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Active, Not Recruiting

NCT Number: NCT04483778

B7H3 CAR T Cell Immunotherapy for Recurrent/Refractory Solid Tumors in Children and Young Adults

This is a phase I, open-label, non-randomized study that will enroll pediatric and young adult research participants with relapsed or refractory non-CNS solid tumors to evaluate the safety, feasibility, and efficacy of administering T cell products derived from the research participant's blood that have been genetically modified to express a B7H3-specific receptor (chimeric antigen receptor, or CAR) that will target and kill solid tumors that express B7H3. On Arm A of the study, research participants will receive B7H3-specific CAR T cells only. On Arm B of the study, research participants will receive CAR T cells directed at B7H3 and CD19, a marker on the surface of B lymphocytes, following the hypothesis that CD19+ B cells serving in their normal role as antigen presenting cells to T cells will promote the expansion and persistence of the CAR T cells. Arm A CAR T cells include the protein EGFRt and Arm B CAR T cells include the protein HER2tG. These proteins can be used to both track and destroy the CAR T cells in case of undue toxicity. The primary objectives of the study will be to determine the feasibility of manufacturing the cell products, the safety of the T cell product infusion, to determine the maximum tolerated dose of the CAR T cells products, to describe the full toxicity profile of each product, and determine the persistence of the modified cell in the participant's body on each arm. Participants will receive a single dose of T cells comprised of two different subtypes of T cells (CD4 and CD8 T cells) felt to benefit one another once administered to the research participants for improved potential therapeutic effect. The secondary objectives of this protocol are to study the number of modified cells in the patients and the duration they continue to be at detectable levels. The investigators will also quantitate anti-tumor efficacy on each arm. Participants who experience significant and potentially life-threatening toxicities (other than clinically manageable toxicities related to T cells working, called cytokine release syndrome) will receive infusions of cetuximab (an antibody commercially available that targets EGFRt) or trastuzumab (an antibody commercially available that targets HER2tG) to assess the ability of the EGFRt on the T cells to be an effective suicide mechanism for the elimination of the transferred T cell products.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Pediatric Solid Tumor Carcinoma Clear Cell Sarcoma Congenital, Hereditary, and Neonatal Diseases and Abnormalities Desmoplastic Small Round Cell Tumor Ewing Sarcoma Eye Diseases Eye Diseases, Hereditary Eye Neoplasms Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Fibrosarcoma Genetic Diseases, Inborn Germ Cell Tumor Hepatoblastoma Kidney Diseases Kidney Neoplasms Male Urogenital Diseases Malignant Peripheral Nerve Sheath Tumors Melanoma Myosarcoma Neoplasms Neoplasms by Histologic Type Neoplasms by Site Neoplasms, Bone Tissue Neoplasms, Complex and Mixed Neoplasms, Connective Tissue Neoplasms, Connective and Soft Tissue Neoplasms, Fibrous Tissue Neoplasms, Germ Cell and Embryonal Neoplasms, Glandular and Epithelial Neoplasms, Muscle Tissue Neoplasms, Nerve Tissue Neoplasms, Neuroepithelial Neoplastic Syndromes, Hereditary Nerve Sheath Neoplasms Nervous System Diseases Nervous System Neoplasms Neuroblastoma Neuroectodermal Tumors Neuroectodermal Tumors, Primitive Neuroectodermal Tumors, Primitive, Peripheral Neuroendocrine Tumors Neurofibroma Neurofibrosarcoma Neuromuscular Diseases Nevi and Melanomas Osteosarcoma Peripheral Nervous System Diseases Peripheral Nervous System Neoplasms Retinal Diseases Retinal Neoplasms Retinoblastoma Rhabdoid Tumor Rhabdomyosarcoma Sarcoma Sarcoma, Clear Cell Sarcoma, Ewing Sarcoma, Synovial Skin Diseases Skin Neoplasms Skin and Connective Tissue Diseases Soft Tissue Sarcoma Synovial Sarcoma Urogenital Diseases Urogenital Neoplasms Urologic Diseases Urologic Neoplasms Wilms Tumor

Age range

0 year–26 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Seattle Children's Hospital

