SARS-CoV-2 CTLS for Mild to Moderate COVID-19 Disease

Last updated: October 24, 2023
Sponsor: New York Medical College
Overall Status: Active - Recruiting

Phase

1/2

Condition

Covid-19

Treatment

SARS-CoV2-CTLS

Standard of Care

Clinical Study ID

NCT04896606
NYMC 604
  • Ages 18-65
  • All Genders

Study Summary

The 2019 Severe Acute Respiratory Syndrome (SARS) is a global pandemic secondary to a novel coronavirus - SARS-CoV-2. The reported case-fatality ratio for SARS-CoV-2 in the United States is 1.8% with a current death toll of >300,000 and climbing.4 There is no accepted standard of care or FDA approved therapies for treatment of COVID-19. Virus specific cytotoxic T lymphocytes (CTLs) have become an important part of the treatment landscape for viral reactivation post hematopoietic and solid organ transplantation. Donor derived CTLs have been shown to be safe and effective against a variety of viruses including CMV, EBV, BK and adenovirus. We hypothesize that SARS-CoV-2 specific CTLs generated from a previously infected family donor will be safe and effective for treatment of COVID-19 in family members with mild to moderate disease.

Eligibility Criteria

Inclusion

INCLUSION CRITERIA

  • Age ≥18 to 65 years. AND
  • Proven infection with SARS-CoV-2, defined as detection of SARS-CoV-2 by RT-PCR fromnasopharyngeal swab or lower respiratory tract specimen AND
  • Hospitalized at the time of enrollment AND
  • HLA Matched Family Related donor with recent SARS-CoV-2 infection is at least 10 daysout from symptom onset. A negative result for COVID-19 by a diagnostic test is notnecessary to qualify the donor AND
  • In Stage I or II of disease (mild or moderate) at the time of enrollment (Table 1) AND
  • ONE of the following high-risk conditions:
  • Chronic lung disease not requiring oxygen at home prior to admission (includingbut not limited to COPD, cystic fibrosis, asthma and sickle cell disease);Underlying heart disease (including hypertension); Patients with an acutemyocardial infarction within the last 3 months will require cardiology clearanceprior to enrollment; Diabetes mellitus (type I or II) ; Obesity (BMI ≥ 30);Immunosuppressed, based on investigator's assessment.

Exclusion

EXCLUSION CRITERIA:

  • Stage III disease (severe) at the time of enrollment (see Table 1)
  • Lack of an identified eligible HLA family related donor
  • No high-risk comorbidities defined in the inclusion criteria (Section 5.1)
  • Patient with acute GVHD > grade 2 or extensive chronic GVHD at the time of enrollment
  • Patient treated with donor lymphocyte infusion (DLI) within 4 weeks prior to CTLInfusion
  • Patients with chronic respiratory failure requiring ventilator support and/or oxygenat home prior to admission are excluded
  • Patients with stage D heart failure and/or symptoms at rest are excluded
  • Renal function: patients with eGFR or CrCl <30 mL/min/1.73 m2 will be excluded fromstudy entry.
  • Liver function: Total bilirubin > 2 mg/dl (unless Gilbert's syndrome) OR ALT/AST > 5 xULN
  • Patients currently listed for transplant or potentially eligible to receive organtransplants are excluded from this study
  • Patient with poor performance status determined by Karnofsky (patients >16 years) orLansky (patients ≤16 years) score ≤50%
  • Female patient of childbearing age who is pregnant or breast-feeding or not willing touse an effective method of birth control during study treatment and for at least 6weeks after the last dose of SARS-CoV-2 CTLS.
  • Male subjects with female partners of childbearing age who are not willing to use aneffective method of birth control during study treatment and for at least 6 weeksafter the last dose of SARS-CoV-2 CTLS.
  • Concurrent use of following medications is prohibited:
  • Steroids (>2 mg/kg/day prednisone equivalent); Immunotherapies within 4 weeksprior to CTL infusion including checkpoint blockade, ATG, Campath, CAR T cells,blinatumomab; Chemotherapy: Tyrosine kinase inhibitors and hydroxyurea must bestopped > 72 hours prior to SARS-COV-2-CTL cell infusion; High dose chemotherapymust be stopped > 2 weeks prior to SARS-CoV-2-CTLs. High dose chemotherapy isdefined in this protocol as any cancer directed therapy causing myelosuppression;Pegylated-asparaginase must be stopped > 4 weeks prior to SARS-COV-2-CTLinfusion; Intrathecal chemotherapy must be stopped > 1 week prior toSARS-COV-2-CTL infusion (e.g. intrathecal methotrexate); Anti T-cell Antibodies:Administration of any T cell lytic or toxic antibody (e.g. alemtuzumab) within 30days prior to SARS-CoV-2-CTLs is prohibited.

Study Design

Total Participants: 50
Treatment Group(s): 2
Primary Treatment: SARS-CoV2-CTLS
Phase: 1/2
Study Start date:
September 20, 2021
Estimated Completion Date:
December 31, 2025

Connect with a study center

  • New York Medical College

    Valhalla, New York 10595
    United States

    Active - Recruiting

  • Nationwide Children's Hosptial

    Columbus, Ohio 43205
    United States

    Site Not Available

  • Children's Hospital of Pennsylvania

    Philadelphia, Pennsylvania 19104
    United States

    Site Not Available

  • Medical College of Wisconsin/Children's Hospital of Wisconsin

    Milwaukee, Wisconsin 53226
    United States

    Site Not Available

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