Clinical trial NCT03139370: Safety and Efficacy of MAGE-A3/A6 T Cell Receptor Engineered T Cells (KITE-718) in HLA-DPB1*04:01 Positive Adults With Advanced Cancers
Official title: A Phase 1 Study Evaluating the Safety and Efficacy of MAGE-A3/A6 T Cell Receptor Engineered T Cells (KITE-718) in HLA-DPB1*04:01 Positive Subjects With Advanced Cancers
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE1
Conditions: Solid Tumor
Lead sponsor: Gilead Sciences
Sponsor class: INDUSTRY
First posted: 2017-05-03
Enrollment: 16
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The primary objectives of Phase 1A are to evaluate the safety of KITE-718, determine a recommended Phase 1B dose, and to evaluate the efficacy of KITE-718 in Phase 1B.

Detailed description: Participants found to be human leukocyte antigen (HLA)-DPB1\*04:01 positive and whose tumors are MAGE-A3 and/or MAGE-A6 positive can participate if all eligibility criteria are met. Other tests required to determine eligibility include a physical exam, electrocardiogram (ECG) and echocardiogram (ECHO) of the heart, CT or MRI scans, and blood draws. Eligible participants have white blood cells collected by leukapheresis. These cells are genetically modified to make the experimental treatment KITE-718. The desired outcome is that the genetically modified T cells will target tumor cells that express MAGE-A3 and/or MAGE-A6, which are proteins that can be expressed by cancer cells. Participants receive chemotherapy prior to the KITE-718 infusion. After the KITE-718 infusion, participants will be followed for side effects and have scans performed to see any potential impact on their cancers. Study procedures may be performed while hospitalized and/or in the outpatient setting. Subjects who received an infusion of KITE-718 will complete the remainder of the 15 year follow-up assessments in a separate long-term follow-up study, KT-US-982-5968

Eligibility criteria: Key Inclusion Criteria:

* Age ≥ 18 years
* Advanced cancer defined as relapsed or refractory disease after a systemic standard of care treatment regimen and, if available, at least one standard of care salvage regimen unless the subject refuses such therapy. Multiple myeloma (MM) subjects must have had both a protease inhibitor (PI) and immunomodulatory drugs (IMiD) as part of the last regimen, or at least 3 prior lines of therapy, including a PI and an IMiD. Additionally, subjects must not have disease amenable to definitive locoregional therapy.
* MAGE-A3/A6 positive tumor as confirmed by the central laboratory
* HLA-DPB1\*04:01 positive
* At least 1 measurable lesion on CT or MRI
* No evidence of central nervous system (CNS) disease by MRI or CT of the brain. Note: Prior brain metastasis which have been treated with definitive therapy are eligible provided that the definitive therapy was completed more than six months prior to screening.
* Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
* Toxicities due to prior therapy must be recovered to baseline or ≤ grade 1, except for clinically non-significant toxicities such as alopecia
* Adequate bone marrow function as evidenced by:

  * Absolute neutrophil count (ANC) ≥ 1000/mm\^3
  * Platelet ≥ 100/mm\^3
  * Hemoglobin \> 8 g/dL
* Adequate renal, hepatic, cardiac, and pulmonary function as evidenced by:

  * Creatinine clearance (as estimated by Cockcroft Gault) ≥ 60 cc/min (24-hour urine creatinine clearance is also acceptable)
  * Alanine transaminase (ALT)/aspartate aminotransferase (AST) ≤ 2.5 x upper limit normal (ULN) or ≤ 5 x ULN if documented liver metastases
  * Total bilirubin ≤ 1.5 mg/dL
  * Cardiac ejection fraction ≥ 50%, no evidence of pericardial effusion as determined by an ECHO, and no clinically significant ECG findings (For ejection fraction only, MUGA scan is also acceptable)
  * No clinically significant pleural effusion
  * Baseline oxygen saturation \> 92% on room air

Key Exclusion Criteria:

