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Letetresgene Autoleucel Engineered T Cells in NY-ESO -1 Positive Advanced Non-Small Cell Lung Cancer (NSCLC)

A Pilot Open-Label Clinical Trial Evaluating the Safety and Efficacy of Autologous T Cells Expressing Enhanced TCRs Specific for NY-ESO-1 in Subjects With Stage IIIb or Stage IV Non-Small Cell Lung Cancer (NSCLC)

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02588612
Enrollment
10
Registered
2015-10-28
Start date
2016-02-01
Completion date
2020-08-10
Last updated
2021-09-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Neoplasms

Keywords

Letetresgene autoleucel, Adoptive TCR T-cell therapy, NY-ESO-1, T Cell Receptor, Non-Small Cell Lung Cancer, Leukapheresis

Brief summary

This trial will evaluate safety and efficacy of letetresgene autoleucel (GSK3377794) in participants with metastatic NSCLC.

Detailed description

New York esophageal antigen-1 (NY-ESO-1) and L antigen family member (LAGE)-1a antigens are tumor-associated proteins that have been found in several tumor types. Clinical trials using adoptively transferred T-cells directed against NY-ESO-1/LAGE-1a have shown objective responses. Letetresgene autoleucel (GSK3377794) is the first generation of NY-ESO-1 specific T-cell receptor engineered TCR T-cells. This protocol investigates letetresgene autoleucel treatment in Human Leukocyte Antigen (HLA)\*-A\*02+ participants with NY-ESO1+ advanced metastatic non-small cell lung cancer as second line treatment.

Interventions

letetresgene autoleucel (GSK3377794) as an IV infusion.

DRUGCyclophosphamide

Cyclophosphamide will be used as a lymphodepleting chemotherapy.

DRUGFludarabine

Fludarabine will be used as a lymphodepleting chemotherapy.

Sponsors

GlaxoSmithKline
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Participant is \>=18 years of age on the day of signing informed consent. * Participant has a diagnosis of histologically or cytologically confirmed advanced non-small cell lung cancer (Stage IIIB or IV) or recurrent disease. * Participants with known epidermal growth factor receptor (EGFR) mutations or Anaplastic lymphoma kinase receptor (ALK) or ROS1 gene rearrangements must have failed (disease progression \[PD\] or unacceptable toxicity) prior EGFR or ALK or ROS1 tyrosine kinase inhibitor, respectively (PD or unacceptable toxicity). There is no limit to lines of prior anti-cancer therapy. * Participant has measurable disease according RECIST v1.1 criteria. * Participant is HLA-A\*02:01, HLA-A\*02:05 and/or HLA-A\*02:06 positive. * Participant's tumor is positive for NYESO and/or LAGE-1a expression by a designated central laboratory. * Participant has Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1. * Participant has an anticipated life expectancy \>3 months. * Participant has left ventricular ejection fraction \>=50 percent(%). * Participant is fit for leukapheresis and has adequate venous access for the cell collection. * Male or Female. Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. * Participant must have adequate organ function.

