Study of FT516 for the Treatment of COVID-19 in Hospitalized Patients With Hypoxia

This is a Phase I study with the primary objective of identifying the maximum tolerated dose (MTD) of FT516 using 3 dose-escalation strategies (number of doses and cell dose) for the treatment of coronavirus disease 2019 (COVID-19). This study provides initial estimates of safety and efficacy based on stable respiratory function, as well as, determining the feasibility for full-scale studies designed both for efficacy and safety.

Given the urgency of COVID-19 and the known anti-viral activity of natural killer (NK) cells, this clinical trial uses immediately available off-the-shelf induced pluripotent stem cell (iPSC) derived NK cells already being used to treat cancer patients.

FT516 is an off-the-shelf cryopreserved NK cell product derived from an iPSC that was transduced with a high affinity, ADAM17 non-cleavable CD16 (Fc receptor) that maintains CD16 on the cell surface, which remains fully functional after NK cell activation. The investigators expect that natural developing anti-COVID IgG (early data suggest that some develop in 7-10 days after diagnosis) will enhance targeting of FT516 to infected cells.

Eligibility Criteria:
Inclusion Criteria:

* Has laboratory-confirmed novel coronavirus (SARS-CoV-2) infection as determined by polymerase chain reaction (PCR), or other commercial or public health assay.
* Requires hospitalization and meets the following:

  * Radiographic infiltrates by imaging (chest x-ray, CT scan)
  * Able to maintain Sp02 ≥ 93% oxygen supplementation to a maximum 4L by low flow O2-delivery device at rest
  * IL-6 level ≥40 pg/ml but \<150 pg/mL OR CRP ≥40 mg/L (4 mg/dL) but \<150 mg/L (15 mg/dL)
  * Ferritin \< 1000 ng/mL
  * HCT-CI score of 4 or less - For this score, if PFTs results are not available, any patient requiring oxygen prior to COVID-19 illness is not eligible
* Report of usual daily activity level (before COVID-19 illness) of Karnofsky ≥70%
* ≥ 18 years of age, but \< 76 years at time of consent signing
* Females of child-bearing potential and males with partners of child-bearing potential must agree to use highly effective contraception from the time of consent and for at least 3 months after the last dose of FT516
* Agrees to and signs the separate consent for up to 15 years of follow-up on a separate LTFU companion study (IDIM-2020-28770)
* Voluntary written consent prior to the performance of any research related procedures

Exclusion Criteria:

* Any medical condition or clinical laboratory abnormality that per Investigator judgement precludes safe participation in and completion of the study, or which could affect compliance with protocol conduct or interpretation of results.
* Need for higher-percentage oxygen delivery device (face mask, oxymizer, nonrebreather, venti-mask or pressure support with CPAP/BiPAP)
* Patients with adequate oxygenation on room air
* Receiving concomitant COVID-19 directed therapy (drugs may be stopped to make patients eligible)
* Known allergy to the following FT516 components: albumin (human) or DMSO
* Any known condition that requires systemic immunosuppressive therapy (\> 5mg prednisone daily or equivalent) topical and inhale steroids are permitted
* Active autoimmune disease requiring systemic immunosuppressive therapy
* History of severe asthma and currently on chronic systemic medications (mild asthma requiring inhaled steroids only is eligible)
* Known history of HIV positivity
* Pregnant or breast feeding