Clinical trial • Phase II • Oncology

Autologous T cells expressing CD8A and a T-cell receptor targeting MAGE-A4 for Recurrent ovarian cancer (MAGE-A4 positive) | Primary peritoneal carcinoma (MAGE-A4 positive) | Fallopian tube carcinoma (MAGE-A4 positive)

Phase II trial of Autologous T cells expressing CD8A and a T-cell receptor targeting MAGE-A4 for Recurrent ovarian cancer (MAGE-A4 positive) | Primary per…

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Recurrent ovarian cancer (MAGE-A4 positive) | Primary peritoneal carcinoma (MAGE-A4 positive) | Fallopian tube carcinoma (MAGE-A4 positive)
Trial Stage
Phase II
Drug Modality
Cell therapy | Monoclonal antibody

Key dates

Initial CTIS Submission Date
07-06-2024
First CTIS Authorization Date
03-07-2024

Trial design

Randomised, open-label, adp-a2m4cd8 monotherapy; adp-a2m4cd8 in combination with nivolumab (opdivo 10 mg/ml concentrate for solution for infusion). dose and schedule details not specified in the provided ctis data.-controlled Phase II trial in France, Spain.

Randomised
Yes
Open Label
Yes
Comparator
ADP-A2M4CD8 monotherapy; ADP-A2M4CD8 in combination with nivolumab (OPDIVO 10 mg/mL concentrate for solution for infusion). Dose and schedule details not specified in the provided CTIS data.
Biomarker Stratified
True - HLA-A*02 allele status (HLA-A*02:01, HLA-A*02:02, HLA-A*02:03, HLA-A*02:06 and other adjudicated A*02 alleles) and MAGE-A4 expression (≥30% tumor cells, ≥2+ by IHC).
Target Sample Size
38

Eligibility

Recruits 38 Vulnerable population flag is selected. Consent is required from the subject or a legally authorized representative: "Subject (or legally authorized representative) has voluntarily agreed to participate by giving written informed consent..." Pre-screening informed consent (ICF) is used. The trial enrols adults only (≥18 and ≤75) so no paediatric assent. Long-term follow-up (LTFU) is required and participants agree to protocol-required assessments and management for study duration..

Pregnancy Exclusion
Subjects of childbearing potential must have a negative urine or serum pregnancy test AND must agree to use a highly effective method of contraception starting at the firstdose of chemotherapy and continue for at least 12 months or for 4 months after the gene-modified cells are no longer detected in the blood, or 6 months after the last dose of nivolumab, whichever is longer. Subjects of childbearing potential must also agree to refrain from egg donation, storage, or banking during these same time periods.
Vulnerable Population
Vulnerable population flag is selected. Consent is required from the subject or a legally authorized representative: "Subject (or legally authorized representative) has voluntarily agreed to participate by giving written informed consent..." Pre-screening informed consent (ICF) is used. The trial enrols adults only (≥18 and ≤75) so no paediatric assent. Long-term follow-up (LTFU) is required and participants agree to protocol-required assessments and management for study duration.

