A Phase I/II Clinical Trial of Off-the-shelf NK Cell Administration in Combination With Allogeneic SCT to Decrease Disease Relapse in Patients With High-risk Myeloid Malignancies Undergoing Matched Related, Matched Unrelated, One Antigen Mismatched Unrelated, or Haploidentical Stem-cell Transplantation

Who is this study for? Patients with high-risk myeloid malignancies
Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1/Phase 2
SUMMARY

The goal of this clinical research study is to learn about the safety and effectiveness of giving KDS-1001 in combination with a standard stem cell transplant to patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), or chronic myeloid leukemia (CML). KDS-1001 is a study product created using certain immune cells called natural killer (NK) cells collected from a third-party donor.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 70
Healthy Volunteers: No
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⁃ Patients ages 18 to 70 years old at the time of enrollment.

⁃ Patients weighing at least 42 kg

⁃ Patient with the hematologic malignancies described below, as well as an HLA matched related donor, HLA matched unrelated donor, a haploidentical related donor, or a one antigen mismatched unrelated donor. HLA matching includes HLA A, B, C, and DR-B1.

⁃ Patients must have one of the following diseases:

⁃ Acute myeloid leukemia (AML):

⁃ a. With one or more high-risk features defined as: (i) Greater than 1 cycle of induction therapy required to achieve remission; (ii) Preceding myelodysplastic syndrome (MDS);

⁃ Presence of FLT3 mutations or internal tandem duplication or other mutations designated as adverse-risk by the ELN Leukemia Net AML Classification (see Appendix 2):

⁃ Adverse:

⁃ t(6;9)(p23;q34.1); DEK-NUP214

⁃ t(v;11q23.3); KMT2A rearranged

⁃ t(9;22)(q34.1;q11.2); BCR-ABL1

⁃ inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2,MECOM(EVI1)

• 5 or del(5q); -7; -17/abn(17p)

⁃ Complex karyotype, monosomal karyotype

⁃ Wild-type NPM1 and FLT3-ITDhigh

⁃ Mutated RUNX1

⁃ Mutated ASXL1

⁃ Mutated TP53 (iv) FAB M6 or M7 classification; (v) Adverse cytogenetics: -5, del 5q, -7, del7q, abnormalities involving 3q, 9q, 11q, 20q, 21q, 17, +8 or complex karyotype [> 3 abnormalities]; or other mutations designated as adverse-risk by the ELN criteria; (vi) Treatment-related AML (vii) Primary induction failure with partial response to therapy who achieve adequate cytoreduction (viii) Aplastic/hypoplastic marrow with or without detectable persistent disease after induction chemotherapy or after salvage chemotherapy.

⁃ (ix) Have minimal residual disease by flow cytometry, FISH, detection of disease related mutations or cytogenetic abnormality after first course of induction chemotherapy (x) Have relapsed after prior allogeneic hematopoietic transplant

⁃ AND

⁃ b. Patients must be in one of the following (i) CR: complete remission, (ii) CRi: CR with incomplete hematologic recovery, or (iii) MLFS: morphological leukemia-free state with less than 5% bone marrow blasts.

⁃ (iv) If not in either of the above i-iii, then may be in either of the following:

⁃ Primary induction failure with partial response to therapy who achieve adequate cytoreduction

⁃ Aplastic/hypoplastic marrow with or without detectable persistent disease after induction chemotherapy or after salvage chemotherapy

⁃ Myelodysplastic syndromes (MDS):

⁃ a. De novo MDS with intermediate or high-risk IPSS scores, chronic myelomonocytic leukemia (CMML) or treatment-related MDS. Patients with intermediate-1 features should have failed to respond to hypomethylating agent therapy. .

⁃ Patients must have less than 10% bone marrow blasts

⁃ Chronic myeloid leukemia (CML):

⁃ Failed to achieve cytogenetic remission or have cytogenetic relapse after treatment with at least 2 tyrosine kinase inhibitors, or

⁃ Accelerated phase or blast phase at any time, or

⁃ Intolerant of available TKIs

⁃ Performance score of at least 70% by Karnofsky or 0 to 1 by ECOG.

⁃ Adequate major non-hematopoietic organ system function as demonstrated by:

⁃ Serum creatinine clearance equal or more than 50 ml/min (calculated with Cockcroft-Gault formula).

⁃ Bilirubin equal or less than 1.5 mg/dL except for Gilbert's disease. ALT or AST equal or less than 200 U/L for adults. Conjugated (direct) bilirubin less than 2x upper limit of normal.

⁃ Left ventricular ejection fraction equal or greater than 45%.

⁃ Diffusing capacity for carbon monoxide (DLCO) equal or greater than 60% predicted corrected for hemoglobin.

⁃ Ability to understand and willingness to sign the written informed consent document.

⁃ Sexually active males and females of childbearing potential must agree to use a form of contraception considered effective and medically acceptable by the Investigator while on study.

Locations
United States
Texas
M D Anderson Caner Center
Recruiting
Houston
Contact Information
Primary
Jeremy Ramdial, MD
jlramdial@mdanderson.org
(713) 745-0146
Time Frame
Start Date: April 8, 2022
Estimated Completion Date: June 1, 2024
Participants
Target number of participants: 24
Treatments
Experimental: Cyclophosphamide
On Days 3 and 4, you will receive cyclophosphamide by vein over about 3 hours to help lower the risk of graft-versus-host disease
Experimental: Mesna
On Days 3 and 4, You will also receive mesna by vein over 30 minutes every 4 hours for a total of 10 mesna doses.
Experimental: Filgrastim
Starting on Day 7, you will begin to receive filgrastim as an injection under the skin 1 time a day.
Experimental: Melphalan
On Day -7, you will receive melphalan by vein over about 30 minutes.
Experimental: Fludarabine phosphate
On Days -7, -6, -5, and -4, you will receive fludarabine by vein about 1 hour.
Experimental: Tacrolimus
Starting on Day 5, you will begin receiving tacrolimus to help lower the risk of GVHD. You will begin by receiving it nonstop by vein until you are able to take it by mouth. You will then take tacrolimus by mouth 2 times a day for about 3 months.
Experimental: Mycophenolate mofetil
by mouth 3 times a day for 90 days or longer.
Experimental: Total Body Irradiation One Dose
on Day -2, you may receive 1 dose of total body irradiation (TBI).
Sponsors
Leads: M.D. Anderson Cancer Center

This content was sourced from clinicaltrials.gov

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