May 2034 (estimated)
Last update
Jul 12, 2022

Study contacts

Bellicum Pharmaceuticals
study director · Bellicum Pharmaceuticals, Inc.

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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