Exclusion criteria

* Current active liver or biliary disease (with the exception of Gilbert's syndrome or asymptomatic gallstones, liver metastases or otherwise stable chronic liver disease per Investigator assessment). * Washout periods for prior radiotherapy and chemotherapy and other systemic therapy must be followed. * Experimental anti-cancer vaccine within 2 months prior to leukapheresis in the absence of response or in the opinion of the Investigator is responding to an experimental vaccine given within 6 months prior to leukapheresis. * Any prior gene therapy using an integrating vector. * Toxicity from previous anti-cancer therapy that has not recovered to less than or equal to (\<=)Grade 1 prior to enrollment (with exceptions). * History of allergic reactions attributed to compounds of similar chemical or biologic composition to cyclophosphamide, fludarabine, or other agents used in the study. * Central nervous system (CNS) metastases. * Active brain metastases or leptomeningeal metastases. * History of chronic or recurrent (within the last year prior to enrollment) severe autoimmune or active immune-mediated disease requiring steroids or other immunosuppressive treatments. * Other active malignancies besides NSCLC within 3 years prior to Screening not in complete remission. * Unintended weight loss \>10% in 6 months preceding study entry. * Corrected QT interval (QTc) \>450 milliseconds (msec) or QTc \>480 msec for participants with Bundle Branch Block (BBB). * Uncontrolled intercurrent illness. * Participants who in the opinion of the Investigator will be unlikely to fully comply with protocol requirements. * Active infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) or human T-cell lymphotropic virus (HTLV). * Participant is pregnant or breastfeeding. * Major surgery within 4 weeks prior to lymphodepleting chemotherapy.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Non-serious Adverse Events (AEs) and Serious Adverse Events (SAEs)Up to 24 monthsAn AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study intervention, whether or not considered related to the study intervention. An SAE is any untoward medical occurrence that, at any dose results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent disability/incapacity, is a congenital anomaly/birth defect or is clinically significant or requires intervention to prevent one of the outcomes listed before. Number of participants with common (greater than or equal to \[\>=\]5 percent\[%\]) non-serious AEs and SAEs are presented.
Number of Participants With Hematology Results by Maximum Grade Increase Post-BaselineUp to 24 monthsBlood samples were collected for the analysis of following hematology parameters: hemoglobin, lymphocytes, neutrophils, platelets and leukocytes. Laboratory parameters were graded according to National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE) version 4.03 where, Grade1: mild; Grade 2: moderate; Grade 3: severe or medically significant; Grade 4: life-threatening consequences. Baseline is the most recent, non-missing value from a central laboratory within 7 days prior to the lymphodepleting chemotherapy. An increase in grade is defined as an increase in CTCAE grade relative to Baseline grade. Data for any grade increase at worst-case post-Baseline is presented
Number of Participants With Any Grade Increase in Clinical Chemistry ParametersUp to 24 monthsBlood samples were collected for analysis of clinical chemistry parameters: glucose (Gl), albumin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin (Bil), creatinine (Creat), potassium (Pot), magnesium (Mg), phosphate (Ph), sodium (Sod) and calcium. Laboratory parameters were graded according to NCI-CTCAE version 4.03 where, Grade1: mild; Grade 2: moderate; Grade 3: severe or medically significant; Grade 4: life-threatening consequences. An increase in grade is defined as an increase in CTCAE grade relative to Baseline grade. Data for any grade increase at worst-case post-Baseline is presented.
Number of Participants With Worst Case Post-Baseline Abnormal Electrocardiogram (ECG) FindingsUp to 24 months12-lead ECGs were recorded in semi-supine position after 5 minutes rest using an ECG machine that automatically calculated the heart rate and measured PR, RR, QRS and QT duration corrected for heart rate by Fridericia's formula (QTcF) intervals. Data for number of participants with abnormal not clinically significant (NCS) and clinically significant (CS) ECG findings for worst case post-Baseline have been presented. Clinically significant abnormal laboratory findings are those which are not associated with the underlying disease, unless judged by the investigator to be more severe than expected for the participant's condition.
Change From Baseline in Oxygen SaturationBaseline, Day 1 (pre-dose, 5, 15, and 30 minutes, 1, 1.5, 2, and 4 hours post dose), Days 2, 3, 4, 5, 8 and Week 2Oxygen saturation measures the capacity of blood to transport oxygen to other parts of the body. Oxygen saturation was measured using a pulse oximeter. Baseline is the most recent, non-missing value within 7 days prior to initiating the lymphodepleting chemotherapy. Change from Baseline is the post-Baseline visit value minus Baseline value.

