Clinical Trials

MainTitle

Safety Study of a Dual Anti-HIV Gene Transfer Construct to Treat HIV-1 Infection

This study is ongoing, but not recruiting participants.
Sponsor
Calimmune, Inc.


Information provided by (Responsible Party)
Calimmune, Inc.
ClinicalTrials.gov Identifier
NCT01734850

First received: November 19, 2012
Last updated: November 28, 2016
Last Verified: November 2016
History of Changes
Purpose

Purpose

This is an early phase research study looking at whether an experimental gene transfer, LVsh5/C46 (also known as Cal-1), is safe and if it can protect the immune system from the effects of HIV without the use of antiretroviral drugs.

Cal-1 is an experimental gene transfer agent designed to inhibit HIV infection through 2 active parts:

  1. Removing a protein named CCR5 from bone marrow and white blood cells
ng a protein named C46 on bone marrow and white blood cells

Condition Intervention Phase
Human Immunodeficiency Virus

Drug : Busulfan
Biological : Cal-1 modified HSPC
Biological : Cal-1 modified CD4+ T lymphocytes
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Adaptive Phase I/II Study of the Safety of CD4+ T Lymphocytes and CD34+ Hematopoietic Stem/Progenitor Cells Transduced With LVsh5/C46, a Dual Anti-HIV Gene Transfer Construct, With and Without Conditioning With Busulfan in HIV-1 Infected Adults Previously Exposed to ART

Further study details as provided by Calimmune, Inc.:

Primary Outcome Measures

  • Feasibility and safety of the introduction of Cal-1 into HSPC and CD4+ T lymphocyte cell populations, and the associated delivery procedures. [ Time Frame: 48 weeks ]
    Baseline demographic and clinical information, treatment, and duration of follow-up will be summarized by group and overall. Severity of clinical adverse events (AEs) and laboratory safety parameters will be graded according to DAIDS criteria. Numbers of individual AEs, in numbers of subjects, will be summarized by severity and treatment. AEs will also be summarized and aggregated by body system for clinical events. The worst severity of each clinical and laboratory AE, for each subject, will be summarized by treatment. All grade 3 and 4 AEs, and any other events that lead to a subject ceasing trial follow-up, will be listed by treatment, with duration and resolution. Feasibility measures include the number of manufacturing procedures successfully completed (i.e. complying with all release criteria); number of gene modified cells, as affected by CD4+ and CD34+ purity, transduction efficiency, and viability; and the number of target cells harvested.
Secondary Outcome Measures:
  • The benefit of busulfan conditioning in impacting efficacy of Cal-1 in controlling HIV-1 infection [ Time Frame: 48 weeks ]
    Log10 HIV-1 RNA, CD4+ T lymphocyte count, CD4+ %, CD4:CD8 ratio, measures of Cal-1 marking/expression and thymopoiesis will be plotted over time for each individual subject, and will be summarized for each nominal study week. Changes in Log10 HIV-1 RNA and CD4+ T lymphocyte count from baseline will be formally compared in all subjects. Associations between feasibility and safety measures and secondary outcomes include: Number of gene-modified cells infused and peripheral blood marking, plasma HIV RNA and CD4+ T cell counts Integration profile of the Ttn and HSPCtn products and observations in integration analysis of peripheral blood post infusion HSPCtn methylcellulose colony forming units and peripheral blood subpopulation marking

Enrollment: 12
Study Start Date: April 2013
Estimated Study Completion Date: October 2017
Estimated Primary Completion Date: June 2017 (Final data collection date for primary outcome measure)

Arms Assigned Interventions
Experimental: No busulfan pre-conditioning
Cal-1 modified HSPC and Cal-1 modified CD4+ T lymphocytes without busulfan preconditioning
Biological: Cal-1 modified HSPC

Hematopoietic progenitor/stem cells (HSPC) modified with LVsh5/C46 (Cal-1)

Other Name: LVsh5/C46 modified HSPC
Biological: Cal-1 modified CD4+ T lymphocytes