Seattle, Washington, 98105, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Participants age ≤ 26 years at the time of consent for study participation; the first 2 participants enrolled and treated with CAR T cells in both Arms A and B will be ≥ 15 years. and ≤ 26 years at time of consent for study participation
  • Histologically diagnosed malignant, non-primary CNS solid tumor
  • Evidence of refractory or recurrent disease
  • Lansky or Karnofsky score ≥ 50
  • Life expectancy ≥ 8 weeks
  • Recovered from significant acute toxic effects of all prior chemotherapy, immunotherapy and radiotherapy
  • If no apheresis product or usable T cell product is available, all chemotherapy has been discontinued ≥ 7 days prior to enrollment
  • If no apheresis or usable T cell product is available, all biologic therapy has been discontinued ≥ 7 days prior to enrollment
  • If no apheresis product or T cell product is available, all systemic corticosteroid therapy has been discontinued ≥ 7 days prior to enrollment (physiologic replacement dosing is allowed)
  • If no apheresis product or usable T cell product is available, at least 3 half-lives or 30 days (whichever is shorter) from time of last dose of anti-tumor directed antibody therapy (including checkpoint inhibitor) at time of enrollment
  • If no apheresis product or usable T cell product is available, at least 6 weeks post last dose of myeloablative therapy and autologous and/or allogeneic stem cell transplant, or non-myeloablative therapy and allogeneic stem cell transplant (all timed from stem cell infusion). Participants who receive autologous stem cell infusion following non-myeloablative therapy are eligible once all other eligibility requirements are met.
  • If no apheresis product or usable T cell product is available, participants who have received genetically modified cell therapy must be at least 30 days from most recent cell infusion prior to enrollment
  • If no apheresis product or usable T cell product is available, participants with neuroblastoma must be at least 12 weeks from I131 MIBG therapy.
  • Adequate organ function
  • Adequate laboratory values
  • Participant is able to tolerate apheresis (including placement of temporary apheresis catheter, if necessary), or already has an apheresis product available for use in manufacturing.
  • Participants of childbearing potential must agree to use highly effective contraception

Exclusion criteria

  • Presence of active malignancy other than primary malignant solid tumor diagnosis
  • Current relevant CNS pathology
  • Receiving external beam radiation therapy at time of enrollment
  • Presence of active GVHD, or receiving immunosuppressive therapy for treatment or prevention of GVHD within 4 weeks prior to enrollment
  • Participant is pregnant or breastfeeding
  • Participant has presence of active severe infection
  • Participant has presence of any condition that, in the option of an investigator, would prohibit the participant from undergoing treatment under this protocol
  • Participant has primary immunodeficiency syndrome
  • Unwilling or unable to provide consent/assent for participation in the study and 15 year follow up period

Treatment and study plan

second generation 4-1BBζ B7H3-EGFRt-DHFR

Biological

Autologous CD4+ and CD8+ T-cells lentivirally transduced to express a second generation 4-1BBζ B7H3-EGFRt-DHFR

second generation 4-1BBζ B7H3-EGFRt-DHFR(selected) and a second generation 4-1BBζ CD19-Her2tG

Biological

Autologous CD4+ and CD8+ T-cells lentivirally transduced to express a second generation 4-1BBζ B7H3-EGFRt-DHFR(selected) and a second generation 4-1BBζ CD19-Her2tG

Pembrolizumab

Drug

SCRI-CARB7H3(s)x19 plus pembrolizumab

Primary outcomes

  1. Assess the safety and tolerability of cellular immunotherapy utilizing ex-vivo expanded autologous T cells genetically modified to express B7H3-specific CAR (Arm A)

    Time frame: 28 days

    Type, frequency, severity, and duration of adverse events will be tabulated and summarized

  2. Assess the safety and tolerability of cellular immunotherapy utilizing ex-vivo expanded autologous T cells genetically modified to express a bispecific B7H3xCD19 CAR (Arm B)

    Time frame: 28 days

    Type, frequency, severity, and duration of adverse events will be tabulated and summarized

