Phase I Study of Adoptive Transfer of Autologous T Lymphocytes Engrafted With a Chimeric Antigen Receptor Targeting the Kappa Light Chain of Immunoglobulin Expressed in Patients With CLL, B-Cell Lymphoma or Multiple Myeloma

Description

Patients have a type of cancer called NHL, Multiple Myeloma (MM) or CLL that has come back or has not gone away after treatment. There is no standard treatment for the cancer at this time or the currently used treatments do not work completely in all cases like these. This is a gene transfer research study using special immune cells. The body has different ways of fighting infection and disease. No single way seems perfect for fighting cancers. This research study combines two different ways of fighting disease, antibodies and T cells, that investigators hope will work together. Antibodies are types of proteins that protect the body from bacterial and other diseases. T cells, also called T lymphocytes, are special infection-fighting blood cells that can kill other cells, including tumor cells. Both antibodies and T cells have been used to treat patients with cancers; they have shown promise, but have not been strong enough to cure most patients. The antibody used in this study recogn

Trial Eligibility

INCLUSION CRITERIA: BLOOD PROCUREMENT: * B-CLL or recurrent or refractory B-cell lymphoma (or other B-cell neoplasm) or multiple myeloma monoclonal for Kappa-light chain * Life expectancy of at least 12 weeks or greater. * No history of other cancer (except non-melanoma skin cancer or in situ breast cancer or cervix cancer) unless the tumor was successfully treated with curative intent at least 2 years before trial entry * If requires pheresis to collect blood, Cre and AST less than 1.5 upper limit of normal * If requires pheresis to collect blood, PT and PTTK less than 1.5 upper limit normal T CELL TREATMENT: Diagnosis of: 1. B-CLL monoclonal for Kappa light chain with one of the following criteria: 1. Evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia and/or thrombocytopenia 2. Massive (ie, at least 6 cm below the left costal margin) or progressive or symptomatic splenomegaly 3. Massive nodes (ie, at least 10 cm in longest diameter) or progressive or symptomatic lymphadenopathy 4. Progressive lymphocytosis with an increase of more than 50% over a 2-month period or lymphocyte doubling time (LDT) of less than 6 months. 5. Constitutional symptoms, defined as any one or more of the following disease-related symptoms or signs: 1. Unintentional weight loss of 10% or more within the previous 6 months; 2. Significant fatigue (ie, ECOG PS 2 or worse; inability to work or perform usual activities); 3. Fevers higher than 100.5°F or 38.0°C for 2 or more weeks without other evidence of infection; or 4. Night sweats for more than 1 month without evidence of infection. 5. Patients who have resistant disease after primary treatment 6. Patients who have a short time to progression after the first treatment (less than 2 years) OR 2. Indolent or aggressive B-cell lymphoma (or other B-cell neoplasm) monoclonal for Kappa-light chain with measurable disease after receiving at least one chemotherapy regimen that includes Rituximab or an equivalent monoclonal antibody OR 3. Multiple myeloma monoclonal for Kappa-light chain with measurable disease after receiving at least one chemotherapy regimen * Life expectancy of at least 12 weeks or greater. * Recovered from the toxic effects of all prior chemotherapy before entering this study. PD1/PDL1 inhibitors will be allowed if medically indicated * ANC \> 500, Hgb greater than or equal to 7.0. * Bilirubin less than 3 times the upper limit of normal. * AST less than 5 times the upper limit of normal. * Estimated GFR \> 50mL/min * Pulse oximetry of \> 90% on room air * Karnofsky score of \> 60%. * Negative serology for HIV. * Available autologous transduced peripheral blood T-cells with 15% or more expression of CAR-Kappa determined by flow-cytometry. * Patients must sign an informed consent indicating that they are aware this is a research study and have been told of its possible benefits and toxic side effects. Patients will be given a copy of the consent form. * Sexually active patients must be willing to utilize one of the more effective birth control methods during the study and for 3 months after the study is concluded. The male partner should use a condom. * If patient has CLL, must have negative Coombs test. EXCLUSION CRITERIA: BLOOD PROCUREMENT: * Active infection requiring antibiotics * Active autoimmune disease T CELL TREATMENT: * Symptomatic cardiac disease. * History of hypersensitivity reactions to murine protein-containing products. Currently receiving any investigational agents within the previous six weeks or received any tumor vaccines within the previous 6 weeks. * Tumor in a location where enlargement could cause airway obstruction. * Pregnant or lactating.

Study Info

Interventions

Locations Recruiting

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