Inclusion criteria

  • {"criterion_text":"- Subject (or legally authorized representative) has voluntarily agreed to participate by giving written informed consent in accordance with International Council for Harmonisation (ICH) Good Clinical Practice (GCP) guidelines and applicable local regulations.\n- Subject has left ventricular ejection fraction (LVEF) of ≥ 50% or the institutional lower limit of normal range, whichever is lower.\n- Subject is fit for leukapheresis, and adequate venous access can be established for the cell collection.\n- Subjects of childbearing potential must have a negative urine or serum pregnancy test AND must agree to use a highly effective method of contraception starting at the firstdose of chemotherapy and continue for at least 12 months or for 4 months after the gene-modified cells are no longer detected in the blood, or 6 months after the last dose of nivolumab, whichever is longer. Subjects of childbearing potential must also agree to refrain from egg donation, storage, or banking during these same time periods.\n- Subject (or legally authorized representative) has agreed to abide by all protocol-required procedures including study-related assessments and management by the treating institution for the duration of the study, including LTFU.\n- Subject is ≥ 18 and ≤ 75 years of age at the time the Pre-Screening informed consent form (ICF) is signed.\n- Subject has histologically confirmed diagnosis of high-grade serous or high-grade endometrioid recurrent ovarian carcinoma, including primary peritoneal and fallopian tube carcinoma.\n- Subject has measurable disease according to RECIST v1.1 prior to lymphodepletion. Measurable disease is not required prior to leukapheresis.\n- Subject has the following disease-specific prior therapy requirements: a. The initial therapy must have included at least 3 cycles of a prior platinum and taxane based chemotherapy regimen for primary disease, possibly including intraperitoneal therapy, consolidation, or extended therapy (maintenance/consolidation). b. Subjects may receive up to 4 prior regimens of combination or single agent systemic treatment for their disease, which may include investigational therapies unless discussed and agreed upon with the Sponsor or designee. Note: Neo-adjuvant/adjuvant treatment is considered as one line of treatment. Bridging therapy is permitted and is not considered as a line of treatment. c. Subjects who have received only 1 line of platinum based therapy must have progressed between 93 and 183 days of completing platinum based therapy as a part of front line treatment of ovarian cancer. Subjects who have progressed within 92 days of completing platinum based therapy in front line treatment are excluded. d. Subjects who have received 2 or more lines of platinum based therapy must have progressed during or within 183 days of completing the latest platinum based therapy for treatment of recurrent ovarian cancer. The number of days (platinum free interval) should be calculated from the date of the last administered dose of platinum therapy to the date of documentation of progression. e. Subjects with a known BRCA mutation (germ line or somatic) must have received a poly adenosine diphosphate-ribose polymerase inhibitor (PARPi). f. Subjects must have received bevacizumab.\n- Positive for HLA-A*02:01, HLA-A*02:02, HLA-A*02:03, or HLA- A*02:06 allele as determined by Adaptimmune-designated central laboratory testing. HLA-A*02 alleles having the same protein sequence in the peptide binding domains (P group) will also be included. Other HLA-A*02 alleles may be eligible after adjudication with the Sponsor.\n- MAGE-A4 expression, defined as ≥ 30% of tumor cells that are ≥ 2+ by IHC, should be documented at the pre-screening period based on either an archival specimen or a fresh biopsy. All samples must have been pathologically reviewed by an Adaptimmune designated central laboratory confirming expression.\n- Subject has an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1"}

Exclusion criteria

  • {"criterion_text":"- Positive for HLA-A*02:05 in either allele as determined by Adaptimmune-designated central laboratory. HLA-A*02 alleles having the same protein sequence as HLA-A*02:05 in the peptide binding domains (P groups) will also be excluded. Other alleles may be exclusionary after adjudication with the Sponsor.\n- Subject has received or plans to receive the following therapy/treatment prior to leukapheresis or lymphodepleting chemotherapy, unless stopped according to the washout requirements: Note: The washout periods are provided as a guideline in the table below. For Spain only, minor modifications to washout periods, if assessed as not clinically significant by the site study Investigator or designee, may be acceptable after discussing with the Sponsor Study Physician. (for full details please refer to section 5.3 of the study protocol (Exclusion Criteria 2. )\n- Toxicity from previous anti-cancer therapy that has not recovered to Grade ≤ 1 or baseline prior to enrollment (except for nonclinically significant toxicities, e.g., alopecia and vitiligo). Subjects with Grade 2 toxicities that are deemed stable or irreversible (e.g., peripheral neuropathy) can be enrolled.\n- Subject has a history of allergic reactions attributed to compounds of similar chemical or biologic composition to fludarabine, cyclophosphamide, or other agents used in the study.\n- Subject has an active autoimmune or immune-mediated disease that has not yet resolved. Subjects with immune-mediated AEs secondary to treatment with immunotherapy that resolve to Grade ≤ 1 off steroids are permitted. Subjects with hypothyroidism, type I diabetes, adrenal insufficiency, or pituitary insufficiency that are stable on replacement therapy are eligible. Subjects with disorders such as asthma, vitiligo, psoriasis, or atopic dermatitis that are well controlled without requiring systemic immunosuppression are also eligible. Other stable immune conditions that do not require prednisone > 20 mg/day (or its equivalent for other corticosteroid agents) may be acceptable with the agreement of the Sponsor.\n- Subject had major surgery within 4 weeks prior to lymphodepletion; subjects should have been fully recovere from any surgical-related toxicities. Surgical-related toxicities which are not clinically significant per Investigator assessment may be acceptable after discussion and agreement with Study Physician.\n- Leptomeningeal disease, carcinomatous meningitis, or symptomatic central nervous system (CNS) metastases. Subjects with prior history of symptomatic CNS metastases must have received treatment (i.e., SRS, WBRT, or surgery) and be neurologically stable for at least 1 month, not requiring anti-seizure medications, and off of steroids for at least 14 days prior to leukapheresis and lymphodepletion. Subjects who have asymptomatic CNS metastases without associated edema, shift, or requirement for steroids or antiseizure medications are eligible. If such a subject receives SRS or WBRT, a minimum period of 2 weeks needs to lapse between the therapy and lymphodepletion. Prophylactic anti- seizure medication is allowed.\n- Subject has any other prior malignancy that is not considered by the Investigator to be in complete remission. Resectable squamous or basal cell carcinoma of the skin is acceptable. Prior malignancies that have been surgically resected and show no evidence of disease are acceptable.\n- Clinically significant cardiovascular disease including, but not limited to, any of the following: a. Electrocardiogram (ECG) showing clinically significant abnormality at Screening b. Uncontrolled clinically significant arrhythmias c. Known family history or congenital history of prolonged QT syndrome or history of torsades de pointes d. Uncontrolled hypertension despite optimal medical therapy e. Acute coronary syndrome (angina or myocardial infarction) in the last 6 months f. Clinically significant cardiac disease defined by congestive heart failure New York Heart Association Class 3 and 4 g. History of stroke, CNS bleeding, transient ischemic attack, or reversible ischemic neurological deficit within the last 6 months."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The primary endpoint for efficacy is OR defined as complete response(CR) or partial response (PR) according to RECIST v1.1 by IRAC, from T-cell infusion until documented disease progression. Both CR and PR must be confirmed by repeat assessments performed no less than 4 weeks after the criteria of response are first met.","definition_or_measurement_approach":"Objective response (OR) defined as complete response (CR) or partial response (PR) assessed per RECIST v1.1 by an Independent Radiology Assessment Committee (IRAC); measured from T-cell infusion until documented disease progression; CR/PR must be confirmed by repeat assessments ≥4 weeks after first meeting response criteria."}

