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A Phase I/II Study of Polyclonally Activated, Intentionally Mis-Matched, Allogeneic Th1 Memory Cells (AlloStimTM) in Patients With Relapsed or Refractory Hematological Malignancy Without Prior Conditioning


Phase 1/Phase 2
18 Years
N/A
Not Enrolling
Both
Advanced or Refractory Leukemia, Lymphoma, Multiple Myeloma

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Trial Information

A Phase I/II Study of Polyclonally Activated, Intentionally Mis-Matched, Allogeneic Th1 Memory Cells (AlloStimTM) in Patients With Relapsed or Refractory Hematological Malignancy Without Prior Conditioning


AlloStim is being tested to determine if it might elicit the same anti-tumor mechanism that
occurs in allogeneic bone marrow/stem cell transplant (BMT) procedures, without the toxicity
associated with graft vs. host disease (GVHD). In allogeneic BMT settings, patients are
first conditioned to weaken the immune system in order to enable the engraftment of
allogeneic donor cells. Patients require a matched-tissue donor in this setting in order to
enable engraftment and also to minimize GVHD toxicity. While allogeneic BMT is a potentially
curatve therapy, the treatment-related mortality, mostly related to GVHD toxicity, is high.
This toxicity limits the clinical utility of this procedure. AlloStim is being tested to
determine if it might be a less toxic alternative to allogeneic BMT.

In this protocol, patients are not conditioned with chemotherapy prior to treatment.
Therefore, the allogeneic cells in AlloStim are expected to be rejected by the patient's
immune system within 24-48 hours of infusion.


Inclusion Criteria:



- Histologically confirmed hematological malignancy of 1 of the following types:

- Acute Myeloid Leukemia (AML) meeting the following criteria:

- Relapsed or primary refractory disease with ≤ 10% blasts in the peripheral
blood and ≤ 20% blasts in the bone marrow.

- Acute Lymphoblastic Leukemia (ALL) meeting the following criteria:

- Relapsed or primarily refractory disease with ≤ 10% blasts in the
peripheral blood and ≤ 20% blasts in the bone marrow

- Chronic Myeloid Leukemia (CML)* with an inadequate response to imatinib meeting
1 of the following criteria:

- Second or subsequent chronic phase

- Accelerated phase [*Patients with CML in blast crisis (> 30% promyelocytes
and myeloblasts in the bone marrow) are not eligible]

- Non-Hodgkin's Lymphoma (NHL) including Mantle Cell Lymphoma (MCL) meeting 1 of
the following criteria:

- Primary refractory disease or in refractory relapse

- Relapsed disease after autologous stem cell transplantation

- Chemosensitive relapsed disease without CR to standard salvage therapy AND
no option for autologous stem cell transplantation due to blood or marrow
involvement or failure to harvest sufficient autologous stem cells.

- Chronic Lymphocytic Leukemia (CLL) meeting both of the following criteria:

- Stage III or IV disease

- Refractory to fludarabine, Rituxan® and Campath® or refuses

- Multiple Myeloma (MM) meeting 1 of the following criteria:

- Primary refractory disease or in refractory relapse

- Relapsed disease after autologous stem cell transplantation

- Hodgkin's Disease

- Relapsed after prior autologous transplant or after 2 or more combination
chemotherapy regimens and ineligible for autologous stem cell transplant.

- EBV driven lymphoproliferative disorders in immunocompetent patients progressing
despite standard therapies, including:

- T-cell Non-Hodgkin's Lymphoma

- Burkitt's Lymphoma

- EBV+ Hodgkin's Disease

- Ability to comprehend the investigational nature of the study and
provide informed consent.

- Measurable or evaluable disease

- Eastern Cooperative Oncology Group (ECOG) performance status of <2.

- Age 18 years or older

- Expected survival 6 months or longer

- No radiation or chemotherapy in previous 2 weeks

- No immunotherapy in the previous 4 weeks

- Absence of active infection within 2 weeks

- Adequate hepatic function, with total bilirubin level less than 1.2
times the upper limit of normal (ULN) and aspartate and alanine
aminotransferase levels less than 2.5 times the ULN prior to infusion

- Adequate bone marrow function defined as a white blood cell count of
at least 2 x 109/L (2000/µL), absolute neutrophil count of at least 1
x 109/L (1000/µL), hemoglobin level of at least 80 g/L (8.0 g/dL), and
a platelet count of at least 50 x 109/L (50,000/µL) priot to infusion.
Patients who are transfusion- or growth factor-dependent are allowed,
provided these values could be achieved with transfusion.

- Adequate cardiovascular function defined as no ischemia, no new
conduction system abnormalities, no class 3 or 4 New York Heart
Association congestive heart failure, and no myocardial infarction in
the previous 6 months. A ≥45% left ventricular ejection fraction
(LVEF) required in the previous 6 months.

- Adequate kidney function defined as serum creatinine level 1.5 mg/dL
or less, or an estimated creatinine clearance level of at least 60
mL/min prior to infusion.

- Adequate lung function defined as pulse oxymetry greater than or equal
to 92% on room air prior to infusion, DLco≥50%, FEV1 and FVC ≥50%
within 2 weeks

- No known allergy to murine products or HAMA testing results within
normal limits

- No known allergy to bovine products

Exclusion Criteria:

- No pregnancy or breast feeding

- No known human immunodeficiency virus (HIV+)

- No seropositivity or active viral hepatitis (HBV+, HCV+)

- No prior allogeneic transplant (cell or organ)

- No serious concomitant medical or psychiatric conditions that could interfere with
treatment.

- No EBV-induced lymphomas associated with immunosuppression, including patients with
iatrogenic immunodeficiencies (such as organ transplant) or HIV-related
immunodefiency.

- No chronic myelogenous leukemia in blast crisis.

- No myelodysplastic syndromes with refractory anemia

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

To evaluate the safety of administration of an intravenous AlloStim-9 infusion and to define any drug-related toxicity and reversibility of such toxicity

Outcome Time Frame:

7 days

Safety Issue:

Yes

Principal Investigator

Dr. Michael Har-Noy

Investigator Role:

Study Director

Investigator Affiliation:

Immunovative Therapies, Ltd.

Authority:

United States: Food and Drug Administration

Study ID:

ITL-001-HM

NCT ID:

NCT00861965

Start Date:

January 2010

Completion Date:

December 2012

Related Keywords:

  • Advanced or Refractory Leukemia, Lymphoma, Multiple Myeloma
  • Leukemia
  • Lymphoma
  • Multiple Myeloma
  • Leukemia
  • Lymphoma
  • Multiple Myeloma
  • Neoplasms, Plasma Cell

Name

Location

Immunovative Clinical Research, Inc Carlsbad, California  92010