Secondary

MeasureTime frameDescription
Overall Response Rate (ORR)Up to 24 MonthsORR is defined as the percentage of participants with a confirmed Partial response (PR) or Complete response (CR) as the Best overall response (BOR), as assessed by the investigator per Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1.1. Confidence Interval (CI) was calculated using the exact method. Partial response is defined as at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the Baseline sum diameters. Complete response is defined as the disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to less than (\<)10 millimeters.
Time to ResponseUp to 24 monthsTime to response is defined as the interval of time (in months) between the date of T-cell infusion and the first documented evidence of response (PR or CR) in the subset of participants with a confirmed PR or CR as the BOR as assessed by the investigator per RECIST v1.1.
Duration of ResponseUp to 24 monthsDuration of response (DoR), defined as the interval of time in months from first documented evidence of PR or better to the time when disease progression is documented as assessed by RECIST v1.1 or death due to any cause among participants with a confirmed PR or CR as the BOR.
Disease Control Rate (DCR)Up to 24 monthsDCR is defined as the percentage of participants with a stable disease (SD) or better as the BOR (Confirmed PR, confirmed CR, or SD \>=12 weeks), as assessed by the investigator per RECIST v1.1. CI was calculated using the exact method.
Progression-Free Survival (PFS) by Investigator AssessmentUp to 24 monthsProgression-free survival (PFS) is defined as the interval of time (in months) between the date of T-cell infusion and the earlier of the date of disease progression as assessed by the investigator and the date of death due to any cause. Progressive Disease (PD) is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. PFS based on responses assessed by investigator per RECIST v1.1 is presented. Median and inter-quartile range (first quartile and third quartile) are presented.

Countries

United States

Participant flow

Recruitment details

This was an open-label study evaluating the safety and tolerability of autologous T-Cells expressing enhanced T-cell receptors (TCRs) specific for New York esophageal squamous cell carcinoma (NY-ESO)-1 (letetresgene autoleucel, lete-cel, GSK3377794) in Human Leukocyte Antigen (HLA)-A\*02:01, HLA-A\*02:05 and/or HLA-A\*02:06 participants with stage IIIb or stage IV non-small cell lung cancer (NSCLC).

Pre-assignment details

Participants were screened for the specified HLA alleles and target antigen expression (NY-ESO-1), and evaluated for study eligibility. A total of 10 participants who met all the eligibility criteria were enrolled in this study which consisted of Intent-to-Treat (ITT) population. This study was conducted across 3 sites in the United States.

Participants by arm

ArmCount
Lete-cel
Eligible participants were leukapheresed to manufacture lete-cel. Participants then underwent lymphodepleting chemotherapy with cyclophosphamide and fludarabine followed by a single intravenous (IV) infusion of lete-cel.
10
Total10

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyDeath prior to T-cell infusion1
Overall StudyFailed eligibility prior to chemotherapy2
Overall StudyLeukapheresis did not yield enough cells1
Overall StudyPhysician Decision1

Baseline characteristics

CharacteristicLete-cel
Age, Continuous
Overall study
57.7 Years
STANDARD_DEVIATION 12.91
Race/Ethnicity, Customized
Asian
1 Participants
Race/Ethnicity, Customized
White
9 Participants
Sex: Female, Male
Female
4 Participants
Sex: Female, Male
Male
6 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
4 / 10
other
Total, other adverse events
6 / 10
serious
Total, serious adverse events
4 / 10

Outcome results

Primary

Change From Baseline in Oxygen Saturation

Oxygen saturation measures the capacity of blood to transport oxygen to other parts of the body. Oxygen saturation was measured using a pulse oximeter. Baseline is the most recent, non-missing value within 7 days prior to initiating the lymphodepleting chemotherapy. Change from Baseline is the post-Baseline visit value minus Baseline value.

Time frame: Baseline, Day 1 (pre-dose, 5, 15, and 30 minutes, 1, 1.5, 2, and 4 hours post dose), Days 2, 3, 4, 5, 8 and Week 2

Population: mITT Population. Only those participants with data available at the specified data points were analyzed (represented by n=X in category titles).

