A Phase 1/2 interventional study of Tumor Infiltrating Lymphocytes (TIL) and Cyclophosphamide in Lung Cancer, Lung Cancer Metastatic and Lung Cancer, Non-small Cell, sponsored by Essen Biotech. Recruiting at 1 site in China. Open to participants aged 16 Years to 90 Years. Per ClinicalTrials.gov, last updated 2024-10-15.
Sponsored by Essen Biotech · Phase 1/2, Interventional, and Treatment
This Phase I/II study evaluates the safety and efficacy of autologous tumor-infiltrating lymphocytes (TIL) therapy combined with Pembrolizumab (Keytruda) immunotherapy in patients with advanced or metastatic refractory lung cancer. Lifileucel (Amtagvi), the first FDA-approved TIL therapy, has demonstrated significant success in treating unresectable or metastatic melanoma by utilizing the patient's own immune cells to combat cancer. This study aims to apply a similar approach to lung cancer. TILs will be harvested from patients' tumors, expanded in vitro, and infused back into the patients following a non-myeloablative lymphodepletion regimen. Pembrolizumab, a monoclonal antibody targeting the PD-1 receptor on T cells, will be administered to enhance the immune response. The primary endpoint is to determine the objective response rate (ORR) of this combined therapy. Secondary endpoints include disease control rate (DCR), progression-free survival (PFS), overall survival (OS), duration of response (DOR), and quality of life (QoL). This trial aims to offer a novel, personalized treatment option for patients with limited therapeutic alternatives.
Tumor-infiltrating lymphocytes (TILs) therapy is an innovative form of adoptive cell therapy that utilizes the patient's own immune cells to target and destroy cancer cells. Lifileucel (Amtagvi), the first FDA-approved TIL therapy, has shown remarkable efficacy in treating unresectable or metastatic melanoma. By extracting lymphocytes from the patient's tumor, expanding them ex vivo, and reinfusing them, Lifileucel has significantly improved the immune system's ability to combat cancer cells. This promising approach forms the basis for this study, which aims to apply similar methodologies to advanced or metastatic refractory lung cancer, a condition that generally has a poor prognosis and limited treatment options.
This trial involves several steps: initially, tumor samples are collected from patients for TIL extraction. Afterward, a lymphodepletion regimen using cyclophosphamide and fludarabine is administered to prepare the body for the infusion of expanded autologous TILs. Following the TIL infusion, Aldesleukin (IL-2) is administered to stimulate the TILs' activity. Pembrolizumab (Keytruda), an immunotherapy targeting the PD-1 receptor on T cells, is also given to further enhance the immune response against the tumor.
The primary goal of this trial is to determine the objective response rate (ORR) of this combined therapy. Secondary endpoints include the disease control rate (DCR), progression-free survival (PFS), overall survival (OS), duration of response (DOR), and changes in the quality of life (QoL) of patients.
Patients will be closely monitored for side effects and reactions during their hospital stay and throughout the follow-up period. Safety will be assessed based on the incidence and severity of adverse events, while efficacy will be evaluated using RECIST v1.1 criteria. By leveraging the patient's own immune cells and combining them with advanced immunotherapies, this trial aims to provide a novel, personalized treatment option for patients with advanced or metastatic refractory lung cancer, building on the success observed with Lifileucel (Amtagvi) in melanoma treatment.
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Exclusion Criteria:
Patients receive pembrolizumab IV on day -14, cyclophosphamide IV QD on days -7 to -6, fludarabine IV over 30 minutes QD on days -5 to -1, and TILs IV infusion on day 0. Patients also receive pembrolizumab IV on day 28 and 70, and undergo surgery on day 80. MAINTENANCE: Patients receive pembrolizumab IV every 6 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity.
Biological: Tumor Infiltrating Lymphocytes (TIL) · Drug: Cyclophosphamide · Drug: Fludarabine · Drug: Interleukin-2 · Drug: Pembrolizumab
Tumor Infiltrating Lymphocytes (TIL) IV
Cyclophosphamide will be administered as an intravenous (IV) infusion for two days.
Fludarabine will be administered as an intravenous (IV) infusion for five days.
After TIL infusion, IL-2 will be started as a bolus administration every eight hours, for a maximum of eight doses.
Intravenous (IV) infusion
Adverse Events
To characterize the safety profile of (TIL) and natural autologous TIL in patients with advanced solid tumors who were failed to standard treatment as assessed by incidence of adverse events.
Time frame: 6 months
Objective Response Rate (ORR)
Proportion of patients with response per Response Evaluation Criteria in Solid Tumors
Time frame: Up to 36 months
Disease Control Rate (DCR)
Percentage of patients that meet CR, PR and SD criteria set in this study
Time frame: Up to 36 months
Duration of Response (DOR)
The time length between the first confirmed objective response to the treatment and the subsequent disease progression
Time frame: Up to 36 months
Progression-Free Survival (PFS)
The time length between TIL infusion and confirmed subsequent disease progression
Time frame: Up to 36 months
Plan to share: No
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