NCT04171843

Brief Summary

This is a Phase 1/2a, nonrandomized, open-label, parallel assignment, single-dose, dose-escalation, and dose-expansion study to evaluate the safety and clinical activity of PBCAR269A, with or without nirogacestat, in adults with r/r MM. Study subjects in Cohort A will receive PBCAR269A and study subjects in Cohort B will receive PBCAR269A and nirogacestat. At each dose level, study subjects in Cohort A and Cohort B will receive the same dose of PBCAR269A. In Cohort B, all study subjects will follow the same dosing regimen of nirogacestat. This study was terminated prior to beginning of Phase II due to lack of sufficient therapeutic effect

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
48

participants targeted

Target at P50-P75 for phase_1

Timeline
Completed

Started Apr 2020

Typical duration for phase_1

Geographic Reach
1 country

5 active sites

Status
terminated

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 12, 2019

Completed
9 days until next milestone

First Posted

Study publicly available on registry

November 21, 2019

Completed
5 months until next milestone

Study Start

First participant enrolled

April 30, 2020

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 19, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 19, 2022

Completed
Last Updated

September 21, 2023

Status Verified

September 1, 2023

Enrollment Period

2.5 years

First QC Date

November 12, 2019

Last Update Submit

September 18, 2023

Conditions

Outcome Measures

Primary Outcomes (1)

  • Maximum Tolerated Dose (MTD) of PBCAR269A

    To determine the maximum tolerated dose (MTD), which is defined as the dose level at which fewer than 33% of patients experience a dose limiting toxicity (DLT) using a 3+3 strategy.

    Day 1 - Day 28

Secondary Outcomes (2)

  • Number of Participants with Dose Limiting Toxicity(ies)

    1 year

  • Objective Response Rate of Patients

    1 year

Study Arms (6)

PBCAR269A at Dose Level 1 (Cohort A)

EXPERIMENTAL

The starting dose of PBCAR269A will be 6 x 10\^5 CAR T cells/kg body weight.

Genetic: PBCAR269ADrug: FludarabineDrug: Cyclophosphamide

PBCAR269A at Dose Level 2

EXPERIMENTAL

2 × 10\^6 CAR T cells/kg body weight.

Genetic: PBCAR269ADrug: FludarabineDrug: Cyclophosphamide

PBCAR269A at Dose Level 3

EXPERIMENTAL

6 × 10\^6 CAR T cells/kg body weight.

Genetic: PBCAR269ADrug: FludarabineDrug: Cyclophosphamide

PBCAR269A at Dose Level 2 (Cohort B)

EXPERIMENTAL

2 × 10\^6 CAR T cells/kg body weight.

Genetic: PBCAR269ADrug: FludarabineDrug: CyclophosphamideDrug: Nirogacestat

PBCAR269A at Dose Level 1 (Cohort B)

EXPERIMENTAL

6 x 10\^5 CAR T cells/kg body weight.

Genetic: PBCAR269ADrug: FludarabineDrug: CyclophosphamideDrug: Nirogacestat

PBCAR269A at Dose Level 3 (Cohort B)

EXPERIMENTAL

6 × 10\^6 CAR T cells/kg body weight.

Genetic: PBCAR269ADrug: FludarabineDrug: CyclophosphamideDrug: Nirogacestat

Interventions

PBCAR269AGENETIC

Allogeneic anti-BCMA CAR T-cell

PBCAR269A at Dose Level 1 (Cohort A)PBCAR269A at Dose Level 1 (Cohort B)PBCAR269A at Dose Level 2PBCAR269A at Dose Level 2 (Cohort B)PBCAR269A at Dose Level 3PBCAR269A at Dose Level 3 (Cohort B)

Fludarabine is used for lymphodepletion.

PBCAR269A at Dose Level 1 (Cohort A)PBCAR269A at Dose Level 1 (Cohort B)PBCAR269A at Dose Level 2PBCAR269A at Dose Level 2 (Cohort B)PBCAR269A at Dose Level 3PBCAR269A at Dose Level 3 (Cohort B)

Cyclophosphamide is used for lymphodepletion.

PBCAR269A at Dose Level 1 (Cohort A)PBCAR269A at Dose Level 1 (Cohort B)PBCAR269A at Dose Level 2PBCAR269A at Dose Level 2 (Cohort B)PBCAR269A at Dose Level 3PBCAR269A at Dose Level 3 (Cohort B)

