A Phase 1/2a Multicenter Ascending Dose Study to Evaluate the Safety of HA-1 Minor Histocompatibility Antigen-Reactive TCR-Modified T Cells (BSB-1001) in Patients Undergoing HLA-Matched Allogenic Hematopoietic Stem Cell Transplant for AML, ALL or MDS
Summary
The goal of this clinical trial is to test BSB-1001 which is a new type of cellular therapy to treat blood cancers (AML, ALL and MDS). It will evaluate the safety of BSB-1001 and also determine whether it works to prevent relapse of your cancer.
Detailed description
This is a first-in-human, multicenter, open-label, dose-finding study for the evaluation of an HA-1 minor histocompatibility antigen (miHA)-reactive TCR-modified T cell product (BSB-1001) derived from an HLA-matched allogenic donor, in patients with AML, ALL or MDS undergoing an HLA-matched alloHSCT who are at a high risk for relapse post-HSCT. BSB-1001 targets the HLA-A\*02:01-restricted HA-1 miHA. Enrolled patients must be HLA-A\*02:01 and HA-1-positive (H/H or H/R), with an identified HLA-matched, HA-1-negative (R/R) donor. Patients will undergo one of the following myeloablative conditioning regimens, according to standard institutional procedures, which include either fludarabine+thiotepa+total body irradiation, or busulfan+ melphalan+ fludarabine. After conditioning is completed, patients will receive the CD34-selected alloHSCT followed by BSB-1001 on day 0, without any prophylactic immunosuppression. The study is an adaptive dose escalation design with 1 to 3 cohorts to evaluate single doses of BSB-1001. Three to six patients will be enrolled in each cohort and enrolled patients will be followed until completion of the study. If the maximum tolerated dose (MTD) is reached or if a dose is deemed promising, the Sponsor may determine to either cease enrollment or open an expansion cohort at the desired dose level. The optional expansion part of the study is planned to include approximately 20 additional AML patients at the recommended dose.
Arms & interventions
- DrugSOC + BSB-1001 Dose Escalation Cohort
Patients will receive BSB-1001 a single intravenous (IV) infusion on day 0 following the infusion of the CD34-allo hematopoietic stem cell transplant (HCT).
- DrugSOC+BSB-1001 Expansion Dose
Patients will receive BSB-1001 a single intravenous (IV) infusion on day 0 following the infusion of the CD34-allo hematopoietic cell transplant (HCT).
Outcome measures
Primary
Number of participants with treatment-emergent adverse events (TEAEs), including SAEs, GVHD and dose-limiting toxicities
Incidence of TEAEs (per Common Terminology Criteria for Adverse Events \[CTCAE\])
Time frame: 365 days
Cellular kinetics of BSB-1001 in peripheral blood
Quantitation of BSB-1001 (copies per μL of genomic DNA)
Time frame: 365 days
Secondary
Number of patients with relapse
Time frame: Through 365 days post HSCT
Incidence of Grades II-IV acute GVHD
Time frame: Through 100 days post HSCT
Incidence of Grades III-IV acute GVHD
Time frame: Through 100 days post HSCT
Time to neutrophil engraftment
Time frame: Through 365 days post HSCT
Time to platelet engraftment
Time frame: Through 365 days post HSCT
Incidence of moderate to severe chronic GVHD
Time frame: Through 365 days post HSCT
Overall survival
Time frame: Through 365 days
GVHD-free, relapse-free survival (GFRS)
Time frame: Through 365 days post HSCT
GVHD-free survival (GFS)
Time frame: Through 365 days post HSCT
Incidence of systemic infections
Time frame: Through 365 days post HSCT
Eligibility criteria
Study locations (6)
City of Hope National Medical Center
Duarte, California, 91010
Moffitt Cancer Center
Tampa, Florida, 33612
University of Michigan
Ann Arbor, Michigan, 48109
University of Minnesota
Minneapolis, Minnesota, 55455
Washington University at St Louis
St Louis, Missouri, 63110
The Ohio State University
Columbus, Ohio, 43210