T-cell therapy for viral infections after stem cell transplant
Treatment of Chemo-refractory Viral Infections After Allogeneic Stem Cell Transplantation With Multispecific T Cells Against CMV, EBV and AdV: A Phase III, Prospective, Multicentre Clinical Trial
PHASE3 · University Hospital Freiburg · NCT04832607
This study is testing whether giving special T-cells that target specific viruses can help patients who have had a stem cell transplant and are struggling with tough viral infections.
Quick facts
| Phase | PHASE3 |
|---|---|
| Study type | Interventional |
| Enrollment | 149 (estimated) |
| Ages | 2 Months and up |
| Sex | All |
| Sponsor | University Hospital Freiburg (other) |
| Drugs / interventions | Rituximab, Prednisone, chemotherapy |
| Locations | 33 sites (Brussels and 32 other locations) |
| Trial ID | NCT04832607 on ClinicalTrials.gov |
What this trial studies
This Phase III trial investigates the efficacy of multivirus-specific T-cell transfer in patients who have undergone allogeneic stem cell transplantation and are suffering from refractory viral infections such as CMV, EBV, and AdV. The study aims to restore T-cell immunity in these immunocompromised patients, who are at high risk for life-threatening infections due to delayed immune reconstitution. Participants will receive T-cells specifically targeting the viruses causing their infections, with the goal of improving their clinical outcomes compared to standard antiviral treatments. The trial includes both adult and pediatric patients, and eligibility is based on specific criteria related to their viral load and immune response.
Who should consider this trial
Good fit: Ideal candidates include adults and children over 2 months old who have undergone allogeneic stem cell transplantation and have viral infections that are resistant to standard antiviral therapies.
Not a fit: Patients with acute graft-versus-host disease greater than grade II or those receiving high-dose steroids may not benefit from this treatment.
Why it matters
Potential benefit: If successful, this treatment could significantly reduce morbidity and mortality associated with viral infections in patients post-stem cell transplant.
How similar studies have performed: Previous studies have shown promise in using T-cell therapies for viral infections post-transplant, indicating a potential for success in this approach.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
1. Adult or paediatric patients (\> 2 months of age) after allogeneic stem cell transplantation (SCT) (no time restrictions apply) suffering from new or reactivated CMV or EBV or AdV infection refractory to standard antiviral treatment for two weeks (defined as no decrease or insignificant decrease of less than 1log in viral load over two weeks) as confirmed by quantitative blood PCR analysis.
2. Original HSCT-donor available with an immune response at least to the virus causing the therapy-refractory (=underlying) infection.
3. Written informed consent given (patient or legal representative) prior to any study-related procedures.
Exclusion Criteria:
1. Patient with acute GvHD \> grade II or extensive chronic GvHD at the time of IMP transfer
2. Patient receiving steroids (\>1 mg/kg BW Prednisone equivalent) at Screening.
3. Therapeutic donor lymphocyte infusion (DLI) from 4 weeks prior to IMP infusion until 8 weeks post IMP infusion. Prescheduled prophylactic DLI ≤3x105 T cells/kg BW in case of T-cell depleted HSCT is not considered an exclusion criterion.
4. Patient with organ dysfunction or failure as determined by Karnofsky (patients \>16 years) or Lansky (patients ≤16 years) score ≤30%
5. Concomitant enrolment in another clinical trial interfering with the endpoints of this study
6. Any medical condition which could compromise participation in the study according to the investigator's assessment
7. Progression of underlying disease (disease that has led to the indication of HSCT, e.g. leukaemia) that will limit the life expectance below the duration of the study
8. Second line or experimental antiviral treatment other than Ganciclovir/Valganciclovir, Foscarnet, Cidofovir and Rituximab until 8 weeks after IMP Infusion or prophylactic Treatment other than Aciclovir or Letermovir throughout the study except approved by sponsor
9. Known HIV infection. In case patients do not have a negative HIV test performed within 6 months before enrolment in the study, HIV negativity has to be confirmed by a negative laboratory test.
10. Female patient who is pregnant or breast-feeding. Female patient of child-bearing potential (i.e. post menarche and not surgically sterilized) or male patient of reproductive potential not willing to use an effective method of birth control from Screening until the last follow-up visit (FU6, Visit 8).
