ACTIVE_NOT_RECRUITING

Kappa-CD28 T Lymphocytes, Chronic Lymphocytic Leukemia, B-cell Lymphoma or Multiple Myeloma, CHARKALL

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Patients have a type of cancer called NHL, Multiple Myeloma (MM) or CLL that has come back or has not gone away after treatment. There is no standard treatment for the cancer at this time or the currently used treatments do not work completely in all cases like these. This is a gene transfer research study using special immune cells. The body has different ways of fighting infection and disease. No single way seems perfect for fighting cancers. This research study combines two different ways of fighting disease, antibodies and T cells, that investigators hope will work together. Antibodies are types of proteins that protect the body from bacterial and other diseases. T cells, also called T lymphocytes, are special infection-fighting blood cells that can kill other cells, including tumor cells. Both antibodies and T cells have been used to treat patients with cancers; they have shown promise, but have not been strong enough to cure most patients. The antibody used in this study recognizes a protein on the lymphoma, MM or CLL cells called kappa immunoglobulin. Antibodies can stick to lymphoma, MM or CLL cells when it recognizes the kappa molecules present on the tumor cells. For this study, the kappa antibody has been changed so that instead of floating free in the blood it is now joined to the T cells. When an antibody is joined to a T cell in this way it is called a chimeric receptor. These chimeric receptor-T cells seem to kill some of the tumor, but they don't last very long and so their chances of fighting the cancer are limited. In the laboratory, investigators found that T cells work better if they also add a protein that stimulates T cells to grow called CD28. By joining the anti-kappa antibody to the T cells and adding the CD28, the investigators expect to be able to make cells that will last for a longer time in the body (because of the presence of the CD28). They are hoping this will make the cells work better. Previously, when patients enrolled on this study, they were assigned to one of three different doses of the kappa-CD28 T cells. We found that all three dose levels are safe. Now, the plan is to give patients the highest dose that we tested. These chimeric T cells (kappa-CD28) are an investigational product not approved by the FDA.

Official Title

Phase I Study of Adoptive Transfer of Autologous T Lymphocytes Engrafted With a Chimeric Antigen Receptor Targeting the Kappa Light Chain of Immunoglobulin Expressed in Patients With CLL, B-Cell Lymphoma or Multiple Myeloma

Quick Facts

Study Start:2009-07
Study Completion:2035-07
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:ACTIVE_NOT_RECRUITING

Study ID

NCT00881920

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * B-CLL or recurrent or refractory B-cell lymphoma (or other B-cell neoplasm) or multiple myeloma monoclonal for Kappa-light chain
  2. * Life expectancy of at least 12 weeks or greater.
  3. * No history of other cancer (except non-melanoma skin cancer or in situ breast cancer or cervix cancer) unless the tumor was successfully treated with curative intent at least 2 years before trial entry
  4. * If requires pheresis to collect blood, Cre and AST less than 1.5 upper limit of normal
  5. * If requires pheresis to collect blood, PT and PTTK less than 1.5 upper limit normal
  6. 1. B-CLL monoclonal for Kappa light chain with one of the following criteria:
  7. 1. Evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia and/or thrombocytopenia
  8. 2. Massive (ie, at least 6 cm below the left costal margin) or progressive or symptomatic splenomegaly
  9. 3. Massive nodes (ie, at least 10 cm in longest diameter) or progressive or symptomatic lymphadenopathy
  10. 4. Progressive lymphocytosis with an increase of more than 50% over a 2-month period or lymphocyte doubling time (LDT) of less than 6 months.
  11. 5. Constitutional symptoms, defined as any one or more of the following disease-related symptoms or signs:
  12. 1. Unintentional weight loss of 10% or more within the previous 6 months;
  13. 2. Significant fatigue (ie, ECOG PS 2 or worse; inability to work or perform usual activities);
  14. 3. Fevers higher than 100.5°F or 38.0°C for 2 or more weeks without other evidence of infection; or
  15. 4. Night sweats for more than 1 month without evidence of infection.
  16. 5. Patients who have resistant disease after primary treatment
  17. 6. Patients who have a short time to progression after the first treatment (less than 2 years)
  18. 2. Indolent or aggressive B-cell lymphoma (or other B-cell neoplasm) monoclonal for Kappa-light chain with measurable disease after receiving at least one chemotherapy regimen that includes Rituximab or an equivalent monoclonal antibody
  19. 3. Multiple myeloma monoclonal for Kappa-light chain with measurable disease after receiving at least one chemotherapy regimen
  20. * Life expectancy of at least 12 weeks or greater.
  21. * Recovered from the toxic effects of all prior chemotherapy before entering this study. PD1/PDL1 inhibitors will be allowed if medically indicated
  22. * ANC \> 500, Hgb greater than or equal to 7.0.
  23. * Bilirubin less than 3 times the upper limit of normal.
  24. * AST less than 5 times the upper limit of normal.
  25. * Estimated GFR \> 50mL/min
  26. * Pulse oximetry of \> 90% on room air
  27. * Karnofsky score of \> 60%.
  28. * Negative serology for HIV.
  29. * Available autologous transduced peripheral blood T-cells with 15% or more expression of CAR-Kappa determined by flow-cytometry.
  30. * Patients must sign an informed consent indicating that they are aware this is a research study and have been told of its possible benefits and toxic side effects. Patients will be given a copy of the consent form.
  31. * Sexually active patients must be willing to utilize one of the more effective birth control methods during the study and for 3 months after the study is concluded. The male partner should use a condom.
  32. * If patient has CLL, must have negative Coombs test.
  1. * Active infection requiring antibiotics
  2. * Active autoimmune disease
  3. * Symptomatic cardiac disease.
  4. * History of hypersensitivity reactions to murine protein-containing products. Currently receiving any investigational agents within the previous six weeks or received any tumor vaccines within the previous 6 weeks.
  5. * Tumor in a location where enlargement could cause airway obstruction.
  6. * Pregnant or lactating.

Contacts and Locations

Principal Investigator

Carlos Ramos, MD
PRINCIPAL_INVESTIGATOR
Baylor College of Medicine - Texas Children's Hospital

Study Locations (Sites)

Houston Methodist Hospital
Houston, Texas, 77030
United States
Texas Children's Hospital
Houston, Texas, 77030
United States

Collaborators and Investigators

Sponsor: Baylor College of Medicine

  • Carlos Ramos, MD, PRINCIPAL_INVESTIGATOR, Baylor College of Medicine - Texas Children's Hospital

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2009-07
Study Completion Date2035-07

Study Record Updates

Study Start Date2009-07
Study Completion Date2035-07

Terms related to this study

Keywords Provided by Researchers

  • Lymphocytic
  • Leukemia
  • B Cell
  • Non-Hodgkin
  • Multiple Myeloma
  • Lymphoma

Additional Relevant MeSH Terms

  • Lymphoma
  • Myeloma
  • Leukemia