Study Stopped
Study was closed due to lack of accrual and study outcomes overlapped with another protocol's eligibility.
Administering Peripheral Blood Lymphocytes Transduced With a Murine T-Cell Receptor Recognizing the G12D Variant of Mutated RAS in HLA-A*11:01 Patients
A Phase I/II Study Administering Peripheral Blood Lymphocytes Transduced With a Murine T-Cell Receptor Recognizing the G12D Variant of Mutated RAS in HLA-A*11:01 Patients
2 other identifiers
interventional
5
1 country
1
Brief Summary
Background: A new cancer therapy takes white blood cells from a person, grows them in a lab, genetically changes them, then gives them back to the person. Researchers think this may help attack tumors in people with certain cancers. It is called gene transfer using anti-Kirsten rat sarcoma virus (KRAS) Glycine(G) to Aspartic Acid(D) substitution at codon 12(G12D) murine T-cell receptor (mTCR) cells. Objective: To see if anti-KRAS G12D mTCR cells are safe and cause tumors to shrink. Eligibility: Adults ages 18-72 who have cancer with a molecule on the tumors that can be recognized by the study cells Design: Participants will be screened with medical history, physical exam, scans, photography, and heart, lung, and lab tests. An intravenous (IV) catheter will be placed in a large vein in the chest. Participants will have leukapheresis. Blood will be removed through a needle in an arm. A machine will divide the blood and collect white blood cells. The rest of the blood will be returned to the participant through a needle in the other arm. A few weeks later, participants will have a hospital stay. They will:
- Get 2 chemotherapy medicines by IV over 5 days.
- Get the changed cells through the catheter. Get up to 9 doses of medicine to help the cells. They may get a shot to stimulate blood cells.
- Recover in the hospital for up to 3 weeks. They will provide blood samples. Participants will take an antibiotic for at least 6 months. Participants will have several follow-up visits over 2 years. They will repeat most of the screening tests and may have leukapheresis. Participants blood will be collected for several years.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for phase_1
Started May 2019
Typical duration for phase_1
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
November 16, 2018
CompletedFirst Posted
Study publicly available on registry
November 19, 2018
CompletedStudy Start
First participant enrolled
May 16, 2019
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 23, 2022
CompletedStudy Completion
Last participant's last visit for all outcomes
August 23, 2022
CompletedResults Posted
Study results publicly available
May 19, 2026
CompletedMay 19, 2026
May 1, 2026
3.3 years
November 16, 2018
April 8, 2026
May 5, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (4)
Phase I: Number of Grades 1, 2, 3, 4, and/or 5 and Type of Serious and/or Non-serious Toxicities Experienced by Participants at Each Dose Level
All participants will be evaluable for toxicity from the time of their first treatment with cyclophosphamide. Toxicity was assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned. Grade 1 is mild. Grade 2 is moderate. Grade 3 is severe. Grade 4 is life-threatening. Grade 5 is death related to adverse event.
from the start of cyclophosphamide, through the first follow-up evaluation (6 weeks [± 2 weeks]) following administration of the cell product) until off study, whichever comes first, an average of 2.3 months
Phase I: Percentage of Participants Who Experienced a Grade 3, 4 and/or 5 Serious Dose-Limiting Toxicity (DLT) Reported With Type at Each Dose Level
Toxicity was assessed by the Common Terminology Criteria for Adverse Events. A DLT is all grade 3 and greater toxicities related to the cell infusion with exceptions, such as myelosuppression, defined as lymphopenia, neutropenia, decreased hemoglobin and thrombocytopenia due to the non-myeloablative lymphodepleting preparative regimen, expected chemotherapy toxicities, Aldesleukin expected toxicities, immediate hypersensitivity reactions occurring within 2 hours of cell infusion that are reversible to a grade 2 or less within 24 hours of cell administration with standard therapy, Grade 3 fever, Grade 3 metabolic laboratory abnormalities without significant clinical sequela that resolve to grade 2 within 7 days, Grade 3 autoimmune toxicity that resolves to grade 2 or less within 10 days unless immunosuppression is required, and events that are clearly related to the participants disease. Grade 3 is severe. Grade 4 is life-threatening. Grade 5 is death related to adverse event.
