Using activated T lymphocytes to treat liver cancer after surgery

A Phase II Study to Evaluate the Efficacy and Safety of Activated T Lymphocytes (ATL) in Hepatocellular Carcinoma (HCC) Patients After Curative Treatment

This study is testing if giving activated T lymphocytes to patients with liver cancer after surgery can help them stay cancer-free longer.

Quick facts

• Phase: Phase 2
• Study type: Interventional
• Enrollment: 95 (estimated)
• Ages: 20 Years and up
• Sex: All
• Sponsor: Lukas Biomedical Inc. (Industry-sponsored)
• Drugs / interventions: immunotherapy
• Locations: 13 sites (Hualien City, Taiwan and 12 other locations)
• Trial ID: NCT05304481 on ClinicalTrials.gov

What this trial studies

This Phase II clinical study evaluates the safety and efficacy of administering activated T lymphocytes (ATL) to patients with hepatocellular carcinoma (HCC) who have undergone curative treatment. The study involves a single-arm, open-label design where eligible patients will receive ATL infusions over a 22-week period. The primary goal is to assess the effectiveness of ATL in improving the recurrence-free survival (RFS) rate of patients within 12 months post-treatment. A Data and Safety Monitoring Board will oversee safety data throughout the study to ensure participant safety and protocol adherence.

Who should consider this trial

Good fit: Ideal candidates are adults aged 20 and older who have been diagnosed with HCC at stages I, II, or IIIa and have received curative treatment.

Not a fit: Patients who have not undergone curative treatment for HCC or those with advanced stages of the disease may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could significantly improve the chances of preventing cancer recurrence in patients who have been treated for liver cancer.

How similar studies have performed: Previous studies have shown promising results with activated T lymphocyte therapies, indicating potential for success in this approach.

Eligibility criteria

Inclusion Criteria for Donor

1. Patients must be able to understand and sign the informed consent documents and aware of the investigational nature of the study.
2. Patient is ≥ 20 years old.
3. Patient has been diagnosed as HCC by pathological data or radiological test in the stage of I, II or IIIa according to the American Joint Committee on Cancer staging system (8th Edition).
4. Patient is scheduled to or has received tumor removal by curative treatments (e.g., surgical operation, percutaneous ethanol injection \[PEI\], microwave ablation \[MWA\], or radiofrequency ablation \[RFA\]).
5. Patient meets below conditions by blood test, kidney and liver function test:

   White blood cell (WBC) count \> 3,000/μL Absolute neutrophil count (ANC) ≥ 1,500/μL Hemoglobin (Hb) ≥ 9.0 g/dL Thrombocyte count \> 50,000/μL Blood urea nitrogen (BUN) and serum Creatinine ≤ 1.5× Upper Limit of Normal (ULN) AST and ALT ≤ 5×ULN
6. Female patient with childbearing potential should be confirmed of not being pregnant at the screening and during the study.

Exclusion Criteria for Donor

1. Patient with syphilis, human immunodeficiency virus I/II (HIV-I/II), human T-lymphotropic virus I/II (HTLV-I/II), or an increased risk (or has been diagnosed) for human transmissible spongiform encephalopathy (TSE); including Creutzfeldt-Jakob disease (CJD)
2. Patient with ongoing active hepatitis including acute or active chronic HBV/HCV infection, alcohol-associated hepatitis, and autoimmune hepatitis, etc., according to site-specific diagnostic criteria and laboratory parameters at screening
3. Patient who has clinically significant and unstable gastrointestinal, renal, endocrine, pulmonary, or cardiovascular disease judged by the investigator
4. Patient who has disease history of malignancy other than HCC except for curatively treated non-melanoma skin cancer, cervical carcinoma in situ, or superficial bladder tumors within 5 years before participating in this clinical trial
5. Patient who has medical history of immune deficiency or auto-immune disease (including but not limited to: rheumatoid arthritis , Burger's disease, multiple sclerosis and Type I diabetes)
6. Patient with the following medication or treatment should be excluded as the donor:

   1. Systemic corticosteroids within 4 weeks prior to blood collection
   2. Immunosuppressive treatment within 4 weeks prior to blood collection
   3. Other anti-cancer treatments within 3 months prior to blood collection
   4. Attenuated vaccines within 4 weeks prior to blood collection
7. Patient who has participated in other investigational studies and received any investigational therapy within 4 weeks prior to blood collection
8. Patient who has known or suspected hypersensitivity to any ingredient in the product (e.g. kanamycin, streptomycin or albumin, etc.)

