Clinical trial NCT05549921: Phase II Study of TAEST16001 in Soft Tissue Sarcoma
Official title: TAEST16001 in Patients With Soft Tissue Sarcoma With Positive NY-ESO-1 Expression (Genotype: HLA-A*02:01): an Multi-center, Open-label and Single Arm Phase II Study
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE2
Conditions: Soft Tissue Sarcoma
Lead sponsor: Sun Yat-sen University
Sponsor class: OTHER
Collaborators: name: Guangdong Xiangxue Precision Medical Technology Co., Ltd.
First posted: 2022-09-22
Enrollment: 70
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The main purpose of this trial is to evaluate the efficacy and safety of TAEST16001 cells in the treatment of advanced soft tissue sarcoma patients with HLA-A\*02:01 tissue genotype and positive tumor antigen NY-ESO-1 expression.

Detailed description: This is a single-arm, open label, multi-center, phase II study. The investigators include advanced soft tissue sarcoma with failure in standard treatment or no recommended standard therapy.

TCR-T cell therapy has made a breakthrough for tumors in recent years. Phase I/II trial of NY-ESO-1-specific TCR-T treatment for synovial sarcoma and melanoma, conducted by the Rosenberg team at the National Cancer Institute, showed that 61% Synovial cell sarcoma patients and 55% melanoma patients benefit from this treatment, without severe side effects found in T cell receptor (TCR) transduced T-Cell Immunotherapy.

This clinical trial is mainly focused on cancer-testis antigen, because it is not expressed in normal cells. NY-ESO-1 antigen as one member of cancer-testis antigen, is commonly expressed in 10-50% of melanoma, lung, liver, esophageal, breast, prostate, bladder, thyroid and ovarian cancer cases, 60% of multiple myeloma cases, and 70-80% of synovial sarcoma. NY-ESO-1 expression was also found in 88.2% of myxoid liposarcomas, 61.1% of synovial sarcomas, 31.3% of osteosarcomas, 21.4% of pleomorphic liposarcomas, 16.7% of desmoplastic small round cell tumors, and 14.3% of chondrosarcomas. Although the NY-ESO-1 TCR cell therapy for synovial sarcoma and melanoma has benefited many patients and the phase I trial has been performed, its effect and safety on advanced soft tissue sarcoma is still unknown.

The patients must meet the two criteria: HLA-A\*0201positive and NY-ESO-1 positive cells≥20% by immunohistochemistry.

Eligibility criteria: Inclusion Criteria:

* Before any research-related operations, they should sign the informed consent Consent Form (ICF) (Genotype and Tumor Antigen Screening and Primary Screening);
* Age ≥18 years, and ≤70 years;
* His/cytology confirmed, unresectable or metastatic soft tissue sarcoma;
* The current stage is the failure of standard treatment (disease progression or recurrence or intolerance, such as chemotherapy, radiotherapy, targeted therapy, etc.) or lack of effective treatment methods, specifically: In addition to acinar soft tissue sarcoma and for pathological subtypes other than epithelioid sarcoma, at least adriamycin or doxorubicin combined with ifosfamide standard chemotherapy regimen should fail or not tolerate chemotherapy; For acinar soft tissue sarcoma and epithelioid sarcoma, need failure or intolerance of previous targeted drugs \[anti-angiogenesis such as Anlotinib, pazopanib, etc.\]; Note: Treatment failure refers to disease progression or inability during treatment or within 3 months of the last treatment Tolerable; disease progression in patients with neoadjuvant or adjuvant therapy \> 6 months after the end of treatment can be considered first-line therapy;
* At least 1 measurable lesion (according to RECIST1.1 criteria \[see Appendix 4 for details\]);
* Genotype and tumor antigen screening must meet the following 2 criteria: HLA-A\*02:01 positive; NY-ESO-1\* positive: immunohistochemical staining positive cells are ≥20%;
* ECOG score of 0-1 and expected survival period of more than 3 months;
* Echocardiography showed left ventricular ejection fraction ≥ 50%;
* Laboratory test results should at least meet the following specified indicators: White blood cell count ≥ 3.0×109 /L; Absolute neutrophil count (ANC) ≥ 1.5×109/L (without G-CSF and GM-CSF support, at least 14 days before lymphadenectomy); Absolute lymphocyte count (ALC) ≥ 0.7× 109/L; Platelet (PLT) ≥ 75×109/L (no blood transfusion therapy 14 days before lymphadenectomy chemotherapy); hemoglobin ≥ 9 g/dL (no blood transfusion therapy 14 days before lymphoid clearing chemotherapy); Coagulation International Normalized Ratio (INR) ≤ 1.5×ULN unless anticoagulant therapy;Partial prothrombin time (APTT) ≤ 1.5×ULN unless anticoagulant therapy; Serum creatinine ≤ 1.5 mg /dL (or 132.6 μmol/L); Creatinine clearance ≥60 mL/min; Aspartate aminotransferase (AST/SGOT)≤2.5×ULN; Alanine aminotransferase (ALT/SGPT)≤2.5×ULN; Total bile red Prime (TBIL)≤1.5×U LN; Note: If patients with liver metastases or patients with primary liver tumor lesions, aspartate aminotransferase and alanine aminotransferase should be ≤5× ULN;
* Females of childbearing age who have not received sterilization before menopause must agree to be removed from the study treatment (clearing). effective contraceptive measures should be used from the beginning of the last cell infusion to one year after the last cell infusion, and the serum pregnancy test was negative within 14 days before the first cell infusion; ) and up to one year after the last cell infusion, use effective contraception.