CD4+ T lymphocytes modified with LVsh5/C46 (Cal-1)

Other Name: LVsh5/C46 modified CD4+ T lymphocytes
Experimental: 1 x 4mg/kg busulfan preconditioning
Cal-1 modified HSPC and Cal-1 modified CD4+ T lymphocytes, with single 4mg/kg busulfan dose administered as pre-conditioning for transplant
Drug: Busulfan

Intravenous busulfan

Other Name: Busulfex
Biological: Cal-1 modified HSPC

Hematopoietic progenitor/stem cells (HSPC) modified with LVsh5/C46 (Cal-1)

Other Name: LVsh5/C46 modified HSPC
Biological: Cal-1 modified CD4+ T lymphocytes

CD4+ T lymphocytes modified with LVsh5/C46 (Cal-1)

Other Name: LVsh5/C46 modified CD4+ T lymphocytes
Experimental: 2 x 4mg/kg busulfan pre-conditioning
Cal-1 modified HSPC and Cal-1 modified CD4+ T lymphocytes, with two 4mg/kg busulfan doses administered as pre-conditioning for transplant
Drug: Busulfan

Intravenous busulfan

Other Name: Busulfex
Biological: Cal-1 modified HSPC

Hematopoietic progenitor/stem cells (HSPC) modified with LVsh5/C46 (Cal-1)

Other Name: LVsh5/C46 modified HSPC
Biological: Cal-1 modified CD4+ T lymphocytes

CD4+ T lymphocytes modified with LVsh5/C46 (Cal-1)

Other Name: LVsh5/C46 modified CD4+ T lymphocytes

Detailed Description:

It is estimated that 33 million individuals are currently infected with HIV. HIV/AIDS is a disease that impairs immune function, primarily by decreasing CD4+ T lymphocytes. The progression can be contained by daily dosing with antiretroviral therapy (ART) but there are side effects that can be treatment limiting, and the development of HIV drug resistance can force the physician to modify the ART regimen. There are no effective vaccines currently available for HIV.
LVsh5/C46 (also known as Cal-1) is a dual therapeutic, self-inactivating lentiviral vector that encodes for both a short hairpin RNA against the HIV-1 co-receptor CCR5 (sh5) and a HIV-1 fusion inhibitor, C46 and inhibits two processes required for HIV-1 infection:

  1. Binding of the virus to the cellular CCR5 co-receptor and
  2. Fusion of the virus with the host cell
The rationale is that Cal-1 introduced into hematopoietic progenitor/stem cells (HSPC) and mature CD4+ T lymphocytes will protect these cells and their progeny cells from HIV-1 infection and its pathogenic sequelae. This may provide a continuous means of controlling HIV-1 after a single or infrequent dose(s), thereby decreasing or delaying (partially or completely) the need for antiretroviral drug therapy.

Eligibility

Eligibility

Ages Eligible for Study: 18 Years to 65 Years  
Sexes Eligible for Study: All  
Accepts Healthy Volunteers: No  

Criteria

Inclusion Criteria:

  • Prior to any study-related procedures, signed informed consent indicating that they understand the purpose, risks and procedures required for the study and are willing to participate in the study
  • Individuals aged 18 to 65 years of age (inclusive) at time of consent
  • Documented HIV-1 infection ≥ 6 months prior to Screening 1
  • Previous treatment with antiretroviral agents that had a demonstrated suppressive effect (defined as plasma HIV RNA ≤ 50 copies/ml)
  • A documented viable ART regimen option, as determined by the Investigator, taking into account prior ART experience and HIV geno/phenotyping analyses
  • Not taking antiretroviral therapy for ≥ 6 weeks prior to Screening 1, for one or more of the following reasons:

  • i) Concerns over short-term or long-term toxicities associated with antiretroviral agents, or ii) Treatment fatigue from the daily regimen of life-long therapy
  • Plasma HIV-1 viral RNA ≥ 5,000 copies/mL and ≤ 100,000 copies/ml at Screening 1 and Screening 2
  • CD4+ T lymphocyte count ≥ 500 cells/µl at Screening 1 and Screening 2