Inclusion Criteria for subject

1. Patient must be able to understand and has signed the informed consent documents and been aware of the investigational nature of the study.
2. Patient who has the histopathological or cytological proof (e.g. liver biopsy test) of HCC in the stage of I, II or IIIa. Patient's tumor has been totally removed by curative treatment (surgical operation, PEI, MWA or RFA) in 12 weeks based on the agreement date for written consent and the tumor's removal should be perfectly confirmed by medical imaging (Computed tomography (CT) scan or Magnetic resonance imaging (MRI)) within 4 weeks of first dosing.
3. Hepatic function of Child-Pugh class A
4. ECOG Performance status (ECOG-PS) score ≤ 1
5. Patient's remaining life-time is expected at least more than 3 months.
6. Patient meets below conditions by blood test, kidney and liver function test:

   WBC count \> 3,000/μL ANC ≥ 1,500/μL Hb ≥ 9.0 g/dL Thrombocyte count \> 50,000/μL BUN and serum Creatinine ≤ 1.5× ULN AST and ALT ≤ 5×ULN
7. Female patient with childbearing potential should be confirmed of not being pregnant or not lactating at the screening and during the study.
8. Patient is willing to comply with protocol-stated requirements, instructions and restrictions.
9. All male and female patients with child-bearing potential (between puberty and 2 years after menopause) are willing to use at least any one of the appropriate contraception methods shown below, for during and at least 24 weeks after ATL treatment.

   1. Total abstinence (when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception).
   2. Female sterilization (have had surgical bilateral oophorectomy with or without hysterectomy) or tubal ligation at least six weeks before taking study treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment.
   3. Male sterilization (at least 6 months prior to screening). For female subjects on the study, the vasectomized male partner should be the sole partner for that subject
   4. Combination of any two of the following listed methods: (d.1+d.2 or d.1+d.3, or d.2+d.3):

   d.1Use of oral, injected or implanted hormonal methods of contraception or other forms of hormonal contraception that have comparable efficacy (failure rate \<1%), for example hormone vaginal ring or transdermal hormone contraception.

   d.2Placement of an intrauterine device (IUD) or intrauterine system (IUS). d.3Barrier methods of contraception: Condom or Occlusive cap (diaphragm or cervical/vault caps).

Exclusion Criteria for Subjects

1. Patient who has clinically significant and unstable gastrointestinal, renal, endocrine, pulmonary, or cardiovascular disease judged by the investigator
2. Patient with ongoing active hepatitis including acute or active chronic HBV/HCV infection, alcohol-associated hepatitis, and autoimmune hepatitis, etc., according to site-specific diagnostic criteria and laboratory parameters at screening.
3. Patient who has known or suspected hypersensitivity to any ingredient in the product (e.g. kanamycin, streptomycin or albumin, etc.)
4. Patient with the following medication or treatment should be excluded:

   1. Systemic corticosteroids within 4 weeks prior to receiving ATL or are scheduled to do so during the study.
   2. Immunosuppressive treatment within 4 weeks prior to receiving ATL or are scheduled to do so during the study.
   3. Other anti-cancer treatment within 4 weeks except for curative treatment prior to receiving ATL or are scheduled to do so during the study.
   4. Attenuated vaccines within 4 weeks prior to administration or is scheduled to do so during the study
5. Patient who fails to provide blood collection as a self-donor whose blood collection sample fails to generate adequate amount of ATL
6. Patient who is not able to take MRI or CT scan examination
7. Patient who has serious mental, social or psychological factors that may interfere with compliance and assessments of the study in the investigator's opinion
8. Patient who has participated in other investigational studies and received any investigational therapy within 4 weeks prior to the study dosing.

Where this trial is running

Hualien City, Taiwan and 12 other locations

• Hualien Tzu Chi Hospital — Hualien City, Taiwan, Taiwan (Recruiting)
• Cardinal Tien Hospital — New Taipei City, Taiwan, Taiwan (Not_yet_recruiting)
• National Taiwan University Hospital — Taipei, Taiwan, Taiwan (Recruiting)
• Taipei City Hospital, RENAI Branch — Taipei, Taiwan, Taiwan (Recruiting)
• E-Da Cancer Treatment Hospital — Kaohsiung City, Taiwan (Recruiting)
• Far Estern Memorial Hospital — New Taipei City, Taiwan (Recruiting)
• Taichung Veterans General Hospital — Taichung, Taiwan (Not_yet_recruiting)
• Chi Mei Hospital, Liouying — Tainan, Taiwan (Not_yet_recruiting)
• Taipei Medical University Hospital — Taipei, Taiwan (Recruiting)
• Shin Kong Wu Ho Su Memorial Hospital — Taipei, Taiwan (Not_yet_recruiting)
• Taipei Veterans General Hospital — Taipei, Taiwan (Recruiting)
• Tri-Service General Hospital — Taipei, Taiwan (Recruiting)
• Chang Gung Memorial Hospital, Linkou — Taoyuan, Taiwan (Recruiting)

Study contacts

• Study coordinator: Eric Tang, M.D

Conditions Hepatocellular Carcinoma; Oncology; Activated T lymphocytes