A Phase 1/3 Study of T-Cell Receptor Engineered Donor T Cells in Subjects Undergoing Allogeneic Peripheral Blood Stem Cell Transplantation
Start Date
11/1/2022
Completion Date
6/1/2028
Summary
This is a multi-center, non-randomized, concurrent controlled, multi-arm, Phase 1 interventional, open-label, biologic assignment-based umbrella study evaluating the feasibility, safety and preliminary efficacy of an escalating dose regimen of up to 2 doses of TSC-100 and TSC-101 in patients with AML, MDS, or ALL following HCT from a haploidentical donor, MMUD, or MUD
Detailed Description
A multi-center, non-randomized, controlled, multi-arm, Phase 1 interventional, open label, biologic assignment-based umbrella study is planned to evaluate the feasibility, safety, and preliminary efficacy of repeated dose regimen of TSC-100 and TSC-101 (TSC-100 and TSC-101 is a genetically engineered, donor-derived T cell targeting HA-1 and HA-2 respectively) in patients with AML, MDS, or ALL following HCT from a haploidentical donor, MUD, or MMUD. The primary objective of this study is to investigate the safety of single and repeated dosing of TSC-100 and TSC-101 in HLA A\*02:01 positive patients undergoing haploidentical allogeneic peripheral blood hematopoietic cell transplantation and determine the optimally tolerated dose range. The primary endpoints are: (1) incidence of dose-limiting toxicities (DLTs), and (2) incidence of adverse events (AEs) and serious AEs (SAEs) of TSC-100 and TSC-101 combined with the standard of care (SOC) compared with the SOC alone at 2 years of follow-up. The study will also investigate the efficacy of TSC-100 and TSC-101 combined with the SOC compared with that of the SOC alone to treat the study population and assess the immunogenicity of TSC-100 and TSC-101. Depending on the HLA type and minor antigen positivity, patients will receive either TSC-100 or TSC-101 combined with the SOC or only SOC. TSC-100 or TSC-101 will be administered intravenously. Standard of care will include reduced intensity conditioning (RIC), hematopoietic cell infusion, and acute graft-versus-host disease (GvHD) prophylaxis. Patients will undergo one of the following RIC regimens, following standard institutional procedures: fludarabine+cyclophosphamide+total body irradiation, fludarabine+melphalan+/-total body irradiation, thiotepa+busulfan+fludarabine, flurdarabine+melphalan+thiotepa or fludarabine+melphalan (for MMUds only). In addition, patients may receive other supportive care measures and infectious prophylaxis as necessary, according to institutional guidelines or standards. Successive cohorts of patients in the treatment arms will be started according to an interval 3+3 (i3+3) dose escalation design. Once the RP2D is identified, up to 20 additional patients may be enrolled at the RP2D. Dose escalations to the next cohort of TSC-100 and TSC-101 will be considered after the safety review committee (SRC) establishes reasonable safety for all patients enrolled into the current cohort. The safety and necessity of repeat dosing will also be determined by the SRC. The safety data for all patients that received at least one dose of TSC-100 or TSC-101 in the treatment arms will be included in the safety assessment to proceed to the next dosing level and the dose escalation meeting will occur when the last patient in the cohort completes the 40-day DLT evaluation period. Depending on the number of DLTs observed, the range of patients that could be enrolled in the dose escalation stage of this i3+3 study is 35 to 300, including patients in the control arm.
Eligibility Criteria
Age Range: 18 years to No maximum
Interventions
SOC + TSC-101
Control
SOC + TSC-100
Conditions
Locations
City of Hope
Duarte, California 91010
United States
University of Colorado - Anschutz Cancer Center
Aurora, Colorado 80045
United States
SCRI - Colorado Blood Cancer Institute
Denver, Colorado 80218
United States
Yale
New Haven, Connecticut 06510
United States
Memorial Cancer Institute
Hollywood, Florida 33021
United States
Moffitt Cancer Institute
Tampa, Florida 33612
United States
Northside Hospital
Atlanta, Georgia 30342
United States
Johns Hopkins University
Baltimore, Maryland 21287
United States
Mass General Hospital
Boston, Massachusetts 02114
United States
Dana-Farber Cancer Institute - Hematology/Oncology
Boston, Massachusetts 02215
United States
Karmanos Cancer Institute
Detroit, Michigan 48201
United States
Hackensack University Medical Center
Hackensack, New Jersey 07601
United States
Columbia University
New York, New York 10027
United States
Mount Sinai
New York, New York 10029-6696
United States
University North Carolina
Chapel Hill, North Carolina 27599
United States
University of Pennsylvania
Philadelphia, Pennsylvania 19104
United States
SCRI - TriStar Bone Marrow Transplant
Nashville, Tennessee 37203
United States
St. David's South Austin Medical Center
Austin, Texas 76704
United States
Baylor University Medical Center
Dallas, Texas 75246
United States
MD Anderson
Houston, Texas 77030
United States
Froedert and Medical College of Wisconsin
Milwaukee, Wisconsin 53226
United States