At the time of cell infusion and end two weeks after cell infusion, an average of one month
Phase II: Percentage of Participants With a Clinical Response (Complete Response (CR) + Partial Response (PR) Reported With 80% Confidence Interval
Percentage of participants who have a clinical response (PR+CR) to treatment (objective tumor regression). Response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.1). CR is a disappearance of all target lesions. PR is at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
6 weeks and 12 weeks following administration of the cell product, then every 3 months x3, then every 6 months x 2 years, then per principal investigator (PI) discretion
Phase II: Percentage of Participants With a Clinical Response (Complete Response (CR) + Partial Response (PR) Reported With 95% Confidence Interval
Percentage of participants who have a clinical response (PR+CR) to treatment (objective tumor regression). Response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.1). CR is a disappearance of all target lesions. PR is at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
6 weeks and 12 weeks following administration of the cell product, then every 3 months x3, then every 6 months x 2 years, then per principal investigator (PI) discretion
Other Outcomes (1)
Phase I: Number of Participants With Serious and/or Non-serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0).
from the start of cyclophosphamide, through the first follow-up evaluation (6 weeks [± 2 weeks]) following administration of the cell product) until off study, whichever comes first, an average of 2.3 months
Study Arms (2)
Arm 1/Phase I Non-myeloablative, Lymphodepleting Preparative Regimen
EXPERIMENTALCohort 1, Arm 1. Participants enrolled with measurable, metastatic, or unresectable malignancy expressing G12D mutated KRAS. Non-myeloablative, lymphodepleting preparative regimen of cyclophosphamide and fludarabine + escalating doses of anti-Kirsten rat sarcoma virus (KRAS) Glycine(G) to Aspartic Acid(D) substitution at codon 12(G12D) murine T-cell receptor (mTCR) peripheral blood lymphocytes (PBL) + highdose aldesleukin.
Arm 2/Phase II Non-myeloablative, Lymphodepleting Preparative Regimen
EXPERIMENTALCohort 2a: Participants with a diagnosis of pancreatic cancer. Cohort 2b: Participants with a diagnosis other than pancreatic cancer. Non-myeloablative, lymphodepleting preparative regimen of cyclophosphamide and fludarabine + maximum tolerated dose (MTD) of anti-Kirsten rat sarcoma virus (KRAS) Glycine(G) to Aspartic Acid(D) substitution at codon 12(G12D) murine T-cell receptor (mTCR) peripheral blood lymphocytes (PBL) + high-dose aldesleukin.
Interventions
Days -7 and -6: Cyclophosphamide 60 mg/kg/day x 2 days intravenous (IV) in 250 mL 5% Dextrose in water (D5W) infused simultaneously with mesna 15 mg/kg/day over 1 hour x 2 days.
Days -7 to -3: Fludarabine 25 mg/m\^2/day intravenous piggyback (IVPB) daily over 30 minutes for 5 days.
Aldesleukin 720,000 IU/kg intravenous (IV) (based on total body weight) over 15 minutes approximately every 8 hours beginning within 24 hours of cell infusion and continuing for up to 3 days (maximum 9 doses).
Day 0: Cells will be infused intravenously on the Patient Care Unit over 20-30 minutes (2-4 days after the last dose of fludarabine).
Baseline within 14 days prior to preparative regimen
Within 6 weeks and post treatment follow-up
Within 6 weeks and post treatment follow-up
Within 6 weeks and post treatment follow-up
Baseline within 14 days prior to preparative regimen
Within 6 weeks and post treatment follow-up
Eligibility Criteria
You may qualify if:
- Measurable (per Response Evaluation Criteria in Solid Tumors v1.1 criteria), metastatic, or unresectable malignancy expressing G12D mutated KRAS as assessed by one of the following methods: Reverse Transcription Polymerase Chain Reaction (RT-PCR) on tumor tissue, tumor deoxyribonucleic acid (DNA) sequencing, or any other Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory test on resected tissue. Patients shown to have tumors expressing Glycine(G) to Aspartic Acid(D) substitution at codon 12(G12D) mutated neuroblastoma rat sarcoma (NRAS) and Harvey rat sarcoma viral oncogene homolog (HRAS) will also be eligible as these oncogenes share complete amino acid homology with G12D mutated KRAS for their first 80 N-terminal amino acids, completely encompassing the target epitope.
- Patients must be human leukocyte antigens (HLA) -A\*11:01 positive as confirmed by the National Institutes of Health (NIH) Department of Transfusion Medicine.
- Confirmation of the diagnosis of cancer by the National Cancer Institute (NCI) Laboratory of Pathology.
- Patients must have:
- previously received standard systemic therapy for their advanced cancer and have been either non-responders or have recurred, specifically:
- Patients with metastatic colorectal cancer must have had at least two systemic chemotherapy regimens that include 5-Fluorouracil (5-FU), leucovorin, bevacizumab, oxaliplatin, and irinotecan (or similar agents), or have contraindications to receiving those medications.
- Patients with pancreatic cancer must have received gemcitabine, 5FU, and oxaliplatin (or similar agents), or have contraindications to receiving those medications.
