Recruiting
Phase 1

A2-ESO-1 TCR-T Cells

Sponsor:

University of Southern California

Code:

NCT05989828

Conditions

Triple Negative Breast Cancer

Eligibility Criteria

Sex: Female

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Aldesleukin

Anti-HLA-A2/NY-ESO-1 TCR-transduced Autologous T Lymphocytes

Biopsy

Biospecimen Collection

Computed Tomography

Study Details

Brief summary:

This phase Ib trial tests the safety, side effects and best dose of anti-HLA-A2/NY-ESO-1 T-cell receptor (TCR)-transduced autologous T lymphocytes (A2-ESO-1 TCR-T cells) in treating patients with NY-ESO-1 overexpression positive triple negative breast cancer (TNBC) that has come back after a period of improvement (relapsed/recurrent) or that does not respond to treatment (refractory), and that may have spread from where it first started (primary site) to nearby tissue, lymph nodes (advanced) or to other places in the body (metastatic). NY-ESO-1 is an antigen found on the surface of many different types of tumor cells including TNBC. Antigens make it possible for immune cells to recognize and kill germ cells that invade the body, however, it is more difficult for immune cells to recognize antigens on tumor cells. T cells are a special type of immune cell in the blood. These T cells may be trained to recognize the NY-ESO-1 antigen on tumor cells, allowing the T cells to attack and kill those tumor cells. The A2-ESO-1 TCR-T cells are T cells that have been removed from the patient's blood through a process called leukapheresis and then changed in the laboratory to recognize NY-ESO-1 on tumor cells. When given back to the patient, these A2-ESO-1 TCR-T cells find and attack tumor cells that express NY-ESO-1. Chemotherapy drugs, such as cyclophosphamide and fludarabine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. They are given before the T cells to support optimum activity of the A2-ESO-1 TCR-T cells. IL-2 (aldesleukin) is in a class of drugs known as cytokines. It is a man-made version of a naturally occurring protein that stimulates the body to produce other chemicals which increase the body's ability to fight cancer. A2-ESO-1 TCR-T cells may kill more tumor cells in patients with recurrent or refractory advanced or metastatic TNBC that overexpresses NY-ESO-1.

Conditions

Triple Negative Breast Cancer

Study ID

NCT05989828

Start date

Dec 17, 2024

Status verified date

May, 2026

Completion date

Dec 31, 2028

Anticipated

Primary completion date

Dec 31, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: Female

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Female aged >= 18 years
  • Histologically confirmed advanced or metastatic TNBC that have relapsed on or are refractory to 2 or more lines of standard-of-care therapy. TNBC is defined as estrogen receptor (ER) and progesterone receptor negative (< 10% immunohistochemistry \[IHC\] staining) and HER2 negative (IHC 1+ or 0 AND/OR in situ hybridization negative based on:

  • Single-probe average HER2 copy number < 4.0 signals/cell
  • Dual-probe HER2/CEP17 ratio < 2.0 with an average HER2 copy number < 4.0 signals/cell)
  • HLA-A2+ and tumoral overexpression of NY-ESO-1 (2 to 3+ IHC staining in > 50% of cells)
  • Have measurable disease based on RECIST 1.1
  • Life expectancy >= 6 months
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Hemoglobin >= 9.0 g/dL (transfusions permitted)
  • Absolute neutrophil count (ANC) >= 1500/mm\^3
  • Platelet count >= 100,000/mm\^3
  • Creatinine (Cr) < 2 x upper limit of normal (ULN), and Cr clearance (CrCl) >= 50 mL/min by Cockcroft and Gault
  • Alanine transaminase (ALT) and aspartate transaminase (AST) < 2 x ULN (Patients with liver metastases whose ALT/AST are < 5 x ULN are eligible for enrollment)
  • Bilirubin < 2 x ULN
  • Lymphocyte count >= 500/uL
  • Cardiac left ventricular ejection fraction (LVEF) >= 50%
  • Negative serum pregnancy (human chorionic gonadotropin \[beta-hCG\]) test within 7 days of leukapheresis for women of childbearing potential (WOCBP). WOCBP must be willing to use a highly effective method of contraception for the course of the study through 90 days after A2-ESO-1 TCR-engineered T cell infusion
  • Willing and able to provide written informed consent for the study
  • Willing to provide biopsy tissues and blood samples as required by the study

Exclusion Criteria:

