Clinical Trial: Phase I Study of Cellular Immunotherapy for Recurrent/Refractory Malignant Glioma Using Intratumoral Infusions of GRm13Z40-2, An Allogeneic CD8+ Cytolitic T-Cell Line Genetically Modified to Express the IL 13-Zetakine and HyTK and to be Resistant to Glucocorticoids, in Combination With Interleukin-2

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Phase I Study of Cellular Immunotherapy for Recurrent/Refractory Malignant Glioma Using Intratumoral Infusions of GRm13Z40-2, An Allogeneic CD8+ Cytolitic T-Cell Line Genetically Modified to Express t

Brief Summary:

RATIONALE: Biological therapies, such as cellular adoptive immunotherapy, may stimulate the immune system in different ways and stop tumor cells from growing. Donor T cells that are treated in the laboratory may be effective treatment for malignant glioma. Aldesleukin may stimulate the white blood cells to kill tumor cells. Combining different types of biological therapies may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best way to give therapeutic donor lymphocytes together with aldesleukin in treating patients with stage III or stage IV malignant glioma.


Detailed Summary:

PRIMARY OBJECTIVES:

I. To assess the safety of GRm13Z40-2 CTL CNS loco-regional cellular immunotherapy in research participants with recurrent or refractory/ progressive malignant glioma (WHO Grades 3 or 4).

II. To assess the safety of convection enhanced delivery (CED) of recombinant human Interleukin-2 (rhuIL-2) used in conjunction with GRm13Z40-2 CTL adoptive transfer.

SECONDARY OBJECTIVES:

I. To investigate the ability of 9-(4-fluoro-3-hydroxy-methyl-butyl) guanine (18FHBG) positron emission tomography PET to image GRm13Z40-2 CTL's in research participants.

II. To study the impact of concurrent dexamethasone administration on the tempo and magnitude of T cell allograft rejection responses in treated research participants by tracking the frequency of anti-GRm13Z40-2 immune responses in serially acquired peripheral blood samples.

III. To evaluate ganciclovir administration for ablating transferred GRm13Z40-2 in vivo should significant graft-mediated toxicities be encountered.

OUTLINE: Patients receive GRm13Z40-2 therapeutic allogeneic lymphocytes intratumorally (IT) over 10 minutes on days 1 and 3 and aldesleukin IT over 3 hours on days 2-5 (days 1-5 in week 2). Treatment repeats every week for 2 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed annually for at least 15 years.


Sponsor: City of Hope Medical Center

Current Primary Outcome:

  • Safety of GRm13Z40-2 CTL CNS loco-regional cellular immunotherapy [ Time Frame: Daily for first 2 weeks, weekly for month 1, every other week for month 2 , monthly for 6 months ]
  • Safety of convection enhanced delivery (CED) of recombinant human Interleukin-2 (rhuIL-2) used in conjunction with GRm13Z40-2 CTL adoptive transfer [ Time Frame: Weeks 1 and 2 ]
  • Toxicity as assessed by NCI CTCAE version 4.0 [ Time Frame: During treatment and up to 21 days after the last GRm13Z40-2 or CED rhuIL-2 infusion ]


Original Primary Outcome:

  • Safety of GRm13Z40-2 CTL CNS loco-regional cellular immunotherapy [ Time Frame: Daily for first 2 weeks, weekly for month 1, every other week for month 2 , monthly for 6 months ]
  • Safety of convection enhanced delivery (CED) of recombinant human Interleukin-2 (rhuIL-2) used in conjunction with GRm13Z40-2 CTL adoptive transfer [ Time Frame: Weeks 1 and 2 ]


Current Secondary Outcome:

  • Ability of 9-(4-fluoro-3-hydroxy-methyl-butyl) guanine (18FHBG) positron emission tomography PET to image GRm13Z40-2 CTLs [ Time Frame: Prior to immunotherapy and 3 weeks post immunotherapy ]
  • Impact of concurrent dexamethasone on the tempo and magnitude of T cell allograft rejection responses by tracking the frequency of anti-GRm13Z40-2 immune responses in serially acquired peripheral blood samples [ Time Frame: Post infusion day 1, weeks 2-4 and week 8 ]
  • Evaluation of ganciclovir administration for ablating transferred GRm13Z40-2 in vivo should significant graft-mediated toxicities be encountered [ Time Frame: When/if grade 3 or 4 toxicity occurs ]


Original Secondary Outcome: Same as current

Information By: City of Hope Medical Center

Dates:
Date Received: March 5, 2010
Date Started: May 2010
Date Completion:
Last Updated: June 3, 2015
Last Verified: June 2015