Secondary endpoints

  • {"endpoint_text":"- AEs, including SAEs","definition_or_measurement_approach":"Adverse events captured including serious adverse events (standard safety reporting; details not further specified in provided data)."}
  • {"endpoint_text":"- Incidence, severity, and duration of the adverse events of special interest (AESIs)","definition_or_measurement_approach":"AESIs incidence, severity and duration to be recorded; specific AESIs and measurement methods not detailed in provided data."}
  • {"endpoint_text":"- Replication competent lentivirus (RCL)","definition_or_measurement_approach":"Monitoring/testing for presence of replication competent lentivirus; specific assay details not provided in the source JSON."}
  • {"endpoint_text":"- T-cell clonality and insertional oncogenesis (IO)","definition_or_measurement_approach":"Assessment of T-cell clonality and insertional oncogenesis; specific assays/methods not detailed in provided data."}

Recruitment

Planned Sample Size
38
Recruitment Window Months
204
Consent Approach
Written informed consent required from the subject or legally authorized representative per ICH GCP and local regulations; Pre-Screening informed consent form (ICF) used. Participants are adults (≥18) so no assent process described. Languages of consent documents not specified in provided data.

Geography

Total Number Of Sites
13
Total Number Of Participants
38

France

Earliest CTIS Part Ii Submission Date
30-05-2024
Latest Decision Or Authorization Date
03-07-2024
Processing Time Days
34
Number Of Sites
5
Number Of Participants
6

Sites

Site Name
Institut Regional Du Cancer De Montpellier
Department Name
Val d'Aurelle
Contact Person Name
Michel Fabbro
Contact Person Email
Michel.Fabbro@icm.unicancer.fr
Site Name
Centre Leon Berard
Department Name
Service d'Oncologie Médicale
Contact Person Name
Isabelle Ray-Coquard
Site Name
Hospices Civils De Lyon
Department Name
Service d'Oncologie Médicale – 1F
Contact Person Name
Benoit You
Contact Person Email
benoit.you@chu-lyon.fr
Site Name
Institut Gustave Roussy
Department Name
Département de médecine
Contact Person Name
Alexandra Leary
Site Name
Institut De Cancerologie Strasbourg Europe
Department Name
Service d'Oncologie Médicale
Contact Person Name
Lauriane Eberst
Contact Person Email
l.eberst@icans.eu

Spain

Earliest CTIS Part Ii Submission Date
30-05-2024
Latest Decision Or Authorization Date
03-07-2024
Processing Time Days
34
Number Of Sites
8
Number Of Participants
22

