About this trial
This is a single-site, open-label Phase I treatment study evaluating the manufacturing feasibility and safety of chimeric antigen receptor (CAR) T cells targeting the oncofetal protein Glypican-2 (GPC2) in pediatric and young adult patients with recurrent or refractory (R/R) medulloblastoma. Subjects with other non-medulloblastoma CNS embryonal tumors may enroll.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Diagnosis: Histologically confirmed diagnosis of medulloblastoma or other primary CNS embryonal tumor according to 2021 CNS WHO Classification (5th edition)
Embryonal Tumor with Multilayered Rosettes (ETMR)
Pineoblastoma
Atypical Teratoid/Rhabdoid Tumor (ATRT) of the CNS
Disqualifiers
Any patient with metastatic disease OUTSIDE the CNS.
Unwilling or unable, in the investigator's judgement, to have a CSF reservoir (Ommaya or Rickham) placed. Does not apply to subjects who have a pre-existing device suitable for ICV delivery of CAR T cells and ICP monitoring.
Clinical evidence of active/on-going significant increased intracranial pressure (i.e., impending herniation) or uncontrolled seizures.
Prior receipt of a chimeric antigen receptor (CAR)-based therapy.
Trial design
Sequential
Treatments tested in this trial
GPC2-CAR T cells
GeneticAutologous T cells transduced with a retroviral vector encoding a second-generation GPC2-targeted chimeric antigen receptor (GPC2-CAR), administered intracerebroventricularly. Up to 16 doses (cycles) are administered using an intrapatient dose-escalation strategy. Cycle 2 may occur no earlier than Day 28 following Cycle 1, and Cycles 3 through 16 may occur as early as Day 22 following the preceding cycle.
Fludarabine
DrugParticipants who meet eligibility criteria for lymphodepletion chemotherapy will receive fludarabine 30 mg/m²/day administered intravenously on Days -4, -3, and -2 prior to study treatment. Participants weighing \<12 kg will receive protocol-specified dose adjustments.
Cyclophosphamide
DrugParticipants who meet eligibility criteria for lymphodepletion chemotherapy will receive cyclophosphamide 500 mg/m²/day administered intravenously on Days -4, -3, and -2 prior to study treatment. Participants weighing \<12 kg will receive protocol-specified dose adjustments.
Treatment groups
Trial outcomes
Primary outcomes
Manufacturing Feasibility
Proportion of manufacturing attempts that result in at least one dose of GPC2-CAR T cells that meet the IND release criteria and protocol-specified dose.
Incidence of Dose Limiting Toxicities (DLTs)
Number and severity of DLTs following GPC2-CAR T cell administration at each dose level using protocol-defined criteria.
Secondary outcomes
Objective Response Rate (ORR)
Percentage of subjects achieving a protocol-defined response (complete response, partial response, or stable disease) based on imaging and neurological exam.
Progression-Free Survival (PFS)
Time from enrollment to radiographic disease progression.
Overall Survival (OS)
Time from initial diagnosis to death from any cause.
Sponsors and contacts
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