This study is intended for men and women at least 18 years of age who have relapsed and/or refractory multiple myeloma. This 2-arm randomized pilot study will test the safety, tolerability and efficacy of NY-ESO-1C259T alone (Arm 1) or in combination with pembrolizumab (Arm 2) in subjects who have the appropriate HLA-A2 marker, and whose bone marrow expresses the NY-ESO-1 and/or LAGE-1a protein.
This study will take a subject's T cells and give them a T cell receptor protein that recognizes and attacks the tumors.
This is a randomized pilot study of the efficacy and safety of NY-ESO-1ᶜ²⁵⁹T alone or in combination with pembrolizumab in patients with relapsed or refractory multiple myeloma, who are HLA-A*02:01, HLA-A*02:05, and/or HLA-A*02:06 positive, and whose plasma cells from a bone marrow (BM) aspirate test positive for NY-ESO-1 and/or LAGE-1a antigen.
Subjects meeting all eligibility criteria will be randomly assigned to a treatment Arm: NY-ESO-1ᶜ²⁵⁹T alone (Arm 1) or NY-ESO-1ᶜ²⁵⁹T in combination with pembrolizumab (Arm 2).
Leukapheresis is performed to obtain cells for the manufacture of autologous NY-ESO-1ᶜ²⁵⁹T cells. When the manufactured NY-ESO-1ᶜ²⁵⁹T cells are available, subjects will undergo lymphodepleting chemotherapy with cyclophosphamide and fludarabine, followed by a single infusion of NY-ESO-1ᶜ²⁵⁹T (transduced cell range: 1 to 8 billion cells) that will be administered on Day 1.
In Arm 2, three (3) weeks after the infusion of NY-ESO-1ᶜ²⁵⁹T, an initial dose of pembrolizumab will be administered on Day 22. If toxicities preclude Week 3 treatment, the first dose of pembrolizumab may be given at Week 6 (Day 43). The second dose of pembrolizumab will be administered 3 weeks later, at Week 6 (or Week 9), and subsequent doses of pembrolizumab will be administered every 3 weeks thereafter up to Week 108 post T-cell infusion.
Treatment Limiting Toxicities (TLTs) will be evaluated for subjects in the combination arm (Arm 2).
A complete safety review of the first 3 subjects dosed with T-cells and pembrolizumab on Arm 2 will be conducted before enrolling any further subject. The study may be paused to evaluate safety at any time or if at an interim assessment the predictive probability that the TLT rate at the end of the trial exceeds 33%, is greater than 50%.
Efficacy will be assessed using International Myeloma Working Group (IMWG) Uniform Response Criteria.
Upon confirmation of their disease progression, subjects will be considered completing for the primary analysis. Subjects will complete the study once they have met the criteria to be transferred into a Long-Term Follow-Up protocol, where they will continue to be followed for up to 15 years from the date of their T-cell infusion.
The following criteria is a partial list of reasons why patients may or may not be eligible to participate in this clinical trial. Further evaluation with a medical professional will be required to determine full eligibility.
The following criteria is provided for health care professionals.
The following is a listing of trial locations that are open and accepting patients.
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