* Malignancy other than non-melanoma skin cancer, carcinoma in situ, or low grade prostate cancer for which watch-and-wait approach is standard of care, unless disease free for at least 3 years
* Clinically significant cardiac disease within last 12 months
* Stroke or transient ischemic attack (TIA) within 12 last months
* Symptomatic deep vein thrombosis or pulmonary embolism within last 6 months, catheter associated thrombosis is not included as exclusion criteria.
* Prior T-cell therapy, including KITE-718 or MAGE-A3/A6-targeting therapy.
* Live vaccine ≤ 4 weeks prior to enrollment
* Systemic corticosteroid therapy within 7 days before enrollment.
* History of severe, immediate hypersensitivity reaction attributed to aminoglycosides
* Presence of fungal, bacterial, viral, or other infection requiring IV antimicrobials for management.
* Presence of any indwelling line or drain. Note: Dedicated central venous access catheters such as a Port-a-Cath or Hickman catheter as well as feeding tubes such as a G-tube, are permitted.
* Primary immunodeficiency
* Autoimmune disease resulting in end-organ injury or requiring systemic immunosuppression/systemic disease modifying agents within the last 2 years prior to enrollment.
* Known history of infection with HIV, hepatitis B (HBsAg positive), or hepatitis C (anti-HCV positive). A history of treated hepatitis B or hepatitis C is permitted if the viral load is undetectable per quantitative polymerase chain reaction (PCR) and/or nucleic acid testing.
* Females who are pregnant as confirmed by a positive serum or urine pregnancy test or are breastfeeding.
* Individuals of both genders of child-bearing potential who are not willing to practice birth control from the time of consent through 6 months after the completion of KITE-718

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Primary outcomes:
measure: Phase 1A - Percentage of Participants Experiencing Adverse Events Defined as Dose-Limiting Toxicities
timeFrame: Up to 21 days
measure: Phase 1B - Efficacy: Objective Response Rate (ORR)
timeFrame: Up to year 2 for solid tumor participants and up to Year 5 for multiple myeloma participants
Secondary outcomes:
measure: Duration of Response (DOR)
timeFrame: Up to year 2 for solid tumor participants and up to year 5 for multiple myeloma participants
measure: Progression-Free Survival (PFS)
timeFrame: Up to year 2 for solid tumor participants and up to year 5 for multiple myeloma participants
measure: Overall Survival
timeFrame: Up to 15 years
measure: Percentage of Participants Experiencing Adverse Events
timeFrame: Up to 15 years
measure: Percentage of Participants with Anti-KITE-718 Antibodies
timeFrame: Up to 2 years
measure: Percentage of Participants Experiencing Replication-competent Retrovirus (RCR)
timeFrame: Up to 2 years
measure: Levels of MAGE-A3/A6 TCR-transduced T Cells in Blood
timeFrame: Up to 2 years
Other outcomes:
Locations:
city: Gilbert
country: United States
facility: Banner MD Anderson Cancer Center
state: Arizona
city: Los Angeles
country: United States
facility: USC/Norris Comprehensive Cancer Center
state: California
city: Los Angeles
country: United States
facility: UCLA Hematology/Oncology
state: California
city: Sacramento
country: United States
facility: University of California Davis Comprehensive Cancer Center
state: California
city: Tampa
country: United States
facility: H. Lee Moffitt Cancer and Research Institute
state: Florida
city: Chicago
country: United States
facility: University of Chicago
state: Illinois
city: Boston
country: United States
facility: Massachusetts General Hospital
state: Massachusetts
city: New York
country: United States
facility: Icahn School of Medicine at Mount Sinai
state: New York
city: New York
country: United States
facility: Memorial Sloan Kettering Cancer Center
state: New York
city: Dallas
country: United States
facility: Baylor Scott & White Charles A. Sammons Cancer Center
state: Texas
city: Houston
country: United States
facility: The University of Texas MD Anderson Cancer Center
state: Texas
city: Salt Lake City
country: United States
facility: University of Utah, Huntsman Cancer Institute
state: Utah
Study officials:
affiliation: Kite, A Gilead Company
name: Kite Study Director
role: STUDY_DIRECTOR
References: