Phase
Condition
Sarcoma
Melanoma
Metastatic Melanoma
Treatment
Lifileucel (LN-144)
Lifileucel (LN-144/LN-145)
Clinical Study ID
Ages > 18 All Genders
Study Summary
Eligibility Criteria
Inclusion
Inclusion Criteria:
Cohort 1: Must have a confirmed diagnosis of metastatic Uveal Melanoma.
Patients will be eligible regardless of the number of prior systemic therapiesreceived.
Cohort 2: Must have a confirmed diagnosis of unresectable or metastaticundifferentiated pleomorphic sarcoma (UPS) or dedifferentiated liposarcoma (DDLPS) that is refractory to at least 1 prior line of systemic therapy
Unresectable disease will be defined by an expert sarcoma surgical onocologist aseither (a) low liklihood of obtaining an R0 resection or (b) unacceptable morbidityfrom a surgical procedure
Prior systemic therapy in the neoadjuvant or adjuvant setting will count has priorsystemic therapy
Patients who refuse standard of care chemotherapy will be eligible
One (1) lesion at least 1.5cm in size (solitary or aggregate) available for TILharvesting that has not undergone prior embolization or RT in prior 3 monthsunless subsequent growth is demonstrated (at least 0.5cm).
Patients must be ≥ 18 years of age at the time of consent.
Patients must have an Eastern Cooperative Oncology Group (ECOG) performancestatus of 0 or 1
Patients must have an estimated life expectancy of ≥ 6 months in the opinion ofthe Investigator.
Patients must have the following hematologic parameters:
Absolute neutrophil count (ANC) ≥ 1000/mm3
Hemoglobin (Hb) ≥ 9.0 g/dL
Platelet ≥ 100,000/mm^3 Note: Transfusions or growth factors are not allowed 28 daysprior to signing the ICF and continuing through the Screening Period
Patients must have adequate organ function:
Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 timesthe upper limit of normal (≤ 3 × ULN); patients with liver metastasis ≤ 5 × ULN
Estimated creatinine clearance (eCrCl) ≥ 40 mL/min using the Cockcroft-Gault formulaat Screening
Total bilirubin ≤ 2 mg/dL
Patients with Gilbert's syndrome must have a total bilirubin ≤ 3 mg/dL
Patients must be seronegative for the following:
Human immunodeficiency virus (HIV)-1 or HIV-2 antibodies
Hepatitis B antigen (HBsAg), hepatitis B core antibody (anti- HBc), or hepatitis Cantibody (HCV Ab). Patients with acute or chronic hepatitis infections may beenrolled if the viral load by polymerase chain reaction (PCR) is undetectablewith/without active treatment.
Syphilis (Rapid Plasma Reagin [RPR] test or venereal disease research laboratory [VDRL] test)
Cytomegalovirus (CMV) IgM antibody titer or PCR assay; and Epstein-Barr virus (EBV)IgM or PCR assay indicating active infection
Herpes simplex virus (HSV)-1 and HSV-2 IgM serology or PCR assay
Patients who are HSV immunoglobulin M (IgM) or PCR assay positive will need toreceive appropriate treatment and become IgM or PCR assay negative prior tostarting the NMA-LD pre-conditioning regimen
Anyone with prior COVID-19 infection must be asymptomatic for >30 days prior toNMA-LD.
Patients must have a washout period from prior anticancer therapy(ies) of aminimum duration, as detailed below prior to the first study treatment (ie,start of NMA-LD):
Targeted therapy: prior targeted therapy with an EGFR, MEK, BRAF, ALK, ROS1, orother-targeted agents (eg, erlotinib, afatinib, dacomitinib, osimertinib,crizotinib, ceritinib, lorlatinib) is allowed provided the washout is a minimum of 14 days or 5 half-lives (whichever is longer) prior to the start of treatment
Chemotherapy: minimum of 21 days prior to the start of treatment
Immunotherapy: checkpoint-targeted therapy with an anti PD-1/anti PD-L1, othermonoclonal antibodies, or vaccines are allowed, provided the washout is a minimum of 21 days prior to the start of study treatment
Palliative radiation therapy is permitted so long as it does not involvelesions being selected for TIL, or as target or non-target lesions. Washout isnot required if all related toxicities have resolved to ≤ Grade 1 as per CTCAEv 5.0.
Patients must have recovered from all prior anti-cancer therapy-related adverseevents (AEs) to ≤ Grade 1 (per Common Terminology Criteria for Adverse Events [CTCAE] v 5.0), except for alopecia or vitiligo, prior to enrollment.
Patients with documented ≥ Grade 2 diarrhea or colitis as a result of previoustreatment with immune checkpoint inhibitor(s) must have been asymptomatic for atleast 6 months and/or had a normal colonoscopy post-immune checkpointinhibitortreatment, by visual assessment, prior to tumor resection.
Patients with immunotherapy-related endocrinopathies (e.g. hypothyroidism) stablefor at least 6 weeks and controlled with hormonal replacement are allowed.
Previous surgical procedure(s) is/are permitted provided that wound healing hasoccurred, all complications have resolved, and at least 14 days have elapsed (for major operative procedures) prior to the tumor resection.
