ClinicalTrials.gg
Active, not recruitingNCT03500991Updated Dec 17, 2025

HER2-specific CAR T Cell Locoregional Immunotherapy for HER2-positive Recurrent/Refractory Pediatric CNS Tumors

A Phase 1 interventional study of HER2-specific chimeric antigen receptor (CAR) T cell in Central Nervous System Tumor, Pediatric, Glioma and Ependymoma, sponsored by Seattle Children's Hospital. Active, not recruiting at 1 site in United States. Open to participants aged 1 Year to 26 Years. Per ClinicalTrials.gov, last updated 2025-12-17.

Primary conditionPinealomaRegistry: Central Nervous System NeoplasmsReclassifiedWhy we changed it
Registry
Central Nervous System Neoplasms — the first condition term the registry derived for this study.
ClinicalTrials.gg
Pinealoma
Why
  1. The study's listed conditions name Pinealoma, a narrower term within Central Nervous System Neoplasms.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Seattle Children's Hospital · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
10
Allocation
Non-randomized
Ages
1 Year to 26 Years
Sex
All
01

Study summary

This is a Phase 1 study of central nervous system (CNS) locoregional adoptive therapy with autologous CD4 and CD8 T cells lentivirally transduced to express a HER2-specific chimeric antigen receptor (CAR) and EGFRt, delivered by an indwelling catheter in the tumor resection cavity or ventricular system in children and young adults with recurrent or refractory HER2-positive CNS tumors. A child or young adult with a refractory or recurrent CNS tumor will have their tumor tested for HER2 expression by immunohistochemistry (IHC) at their home institution or at Seattle Children's Hospital. If the tumor is HER2 positive and the patient meets all other eligibility criteria, including having a CNS catheter placed into the tumor resection cavity or into their ventricular system, and meets none of the exclusion criteria, then they can be apheresed, meaning T cells will be collected. The T cells will then be bioengineered into a second-generation CAR T cell that targets HER2-expressing tumor cells. The patient's newly engineered T cells will then be administered via the indwelling CNS catheter for two courses. In the first course they will receive a weekly dose of CAR T cells for three weeks, followed by a week off, an examination period, and then another course of weekly doses for three weeks. Following the two courses, patient's will undergo a series of studies including MRI to evaluate the effect of the CAR T cells and may have the opportunity to continue receiving additional courses of CAR T cells if the patient has not had adverse effects and if more of their T cells are available.

The hypothesis is that an adequate amount of HER2-specific CAR T cells can be manufactured to complete two courses of treatment with three doses given on a weekly schedule followed by one week off in each course. The other hypothesis is that HER-specific CAR T cells safely can be administered through an indwelling CNS catheter to allow the T cells to directly interact with the tumor cells for each patient enrolled on the study safely can be delivered directly into the brain via indwelling catheter. Secondary aims of the study will include to evaluate CAR T cell distribution with the cerebrospinal fluid (CSF), the extent to which CAR T cells egress or traffic into the peripheral circulation or blood stream, and, if tissues samples from multiple time points are available, also evaluate the degree of HER2 expression at diagnosis versus at recurrence.

02

Conditions studied

  • Central Nervous System Tumor, Pediatric
  • Glioma
  • Ependymoma
  • Medulloblastoma
  • Germ Cell Tumor
  • Atypical Teratoid/Rhabdoid Tumor
  • Primitive Neuroectodermal Tumor
  • Choroid Plexus Carcinoma
  • Pineoblastoma

Keywords

  • CNS, CAR T cell, HER2-positive, brain tumor
  • pediatric, young adults
03

In context

Pinealoma Reclassified

66 studies on the registry are indexed under Pinealoma; 11 are open to participants now.

This study's enrollment of 10 is below the median of 26 across 43 interventional studies indexed under Pinealoma.

Browse Pinealoma studies →

Lead sponsor

Seattle Children's Hospital is the lead sponsor of 215 studies on the registry; 44 are open to participants now.

Compared within Pinealoma, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Central Nervous System Neoplasms. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age ≥ 1 and ≤ 26 years
  2. diagnosed -positive Central Nervous System (CNS) tumor
  3. Evidence of or recurrent CNS disease for which there is no standard therapy
  4. Able to tolerate apheresis, or has apheresis product available for use in manufacturing
  5. CNS reservoir catheter, such as an Ommaya or Rickham catheter
  6. ≥ 8 weeks
  7. Lansky or score ≥ 60
  8. If patient does not have previously obtained apheresis product, patient must have recovered from acute toxic effects of all prior chemotherapy, immunotherapy, and radiotherapy and discontinue the following prior to enrollment:

    1. ≥ 7 days post last chemotherapy/biologic administration
    2. 3 half-lives or 30 days, whichever is shorter post last dose of anti-tumor antibody therapy
    3. Must be at least 30 days from most recent cell infusion
    4. All systemically administered treatment therapy must be stable or decreasing within 1 week prior to enrollment with maximum dexamethasone dose of 2.5 mg/m2/day. Corticosteroid physiologic replacement therapy is allowed.
  9. Adequate organ function
  10. Adequate laboratory values
  11. Patients of childbearing/fathering potential must agree to use highly effective

Exclusion criteria

Exclusion Criteria:

  1. Diagnosis of classic diffuse intrinsic pontine glioma (DIPG)
  2. Presence of Grade ≥ 3 cardiac dysfunction or symptomatic arrhythmia requiring intervention
  3. Presence of primary immunodeficiency/bone marrow failure syndrome
  4. Presence of clinical and/or radiographic evidence of impending herniation
  5. Presence of active other than the primary CNS tumor under study
  6. Presence of active severe infection
  7. Pregnant or breastfeeding
  8. Subject and/or authorized legal representative unwilling or unable to provide consent/assent for participation in the 15-year follow up period
  9. Presence of any condition that, in the opinion of the investigator, would prohibit the patient from undergoing treatment under this protocol
Terms in these criteria, in plain language(8)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

HER2

HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.