- Patients with non-small cell lung cancer (NSCLC) must have had appropriate targeted therapy as indicated by abnormalities in anaplastic lymphoma kinase (ALK), estimated glomerular filtration rate (EGFR), or expression of programmed death-ligand 1 (PD-L1). Other patients must have had platinum-based chemotherapy.
- Patients with ovarian cancer or prostate cancer must have had approved first-line chemotherapy.
- declined standard treatment.
- Patients with 3 or fewer brain metastases that are \< 1 cm in diameter and asymptomatic are eligible. Lesions that have been treated with stereotactic radiosurgery must be clinically stable for one month after treatment for the patient to be eligible. Patients with surgically resected brain metastases are eligible.
- Age greater than or equal to 18 years and less than or equal to 72 years.
- Clinical performance status of Eastern Cooperative Oncology Group (ECOG) 0 or 1
- Patients must be willing to practice birth control from the time of enrollment on this study and for 12 months after the last dose of combined chemotherapy for women and for four months after treatment for men.
- Women of child-bearing potential must be willing to undergo a pregnancy test prior to the start of treatment because of the potentially dangerous effects of the treatment on the fetus.
- +19 more criteria
You may not qualify if:
- Women of child-bearing potential who are pregnant or breastfeeding because of the potentially dangerous effects of the treatment on the fetus or infant.
- Concurrent systemic steroid therapy.
- Active systemic infections requiring anti-infective treatment, coagulation disorders, or any other active or uncompensated major medical illnesses.
- Any form of primary immunodeficiency (such as Severe Combined Immunodeficiency Disease).
- Concurrent opportunistic infections (The experimental treatment being evaluated in this protocol depends on an intact immune system. Patients who have decreased immune competence may be less responsive to the experimental treatment and more susceptible to its toxicities.)
- History of severe immediate hypersensitivity reaction to cyclophosphamide, fludarabine, or aldesleukin.
- History of coronary revascularization or ischemic symptoms.
- For select patients with a clinical history prompting cardiac evaluation: last known left ventricular ejection fraction (LVEF) less than or equal to 45%.
- I. For select patients with a clinical history prompting pulmonary evaluation: known forced expiratory volume at one second (FEV1) less than or equal to 50%.
- j. Patients who are receiving any other investigational agents.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
National Institutes of Health Clinical Center
Bethesda, Maryland, 20892, United States
Related Publications (3)
Abrams SI, Khleif SN, Bergmann-Leitner ES, Kantor JA, Chung Y, Hamilton JM, Schlom J. Generation of stable CD4+ and CD8+ T cell lines from patients immunized with ras oncogene-derived peptides reflecting codon 12 mutations. Cell Immunol. 1997 Dec 15;182(2):137-51. doi: 10.1006/cimm.1997.1224.
PMID: 9514698BACKGROUNDDavis JL, Theoret MR, Zheng Z, Lamers CH, Rosenberg SA, Morgan RA. Development of human anti-murine T-cell receptor antibodies in both responding and nonresponding patients enrolled in TCR gene therapy trials. Clin Cancer Res. 2010 Dec 1;16(23):5852-61. doi: 10.1158/1078-0432.CCR-10-1280.
PMID: 21138872BACKGROUNDWang QJ, Yu Z, Griffith K, Hanada K, Restifo NP, Yang JC. Identification of T-cell Receptors Targeting KRAS-Mutated Human Tumors. Cancer Immunol Res. 2016 Mar;4(3):204-14. doi: 10.1158/2326-6066.CIR-15-0188. Epub 2015 Dec 23.
PMID: 26701267BACKGROUND
Related Links
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Results Point of Contact
- Title
- Dr. James C. Yang
- Organization
- National Cancer Institute
Study Officials
- PRINCIPAL INVESTIGATOR
James C Yang, M.D.
National Cancer Institute (NCI)
Publication Agreements
- PI is Sponsor Employee
- No
- Restrictive Agreement
- No
Study Design
- Study Type
- interventional
- Phase
- phase 1
- Allocation
- NON RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- SEQUENTIAL
- Sponsor Type
- NIH
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Principal Investigator
Study Record Dates
First Submitted
November 16, 2018
First Posted
November 19, 2018
Study Start
May 16, 2019
Primary Completion
August 23, 2022
Study Completion
August 23, 2022
Last Updated
May 19, 2026
Results First Posted
May 19, 2026
Record last verified: 2026-05
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, ICF
- Time Frame
- Clinical data will be available during the study and indefinitely.
- Access Criteria
- Clinical data will be made available via subscription to Biomedical Translational Research Information System (BTRIS) and with the permission of the study principal investigator (PI).
All individual participant data (IPD) recorded in the medical record will be shared with intramural investigators upon request. All collected IPD will be shared with collaborators under the terms of collaborative agreements.