ArmMeasureGroupValue (MEDIAN)
Lete-celChange From Baseline in Oxygen SaturationWeek 2, n=41.5 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 1, pre dose, n=52.0 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 1, 5 minutes post dose, n=42.5 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 1, 15 minutes post dose, n=42.0 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 1, 30 minutes post dose, n=43.0 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 1, 1 hour post dose, n=52.0 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 1, 1.5 hours post dose, n=21.5 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 1, 2 hours post dose, n=33.0 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 1, 4 hours post dose, n=4-1.0 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 2, n=42.5 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 3, n=51.0 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 4 , n=51.0 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 5, n=5-2.0 Percentage of oxygen
Lete-celChange From Baseline in Oxygen SaturationDay 8, n=40.0 Percentage of oxygen
Primary

Number of Participants With Any Grade Increase in Clinical Chemistry Parameters

Blood samples were collected for analysis of clinical chemistry parameters: glucose (Gl), albumin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin (Bil), creatinine (Creat), potassium (Pot), magnesium (Mg), phosphate (Ph), sodium (Sod) and calcium. Laboratory parameters were graded according to NCI-CTCAE version 4.03 where, Grade1: mild; Grade 2: moderate; Grade 3: severe or medically significant; Grade 4: life-threatening consequences. An increase in grade is defined as an increase in CTCAE grade relative to Baseline grade. Data for any grade increase at worst-case post-Baseline is presented.

Time frame: Up to 24 months

Population: mITT Population

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersGl, Hyperglycemia2 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersGl, Hypoglycemia0 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersAlbumin2 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersALP2 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersALT3 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersAST4 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersBil1 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersCreat1 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersPot, Hyperkalemia2 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersPot, Hypokalemia1 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersMg, Hypermagnesemia0 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersMg, Hypomagnesemia2 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersPh4 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersSod, Hypernatremia0 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersSod, Hyponatremia1 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersCalcium, Hypercalcemia1 Participants
Lete-celNumber of Participants With Any Grade Increase in Clinical Chemistry ParametersCalcium, Hypocalcemia3 Participants
Primary

Number of Participants With Hematology Results by Maximum Grade Increase Post-Baseline

Blood samples were collected for the analysis of following hematology parameters: hemoglobin, lymphocytes, neutrophils, platelets and leukocytes. Laboratory parameters were graded according to National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE) version 4.03 where, Grade1: mild; Grade 2: moderate; Grade 3: severe or medically significant; Grade 4: life-threatening consequences. Baseline is the most recent, non-missing value from a central laboratory within 7 days prior to the lymphodepleting chemotherapy. An increase in grade is defined as an increase in CTCAE grade relative to Baseline grade. Data for any grade increase at worst-case post-Baseline is presented

Time frame: Up to 24 months

Population: Modified (m)ITT population consisted of all participants in the ITT population who received NYESO-1 T cell infusion.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Lete-celNumber of Participants With Hematology Results by Maximum Grade Increase Post-BaselineHemoglobin increased0 Participants
Lete-celNumber of Participants With Hematology Results by Maximum Grade Increase Post-BaselineHemoglobin (Anemia)3 Participants
Lete-celNumber of Participants With Hematology Results by Maximum Grade Increase Post-BaselineLymphocytes increased1 Participants
Lete-celNumber of Participants With Hematology Results by Maximum Grade Increase Post-BaselineLymphocytes decreased5 Participants
Lete-celNumber of Participants With Hematology Results by Maximum Grade Increase Post-BaselineNeutrophils5 Participants
Lete-celNumber of Participants With Hematology Results by Maximum Grade Increase Post-BaselinePlatelets5 Participants
Lete-celNumber of Participants With Hematology Results by Maximum Grade Increase Post-BaselineLeukocytes (Leukocytosis)0 Participants
Lete-celNumber of Participants With Hematology Results by Maximum Grade Increase Post-BaselineLeukocytes (Leukopenia)5 Participants
Primary

Number of Participants With Non-serious Adverse Events (AEs) and Serious Adverse Events (SAEs)

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of a study intervention, whether or not considered related to the study intervention. An SAE is any untoward medical occurrence that, at any dose results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent disability/incapacity, is a congenital anomaly/birth defect or is clinically significant or requires intervention to prevent one of the outcomes listed before. Number of participants with common (greater than or equal to \[\>=\]5 percent\[%\]) non-serious AEs and SAEs are presented.

