Using ALPP CAR-T cells to treat advanced solid tumors

A Single-Arm, Single-Center, Open-Label Pilot Study of Anti-ALPP CAR-T Cells for Alkaline Phosphatase, Placental (ALPP)-Positive Advanced Solid Tumors

This study is testing a new type of immune cell treatment called ALPP CAR-T cells to see if it can help adults with advanced solid tumors that haven't responded to other treatments.

Quick facts

• Phase: PHASE1; PHASE2
• Study type: Interventional
• Enrollment: 9 (estimated)
• Ages: 18 Years to 70 Years
• Sex: All
• Sponsor: Xinqiao Hospital of Chongqing (other)
• Drugs / interventions: CAR-T, radiation, prednisone, CAR T, chemotherapy
• Locations: 1 site (ChongQing, Chongqing)
• Trial ID: NCT06556108 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the safety and efficacy of ALPP CAR-T cells in patients with advanced solid tumors who have not responded to standard therapies. It involves a single-center, open-label design where eligible adults aged 18-70 will undergo leukapheresis to collect their lymphocytes, which will then be modified and infused back after lymphodepleting chemotherapy. The study aims to assess the potential of these engineered cells to target and treat various malignant tumors associated with alkaline phosphatase expression.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18-70 with advanced solid tumors that express ALPP and have failed standard therapies.

Not a fit: Patients with solid tumors that do not express ALPP or those who are not eligible due to poor organ function or other health issues may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new therapeutic option for patients with advanced solid tumors that are resistant to conventional treatments.

How similar studies have performed: While CAR-T cell therapies have shown success in hematological malignancies, this specific approach targeting ALPP in solid tumors is relatively novel and has not been extensively tested.

Eligibility criteria

Inclusion Criteria:

1. Be able to understand and sign the Informed of Consent Document. Be willing to follow the procedure and protocol of the clinical trial;
2. Age 18-70 (including boundary value), both male and female;
3. Expected life span is more than 3 months from the date of signing the informed consent;
4. ECOG score 0-1;
5. Metastatic or recurrent solid tumors confirmed by histopathology;
6. Refractory to standard treatment evaluated by radiological assessment;
7. Be able provide fresh or preserved tissue specimen;
8. At least 1 measurable lesion (according to RECIST 1.1);
9. ALPP expression positivity determined by IHC；
10. The organ marrow function of the subjects meets the following requirements:

    1. Marrow function：ANC≥ 1.5×109/L; PLT count≥ 75×109/L; HGB≥ 90 g/L;
    2. Coagulation function: Prothrombin Time (PT)≤ 1.5 times the Upper Limit of Normal (ULN), International Normalized Ratio (INR)≤ 1.5 times ULN, and Activated Partial Thromboplastin Time (APTT)≤ 1.5 times ULN;
    3. Liver function: ALT and AST≤ 2.5 times ULN (in cases of liver transfer/infiltration, ≤ 5.0 times ULN); Total Bilirubin (TBIL) ≤ 1.5 times ULN (with Gilbert's syndrome, \<3×ULN);
    4. Renal function: Serum Creatinine (Cr)≤ 1.5 times ULN or Creatinine Clearance Rate (CrCl) ≥ 60ml/min;
    5. Cardiac function: Left Ventricular Ejection Fractions (LVEF)≥45%;
    6. Pulmonary function: Forced Expiratory Volume in the first second (FEV1) ≥ 50%.
11. Prior to the first dose, subjects must have recovered from toxic effects of previous treatment (CTCAE grade ≤ 1, with the exception of specific criteria such as "alopecia"), and the investigator determines that the corresponding adverse events do not pose a safety risk.
12. For male or female subjects of childbearing potential: from the time of signing the ICF until at least 24 weeks after the last dose, they must agree to practice abstinence or use effective contraceptive methods, including intrauterine devices, etc.

    Note: Women of childbearing potential who have undergone surgical sterilization (including hysterectomy, bilateral oophorectomy, or salpingectomy) or who have been postmenopausal for more than 24 months are considered to have no potential for pregnancy.
13. A suitable venous access for the necessary blood collection can be established, and there are no contraindications for leukapheresis.

Exclusion Criteria:

Inclusion criteria:

1. Be able to understand and sign the Informed of Consent Document. Be willing to follow the procedure and protocol of the clinical trial;
2. Age 18-70 (including boundary value), both male and female;
3. Expected life span is more than 3 months from the date of signing the informed consent;
4. ECOG score 0-1;
5. Metastatic or recurrent solid tumors confirmed by histopathology;
6. Refractory to standard treatment evaluated by radiological assessment;
7. Be able provide fresh or preserved tissue specimen;
8. At least 1 measurable lesion (according to RECIST 1.1);
9. ALPP expression positivity determined by IHC；
10. The organ marrow function of the subjects meets the following requirements:

