Study of B7-H3, EGFR806, HER2, And IL13-Zetakine (Quad) CAR T Cell Locoregional Immunotherapy For Pediatric Diffuse Intrinsic Pontine Glioma, Diffuse Midline Glioma, And Recurrent Or Refractory Central Nervous System Tumors

Study Purpose

This is a Phase 1 study of central nervous system (CNS) locoregional adoptive therapy with SC-CAR4BRAIN, an autologous CD4+ and CD8+ T cells lentivirally transduced to express to express combinations of B7-H3, EGFR806, HER2, and IL13-zetakine chimeric antigen receptors (CAR). CAR T cells are delivered via an indwelling catheter into the ventricular system in children and young adults with diffuse intrinsic pontine glioma (DIPG), diffuse midline glioma (DMG), and recurrent or refractory CNS tumors. A child or young adult meeting all eligibility criteria, including having a CNS catheter placed into their ventricular system, and meeting none of the exclusion criteria will have their T cells collected. The T cells will then be bioengineered into a second-generation CAR T cell that target B7H3, EGFR806, HER2, and IL13-zetakine on tumor cells. Patients will be assigned to 1 of 2 treatment Arms based on the type of their tumor:

  • - Arm A is for patients with DIPG (meaning primary disease localized to the pons, metastatic disease is allowed) anytime after standard radiation OR after progression.
  • - Arm B is for patients with non-pontine DMG (meaning DMG in other parts of the brain such as the thalamus or spine) anytime after standard radiation OR after progression.
This Arm also includes other recurrent/refractory CNS tumors.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 1 Year - 26 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

1. Subjects must be age ≥ 1 and ≤ 26 years (except for the first 3 subjects, who must be age ≥ 12 and ≤ 26 years). 2. Subject disease classified as one of the following: 1. DIPG at any timepoint following completion of standard radiotherapy. 2. DMG at any timepoint following completion of standard radiotherapy. 3. Evidence of refractory or recurrent CNS disease for which there is no routine therapy, defined by either of the following: i. New site or sites of measurable or evaluable disease by radiographic imaging or histologic confirmation following completion of routine care first-line therapy for which curative salvage therapy is not available or amenable, OR ii. Measurable or evaluable disease that persists following completion of routine care first-line therapy for which curative salvage therapy is not available or amenable. 3. Able to tolerate apheresis or already has an apheresis product available for use in manufacturing. 4. CNS reservoir catheter, such as an Ommaya or Rickham catheter, present in the proper location for CNS-directed therapy delivered as specified for BrainChild-04. 5. Life expectancy ≥ 8 weeks. 6. Lansky or Karnofsky score ≥ 60. 7. If patient does not have previously obtained apheresis product, patient must have discontinued, and recovered from acute toxic effects of, all prior chemotherapy, immunotherapy, and radiotherapy and discontinue the following prior to enrollment:
  • - ≥ 7 days post last chemotherapy/biologic therapy administration.
  • - 3 half lives or 30 days, whichever is shorter post last dose of anti-tumor antibody therapy.
  • - Must be at least 30 days from most recent cellular infusion.
  • - All systemically administered corticosteroid treatment therapy must be stable or decreasing within 1 week prior to enrollment with maximum dexamethasone dose of 2.5 mg/m2/day.
Corticosteroid physiologic replacement therapy is allowed. 8. Adequate organ function. 9. Adequate laboratory values. 10. Subjects of childbearing/fathering potential must agree to use highly effective contraception from the time of enrollment through 12 months following the last T cell infusion.

Exclusion Criteria:

1. Presence of ≥ Grade 3 cardiac dysfunction or symptomatic arrhythmia requiring intervention. 2. Presence of primary immunodeficiency/bone marrow failure syndrome. 3. Presence of clinical and/or radiographic evidence of impending herniation in the CNS. 4. For Arm A subjects only: Presence of > Grade 3 dysphagia. 5. Presence of active malignancy other than the CNS tumor under study. 6. Presence of active severe infection, defined as either of the following: 1. Positive blood culture within 48 hours of enrollment, OR. 2. Fever > 38.2ºC AND clinical signs of infection within 48 hours of enrollment. 7. Pregnant or breastfeeding. 8. Subject and/or authorized legal representative unwilling to provide consent/assent for study participation, including participation in the 15-year follow-up period, which is required if CAR T cell therapy is administered. 9. Presence of any condition that, in the opinion of the investigator, would prohibit the subject from undergoing treatment under this protocol

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT05768880
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 1
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Seattle Children's Hospital
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Rebecca Ronsley, MDRebecca Ronsley, MD
Principal Investigator Affiliation Seattle Children's HospitalSeattle Children's Hospital
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other
Overall Status Recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Diffuse Intrinsic Pontine Glioma, Diffuse Midline Glioma, Recurrent CNS Tumor, Adult, Recurrent, CNS Tumor, Childhood, Refractory Primary Malignant Central Nervous System Neoplasm
Arms & Interventions

Arms

Experimental: Arm A - DIPG

Experimental: Arm B - DMG & recurrent/refractory tumors

Interventions

Biological: - SC-CAR4BRAIN

Courses of weekly intraventricular CNS administered SC-CAR4BRAIN infusions for 3 weeks, then 1 week off

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Seattle Children's Hospital, Seattle, Washington

Status

Recruiting

Address

Seattle Children's Hospital

Seattle, Washington, 98105

Site Contact

Rebecca Ronsley, MD

[email protected]

206-987-2106

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