Allogeneic anti-BCMA CAR T-cell

PBCAR269A at Dose Level 1 (Cohort B)PBCAR269A at Dose Level 2 (Cohort B)PBCAR269A at Dose Level 3 (Cohort B)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Diagnosis of MM with relapsed and/or refractory disease according to the IMWG criteria.
  • Measurable disease at Screening including at least 1 of the criteria below. Note: Study participants with immunoglobulin (Ig) A myeloma in whom serum protein electrophoresis is deemed unreliable due to comigration of normal serum proteins with the paraprotein in the beta region may be considered eligible provided total serum IgA level is \>400 mg/dL.
  • Serum myeloma (M)-protein ≥0.5 g/dL or, urine M-protein \>200 mg/24 hour.
  • Serum free light chain \>10mg/dL with abnormal kappa:lambda ratio.
  • Imaging consistent plasmacytoma and the presence of any clonal plasma cells in peripheral blood or bone marrow.
  • Study participants must be refractory to 2 prior MM treatment regimens including an immunomodulatory imide drug and a protease inhibitor prior to entering the study. Study participants must have recovered or stabilized to Grade ≤2 from any AEs experienced during prior treatment with the exception of neuropathy. Prior therapy requirements are as follows:
  • Undergone ≥1 complete cycle of treatment for each regimen, unless progressive disease was the best response to the regimen.
  • Must have received an immunomodulatory agent, a proteasome inhibitor, and an anti- CD38 antibody.
  • Study participants who are not candidates for ≥1 of the above treatments may still be considered eligible.
  • Has an Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1.
  • Has adequate bone marrow, renal, hepatic, pulmonary, and cardiac function defined as:
  • Estimated glomerular filtration rate \>30 mL/min/1.73 m2. A 24-hour urine collection for creatinine clearance may be used at the investigator's discretion.
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels both
  • ≤3 times of upper limit of normal, unless there is suspected disease in the liver, in which case, no limit is set provided serum bilirubin is within eligibility criterion.
  • Total bilirubin \<2.0 mg/dL, except in study participants with Gilbert's syndrome.
  • +8 more criteria

You may not qualify if:

  • Study participant has clinically significant organ involvement by amyloid protein.
  • Study participant has plasma cell leukemia, Waldenstrom's macroglobulinemia, or POEMS syndrome.
  • History of class III or IV congestive heart failure or severe non-ischemic cardiomyopathy, unstable or poorly controlled angina, myocardial infarction, or ventricular arrhythmia within the previous 6 months of starting study treatment.
  • History or presence of clinically relevant central nervous system (CNS) pathology.
  • Active uncontrolled fungal, bacterial, viral, protozoal, or other infection.
  • Any form of primary immunodeficiency (e.g., severe combined immunodeficiency disease).
  • History of human immunodeficiency virus (HIV) infection.
  • Active hepatitis B or hepatitis C confirmed by polymerase chain reaction (PCR). Study participant positive for inactive hepatitis B will be allowed to enroll if on prophylactic treatment.
  • History of hypertension crisis or hypertensive encephalopathy within 3 months prior to Screening.
  • History of severe immediate hypersensitivity reaction to any of the agents used in this study.
  • Abnormal findings during the Screening Period or any other medical condition(s) or laboratory findings that, in the opinion of the investigator, might jeopardize the study participant's safety.
  • History of genetic syndrome such as Fanconi anemia, Kostmann syndrome, Shwachman-Diamond syndrome, or any other known bone marrow failure syndrome.
  • Study participants with active hemolytic anemia.
  • Study participant has received autologous stem cell transplant within 12 weeks of Screening or an allogeneic stem cell transplant within 6 months of starting study treatment. Study participants who have received an allogeneic transplant must be off all immunosuppressive medications for 6 weeks without signs of GvHD.
  • Study participants with second malignancies in addition to MM if the second malignancy has required treatment within the last 3 years or is not in complete remission, with the exception of non-metastatic basal cell or squamous cell skin carcinoma.
  • +6 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (5)

City of Hope

Duarte, California, 91010, United States

Location

University of California San Francisco

San Francisco, California, 94115, United States

Location

Dana Farber Cancer Institute

Boston, Massachusetts, 02215, United States

Location

Columbia University Irving Medical Center

New York, New York, 10032, United States

Location

MD Anderson

Houston, Texas, 77030, United States

Location

MeSH Terms

Conditions

Multiple Myeloma

Interventions

fludarabineCyclophosphamidenirogacestat

Condition Hierarchy (Ancestors)

Neoplasms, Plasma CellNeoplasms by Histologic TypeNeoplasmsHemostatic DisordersVascular DiseasesCardiovascular DiseasesParaproteinemiasBlood Protein DisordersHematologic DiseasesHemic and Lymphatic DiseasesHemorrhagic DisordersLymphoproliferative DisordersImmunoproliferative DisordersImmune System Diseases

Intervention Hierarchy (Ancestors)

Phosphoramide MustardsNitrogen Mustard CompoundsMustard CompoundsHydrocarbons, HalogenatedHydrocarbonsOrganic ChemicalsPhosphoramidesOrganophosphorus Compounds

Study Officials

  • Monika Vainorius, MD

    Precision BioSciences, Inc.

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
SEQUENTIAL
Model Details: In Phase I, 3 escalating dose groups will be enrolled and treated sequentially, with the possibility of a single de-escalation. Within each dose group, at least 3 and at most 6 study participants will be treated with a single dose of PBCAR269A using a standard 3 + 3 design. The starting dose of PBCAR269A will be 6 x 105 CAR T cells/kg body weight. Subsequent dose groups will be treated with escalating doses to a maximum dose of 6 x 106 CAR T cells/kg. In the absence of DLTs, the dose will be increased using a fixed-dose scheme.
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 12, 2019

First Posted

November 21, 2019

Study Start

April 30, 2020

Primary Completion

October 19, 2022

Study Completion

October 19, 2022

Last Updated

September 21, 2023

Record last verified: 2023-09

Locations