    1. Marrow function：ANC≥ 1.5×109/L; PLT count≥ 75×109/L; HGB≥ 90 g/L;
    2. Coagulation function: Prothrombin Time (PT)≤ 1.5 times the Upper Limit of Normal (ULN), International Normalized Ratio (INR)≤ 1.5 times ULN, and Activated Partial Thromboplastin Time (APTT)≤ 1.5 times ULN;
    3. Liver function: ALT and AST≤ 2.5 times ULN (in cases of liver transfer/infiltration, ≤ 5.0 times ULN); Total Bilirubin (TBIL) ≤ 1.5 times ULN (with Gilbert's syndrome, \<3×ULN);
    4. Renal function: Serum Creatinine (Cr)≤ 1.5 times ULN or Creatinine Clearance Rate (CrCl) ≥ 60ml/min;
    5. Cardiac function: Left Ventricular Ejection Fractions (LVEF)≥45%;
    6. Pulmonary function: Forced Expiratory Volume in the first second (FEV1) ≥ 50%.
11. Prior to the first dose, subjects must have recovered from toxic effects of previous treatment (CTCAE grade ≤ 1, with the exception of specific criteria such as "alopecia"), and the investigator determines that the corresponding adverse events do not pose a safety risk.
12. For male or female subjects of childbearing potential: from the time of signing the ICF until at least 24 weeks after the last dose, they must agree to practice abstinence or use effective contraceptive methods, including intrauterine devices, etc.

    Note: Women of childbearing potential who have undergone surgical sterilization (including hysterectomy, bilateral oophorectomy, or salpingectomy) or who have been postmenopausal for more than 24 months are considered to have no potential for pregnancy.
13. A suitable venous access for the necessary blood collection can be established, and there are no contraindications for leukapheresis.

Exclusion criteria:

1. Subjects with primary central nervous system (CNS) malignancies; subjects with CNS metastases who have failed local treatment; subjects without symptomatic brain metastases within 14 days before pretreatment, or with stable clinical symptoms and no requirement for corticosteroids or other treatment for brain metastases, may be included;
2. Prior history of malignancy with non-target indications within the past 5 years, with the exception of: adequately treated malignancies, with more than 5 years of stability and minimal risk of recurrence as judged by the investigator; and in situ carcinoma without evidence of recurrence after adequate treatment;
3. Subjects with any active autoimmune disease, history of autoimmune disease, or requiring systemic corticosteroids (≥10 mg/day prednisone equivalent) or immunosuppressive therapy, or syndromes (subjects with skin diseases that do not require systemic treatment or have resolved childhood asthma/allergies without any intervention as an adult; subjects with stable thyroid hormone replacement therapy for autoimmune hypothyroidism may be included);
4. History of immunodeficiency, including positive HIV testing or other acquired or congenital immunodeficiency diseases;
5. History of hereditary or acquired bleeding disorders;
6. Presence of cardiovascular clinical conditions or symptoms, including: a. History of thromboembolic events ≥ grade 3 in the past 6 months, or currently receiving thrombolytic or anticoagulant therapy due to high thrombotic risk; b. Chronic heart failure with reduced ejection fraction (NYHA class ≥ II); c. History of unstable angina; d. Myocardial infarction in the past 6 months; e. Clinically significant malignant arrhythmias (excluding atrial fibrillation, paroxysmal supraventricular tachycardia); f. Clinically significant QTcF prolongation (QTcF \> 450 ms for males, QTcF \> 470 ms for females, derived from Fridericia's formula); g. Poorly controlled hypertension.
7. Presence of active infection (fever due to tumor growth may be included as judged by the investigator);
8. Active pulmonary tuberculosis detected by history or CT scan, or history of active pulmonary tuberculosis within the past 1 year before inclusion, or history of active pulmonary tuberculosis more than 1 year ago without proper treatment;
9. Patients with active hepatitis B or hepatitis C virus infection (active hepatitis B defined as hepatitis B virus deoxyribonucleic acid (HBV-DNA) \> the lower limit of detection; active hepatitis C defined as hepatitis C virus ribonucleic acid (HCV-RNA) \> the lower limit of detection) or positive syphilis serology;
10. Pregnant or lactating women, or subjects with a positive blood pregnancy test;
11. Serious surgery or major trauma within 28 days before lymphodepletion;
12. Vaccination with live or attenuated vaccines within 28 days before Lymphodepletion;
13. Systemic corticosteroids (excluding inhaled therapy, topical treatment, or physiological replacement therapy) or other immunosuppressive treatments within 14 days before lymphodepletion;
14. Receiving any investigational drug or participating in another clinical study within 28 days before lymphodepletion (except for subjects participating in observational, non-interventional clinical studies, or in the survival follow-up period of an interventional clinical study);
15. Refractory or persistent seizures, significant pleural or abdominal effusions, active gastrointestinal bleeding, or subjects judged by the investigator to be at high risk of significant bleeding due to tumor necrosis;
16. Concomitant severe organic or psychiatric diseases;
17. Prior history of allogeneic bone marrow or solid organ transplantation, or renal replacement therapy;
18. Under the investigator's judgment, subjects with uncontrollable tumor-related pain or compression symptoms due to a large tumor burden that requires palliative treatment or radiation therapy should have completed treatment before entering the study;
19. History of substance abuse, or alcohol or drug abuse;
20. Prior cellular therapy (TCR-T, CAR-T, TIL, etc);
21. Prior severe allergic reaction to any drug or its components in this trial;
22. Subjects whose condition is judged by the investigator to be unsuitable for this study.

Where this trial is running

ChongQing, Chongqing

• Department of Hematology, Xinqiao Hospital — ChongQing, Chongqing, China (RECRUITING)

Study contacts

• Principal investigator: Qingzhu Jia, M.D. — Xinqiao Hospital
• Study coordinator: Qingzhu Jia, M.D.

Conditions: Advanced Solid Tumors