Using modified T cells to treat advanced melanoma and sarcoma

A Phase I Study Evaluating Safety and Feasibility of Redirected Autologous T Cells Expressing a High Affinity TCR Specific for NY-ESO-1 (LauT-1) in Patients With Advanced Melanoma and Sarcoma

This study is testing a new treatment that uses modified T-cells to see if it can help people with advanced melanoma and sarcoma fight their cancer better.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 9 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Centre Hospitalier Universitaire Vaudois (Academic / other)
• Drugs / interventions: radiation, methotrexate, chemotherapy, cyclophosphamide, fludarabine
• Locations: 2 sites (Lausanne, Canton of Vaud and 1 other locations)
• Trial ID: NCT06889766 on ClinicalTrials.gov

What this trial studies

This Phase I clinical trial investigates the safety and efficacy of LauT-1, a genetically modified T-cell therapy targeting the NY-ESO-1 antigen in patients with advanced melanoma and sarcoma. The approach involves isolating patients' own T-cells, modifying them to express a specific T-cell receptor that recognizes NY-ESO-1, and then reinfusing these cells after a regimen of non-myeloablative chemotherapy and low-dose irradiation. The study aims to enhance T-cell infiltration into tumors and improve the immune response against cancer cells expressing NY-ESO-1.

Who should consider this trial

Good fit: Ideal candidates include patients with advanced or metastatic melanoma or sarcoma that express NY-ESO-1 and have failed prior standard therapies.

Not a fit: Patients whose tumors do not express NY-ESO-1 or who have not received prior therapies may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a novel and effective option for patients with advanced melanoma and sarcoma that express the NY-ESO-1 antigen.

How similar studies have performed: Other studies targeting NY-ESO-1 have shown promise, suggesting that this approach may be effective, although this specific methodology is novel.

Eligibility criteria

Inclusion criteria at pre-screening step-1 1) Patients with histologically confirmed advanced or metastatic cutaneous melanoma or any type of sarcoma.

Inclusion criteria at pre-screening step-2

1\) Immunohistochemically documented NY-ESO-1 expression, defined as ≥ 1+ expression on either archival or fresh tumor tissue by immunohistochemistry, in ≥50% of the sampled tumor tissue.

Inclusion criteria at screening

1. Patients with sarcoma, who have received at least one line of standard therapy (if available) and failed to respond, progressed or were intolerant to that therapy, will be eligible. If the participant refuses or is, in the opinion of the investigator, ineligible for these treatments, the reason must be documented in the medical record.
2. Patients with metastatic melanoma:

   1. Without proto-oncogene B-Raf (BRAF) mutation who have received at least one line of standard therapy and failed to respond, progressed or were intolerant to that therapy, will be eligible. If the participant refuses or is, in the opinion of the investigator, ineligible for these treatments, the reason must be documented in the medical record.
   2. With BRAF mutation who have received at least two lines of standard therapy and failed to respond, progressed or were intolerant to that therapy, will be eligible. If the participant refuses or is, in the opinion of the investigator, ineligible for these treatments, the reason must be documented in the medical record.
3. Patient must be HLA-A\*0201 and/or HLA-A\*0205 positive, as identified by high-resolution genomic deoxyribonucleic acid (DNA) typing of the HLA-A locus.
4. Age ≥ 18 years
5. Able to undergo apheresis
6. At least one lesion accessible to biopsy for translational research (TR) at D30, without putting the patient at unusual risk.
7. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
8. Life expectancy of greater than 12 weeks.
9. Radiologically measurable disease (as per RECIST v1.1).
10. Adequate organ function

Exclusion Criteria:

1. Patients with an active second malignancy
2. Patients with symptomatic and/or untreated brain metastases, as well as leptomeningeal carcinomatosis. Patients with definitively treated brain metastases will be considered for enrolment after agreement with the Principal Investigator, as long as lesions are stable, there are no new brain lesions, and the patient does not require chronic corticosteroid treatment.
3. History of idiopathic pulmonary fibrosis or evidence of active pneumonitis (any origin). History of radiation pneumonitis in the radiation field (fibrosis) is allowed.
4. History of recent myocardial infarction, or unstable angina, within six months prior to enrolment
5. Patients with prior allogeneic stem cell transplantation or organ transplantation
6. Active severe systemic infections within 2 weeks prior to apheresis
7. Patient requiring regular systemic immunosuppressive therapy. All immunosuppressive medications including but not limited to steroids, mycophenolate mofetil, azathioprine, methotrexate, thalidomide, and anti-Tumor Necrosis Factor-alpha (TNF-alpha) agents must have been discontinued at least 2 weeks before apheresis .
8. History of severe immediate hypersensitivity reaction to any of the agents/ excipients of the study products.
9. Women who are pregnant or breastfeeding because of the potentially dangerous effects of the treatment on the fetus or infant.
10. Subjects, for whom there are concerns that they will not reliably comply with the requirements for contraception, should not be enrolled into the study.
11. Any serious underlying medical condition that could interfere with study medication and potential adverse events.

Where this trial is running

Lausanne, Canton of Vaud and 1 other locations

• Centre Hospitalier Universitaire Vaudois (CHUV) — Lausanne, Canton of Vaud, Switzerland (Not_yet_recruiting)
• Centre Hospitalier Universitaire Vaudois — Lausanne, Canton of Vaud, Switzerland (Recruiting)

Study contacts

• Study coordinator: Bernhard Gentner, MD

Conditions Advanced Melanoma; Melanoma Metastatic; Sarcoma; NY-ESO-1; LauT-1; TCR redirected T cell; metastatic melanoma; autolog T-cell