Note: Women of childbearing potential must have a negative serum pregnancy test at study entry ≤7 days before IMP administration on Day 0. Acceptable birth control methods are hormonal oral contraceptive ('pill'), contraceptive injection or patch, intrauterine pessar or the combination of two barrier methods. The combination of female and male condomes is NOT acceptable. If the male partner is sterilized, no further contraceptive is required. Women of post-menopausal status (no menses for 12 months without an alternative medical cause) are also not required to use contraceptives during the study.
11. Known hypersensitivity to iron dextran
12. Patients unwilling or unable to comply with the protocol or unable to give informed consent.
Where this trial is running
Brussels and 32 other locations
- Institut Jules Bordet (JBI) — Brussels, Belgium (RECRUITING)
- UZ Brussel — Brussels, Belgium (RECRUITING)
- Ghent Universal Hospital (UZG) — Ghent, Belgium (RECRUITING)
- UZ Leuven — Leuven, Belgium (RECRUITING)
- Université de Liège (ULG) — Liège, Belgium (RECRUITING)
- Hôpital Jeanne de Flandre, CHU Lille — Lille, France (RECRUITING)
- Institut d'Hématologie et Oncologie Pédiatrique (IHOPe) — Lyon, France (RECRUITING)
- Centre Hospitalier Régional Universitaire de Nancy (CHRU) — Nancy, France (RECRUITING)
- Hôpital de la Pitie-Salpêtrière — Paris, France (RECRUITING)
- Hôpital Necker - Enfants Malades — Paris, France (RECRUITING)
- Hôpital Robert Debré — Paris, France (RECRUITING)
- Charité Berlin (Campus Virchow-Klinikum) - Klinik für Pädiatrie mit Schwerpunkt Onkologie und Hämatologie — Berlin, Germany (RECRUITING)
- Universitätsklinikum Dresden — Dresden, Germany (RECRUITING)
- Universitätsklinikum Düsseldorf - Klinik für Kinder-Onkologie, -Hämatologie und klinische Immunologie — Düsseldorf, Germany (RECRUITING)
- Universitätsklinikum Essen - Pädiatrische Hämatologie-Onkologie — Essen, Germany (RECRUITING)
- Universitätsklinikum Freiburg - Klinik für Pädiatrische Hämatologie und Onkologie — Freiburg im Breisgau, Germany (RECRUITING)
- Medizinische Hochschule Hannover - Zentrum für Kinderheilkunde und Jugendmedizin — Hanover, Germany (RECRUITING)
- Universitäsklinikum Leipzig - Medizinische Klinik und Poliklinik I — Leipzig, Germany (RECRUITING)
- LMU Klinikum - Dr. v. Haunersches Kinderspital — Munich, Germany (RECRUITING)
- Klinikum rechts der Isar der Technischen Universität - Kinderklinik Schwabing — Munich, Germany (RECRUITING)
- LMU Klinikum - Medizinische Klinik und Poliklinik III — München, Germany (RECRUITING)
- Klinikum rechts der Isar der Technischen Universität - Klinik und Poliklinik für Innere Medizin III — München, Germany (RECRUITING)
- Universitätsklinikum Regensburg - Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation — Regensburg, Germany (RECRUITING)
- Universitätsklinikum Tübingen, Center for Pediatric Clinical Studies (CPCS) — Tübingen, Germany (RECRUITING)
- Universitätsklinikum Würzburg - Medizinische Klinik und Poliklinik II & Zentrum Innere Medizin (ZIM) — Würzburg, Germany (RECRUITING)
- Universitätsklinikum Würzburg - Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation — Würzburg, Germany (RECRUITING)
- Ospedale Pediatrico Bambino Gesù (OPBG) — Rome, Italy (RECRUITING)
- Ospedale Infantile Regina Margherita - Oncoematologie Pediatrica — Turin, Italy (RECRUITING)
- Leiden University Medical Centre (LUMC) - Department of Hematology — Leiden, Netherlands (RECRUITING)
- Vall d'Hebron Institute of Oncology (VHIO) — Barcelona, Spain (RECRUITING)
- Hospital Universitario La Paz — Madrid, Spain (RECRUITING)
- Hospital Virgen del Rocío — Seville, Spain (RECRUITING)
- Hospital Universitario Politécnico La Fe — Valencia, Spain (RECRUITING)
Study contacts
- Principal investigator: Tobias Feuchtinger, Prof — Medical Center - University of Freiburg
- Study coordinator: Tobias Feuchtinger, Prof
- Email: kjk.trace-study@uniklinik-freiburg.de
- Phone: 0049 (0)761 270
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: AdV Infection, EBV Infection, CMV Infection, Stem Cell Transplant Complications