Exclusion Criteria:

* Received the last leukocyte apheresis within 4 weeks. Anti-tumor therapy (chemotherapy, endocrine therapy, targeted therapy, tumor embolization or traditional Chinese medicine with anti-tumor indications, etc.); immunotherapy within 1 month before the signing of the main informed consent;
* 4 days before cell infusion received live attenuated vaccine within 1 week;
* Patients with ≥3 bone metastases;
* Known to have allergic reactions to any components used in the treatment of this study;
* No previous surgery or treatment-related adverse reactions recovered to \<Grade 2 CTCAE v5.0;
* Patients with a history of meningeal metastasis or central nervous system metastasis, or patients with clear underlying diseases of the central nervous system within 6 months before cell reinfusion, and left significant symptoms;
* Uncontrolled hypertension (systolic blood pressure \>160 mmHg and/or diastolic blood pressure \>90 mmHg) or clinically significant (eg active) cardiovascular and cerebrovascular diseases, such as cerebrovascular accident within 1 month), myocardial infarction (within 6 months before signing the main informed consent), unstable angina, congestive heart failure with New York Heart Association (NYHA) class II or above, or severe arrhythmia that cannot be treated with drugs Control or have potential impact on study treatment; ECG results show clinically significant abnormality or average QTcF ≥ 450 ms in 3 consecutive times (at least 5 minutes between each time) (see Appendix 2 for the formula);
* Combined with other serious devices;
* Patients with systemic active infections that require treatment, including but not limited to active tuberculosis, known HIV-positive patients or clinically active hepatitis A, B, and C patients, including virus carriers;
* Patients with autoimmune diseases: those with a history of inflammatory bowel disease and a history of autoimmune diseases judged by the investigator to be unsuitable for this study, such as systemic lupus erythematosus, vasculitis, and infiltrative lung disease, should be excluded ( (except for vitiligo and psoriasis that do not require systemic immunosuppressive therapy);
* G-CSF or GM-CSF has been used within 2 weeks before leukapheresis, or within 4 weeks before cell reinfusion and planned to be used during the study period (If there is long-term use) systemic cortisone steroids, hydroxyurea, immunomodulatory drugs (eg: alpha or gamma interferon, GM-CSF, mTOR inhibitors, cyclosporine, thymosin, etc.);
* Organ isotypes History of transplantation, allogeneic stem cell transplantation and renal replacement therapy;
* Known uncontrolled diabetes, pulmonary fibrosis, interstitial lung disease, acute lung disease or liver failure;
* Known alcohol and/or drug abuser;
* Pregnant or lactating women;
* Suffering from any co-existing medical conditions or diseases that the investigators determined may affect the conduct of this trial.
* Subjects with no legal capacity/restricted capacity;
* Previously received treatment targeting NY-ESO-1, or received cellular immunotherapy within 12 months before cell reinfusion, investigator Patients deemed unsuitable for enrollment;
* Received immunotherapy (immune checkpoint blockade therapy: such as PD-1, PD-L1 antibody treatment, etc.) within 3 months before cell reinfusion;
* Patients judged by the investigator Difficulty completing all visits or procedures (including follow-up periods) required by the study protocol, or insufficient compliance to participate in this study; or patients deemed unsuitable for inclusion by the investigator.

Primary outcomes:
measure: Objective response rate
timeFrame: 270 days
Secondary outcomes:
measure: Disease control rate (DCR)
timeFrame: 270 days
measure: Progression-free survival (PFS)
timeFrame: 270 days
measure: Duration of response (DOR)
timeFrame: 270 days
measure: Time to tumor response (TTR)
timeFrame: 270 days
measure: Overall survival (OS)
timeFrame: 270 days
measure: Number of participants with other abnormal laboratory values and/or adverse events that are related to treatment
timeFrame: 270 days
measure: Maximum Plasma Concentration (Cmax)
timeFrame: 270 days
measure: Maximum time to peak (Tmax)
timeFrame: 270 days
measure: Activity of T lymphocyte subsets
timeFrame: 270 days
measure: Activity of peripheral blood antigen specific cytotoxic lymphocyte (CTL)
timeFrame: 270 days
measure: Activity of effector T cells
timeFrame: 270 days
measure: Life quality scale
timeFrame: 270 days
Other outcomes:
Locations:
city: Guangzhou
country: China
facility: Sun Yat-Sen Univerisity Cancer Center
state: Guangdong
city: Beijing
country: China
facility: Peking University Cancer Hospital & Institute
Study officials:
affiliation: Sun Yat-sen University
name: Xing Zhang, PhD, MD
role: PRINCIPAL_INVESTIGATOR
References: