Clinical trial NCT03563326: Intraperitoneal Infusion of EpCAM CAR-T Cell in Advanced Gastric Cancer With Peritoneal Metastasis (WCH-GC-CART)
Official title: Clinical Trial of Intraperitoneal CAR-T Cells Infusion for the Treatment of Advanced Gastric Cancer With Peritoneal Metastasis
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE1
Conditions: Neoplasm, Stomach
Metastases, Neoplasm
Neoplasm Seeding
Keywords: Epithelial Cell Adhesion Molecule
Chimeric Antigen Receptor-modified T cell
Gastric carcinoma
Peritoneal metastasis
Lead sponsor: West China Hospital
Sponsor class: OTHER
First posted: 2018-06-20
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: To investigate the safety and efficacy of intraperitoneal infusion of EpCAM CAR-T cell in advanced gastric cancer with peritoneal metastasis by a prospective nonrandomized controlled trial.

Detailed description: Chimeric antigen receptor modified T (CAR-T) cells have the capability in targeting and recognizing tumor antigen, and can specifically recognize, bind and kill tumor cells with positive antigen. Through local drug delivery, CAR-T cells have successfully achieved remarkable effect to treat solid tumors. Gastric cancer is one of the most frequent malignant tumors with high mortality, especially in China. Peritoneal metastasis is one of the common routes of metastasis. Once peritoneal metastasis occurred, patients should be categorized as clinical pathological stage IV with extremely poor prognosis, and the effect of routine treatments would be unsatisfactory. Epithelial cell adhesion molecule (EpCAM) is highly expressed in gastric cancer cells and closely associated with the poor prognosis of patients. In our previous pre-clinical research researches, the investigators have obtained CAR-T cells targeting EpCAM (EpCAM CAR-T), and finished the preparations of cells which could be used in clinical practice. Based on our previous works, the investigators aim to investigate the safety and efficacy of peritoneal infusion of EpCAM CAR-T cell in advanced gastric cancer with peritoneal metastasis by a prospective nonrandomized controlled trial. The results of this clinical trial are expected to provide the new treatment strategy for gastric cancer patients with peritoneal metastasis.

Eligibility criteria: Inclusion Criteria:

1. Patients with EpCAM positive gastric cancer who have peritoneal metastasis at first visit; Patients with highly suspected or previous proven peritoneal metastasis by biopsy, CT, digital rectal examination, etc. who failed to the routine therapies like chemotherapy;
2. Age between 18 and 75;
3. Estimated survival time is longer than 3 months;
4. Eastern Cooperative Oncology Group (ECOG）scores 0-2;
5. Hemoglobin≥90g/L, ANC≥1.5×109/L, PLT≥80×109/L;
6. Negative pregnancy test for child-bearing period; both male and female patients should agree to apply effective contraceptive methods in the period of treatment and one year after treatment;
7. Both patients and families totally understand the objectives and risks of the treatments and sign the informed consent.

Exclusion Criteria:

1. Comorbidity with other diseases treated by immunosuppressive drugs or steroids therapy systematically;
2. Uncontrolled active infection;
3. HIV positive;
4. Active hepatic B or C virus infection, active tuberculosis;
5. Pregnant or lactation female;
6. Disagree to apply effective contraceptive methods in the period of treatment and one year after treatment;
7. Positive cytology examination alone.

Primary outcomes:
measure: EpCAM CAR-T cells treatment related adverse events
timeFrame: 4 weeks
Secondary outcomes:
measure: Overall survival outcome
timeFrame: 2 years
measure: Metabolism kinetics of CAR-T cells
timeFrame: 2 years
measure: Progress free survival outcome
timeFrame: 2 years
Other outcomes:
Locations:
city: Chengdu
country: China
facility: West China Hospital, Sichuan University
state: Sichuan
Study officials:
affiliation: West China Hospital
name: Jian-Kun Hu, M.D. Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: