cMet RNA CAR T Cells in Treating Patients with Stage III-IV Melanoma or Locally Advanced or Metastatic Breast Cancer
This trial studies the side effects of cMet CAR-mRNA electroporated autologous T Lymphocytes (cMet RNA CAR T Cells) in treating patients with stage III-IV melanoma or breast cancer that has spread to other places in the body. cMet RNA CAR T cells may use patients own blood cells (T cells) to attach tumor cells that contain c Met.
Inclusion Criteria
- Unresectable histologically confirmed stage III/IV melanoma; or metastatic or locally advanced, unresectable breast carcinoma which is ER and PR =< 10% and HER2 neu nonamplified by immunohistochemistry (IHC) and/or fluorescence in situ hybridization (FISH).
- cMET expression in >= 30% tumor cells as demonstrated on immunohistochemistry analysis at the University of Pennsylvania. MET IHC may be performed on tissue from screening biopsy, or archival slides of a metastatic deposit or primary tumor. Punch biopsy or percutaneous core biopsy will be offered to obtain tissue as required for this purpose.
- Patients must have measurable disease as defined by RECIST 1.1 criteria; must have magnetic resonance imaging (MRI) or computed tomography (CT) scan of chest, abdomen, pelvis within 1 month of enrollment that demonstrates measurable disease by RECIST 1.1 criteria in a tumor other than the one being potentially biopsied and resected for correlative studies.
- Failure of at least one prior standard of care therapy for advanced stage disease.
- Eastern Cooperative Oncology Group (ECOG) clinical performance status 0 or 1.
- White blood count (WBC) >= 3.0.
- Absolute neutrophil count (ANC) >= 1500.
- Platelets (Plt) >= 75,000 (no transfusion permitted within 2 weeks to achieve this goal).
- Hemoglobin (Hgb) >= 9 g/dl (transfusions are permitted to achieve this goal.
- Serum creatinine =< 1.5 times upper limit of normal.
- Total bilirubin =< 2 times upper limit of normal.
- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 2 times upper limit of normal.
- Cardiac ejection fraction of >= 40% as measured by resting echocardiogram.
- Women of childbearing potential must have a negative serum or urine pregnancy test and agree to use appropriate contraception from enrollment through the duration of the trial. Men must agree to use appropriate contraception from enrollment through the duration of the trial.
- Patients must provide written informed consent.
Exclusion Criteria
- Known metastatic tumor encasing a great vessel or at risk for imminently causing spinal cord compression.
- Known human immunodeficiency virus (HIV)-1/HIV-2 infection.
- Known active infection with hepatitis B virus or hepatitis C virus.
- Pregnant women or lactating women.
- History of alcohol abuse or illicit drug use within 12 months of enrollment.
- Clinically significant comorbid disease or other underlying condition, including significant active infection, in the opinion of the principal investigator (PI) or sub-investigators, would contraindicate study therapy or interfere with interpretation of study results.
- Significant psychiatric disorder and/or any other reason in the investigator’s opinion that would jeopardize protocol compliance or compromise the patient’s ability to give informed consent.
- Patients with known allergy or hypersensitivity to study product excipients (human serum albumin, dimethyl sulfoxide [DMSO], and Dextran 40).
- Patients with clinically apparent arrhythmia, or arrhythmias that are not stable on medical management within 2 weeks of the screening/enrollment visit.
- Having received prior genetically manipulated T-cells in prior clinical trial.
- History of autoimmune disease (including but not limited to: systemic lupus erythematosis, Sjogren syndrome, rheumatoid arthritis, psoriasis multiple sclerosis, inflammatory bowel disease etc).
- History of immune related severe adverse event (defined as grade 3 or higher toxicities) with previous immunotherapy.
- Chronic use of therapeutic anti-coagulants such as coumadin, heparin, or lovenox.
- Symptomatic or untreated central nervous system (CNS) metastases. Patients (Pts) with previously treated CNS metastases are eligible if lesions are radiographically/clinically stable without requirement of steroids.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT03060356.
PRIMARY OBJECTIVES:
I. To determine the feasibility and safety of treating cMET positive melanoma and breast carcinoma patients with intravenously administered cMet chimeric antigen receptor (CAR)-messenger ribonucleic acid (mRNA) electroporated autologous T Lymphocytes (RNA CAR redirected T cells against cMET).
SECONDARY OBJECTIVES:
I. Estimate the activity of RNA CART-cMET in subjects who receive at least 1 dose of cells by objective response rate using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria and pathological evaluation of resected or biopsied tissue, as feasible. (Clinical)
II. Overall survival (OS) and progression-free survival (PFS) until 4 months post RNA CART-cMET infusion. (Clinical)
III. Duration of response (DOR) for responding subjects until 4 months post RNA CART-cMET infusion. (Clinical)
IV. Determine persistence and trafficking of RNA CART-cMET. (Correlative)
V. Evaluate the immune and biologic activity of RNA CART-cMET in patient blood and tissue samples as feasible. (Correlative)
VI. Evaluate development of general anti-tumor responses through epitope spreading. (Correlative)
VII. Evaluate the development of host anti-CAR immune responses. (Correlative)
OUTLINE:
Patients receive cMet RNA CAR T cells intravenously (IV) on day 0 (Monday or Wednesday), 2, 4, 7, 9, and 11.
After completion of study treatment, patients are followed up every 30 days for up to 4 months.
Trial PhasePhase I
Trial Typetreatment
Lead OrganizationUniversity of Pennsylvania/Abramson Cancer Center
Principal InvestigatorTara C. Mitchell
- Primary IDUPCC 11916
- Secondary IDsNCI-2018-02004
- ClinicalTrials.gov IDNCT03060356