Exclusion Criteria:
  • Abnormal hematology at Screening 1: Absolute neutrophil count (ANC) < 1.5 x 109/L, Platelet count < 100 x 109/L, Hemoglobin < 10 g/dL
  • Abnormal biochemistry at Screening 1: Alanine aminotransferase (ALT) > 2.5 x Upper Limit of Normal (ULN), Total bilirubin > 1.5 x ULN, Serum creatinine > 1.5 x ULN
  • Detection of any CXCR4-tropic HIV-1 at Screening 1
  • Evidence of co-infection with hepatitis B virus, hepatitis C virus, West Nile Virus, or HTLV-1 as detected at Screening 2
  • Evidence of active TB infection determined by positive QuantiFERON®-TB Gold/IGRA test result and clinical confirmation at Screening 2
  • ART or other antiretroviral therapy within 6 weeks of Screening 1 or any time during the pre-infusion period
  • Documented history of CD4+ T lymphocyte count < 250 cells/µl
  • Any previous or current AIDS-defining illnesses (CDC Category C), including AIDS-related dementia, with the exception of Kaposi's sarcoma confined to the skin
  • History of malignancy or systemic chemotherapy within the last 5 years (i.e., subjects with prior malignancy must be disease-free for 5 years), except curatively-treated basal cell carcinoma, cutaneous squamous cell carcinoma, or cervical or anal intra-epithelial neoplasia
  • History of steroid-dependent asthma in the past 5 years
  • History of seizure
  • Any clinical history of hematologic diseases including leukemia, myelodysplasia, myeloproliferative disease, thromboembolic disease, sickle cell disorder, thrombocytopenia or leukopenia
  • Class II-IV heart failure, according to the New York Heart Association classification
  • Inadequate venous access for apheresis, as assessed at Screening 1
  • Current or planned systemic immunosuppressive or immunomodulatory medication
  • Taking warfarin, aspirin or any medication that is likely to affect platelet function or other aspects of blood coagulation, and unable to safely cease this medication for a period of 1 week prior, during, and 1 week after administration of G-CSF (a total period of 19 days)
  • Participation in any study involving any investigational drug or medical device within 30 days prior to Screening 1
  • Receipt of a vaccine for HIV-1 or any gene transfer product at any time
  • Prior treatment with recombinant G-CSF or busulfan or other stem-cell mobilizing or modulating agent within the previous 12 months
  • Known hypersensitivity to busulfan, G-CSF (Neupogen™) or E. coli-derived proteins
  • Subjects who will not accept transfusions of blood products
  • Pregnant or breast-feeding at any time between Screening 1 and Baseline (infusion)
  • History of alcohol or drug abuse within the 12 months prior to Screening 1
  • Inability to understand and provide informed consent

contacts and locations

Contacts and Locations

Choosing to participate in a study is an important personal decision.Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01734850

Locations

United States, California
UCLA CARE Center
Los Angeles, California, United States, 90035
Quest Clinical Research
San Francisco, California, United States, 94115

Sponsors and Collaborators

Calimmune, Inc.

Investigators

Principal Investigator: Ronald Mitsuyasu, M.D. University of California, Los Angeles
More Information

More Information


Responsible Party: Calimmune, Inc.  
ClinicalTrials.gov Identifier: NCT01734850   History of Changes  
Other Study ID Numbers: CAL-USA-11  
Study First Received: November 19, 2012  
Last Updated: November 28, 2016  

Keywords provided by Calimmune, Inc.:

HIV-1

Additional relevant MeSH terms:
Immunologic Deficiency Syndromes
Acquired Immunodeficiency Syndrome
HIV Infections
Busulfan

ClinicalTrials.gov processed this data on December 15, 2017
This information is provided by ClinicalTrials.gov.