Sites

Site Name
Hospital Universitari Vall D Hebron
Department Name
Oncology
Contact Person Name
Ana Oaknin Benzaquen
Contact Person Email
aoaknin@vhio.net
Site Name
Hospital Clinico Universitario De Valencia
Department Name
Oncology
Contact Person Name
Andrés Cervantes Ruiperez
Contact Person Email
andres.cervantes@uv.es
Site Name
Clinica Universidad De Navarra (Madrid)
Department Name
Medical Oncology
Contact Person Name
Antonio González-Martín
Contact Person Email
agonzalezma@unav.es
Site Name
Hospital Universitario Hm Sanchinarro
Department Name
Oncology
Contact Person Name
Arantzazu Barquín García
Contact Person Email
abarquin@hmhospitales.com
Site Name
Hospital Universitario 12 De Octubre
Department Name
Oncology
Contact Person Name
Ainhoa Madariaga
Site Name
Hospital Universitario Ramon Y Cajal
Department Name
Medical Oncology
Contact Person Name
Alfonso Cortés Salgado
Site Name
Clinica Universidad De Navarra (Pamplona)
Department Name
Medical Oncology
Contact Person Name
Antonio González-Martín
Contact Person Email
agonzalezma@unav.es
Site Name
Hospital Universitario Fundacion Jimenez Diaz
Department Name
Oncology
Contact Person Name
Victor Moreno García
Contact Person Email
victor.moreno@startmadrid.com

Sponsor

Primary sponsor

Full Name
USWM Ct LLC
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
Icon Clinical Research Limited
Responsibilities
Sponsor duties codes: 12; 15 (other safety reporting tasks (e.g. DSUR submission)); 6

Third parties

  • {"country":"Ireland","full_name":"Icon Clinical Research Limited","duties_or_roles":"Sponsor duties codes: 12; 15 (other safety reporting tasks (e.g. DSUR submission)); 6","organisation_type":"Pharmaceutical company"}
  • {"country":"Belgium","full_name":"CellCarta","duties_or_roles":"Pre-Screening: assays (CD3, MHCI, PL-L1, MAGE-A4 ); histology evaluation; RNA extraction; code 4","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"American National Red Cross","duties_or_roles":"Pre-screening: HLA typing for Spain","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"United States","full_name":"Medidata Solutions Inc.","duties_or_roles":"Sponsor duties code 7","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"Nmible Limited","duties_or_roles":"Reimbursement Spain","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Precision For Medicine Inc.","duties_or_roles":"Long term storage biorepository for the study","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Bioclinica Inc.","duties_or_roles":"Sponsor duties code 3","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Bioagilytix Labs LLC","duties_or_roles":"HBS processing, storage and shipping; persistence, RCL and cytokine testing; RNA extraction","organisation_type":"Pharmaceutical company"}
  • {"country":"Germany","full_name":"LabConnect GmbH","duties_or_roles":"Persistence, RCL, Cell Phenotyping, Bone Marrow analysis, short term sample storage, PBMC processing","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"France","full_name":"Fm Richard Et Associes","duties_or_roles":"Reimbursement France","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"Netherlands","full_name":"LabConnect Europe B.V.","duties_or_roles":"Long term sample storage","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"Germany","full_name":"BioClinica GmbH","duties_or_roles":"Medical Imaging - image repository","organisation_type":"Pharmaceutical company"}
  • {"country":"Germany","full_name":"IMGM Laboratories GmbH","duties_or_roles":"Pre-screening: HLA typing for France","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United Kingdom","full_name":"Primevigilance Limited","duties_or_roles":"Sponsor duties code 8","organisation_type":"Pharmaceutical company"}
  • {"country":"Belgium","full_name":"Catalent Gosselies","duties_or_roles":"Leukapheresis processing","organisation_type":"Pharmaceutical company"}
  • {"country":"Denmark","full_name":"Klifo A/S","duties_or_roles":"Clinical supplies EU - Nivolumab supply; code 14","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
ADP-A2M4CD8
Active Substance
Autologous T cells expressing CD8A and a T-cell receptor targeting MAGE-A4
Modality
Cell therapy
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
Investigational / Not authorised (product status code 1 in source)
Maximum Dose
10 billion organisms
Investigational Product Name
OPDIVO 10 mg/mL concentrate for solution for infusion (nivolumab)
Active Substance
Nivolumab
Modality
Monoclonal antibody
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
Authorised (marketing authorisation EU/1/15/1014/003)
Maximum Dose
480 mg
Combination Treatment
Yes

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