In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
10 participants (actual)

Study arms

  • Experimental
    ARM A (Tumor Cavity Infusion)

    patients with supratentorial tumors for which CAR T cells will be delivered into the tumor resection cavity Intervention: HER2-specific chimeric antigen receptor (CAR) T cell

    Biological: HER2-specific chimeric antigen receptor (CAR) T cell

  • Experimental
    ARM B (Ventricular System Infusion)

    patients with either infratentorial tumors or leptomeningeal tumors for which the CAR T cells will be delivered into the fourth ventricle or lateral ventricle, respectively Intervention: HER2-specific chimeric antigen receptor (CAR) T cell

    Biological: HER2-specific chimeric antigen receptor (CAR) T cell

Interventions

  • BiologicalHER2-specific chimeric antigen receptor (CAR) T cell

    Autologous CD4 and CD8 T cells lentivirally transduced to express a HER2 specific chimeric antigen receptor (CAR) and EGFRt given via indwelling central nervous system (CNS) catheter

06

What researchers measure

Primary outcomes

  1. Establish the safety, defined by the adverse events, of HER2-specific CAR T cell infusions delivered by a central nervous system (CNS) catheter into the tumor resection cavity or ventricular system

    The type, frequency, severity, and duration of adverse events as a result of HER2-specific CAR T cell infusion will be summarized

    Time frame: up to 6 months

  2. Establish the feasibility, defined by the ability to produce and administer CAR T cell product, of HER2-specific CAR T cell product infusions delivered by a central nervous system (CNS) catheter into the tumor resection cavity or ventricular system

    The proportion of products successfully manufactured and infused will be measured

    Time frame: 28 days

Secondary outcomes

  1. Assess the distribution of CNS-delivered HER2-specific CAR T cells within the cerebrospinal fluid (CSF) and peripheral blood

    The trafficking of HER2-specific CAR T cell product through the CSF by measuring remaining CAR T cells from a prior infusion at the time of each infusion and the trafficking of HER2-specific CAR T cells from the CSF into the peripheral blood will be evaluated

    Time frame: up to 6 months

  2. Assessment of whether HER2 expression changes in relapsed CNS tumors that were HER2 positive prior to treatment with CAR T cells

    The changes in HER2 expression at diagnosis and recurrence of central nervous system (CNS) tumors, if samples from multiple time points is available, will be investigated by evaluating pathology specimens from previous surgeries

    Time frame: 28 days

  3. Assessment of disease response of HER2-expressing refractory or recurrent central nervous system (CNS) tumors to HER2 specific CAR T cell therapy delivered directly into the CNS

    The response of recurrent or refractory central HER2-expressing CNS tumors to HER2-specific CAR T cell therapy delivered directly into the CNS will be determined by evaluating CSF for tumor cells and by CNS imaging with MRIs

    Time frame: up to 6 months

Other outcomes

  1. Analysis of CSF for biomarkers of anti-tumor CAR T cell functional activity

    The presence of biomarkers of CAR T cell functional activity, such as cytokines, will be quantified via protein expression analysis in CSF. These findings will be correlated with safety determined by occurrence of adverse events, and response determined by disease evaluations via CSF cytology and MRI imaging of the CNS.

    Time frame: up to 6 months

07

Study locations

1 site
08

References and documents

Publications

  • Li X, Li W, Xu L, Song Y. Chimeric antigen receptor-immune cells against solid tumors: Structures, mechanisms, recent advances, and future developments. Chin Med J (Engl). 2024 Jun 5;137(11):1285-1302. doi: 10.1097/CM9.0000000000002818. Epub 2023 Aug 28. PubMed 37640679 ↗
  • Vitanza NA, Johnson AJ, Wilson AL, Brown C, Yokoyama JK, Kunkele A, Chang CA, Rawlings-Rhea S, Huang W, Seidel K, Albert CM, Pinto N, Gust J, Finn LS, Ojemann JG, Wright J, Orentas RJ, Baldwin M, Gardner RA, Jensen MC, Park JR. Locoregional infusion of HER2-specific CAR T cells in children and young adults with recurrent or refractory CNS tumors: an interim analysis. Nat Med. 2021 Sep;27(9):1544-1552. doi: 10.1038/s41591-021-01404-8. Epub 2021 Jul 12. PubMed 34253928 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 17, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03500991
Responsible party
Colleen Annesley (Medical Director, Immunotherapy, Seattle Children's Hospital) — Principal investigator
First posted
Apr 18, 2018
Start date
Jul 26, 2018
Primary completion
Jan 17, 2024
Completion
Jul 26, 2039 (estimated)
Last update
Dec 17, 2025

Study contacts

Rebecca Ronsley, MD
study chair · Seattle Children's Hospital

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.

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