  • Radiation therapy, chemotherapy, or non-cytotoxic investigational agent within 2 weeks of leukapheresis
  • Received cyclophosphamide within the past 4 months
  • Evidence of New York Heart Association class III or greater cardiac disease
  • History of myocardial infarction, stroke, ventricular arrhythmia, or symptomatic conduction abnormality within the past 12 months
  • History of congenital QT prolongation
  • Absolute QT interval of > 470 msec in the presence of > 4.0 mEq/L potassium and > 1.8 mg/dL magnesium
  • Brain or leptomeningeal metastases
  • Females who are pregnant or breastfeeding
  • Hypersensitivity or intolerance to cyclophosphamide, fludarabine, IL-2, or their components
  • History of clinically significant gastrointestinal bleeding, gastric or intestinal ulceration, or perforation within 6 months of enrollment.
  • Any severe and/or uncontrolled medical conditions or other conditions that could affect participation in the study, such as severely impaired lung function, any active (acute or chronic) or uncontrolled infection/disorders, and non-malignant medical illnesses that are uncontrolled or whose control may be jeopardized by the study treatment
  • Current use of medications that interact with or compromise the immune system such as steroid doses > 10 mg/day prednisone or equivalent daily within 2 weeks before leukapheresis
  • History of immunodeficiency disease or autoimmune disease, with exceptions such as Hashimoto's thyroiditis / hypothyroidism, or controlled Type 1 diabetes
  • Have any active and uncontrolled infection.
  • Active hepatitis B (as defined as positive hepBsAntigen or detectable hepatitis B DNA) or hepatitis C infection. Patients who are hepatitis B surface Antigen negative and have a negative hep B DNA are allowed. If hepatitis C antibody test is positive, then patients must be tested for the presence of antigen by RT-PCR and be HCV RNA negative. Patients with laboratory evidence of cleared hepatitis B or C infection may enroll. Patients with no prior history of hepatitis B infection who have been vaccinated against hepatitis B and who have a positive antibody against hepatitis B surface antigen as the only evidence of prior exposure may enroll. Patients with a history of hepatitis C infection may be eligible if they have completed antiviral treatment and show no detectable HCV RNA for 6 months prior to enrollment.
  • Human immunodeficiency virus (HIV) infection or seropositive for HIV antigens
  • Concurrent use of any complementary or alternative medicines
  • Unwilling or unable to comply with the study protocol
  • Prior major surgery that requires general anesthesia must be completed at least 4 weeks before leukapheresis and surgery that requires local anesthesia (except for study tissue sample collection) must be completed at least 2 weeks before leukapheresis and surgery that requires local anesthesia (except for study tissue sample collection) must be completed at least 2 weeks before leukapheresis

Study Design

Enrollment

20 participants

Anticipated

Intervention Model

Single group

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Treatment (A2-ESO-1 TCR-T cells)

Patients undergo leukapheresis on day -28 then receive cyclophosphamide IV over 1 hour on days -7 and -6 followed by fludarabine IV over 30 minutes on days -5 to -1. Patients then receive A2-ESO-1 TCR-T cells IV over 30 minutes on day 0 followed by aldesleukin IV over 15 minutes on days 0 to 2. Patients also undergo blood sample collection and CT scans throughout the study. Additionally, patients may undergo a breast biopsy, a mammogram, breast MRI, and breast US at screening and follow up, and ECHO or MUGA at screening.

Interventions

Aldesleukin

Given IV

Anti-HLA-A2/NY-ESO-1 TCR-transduced Autologous T Lymphocytes

Given IV

Biopsy

Undergo biopsy of breast tumor

Biospecimen Collection

Undergo blood sample collection

Computed Tomography

Undergo CT scan

Cyclophosphamide

Given IV

Echocardiography

Undergo ECHO

Fludarabine

Given IV

Leukapheresis

Undergo leukapheresis

Magnetic Resonance Imaging

Undergo breast MRI

Mammogram

Undergo mammogram

Multigated Acquisition Scan

Undergo MUGA scan

Ultrasound Imaging

Undergo ultrasound of breast

Primary outcome measure

  • Maximum tolerated dose (MTD) of anti-HLA-A2/NY-ESO-1 T-cell receptor (TCR)-transduced autologous T lymphocytes (A2-ESO-1 TCR-engineered T cells) [ Time Frame: Up to 6 weeks after A2-ESO-1 TCR-engineered T cell infusion ]
  • Incidence of dose-limiting toxicities [ Time Frame: Up to 6 weeks after A2 ESO-1 TCR-engineered T cell infusion ]

Central Contacts and Locations

Central contacts

Kimberly Arieli, RN

323-865-3935Kimberly.Arieli@med.usc.edu

Locations

USC / Norris Comprehensive Cancer Center

Recruiting

Los Angeles, California, United States, 90033

Contacts

Kimberly Arieli, RN

323-865-0451Kimberly.Arieli@med.usc.edu

Principal Investigator:

Daphne Stewart, MD

More Information

Sponsor

University of Southern California

Last update posted

May 19, 2026

Last verified

May, 2026

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by University of Southern California on 2026-05-19.