ClinicalTrials.gg
RecruitingNCT05642455Updated Aug 11, 2026

SPEARHEAD-3 Pediatric Study

A Phase 1/2 interventional study of Afamitresgene autoleucel in Synovial Sarcoma, Malignant Peripheral Nerve Sheath Tumor (MPNST) and Neuroblastoma (NBL), sponsored by USWM CT, LLC. Recruiting at 10 sites in United States. Open to participants aged 2 Years to 21 Years. Per ClinicalTrials.gov, last updated 2026-08-11.

Sponsored by USWM CT, LLC · Phase 1/2, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2023; still recruiting 3 years 2 months later.
Phase
Phase 1/2
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
2 Years to 21 Years
Sex
All
01

Study summary

This is a pediatric basket study to investigate the safety and efficacy of afamitresgene autoleucel in HLA-A*02 eligible and MAGE-A4 positive subjects aged 2-17 years of age with advanced cancers.

02

Conditions studied

  • Synovial Sarcoma
  • Malignant Peripheral Nerve Sheath Tumor (MPNST)
  • Neuroblastoma (NBL)
  • Osteosarcoma
03

In context

Sarcoma, Synovial

133 studies on the registry are indexed under Sarcoma, Synovial; 29 are open to participants now.

This study's planned enrollment of 20 is below the median of 46 across 117 interventional studies indexed under Sarcoma, Synovial.

Browse Sarcoma, Synovial studies →

Lead sponsor

USWM CT, LLC is the lead sponsor of 9 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
2 Years to 21 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

  • Subject has confirmed diagnosis of any one of the following cancers: (A) Synovial Sarcoma (SS), (B) MPNST, (C) Neuroblastoma, or (D) Osteosarcoma (OS).
  • Age:

(A) Synovial Sarcoma: 2 to 17 years (B) MPNST, Neuroblastoma and Osteosarcoma: 2 to 21 years

  • Body weight ≥ 10 kg
  • Must have previously received a systemic chemotherapy
  • prior to lymphodepletion according to v1.1 (or INCR, 2017 Neuroblastoma only).
  • HLA-A*02 positive
  • Tumor shows MAGE-A4 expression confirmed by central laboratory.
  • Performance Status:

(A) Subjects ≥16: (ECOG) 0 or 1 (B) Subjects 2 to 16: Lansky score ≥ 80

  • Subject has anticipated of greater than 3 months in the opinion of the investigator.

Exclusion criteria

Exclusion Criteria:

  • Positive for HLA-A*02:05 in either allele; or any A*02 having same protein sequence as HLA-A*02:05
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to fludarabine, cyclophosphamide.
  • History of or immune mediated disease
  • Known central nervous system (CNS) .
  • Other prior that is not considered by the Investigator to be in complete remission
  • cardiovascular disease
  • Active infection with , virus, virus, or human T cell leukemia virus
  • Pregnant or breastfeeding
  • Experiencing ongoing rapid disease progression that in the opinion of the Investigator significantly increases the subjects risk associated with treatment.
Terms in these criteria, in plain language(12)

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.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

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.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

05

Study design

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

Study arms

  • Experimental
    Afamitresgene autoleucel

    Genetic: Afamitresgene autoleucel

Interventions

  • GeneticAfamitresgene autoleucel

    Single infusion of afamitresgene autoleucel Dose: For subjects ≥10 kg to \<40 kg: starting dose of 0.025 - 0.200 x 10'9 transduced cells/kg. For subjects ≥40 kg 1.0x109 to 10x109 transduced by a single intravenous infusion

06

What researchers measure

Primary outcomes

  1. Incidence, duration, and severity of Treatment Emergent Adverse Events as assessed by Investigator Evaluation.

    Determination of incidence, severity and duration of adverse events * Incidence of dose limiting toxicities DLTs * AEs including serious adverse events (SAEs) * Incidence, severity, and duration of the AEs of special interest * Replication competent lentivirus (RCL) * T-cell clonality and insertional oncogenesis (IO)

    Time frame: 3.5 years

Secondary outcomes

  1. Efficacy: Objective response rate (ORR) assessed by investigator per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 (or by International Neuroblastoma Response Criteria [INRC] 2017 in Neuroblastoma subjects)

    ORR is defined as incidence of complete responses or partial responses as assessed by RECIST v1.1 or INRC, 2017

    Time frame: 3.5 years

  2. Time to response (TTR)

    For patients who are observed to respond to afamitresgene autoleucel in the time from date of infusion to achieve a partial response or complete response (TTR) is assessed

    Time frame: 3.5 years

  3. Duration of Response (DoR)

    For patients who are observed to respond to afamitresgene autoleucel the DoR is the date of initial response (including confirmation) from date of infusion up until disease progression

    Time frame: 3.5 years

  4. Best overall response (BOR)

    BOR is assessed by the investigator per RECIST V1.1 or INCR, 2017 (for Neuroblastoma subjects)

    Time frame: 3.5 years

  5. Progression Free Survival (PFS)

    PFS is assessed by the investigator from date of infusion of ADP-A2M4 up until the date of disease progression per RECIST v1.1 or death.

    Time frame: 3.5 years

  6. Overall Survival (OS)

    OS is assessed from date of infusion of ADP-A2M4 up until the date of patient death.

    Time frame: 15 years

  7. Characterize the in vivo cellular pharmacokinetics (PK) profile of afamitresgene autoleucel by evaluation of PBMC samples for peak persistence.

    Obtain PBMC samples for the evaluation of peak persistence of afamitresgene autoleucel.

    Time frame: 3.5 years

  8. Development and validation of an invitro diagnostic (IVD) assay for the screening of tumor antigen expression for regulatory approval.

    Retention of additional tumor tissue during Pre-Screening to enable development and validation of a MAGE-A4 antigen expression companion diagnostic (CDx) assay.

    Time frame: 3.5 years

07

Study locations

10 of 10 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 11, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05642455
Lead sponsor
USWM CT, LLC
Responsible party
Sponsor
First posted
Dec 8, 2022
Start date
Sep 1, 2023
Primary completion
Oct 1, 2026 (estimated)
Completion
Jul 30, 2038 (estimated)
Last update
Aug 11, 2026

Study contacts

Fiorella Iglesias Cardenas, MD
principal investigator · Memorial Sloan Kettering Kids

Oversight

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

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No contact was published for this record. The registry link below has the sponsor’s details.

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