A Phase I Study of Allogeneic Ex Vivo Expanded Gamma Delta (γδ) T Cells in Combination With Dinutuximab, Temozolomide, Irinotecan, and Zoledronate in Children With Refractory/ Relapsed, or Progressive Neuroblastoma or Refractory/ Relapsed Osteosarcoma

Status: Recruiting
Location: See location...
Intervention Type: Combination product
Study Type: Interventional
Study Phase: Phase 1
SUMMARY

The goal of this clinical trial is to determine the maximum tolerated dose (MTD) and recommended Phase II dose (RP2D) of allogeneic expanded γδ T cells when delivered with Dinutuximab, temozolomide, irinotecan, and zoledronate in children with refractory or recurrent neuroblastoma or refractory/ relapsed osteosarcoma as well as to define the toxicities of allogeneic expanded γδ T cells when delivered with Dinutuximab, temozolomide, irinotecan, and zoledronate

Eligibility
Participation Requirements
Sex: All
Minimum Age: 1
Healthy Volunteers: f
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• Patients must be ≥ 12 months of age at the time of enrollment in the study.

• Diagnosis: Histological confirmation of neuroblastoma or ganglioneuroblastoma at initial diagnosis. (Bone marrow samples with positive catecholamines are acceptable as confirmation of neuroblastoma) OR histological confirmation of osteosarcoma at diagnosis

• Response to prior therapy:

‣ High-risk neuroblastoma with refractory, relapsed or progressive disease, defined as:

⁃ First or greater relapse of neuroblastoma following completion of aggressive multi- drug frontline therapy.

⁃ First episode of progressive neuroblastoma during aggressive multi-drug frontline therapy.

⁃ Persistent/refractory neuroblastoma as defined by less than a complete response by the revised International Neuroblastoma Response Criteria (INRC) after at least 4 cycles of aggressive multidrug induction chemotherapy on or according to a high-risk neuroblastoma protocol (such as A3973 or ANBL0532).

⁃ Note that this excludes patients initially considered low or intermediate-risk neuroblastoma that progressed to high-risk disease but the patient has not progressed after the diagnosis of high-risk neuroblastoma.

⁃ Relapsed or refractory osteosarcoma that is not responsive to standard treatment

• Disease Status

‣ Patients must have measurable or evaluable disease per revised INRC for subjects with neuroblastoma or measurable or evaluable disease by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 for subjects with Osteosarcoma

⁃ Performance Level:Patients must have a Lansky (≤16 years) or Karnofsky (\>16 years) score of ≥50

• Prior Therapy

‣ Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy before study registration.

• Prior dinutuximab therapy is allowed regardless of prior response or progression on dinutuximab

∙ Prior temozolomide therapy is allowed

∙ Prior zoledronate is allowed

∙ Prior dinutuximab/temozolomide/irinotecan chemoimmunotherapy is allowed

∙ Prior T cell therapy is excluded

• Organ Function Requirements:

‣ Hematologic Functions : Absolute Neutrofil count ≥750/uL and platelet count ≥ 75,000/µl, transfusion independent .

⁃ Renal Function: Patients must have adequate renal function defined as age-adjusted serum creatinine ≤1.5 ULN for age.

⁃ Liver Function: Total bilirubin ≤ 1.5 x ULN for age and serum glutamic-pyruvic transaminase (SGPT) (ALT) ≤ 135 U/L (≤ 3x ULN).

⁃ Cardiac Function: Normal ejection fraction (≥ 55%) documented by either echocardiogram or radionuclide multigated acquisition scan (MUGA) evaluation OR Normal fractional shortening (≥ 27%) documented by echocardiogram

⁃ Pulmonary Function: Normal pulmonary function with no evidence of dyspnea at rest, no exercise intolerance.

Locations
United States
Georgia
Children's Healthcare of Atlanta
RECRUITING
Atlanta
Contact Information
Primary
Kelly Goldsmith, MD
kgoldsm@emory.edu; mpactcto@choa.org
(404) 727-2655
Time Frame
Start Date: 2023-11-06
Estimated Completion Date: 2025-12
Participants
Target number of participants: 24
Treatments
Experimental: Dose Escalation Phase I cohort
Subjects will be assigned a cell therapy dose level at time of registration. The entry dose level is Dose Level 1, with escalation up to Dose Level 3 following a 3 + 3 dose escalation design.~If there is no evidence of progression, patients may receive up to a maximum of 4 courses. Each course includes two administrations of γδ T cells, administered one week apart. Toxicity, for deciding dose escalation and defining the MTD, will be evaluated during Course 1. Disease response assessment will be done after Courses 2 and 4. Dinutuximab (17.5 mg/m2), temozolomide (100 mg/m2), irinotecan (50 mg/m2) and zoledronate (0.0125 mg/kg/dose) will be consistent across all dose levels.The same donor for γδ T cell will be used for both cell therapy product infusions per course. Treatment of the first two subjects in each dose escalation cohort will be staggered. The second subject will not be enrolled until the first subject completes the DLT observation interval (minimum of 21 days).
Sponsors
Leads: Emory University

This content was sourced from clinicaltrials.gov

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