Time frame: Up to 24 months

Population: ITT population consisted of all participants who were enrolled in the trial and met all eligibility criteria.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Lete-celNumber of Participants With Non-serious Adverse Events (AEs) and Serious Adverse Events (SAEs)Non SAEs6 Participants
Lete-celNumber of Participants With Non-serious Adverse Events (AEs) and Serious Adverse Events (SAEs)SAEs4 Participants
Primary

Number of Participants With Worst Case Post-Baseline Abnormal Electrocardiogram (ECG) Findings

12-lead ECGs were recorded in semi-supine position after 5 minutes rest using an ECG machine that automatically calculated the heart rate and measured PR, RR, QRS and QT duration corrected for heart rate by Fridericia's formula (QTcF) intervals. Data for number of participants with abnormal not clinically significant (NCS) and clinically significant (CS) ECG findings for worst case post-Baseline have been presented. Clinically significant abnormal laboratory findings are those which are not associated with the underlying disease, unless judged by the investigator to be more severe than expected for the participant's condition.

Time frame: Up to 24 months

Population: mITT Population

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Lete-celNumber of Participants With Worst Case Post-Baseline Abnormal Electrocardiogram (ECG) FindingsAbnormal, NCS2 Participants
Lete-celNumber of Participants With Worst Case Post-Baseline Abnormal Electrocardiogram (ECG) FindingsAbnormal, CS1 Participants
Secondary

Disease Control Rate (DCR)

DCR is defined as the percentage of participants with a stable disease (SD) or better as the BOR (Confirmed PR, confirmed CR, or SD \>=12 weeks), as assessed by the investigator per RECIST v1.1. CI was calculated using the exact method.

Time frame: Up to 24 months

Population: mITT Population

ArmMeasureValue (NUMBER)
Lete-celDisease Control Rate (DCR)20 Percentage of participants
Secondary

Duration of Response

Duration of response (DoR), defined as the interval of time in months from first documented evidence of PR or better to the time when disease progression is documented as assessed by RECIST v1.1 or death due to any cause among participants with a confirmed PR or CR as the BOR.

Time frame: Up to 24 months

Population: mITT Population. Only those participants with data available at the specified data points were analyzed.

ArmMeasureValue (NUMBER)
Lete-celDuration of Response6.18 Months
Secondary

Overall Response Rate (ORR)

ORR is defined as the percentage of participants with a confirmed Partial response (PR) or Complete response (CR) as the Best overall response (BOR), as assessed by the investigator per Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1.1. Confidence Interval (CI) was calculated using the exact method. Partial response is defined as at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the Baseline sum diameters. Complete response is defined as the disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to less than (\<)10 millimeters.

Time frame: Up to 24 Months

Population: mITT Population

ArmMeasureValue (NUMBER)
Lete-celOverall Response Rate (ORR)20 Percentage of participants
Secondary

Progression-Free Survival (PFS) by Investigator Assessment

Progression-free survival (PFS) is defined as the interval of time (in months) between the date of T-cell infusion and the earlier of the date of disease progression as assessed by the investigator and the date of death due to any cause. Progressive Disease (PD) is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. PFS based on responses assessed by investigator per RECIST v1.1 is presented. Median and inter-quartile range (first quartile and third quartile) are presented.

Time frame: Up to 24 months

Population: mITT Population

ArmMeasureValue (MEDIAN)
Lete-celProgression-Free Survival (PFS) by Investigator Assessment1.81 Months
Secondary

Time to Response

Time to response is defined as the interval of time (in months) between the date of T-cell infusion and the first documented evidence of response (PR or CR) in the subset of participants with a confirmed PR or CR as the BOR as assessed by the investigator per RECIST v1.1.

Time frame: Up to 24 months

Population: mITT Population. Only those participants with data available at the specified data points were analyzed.

ArmMeasureValue (NUMBER)
Lete-celTime to Response12.09 Months

Source: ClinicalTrials.gov · Data processed: Mar 1, 2026