Study of Tumor Infiltrating Lymphocytes Following CCRT in the Treatment of Patients With Cervical Carcinoma

NCT04443296UNKNOWNPHASE1INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Sun Yat-sen University

Enrollment

10

Start Date

2019-10-12

Completion Date

2021-12-31

Study Type

INTERVENTIONAL

Official Title

Study of Tumor Infiltrating Lymphocytes Following Concurrent Chemoradiotherapy in the Treatment of Patients With Cervical Carcinoma

Interventions

CCRT+TIL

Conditions

Cervical Carcinoma

Eligibility

Age Range

18 Years – 70 Years

Sex

FEMALE

Inclusion Criteria:

* Patients with histologically proven squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma of the cervical uteri
* Patients with stage IIIA-IVA cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO)
* Patients who were ≥ 18 and ≤ 70 years old
* Patients with an ECOG performance status of 0, 1, or 2
* Adequate hematological, renal, and hepatic functions defined as:

granulocytes ≥ 1.5 x 109/L, platelets ≥ 100 x 109/L, total bilirubin, ALT and AST ≤ 1.5 x upper normal limit, creatinine ≤ upper normal limit

* Patients provided written, voluntary informed consent
* Patients who were accessible to follow up and management in the treatment center

Exclusion Criteria:

* Patients with past or current history of malignancy other than the entry diagnosis except for a "cured" malignancy more than five years prior to enrollment
* Patients who received previous chemotherapy or radiotherapy
* Patients with active angina or documented myocardial infarction within the 6 months preceding registration and patients with a history of significant ventricular arrhythmia requiring medication or congestive heart failure, as well as a history of 2nd or 3rd degree heart blocks
* Patients with an active infection or other serious underlying medical conditions that would impair the ability of the patient to receive the planned treatment, including prior allergic reactions to drugs containing platinum
* Patients with dementia or altered mental status that would prohibit the understanding and providing of informed consent
* Patients with inadequate caloric and/or fluid intake

Outcome Measures

Primary Outcomes

Toxicity Evaluation

Patients will be monitored for clinical toxicity by by the National Cancer Institute Common Terminology Criteria for Adverse Events.

Time frame: From chemo-radiotherapy start until Day30 after TIL infusion

Feasibility of CCRT in combination with TIL successful infusion

Number of patients receiving a complete TIL infusion

Time frame: 30 days after start of TIL-ACT infusion

Secondary Outcomes

Objective Response Rate (ORR)

Disease response evaluated after the completion of the chemoradiotherapy and TIL treatment. Achievement of complete response, partial response.

Time frame: 1, 3, 6, 9, 12 months

Disease control rate (DCR)

Disease response evaluated after the completion of the chemoradiotherapy and TIL treatment. Achievement of complete response, partial response or stable disease.

Time frame: 1, 3, 6, 9, 12 months

Disease control time (DCT)

Duration from complete response, partial response or stable disease to progression.

Time frame: 1, 3, 6, 9, 12 months

Immunological correlates to tumor response

Post-hoc exploratory analyses for immunological correlates to tumor response.

Time frame: 1, 3, 6, 9, 12 months

Locations

Sun Yat-sen University, Guangzhou, China

Linked Papers

Phase I study of adjuvant immunotherapy with autologous tumor-infiltrating lymphocytes in locally advanced cervical cancer

BACKGROUNDAdoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TILs) has achieved remarkable clinical efficacy in metastatic cancers such as melanoma and cervical cancer (CC). Here, we explored the safety, feasibility, and preliminary tumor response and performed translational investigations of adjuvant immunotherapy using infusion of autogenous TILs (auto-TILs) following concurrent chemoradiotherapy (CCRT) in patients with CC who had locally advanced disease.METHODSTwenty-seven patients with CC with stage III-IV disease were recruited in this single-center, phase I study. TILs were isolated from lesions in the uterine cervix and generated under good manufacturing practice (GMP) conditions and then infused after CCRT plus i.m. IL-2 injections.RESULTSTILs from 20 of the 27 patients were successfully expanded, with a feasibility of 74.1%. Twelve patients received TILs following CCRT. Adverse events (AEs) were primarily attributable to CCRT. Only 1 (8.3%) patient experienced severe toxicity with a grade 3 hypersensitivity reaction after TIL infusion. No autoimmune AEs, such as pneumonitis, hepatitis, or myocarditis, occurred, and there were no treatment-related mortalities. Nine of 12 patients (75.0%) attained a complete response, with a disease control duration of 9-22 months. Translational investigation showed that the transcriptomic characteristics of the infused TIL products and some immune biomarkers in the tumor microenvironment and serum of patients with CC at baseline were correlated with the clinical response.CONCLUSIONTIL-based ACT following CCRT was safe in an academic center setting, with potentially effective responses in patients with locally advanced CC. "Hot" inflammatory immune environments were beneficial to the clinical efficacy of TIL-based ACT as adjuvant therapy.TRIAL REGISTRATIONClinicalTrials.gov NCT04443296.FUNDINGNational Key R&D Program; Sci-Tech Key Program of the Guangzhou City Science Foundation; the Guangdong Province Sci-Tech International Key Program; the National Natural Science Foundation of China.