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RecruitingInterventionalPhase 1

A Phase 1 Dose Escalation and Expansion Study of Orca-Q, an Engineered Donor Graft Derived From Mobilized Peripheral Blood, in Recipients Undergoing Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancies

NCT ID: NCT03802695Sponsor: Orca Biosystems, Inc.Last updated: 2026-06-02

Summary

This study will evaluate the safety, tolerability, and efficacy of engineered donor grafts ("OrcaGraft"/"Orca-Q") in participants undergoing allogeneic hematopoietic cell transplant (alloHCT) transplantation for hematologic malignancies.

Arms & interventions

  • BiologicalOrcaGraft (Orca-Q)

    engineered donor allograft

Outcome measures

Primary

  • Dose Limiting Toxicities through Day +28 (dose escalation)

    Safety and tolerability of Orca-Q (formerly OrcaGraft) in adults undergoing myeloablative allogeneic hematopoietic cell transplantation (MA-alloHCT) will be evaluated by identification of the following dose limiting toxicities: Grade ≥ 3 infusion-related reaction or cytokine release syndrome, Grade ≥ 3 acute GVHD, Any Grade ≥ 3 treatment-related non-hematologic event not clearly related to the underlying malignancy, intercurrent infection, the HCT conditioning regimen, or other pre-existing medical condition

    Time frame: 28 Days after administration of Orca-Q/OrcaGraft

  • Primary Graft failure through Day +28 (dose expansion)

    Primary graft failure in the dose expansion phase, defined as being alive without recovery of neutrophils during the evaluation period

    Time frame: 28 Days after administration of Orca-Q/OrcaGraft

Secondary

  • Neutrophil Engraftment through Day +28

    Time frame: 28 days after administration of Orca-Q/OrcaGraft

  • Platelet Engraftment through Day +50

    Time frame: 50 days after administration of Orca-Q/OrcaGraft

  • Secondary Graft Failure through Day +100

    Time frame: 100 days after administration of Orca-Q/OrcaGraft

  • Acute GVHD through Day +100

    Time frame: 100 days after administration of Orca-Q/OrcaGraft

  • Chronic GVHD through Day +365

    Time frame: 365 days after administration of Orca-Q/OrcaGraft

  • Incidence of Non-relapse Mortality (NRM) through Day +365

    Time frame: 365 days after administration of Orca-Q/OrcaGraft

  • Incidence of Disease Relapse through Day +365

    Time frame: 365 days after administration of Orca-Q/OrcaGraft

  • GVHD-free and Relapse-free Survival (GRFS) through Day +365

    Time frame: 365 days after administration of Orca-Q/OrcaGraft

  • Disease-free Survival (DFS) through Day +365

    Time frame: 365 days after administration of Orca-Q/OrcaGraft

  • Overall Survival through Day +365

    Time frame: 365 days after administration of Orca-Q/OrcaGraft

Eligibility criteria

Sex: AllAge: 12 Years to 78 YearsHealthy volunteers: No
Key Inclusion Criteria: 1. Age at the time of enrollment: 1. For MAC with fully matched donor (Arm A with 8/8 donor and Arm C) and NMA/RIC: Age ≥ 12 and ≤ 78 years 2. For MAC with mismatched donors (Arm A with 7/8 donor and Arm B): Age ≥ 12 and ≤ 65 years 2. Diagnosed acute myeloid, lymphoblastic or mixed phenotype leukemia, or high or very high risk myelodysplastic syndrome (MDS) either in complete remission (CR) or with ≤ 10 percent of blast cells in bone marrow (BM) 3. Indicated for allogeneic hematopoietic stem cell transplant (alloHCT) 4. Matched to a 8/8 or 7/8 related or unrelated donor, or to a related haploidentical donor 5. Estimated glomerular filtration rate (eGFR) \> 50 mL/minute (MAC with tacrolimus) or \> 30 mL/minute (NMA/RIC or MAC without tacrolimus) 6. Cardiac parameters: Cardiac ejection fraction ≥ 45 percent (MAC) or ≥ 40 percent (NMA/RIC) 7. Diffusing capacity of the lung for carbon monoxide (DLCO) (adjusted for hemoglobin) ≥ 50 percent for MAC or ≥ 40 percent for NMA/RIC 8. Liver function: Total bilirubin \< 1.5 times upper limit of normal (ULN) (MAC) or \< 3 times ULN (NMA/RIC); alanine transaminase (ALT)/aspartate transaminase (AST) \< 3 times ULN (MAC) or \< 5 times ULN (NMA/RIC) 9. Participants enrolling on NMA/RIC-alloHCT arms must be deemed unfit for a myeloablative alloHCT per assessment of the principal investigator (PI) Key Exclusion Criteria: 1. Prior alloHCT 2. Currently receiving corticosteroids or other immunosuppressive therapy except for approved disease-specific therapy for the patient's underlying hematologic malignancy. Topical corticosteroids or oral systemic corticosteroid doses less than or equal to 10 mg/day are allowed 3. Planned donor lymphocyte infusion (DLI) 4. Planned pharmaceutical in vivo or ex vivo T cell depletion, e.g., post-transplant cyclophosphamide (Cy) or alemtuzumab 5. Positive anti-donor HLA antibodies against a mismatched allele in the selected donor 6. Low performance score: For MAC: Karnofsky Performance Score (KPS) \< 70 percent, For NMA/RIC: \<60 percent 7. High HCT-specific Comorbidity Index (HCT-CI): For MAC \> 4, For NMA/RIC \>6 8. Uncontrolled bacterial, viral or fungal infections (currently taking antimicrobial therapy and with progression or no clinical improvement) at time of enrollment 9. Seropositive for human immunodeficiency virus (HIV)-1 or -2, human T-lymphotropic virus (HTLV)-1 or -2 or Hepatitis B surface antigen (HbsAg) or anti-Hepatitis C virus (HCV) antibody (Ab) 10. Any uncontrolled autoimmune disease requiring active immunosuppressive treatment 11. Concurrent malignancies or active disease within 1 year, except non-melanoma skin cancers that have been curatively resected. Patients with concurrent indolent hematologic malignancies that do not require active treatment and are under active surveillance only (such as CLL, low-grade lymphomas, smoldering MM, MZL) may be included with the approval of Medical Monitor 12. History of idiopathic or secondary myelofibrosis 13. Women who are pregnant or breastfeeding

Study locations (11)

City of Hope

Duarte, California, 91010

Recruiting
Amandeep Salhotra, MD · Contact

UC Davis

Sacramento, California, 95817

Recruiting
Mehrdad Abedi, MD · Contact

Stanford Health Care

Stanford, California, 94305

Recruiting
Robert Lowsky, MD · Contact

Moffitt Cancer Center

Tampa, Florida, 33612

Recruiting
Rawan Faramand, MD · Contact

Emory University

Atlanta, Georgia, 30322

Active Not Recruiting

The University of Kansas Hospital

Kansas City, Kansas, 66160

Withdrawn

Memorial Sloan Kettering Cancer Center

New York, New York, 10065

Recruiting
Roni Tamari, MD · Contact

Ohio State University

Columbus, Ohio, 43210

Active Not Recruiting

University of Texas MD Anderson Cancer Center

Houston, Texas, 77054

Recruiting
Samer Srour, MD · Contact

Fred Hutchinson Cancer Center

Seattle, Washington, 98109

Recruiting
Boglarka Gyurkocza, MD · Contact

Froedtert Memorial Lutheran Hospital

Milwaukee, Wisconsin, 53226

Withdrawn