ClinicalTrials.gov record NCT05400603
Allogeneic Expanded Gamma Delta T Cells With GD2 Chemoimmunotherapy in Relapsed /Refractory Neuroblastoma or Refractory/ Relapsed Osteosarcoma
A Phase I Study of Allogeneic Ex Vivo Expanded Gamma Delta (γδ) T Cells in Combination With Dinutuximab, Temozolomide, Irinotecan, and Zoledronate in Children With Refractory/ Relapsed, or Progressive Neuroblastoma or Refractory/ Relapsed Osteosarcoma
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AI-written from the registry record, not the study's own wording. May contain errors or omissions. Check the registry text on this page and the original record ↗ before acting on it.
Phase 1 study testing donor-derived (allogeneic) ex vivo expanded γδ T cells given with dinutuximab, temozolomide, irinotecan, and zoledronate for children with refractory, relapsed, or progressive neuroblastoma or relapsed/refractory osteosarcoma. The main goal is to find the maximum tolerated dose (MTD) and a recommended Phase 2 dose, and to describe toxicities. Cells are infused during each course (Day 6 and, if eligible, Day 13) with up to four courses possible and a 3+3 dose-escalation plan.
What it is studying. Whether a defined dose of third-party (donor) expanded γδ T cells can be given safely with dinutuximab plus temozolomide, irinotecan, and zoledronate in children with refractory or relapsed neuroblastoma or osteosarcoma, and to collect early data on side effects and disease responses.
What the researchers hope to learn. Determine the maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D) of allogeneic expanded γδ T cells when given with dinutuximab and chemotherapy; describe treatment-related toxicities; and collect preliminary data on tumor response and clinical outcomes to inform future research on γδ T cells in these tumors.
What this study is about
The study's own summary, as published on ClinicalTrials.gov. Underlined terms have a short explanation.
The goal of this clinical trial is to determine the maximum tolerated dose (MTD) and recommended Phase II dose (RP2D) of allogeneic expanded γδ T cells when delivered with Dinutuximab, temozolomide, irinotecan, and zoledronate in children with refractory or recurrent neuroblastoma or refractory/ relapsed osteosarcoma as well as to define the toxicities of allogeneic expanded γδ T cells when delivered with Dinutuximab, temozolomide, irinotecan, and zoledronate
Interventions being studied
Being studied in this trial does not mean the treatment or procedure is approved or available for this condition.
- Combination product
- Ex Vivo Expanded Allogeneic γδ T Cells in Combination with Dinutuximab, Temozolomide, Irinotecan and Zoledronate
Eligibility
The criteria exactly as listed on ClinicalTrials.gov. Only the study team can say whether they apply to you.
Inclusion criteria
- Patients must be ≥ 12 months of age at the time of enrollment in the study.
- Diagnosis: Histological confirmation of neuroblastoma or ganglioneuroblastoma at initial diagnosis. (Bone marrow samples with positive catecholamines are acceptable as confirmation of neuroblastoma) OR histological confirmation of osteosarcoma at diagnosis
- Response to prior therapy:
- High-risk neuroblastoma with refractory, relapsed or progressive disease, defined as:
- First or greater relapse of neuroblastoma following completion of aggressive multi- drug frontline therapy.
- First episode of progressive neuroblastoma during aggressive multi-drug frontline therapy.
- Persistent/refractory neuroblastoma as defined by less than a complete response by the revised International Neuroblastoma Response Criteria (INRC) after at least 4 cycles of aggressive multidrug induction chemotherapy on or according to a high-risk neuroblastoma protocol (such as A3973 or ANBL0532).
- Note that this excludes patients initially considered low or intermediate-risk neuroblastoma that progressed to high-risk disease but the patient has not progressed after the diagnosis of high-risk neuroblastoma.
- Relapsed or refractory osteosarcoma that is not responsive to standard treatment
- Disease Status
- Patients must have measurable or evaluable disease per revised INRC for subjects with neuroblastoma or measurable or evaluable disease by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 for subjects with Osteosarcoma
- Performance Level:Patients must have a Lansky (≤16 years) or Karnofsky (>16 years) score of ≥50
- Prior Therapy
- Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy before study registration.
- Prior dinutuximab therapy is allowed regardless of prior response or progression on dinutuximab
- Prior temozolomide therapy is allowed
- Prior zoledronate is allowed
- Prior dinutuximab/temozolomide/irinotecan chemoimmunotherapy is allowed
- Prior T cell therapy is excluded
- Organ Function Requirements:
- Hematologic Functions : Absolute Neutrofil count ≥750/uL and platelet count ≥ 75,000/µl, transfusion independent .
- Renal Function: Patients must have adequate renal function defined as age-adjusted serum creatinine ≤1.5 ULN for age.