  3. To assess the safety and tolerability of cellular immunotherapy utilizing ex-vivo expanded autologous T cells genetically modified to express a bispecific B7H3xCD19 CAR given in combination with pembrolizumab (Arm C)

    Time frame: 28 days

    Type, frequency, severity, and duration of adverse events will be tabulated and summarized to determine maximal tolerated dose

  4. To determine the maximum tolerated dose (MTD) of B7H3-specific CAR (Arm A)

    Time frame: 28 days

    Type, frequency, severity, and duration of adverse events will be tabulated and summarized to determine maximal tolerated dose

  5. To determine the maximum tolerated dose of bispecific B7H3xCD19 CAR (Arm B)

    Time frame: 28 days

    Type, frequency, severity, and duration of adverse events will be tabulated and summarized

  6. To determine the feasibility of administration of pembrolizumab in combination with bispecific B7H3xCD19 CAR (Arm C)

    Time frame: 28 days

    Type, frequency, severity, and duration of adverse events will be tabulated and summarized

  7. To assess the dose limiting toxicities (DLTs) and describe the full toxicity profile for each study arm

    Time frame: 28 days

    Type, frequency, severity, and duration of adverse events will be tabulated and summarized

  8. To assess the feasibility of manufacturing B7H3 specific CARs from patient-derived lymphocytes

    Time frame: 28 days

    Type, frequency, severity, and duration of adverse events will be tabulated and summarized

  9. To assess the feasibility of manufacturing B7H3xCD19 bispecific CARs from patient-derived lymphocytes

    Time frame: 28 days

    Type, frequency, severity, and duration of adverse events will be tabulated and summarized

Secondary outcomes

  1. Determine the duration of in vivo persistence of adoptively transferred T cells in the peripheral blood and compare engraftment between T cell products and treatment arms

    Time frame: 84 days

    Presence of CAR T cells in the peripheral blood will be assessed

  2. Determine the magnitude of in vivo persistence of adoptively transferred T cells in the peripheral blood and compare engraftment between T cell products

    Time frame: 84 days

    Number of CAR T cells in the peripheral blood will be assessed

  3. Quantitate anti-tumor responses by measuring changes in tumor burden using disease-specific evaluations

    Time frame: 84 days

    Presence of CAR T cells in the peripheral blood will be assessed

  4. Describe the relative expansion and persistence of the CAR T cell product and retention of function for B7H3xCD19 bispecific CARs determined by maintenance of B cell aplasia (BCA) with and without pembrolizumab

    Time frame: 84 days

    Presence of CAR T cells in the peripheral blood will be assessed

Other outcomes

  1. Evaluate for the presence of B7H3 CAR T cells in tumor tissue and/or normal tissue if a tissue biopsy, tumor biopsy, or resection is clinically indicated post-treatment

    Time frame: 84 days

    Tumor tissue, when obtained, will be assessed for the presence of adoptively transferred CAR T cells

  2. Evaluate B7H3 antigen expression in tumor tissue and/or normal tissue if a tissue biopsy, tumor biopsy, or resection is available

    Time frame: 84 days

    Tumor tissue, when obtained, will be assessed for the presence of B7H3 antigen

  3. Analyze blood, bone marrow, CSF, normal tissue, and/or tumor tissue for biomarkers of safety and/or anti-tumor activity

    Time frame: 84 days

    If a tissue biopsy, tumor biopsy, or resection is clinically indicated post-treatment, pathology will be assessed for the presence of B7H3 CAR T cells

  4. Assess the efficacy of infusional cetuximab and/or trastuzumab in ablating transferred T cells and ameliorating acute toxicities in treated participants

    Time frame: 84 days

    Biologic specimens, when obtained, will be assessed for biomarkers of safety and/or anti-tumor efficacy

Sponsors and collaborators

Lead sponsor

Seattle Children's Hospital

Other

Registry information

Official study title

Phase I Study of B7H3 CAR T Cell Immunotherapy for Recurrent/Refractory Solid Tumors in Children and Young Adults

Important dates

Study start
2020
Primary completion
2040
Study completion
2040
First posted
Jul 23, 2020
Registry last updated
Apr 28, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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