Allogeneic Gamma-delta T Cells Combined With Targeted Therapy and Immunotherapy in a Phase 1 Clinical Trial of Hepatocellular Carcinoma Resistant to PD-1 Monoclonal Antibody

NCT ID: NCT06364800

Last Updated: 2024-04-15

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: EARLY_PHASE1
• Total Enrollment: 18 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-04-26
• Study Completion Date: 2026-09-26

Brief Summary

The purpose of this study is to evaluate the safety and efficacy of allogeneic γδ T cells combined with targeted therapy and PD-1 monoclonal antibody in patients with hepatocellular carcinoma resistant to PD-1 monoclonal antibody.

Hepatocellular Carcinoma

Detailed Description

This is a double-arm, single-center, randomized, open label phase I clinical trial to evaluate the efficacy and safety of the combination of ex-vivo expanded allogeneic γδ T cells plus targeted therapy and PD-1 monoclonal antibody in patients with BCLC stage B or C hepatocellular carcinoma (HCC). A typical 3+3 dose-escalation design will be used to determine the optimal dose level of γδ T cells based on the incidence of dose-limiting toxicity (DLT). The initial infusion dose level will start from 1×10^8/kg to 4×10^8/kg in every 3 weeks.

Conditions

Hepatocellular Carcinoma

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

γδ T cells+ PD-1 monoclonal antibody+ targeted drugs

Patients will receive 4 cycles of ex-vivo expanded allogeneic γδ T cells treatments, at three-weeks' intervals. Ex-vivo expanded γδ T cells are transfused to patients in a typical 3+3 dose-escalation design (Dose escalation, 1×10\^8/kg, 2×10\^8/kg,4×10\^8/kg).

Group Type: EXPERIMENTAL

γδ T cells

Intervention Type: BIOLOGICAL

Cells will be extracted from a healthy donor by apheresis, followed by ex-vivo expansion and activation. The ex-vivo expanded γδ T cells from donors will be adoptively transfused.

PD-1 monoclonal antibody

Intervention Type: DRUG

Humanized programmed death receptor (PD-1) monoclonal antibody that binds to PD- and prevents binding of PD-1 with programed death ligands 1 (PD-L1) and PD-L2. It can function to activate cytotoxic T lymphocytes and inhibit tumor growth.

targeted drugs

Intervention Type: DRUG

Multi-target kinase inhibitors can act on VEGFR-1,VEGFR-2,VEGFR-3,FGFR1,PDGFR,cKit,Ret and other targets.

PD-1 monoclonal antibody+ targeted drugs

PD-1 monoclonal antibody+ targeted drugs

Group Type: ACTIVE_COMPARATOR

PD-1 monoclonal antibody

Intervention Type: DRUG

Humanized programmed death receptor (PD-1) monoclonal antibody that binds to PD- and prevents binding of PD-1 with programed death ligands 1 (PD-L1) and PD-L2. It can function to activate cytotoxic T lymphocytes and inhibit tumor growth.

targeted drugs

Intervention Type: DRUG

Multi-target kinase inhibitors can act on VEGFR-1,VEGFR-2,VEGFR-3,FGFR1,PDGFR,cKit,Ret and other targets.

Interventions

γδ T cells

Cells will be extracted from a healthy donor by apheresis, followed by ex-vivo expansion and activation. The ex-vivo expanded γδ T cells from donors will be adoptively transfused.

Intervention Type: BIOLOGICAL

PD-1 monoclonal antibody

Humanized programmed death receptor (PD-1) monoclonal antibody that binds to PD- and prevents binding of PD-1 with programed death ligands 1 (PD-L1) and PD-L2. It can function to activate cytotoxic T lymphocytes and inhibit tumor growth.

Intervention Type: DRUG

targeted drugs

Multi-target kinase inhibitors can act on VEGFR-1,VEGFR-2,VEGFR-3,FGFR1,PDGFR,cKit,Ret and other targets.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

1. Patients should sign informed consent form voluntarily before the trail and comply with the requirements of this study.

2. Age 18 years up to the age of 75 (≤75), gender unlimited.

3. Hepatocellular Carcinoma diagnosed according to the 2018 edition of the EASL guidelines.

4. BCLC stage B or C.

5. Liver function: Child-Pugh class A/B (5-9).

6. Eastern Cooperative Oncology Group (ECOG) Performance score≤1.

7. Treated with standard treatment options (anti-PD-1, targeted drugs) ≥3months and experiencing progressive disease according to RECIST 1.1.

8. Life expectancy ≥ 6 months.

9. Patients combined with HBV infection require antiviral treatment with nucleoside analogues; patients combined with HCV infection require direct-acting antiviral agent (DAA) treatment.

10. Adequate organ and marrow function (within 4 weeks prior to study treatment initiation).

11. Male and female patients of reproductive potential must agree to use birth control during the study and for at least 30 days post study.

12. Capable of understanding and complying with the study protocol requirements ( including follow-up visit and examinations).

Be willing to signed a written informed consent document before enrollment.

Exclusion Criteria

1. Patients combined with HAV, HEV, HIV or other infectious diseases.

2. Acute infections, gastrointestinal bleeding, etc. occurred within 30 days before screening.

3. Women who are pregnant (urine/blood pregnancy test positive) or lactating; patients with severe autoimmune diseases; patients with uncontrolled infectious diseases.

4. Major organs dysfunction.

5. Combined with other severe organic diseases or mental illnesses, including any uncontrolled clinically significant systematic diseases such as urinary, circulatory, respiratory, neurological, psychiatric, digestive, endocrine and immune diseases.

6. Allergic constitution, history of allergies to blood products, known to be allergic to test substances.

7. Immunosuppressive or systemic cytotoxic drugs may require within 6 months prior to screening or during the study; 6 months prior to screening accepted other cell therapies including NK, CIK, DC, CTL and stem cell therapy etc.

8. Patients currently participating in other clinical trials who may violate this treatment plan and observations.

9. Those who are unable or unwilling to provide informed consent or who are unable to comply with the research requirements.

10. Any situation that investigators believe the risk of the subjects is increased or results of the trial are disturbed: patients with any serious acute or chronic physical or mental illness, or laboratory abnormalities.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Chinese Academy of Medical Sciences

OTHER

Sponsor Role: collaborator

Beijing GD Initiative Cell Therapy Technology Co., Ltd.

INDUSTRY

Sponsor Role: collaborator

Beijing 302 Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Central Contacts

Fan-Ping Meng, Ph.D

Role: CONTACT

drmengfanping@126.com

66933126-6019

Other Identifiers

GDT-001-07-02

Identifier Type: -

Identifier Source: org_study_id