Clinical trial

Clinical Study of Allogeneic Vγ9Vδ2 T Cells in the Treatment of Brain Malignant Glioma

Name
HX-A-2022006-1
Description
Primary brain malignant tumor has become the first lethal tumor in children and young adults, and the treatment is limited, and the prognosis of patients is poor. According to the classification of the World Health Organization, glioblastoma is divided into grade II, III and IV gliomas; The higher the degree of malignancy, the worse the clinical outcome. Among them, the most malignant, most lethal, and most common types of tumors include supratentorial glioblastoma, diffuse endopontine glioma (DIPG), medulloblastoma, and ependymoma. Its high malignancy is mainly manifested in three aspects: extremely rapid growth and obvious invasion; The operation is not easy to remove all; The tumor has a tendency of recurrence and disseminated implantation. It can occur with children and adults of all ages. At present, surgery combined with chemoradiotherapy is the main treatment, but the therapeutic effect is not good. Studies have shown that glioblastoma, as the most common primary brain malignant tumor in adults, after standard surgery, radiotherapy and chemotherapy, the median survival time is less than 15 months, and the overall five-year survival rate is only 5.4%. Even after receiving new and expensive Tumor-treating fields, the median survival time is less than 21 months. The median survival time of DIPG patients is generally less than 1 year, and the 5-year survival rate is less than 5%. The average 5-year survival rate of medulloblastoma and anaplastic ependymoma is 40%\~60%. Innovative treatments are urgently needed. Immunotherapy based on Vγ9Vδ2 T cells has become a promising research direction in recent years. Its unique phosphine antigen recognition does not depend on major histocompatibility complex (MHC), easy to allograft and other advantages. Making it one of the most promising cell therapies. Brain glioma has abnormal cholesterol metabolism and phosphine antigen accumulation, which is easily sensed by Vγ9Vδ2 T cells. Therefore, the clinical exploration of Vγ9Vδ2 T cells for glioma is of great significance to both the scientific and clinical communities.
Trial arms
Trial start
2024-04-30
Estimated PCD
2026-12-30
Trial end
2027-12-30
Status
Not yet recruiting
Phase
Early phase I
Treatment
Vγ9Vδ2 T cell
The trial consisted of two phases: dose climbing phase and extension phase. At least 15 patients with malignant brain glioma (WHO Grade IV) were enrolled in the climbing phase. According to the 3+3 design, the amount of cells suitable for implantable Ommaya capsules for cell transfusion was increased according to the dose of 1x107, 3x107, 1x108 and 3x108 per dose, so as to observe its tolerability and safety. In the expansion phase, 10 patients with malignant brain glioma (WHO Grade IV) were enrolled, and dose expansion therapy was performed according to the optimal dose obtained in the climbing phase to observe its tolerability and safety. One course of treatment every 4 weeks, a total of 3 courses. Vγ9Vδ2 T cells were injected into the ventricle or ventricle once a week for the first three weeks and observed at the fourth week. In some patients, radiotherapy or other chemotherapy drugs (such as temozolomide) may be combined at week 4.
Arms:
To evaluate the safety and feasibility of allogeneic Vγ9Vδ2 T cell therapy., To evaluate the therapeutic effect of allogeneic Vγ9Vδ2 T cells on brain malignant glioma, To investigate the expansion, infiltration and persistence of Vγ9Vδ2 T cells after reinfusion.
Size
25
Primary endpoint
Safety evaluation
up to 12 months
Eligibility criteria
Inclusion Criteria: * Patients with clinically diagnosed malignant brain glioma in an important structural area (WHO Grade IV); * Patients with poor postoperative effect or ineffective guidelines for conventional treatment * Age ≥4 years old, male or female; * KPS score ≥70; * Normal bone marrow reserve function and normal liver and kidney function (as evidenced by the following laboratory tests prior to initial Vγ9Vδ2 T cell therapy) : * Neutrophil absolute value ≥ 1,500/mm3; * hemoglobin 10g/dL; * Platelet count \> 100,000/mm3; * Glutamic pyruvic transaminase/Glutamic oxalacetic transaminase \< 2.5 x ULN; * Serum creatinine 1.5×ULN; * Total bilirubin levels \< 1.5 x ULN. * No obvious genetic diseases; * Normal cardiac function, cardiac ejection index \> 55%; * Suitable for implantation of Ommaya capsule in ventricle or cavity; * No bleeding and coagulation disorders; * Women of reproductive age (15-49 years) must undergo a negative pregnancy test within 7 days before starting treatment and use contraception during the clinical trial period and within 3 months after the last cell transfusion; * Sign the informed consent form. Exclusion Criteria: * Pregnant and lactating women; * Organ failure; * Heart: Grade III and grade IV; * Liver: Level C of the Child-Turcotte liver function scale; * Kidney: renal failure and uremia stage; * Lungs: Symptoms of severe respiratory failure; * Brain: A person with a disorder of consciousness. * Patients with a history of organ transplantation; * Uncontrollable infectious disease or other serious illness, including but not limited to infection (such as HIV positive), congestive heart failure, unstable angina pectoris, arrhythmia, psychosis, or restrictive social environment or what the attending physician considers to be an unpredictable risk; * Patients with systemic autoimmune disease or immunodeficiency; * Patients with allergic constitution; * Use of systemic steroid drugs; * Have a chronic disease that requires the use of immune agents or hormone therapy; * Prior treatment with any other immune cell; * Have participated in other clinical trials within the past 30 days; * The researchers believe that other reasons are not suitable for clinical trials
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['EARLY_PHASE1'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'QUADRUPLE', 'whoMasked': ['PARTICIPANT', 'CARE_PROVIDER', 'INVESTIGATOR', 'OUTCOMES_ASSESSOR']}}, 'enrollmentInfo': {'count': 25, 'type': 'ESTIMATED'}}
Updated at
2024-05-02

1 organization

1 product

3 indications

Indication
Glioblastoma
Indication
Medulloblastoma