Patients of childbearing potential (or female partners of male participants)must be willing to take the appropriate precaution to avoid pregnancy orfathering a child for the duration of the study and practice an approved,highly effective method of birth control during treatment and for 12 monthsafter their last dose of IL-2. Approved methods of birth control are asfollows:
Combined (estrogen and progesterone containing) hormonal birth control associatedwith inhibition of ovulation: oral, intravaginal, transdermal
Progesterone-only hormonal birth control associated with inhibition of ovulation:oral, injectable, implantable
Intrauterine device (IUD)
Intrauterine hormone-releasing system (IUS)
Bilateral tubal occlusion
Vasectomized partner
True sexual abstinence when this is in line with the preferred and usual lifestyleof the patient. Periodic abstinence (eg, calendar ovulation, symptothermal,post-ovulation methods) is not acceptable
Patients (or legally authorized representative) must have the ability tounderstand the requirements of the study, have provided written informedconsent as evidenced by signature on an ICF approved by an Institutional ReviewBoard/Independent Ethics Committee (IRB/IEC), and agree to abide by the studyrestrictions and return to the site for the required assessments, including theOS Follow-up Period.
Exclusion
Exclusion Criteria:
Patients who have received an organ allograft or prior cell transfer therapy thatincluded a non-myeloablative or myeloablative chemotherapy regimen.
Patients who have a history of hypersensitivity to any component or excipient ofLN-144/LN-145 or other study drugs:
NMA-LD preconditioning regimen (cyclophosphamide, mesna, and fludarabine)
Proleukin®, aldesleukin, IL-2
Antibiotics (ABX) of the aminoglycoside group (i.e., streptomycin, gentamicin);except those who are skin-test negative for gentamicin hypersensitivity
Any component of the LN-144/LN-145 infusion product formulation includingdimethyl sulfoxide (DMSO), human serum albumin (HSA), IL-2, and dextran-40.
Patients with symptomatic brain metastases (of any size and any number). o Patients with definitively treated brain metastases may be considered forenrollment, if, prior to tumor resection for TIL, the patient is clinically stablefor ≥ 14 days, there are no symptomatic brain lesions, and that the patient does notrequire ongoing corticosteroid treatment.
Patients who are on chronic systemic immunosuppressive therapy except for thoserequiring steroid therapy for management of adrenal insufficiency; these patientsmay receive no more than 10 mg of prednisone or its equivalent daily. Transient useof steroids, e.g. in the perioperative period, is not an exclusion.
Patients who are pregnant or breastfeeding.
Patients who have active medical illness(es) that would pose increased risk forstudy participation, including: active systemic infections requiring systemic ABX,coagulation disorders, or other active major medical illnesses of thecardiovascular, respiratory, or immune systems.
Patients who have received a live or attenuated vaccination within 28 days prior tothe start of NMA-LD pre-conditioning regimen.
Patients who have any form of primary immunodeficiency (such as severe combinedimmunodeficiency disease [SCID] and acquired immunodeficiency syndrome [AIDS]).
Patients who have a left ventricular ejection fraction (LVEF) <45% or New York HeartAssociation (NYHA) functional classification > Class 1.
Patients ≥ 60 years of age and who have a history of ischemic heart disease,chest pain, or clinically significant atrial and/or ventricular arrhythmiasmust have a cardiac stress test.
Patients with any irreversible wall movement abnormalities are excluded.
Patients who have a smoking history or signs or symptoms of obstructive orrestrictive pulmonary disease and have a documented forced expiratory volume in 1second (FEV1) of ≤ 60% of predicted normal:
If a patient is not able to perform reliable spirometry due to abnormal upperairway anatomy (i.e., tracheostomy), a 6-minute walk test may be used to assesspulmonary function.
Patients who are unable to walk a distance of at least 80% predicted for ageand sex or demonstrates evidence of hypoxia at any point during the test (SpO2 < 90%) are excluded.
Patients who have had another primary malignancy within the previous three (3) years (with the exception of carcinoma in situ of the breast, cervix, or bladder;localized prostate cancer; and non-melanoma skin cancer that has been adequatelytreated).
Active, uncontrolled systemic infections, including COVID-19, within 30 days ofsurgery or NMA-LD. An uncomplicated bacterial UTI treated successfully with symptomresolution is not an exclusion.
Participation in another clinical study with an investigational product within 21days of the initiation of NMA-LD.
Eligibility Designation for Lymphodepletion
Patients meeting eligibility criteria above between Day -21 and Day -8 prior to the planned initiation of lifileucel will be enrolled to the therapeutic portion of the protocol.
All patients' eligibility criteria, including repeating cardiopulmonary function tests as necessary, will be reassessed within several days prior to the scheduled lymphodepletion in all cases.
Prior to beginning the NMA-LD preparative regimen the following requirements must be met:
Patients must meet all eligibility criteria at the time of NMA-LD.
Full resolution of any active infection should be documented
Critical evaluation of changes in cardiovascular, respiratory, renal, coagulopathy,or immune problems and other major illnesses that may have developed or worsenedmust be documented
Patients with symptomatic, recurrent, pleural effusions that require drainage shouldnot proceed to lymphodepletion without prior placement of a temporary in-dwellingpleural drain
All active medical issues must be addressed by Investigator or designee.Re-evaluation with additional imaging or testing may be required
Benefit over risk should be assessed and reassessed throughout the treatment course. Successive lifileucel components (preparative lymphodepleting chemotherapy, LN-144/LN-145 and IL-2 ) should be withheld or discontinued if at any time during the treatment course, at the discretion of the treating physician, benefit may not be justified by risks to the patient
Subsequent delays of lymphodepletion up to 14 days due to logistical issues such as production of lifileucel and/or major weather events will not constitute protocol violations and out of window assessments will not need to be repeated unless there is a change in clinical status.
Study Design
Connect with a study center
Memorial Sloan Kettering Westchester
Harrison, New York 10604
United StatesActive - Recruiting
Memorial Sloan Kettering Cancer Center (All Protocol Activities)
New York, New York 10065
United StatesActive - Recruiting
Memorial Sloan Kettering Westchester
West Harrison, New York 10604
United StatesSite Not Available
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