- Liver Function: Total bilirubin ≤ 1.5 x ULN for age and serum glutamic-pyruvic transaminase (SGPT) (ALT) ≤ 135 U/L (≤ 3x ULN).
- Cardiac Function: Normal ejection fraction (≥ 55%) documented by either echocardiogram or radionuclide multigated acquisition scan (MUGA) evaluation OR Normal fractional shortening (≥ 27%) documented by echocardiogram
- Pulmonary Function: Normal pulmonary function with no evidence of dyspnea at rest, no exercise intolerance.
Exclusion criteria
- Prior T cell therapy
- Pregnancy, breast feeding, or unwillingness to use effective contraception during the study will not be entered on this study.
- Patients who, in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study.
- Patients with known active Central Nervous System (CNS) disease (excluding skull disease with intracranial extension). Patients with a history of CNS disease are required to have a brain CT and/ or MRI at study registration.
- Patients with prior allogeneic stem cell transplant
- Patients who are on hemodialysis
- Patients with an active or uncontrolled infection. Patients on prolonged antifungal therapy are still eligible if they are culture negative, afebrile, and meet other organ function criteria
- Known history of human immunodeficiency virus (HIV) infection, hepatitis B, or hepatitis C. Testing is not required in the absence of clinical findings or suspicion.
- Patients with disease of any major organ system that would compromise their ability to withstand therapy.
- Patients who have had to permanently discontinue Dinutuximab due to toxicity
- Patients with serious, uncontrolled cardiac arrhythmias
- Patients with a history of myocarditis
- Patients who have received any live vaccines within 30 days before enrollment
Study description and what participation involves
The study's detailed description, as published on ClinicalTrials.gov.
Show the detailed description from the registry
High-risk neuroblastoma and metastatic osteosarcoma are aggressive and lethal pediatric solid tumors. Survival remains less than 50% and those patients who do survive suffer many treatment-related acute and chronic toxicities, stressing a critical need for novel tumor-targeting therapies. γδ T cells are an innovative approach to cell therapy for neuroblastoma and osteosarcoma as they are MHC-independent and directly cytolytic to tumor cells. The team has developed a GMP-compliant manufacturing strategy to expand γδ T cells from normal donor and neuroblastoma patient apheresis products for this trial. This is a Phase 1 study to determine the safety, recommended Phase 2 cell therapy dose, and preliminary efficacy of allogenic (third party) ex vivo expanded gamma delta (γδ) T cells in combination with dinutuximab, temozolomide, irinotecan, and zoledronate in children with refractory, relapsed, or progressive neuroblastoma or osteosarcoma. The purpose of this study is to help doctors and scientists learn if γδ T cells will aid in clinical and disease response in this population and to determine the maximum tolerated dose (MTD). Third-party γδ T cells will be prepared from healthy donors and expanded under GMP conditions at Expression Therapeutics, LLC. γδ T cells will be expanded, cryopreserved as numerous aliquots, and transported to The Children's Healthcare of Atlanta, Egleston Campus. At the appropriate time, an aliquot of γδ T cells appropriate for the size of the subject will be thawed and infused into the patient according to institutional protocol. Subjects will receive a single infusion of third-party, ex vivo expanded, frozen then thawed γδ T cell product on Day 6, and then if they meet the criteria for subsequent γδ T cell dose will receive a second dose on Day 13. The γδ T cell dose will be infused after the dinutuximab, temozolomide, irinotecan, and zoledronate schedule is complete. There will be no intra-patient dose escalation. The entry dose level is Dose Level 1, with escalation up to Dose Level 3 following standard 3+3 rules for γδ T cell dose escalation design. A minimum of 6 and a maximum of 24 patients with refractory, relapsed, or progressive neuroblastoma or osteosarcoma will be recruited through various strategies, including face-to-face encounters between participants and study staff during clinical encounters at CHOA. Leftover blood samples collected may be stored for future research by the sponsor of this study. This research will advance scientific knowledge and clinical data in the solid tumor field and knowledge of γδ T cells. Cell therapy has been a promising treatment for solid tumors, so with this advancement in T-cell therapy, the team can potentially advance patient outcomes.
AI summaryWhat participation may involve, in plain languageShow ▾Hide ▴
AI-written from the registry record, not the study's own wording. May contain errors or omissions. Check the registry text on this page and the original record ↗ before acting on it.
Participants receive combination chemoimmunotherapy (dinutuximab, temozolomide, irinotecan, and zoledronate) plus infusions of donated, expanded γδ T cells—one infusion on Day 6 and, if eligible, a second on Day 13 of each course. γδ T‑cell dose is escalated across participants (standard 3+3 design) to determine the recommended Phase II dose; up to four courses may be given if disease does not progress. Study visits include infusions, close safety monitoring for dose‑limiting toxicities (especially in Course 1), blood tests, and imaging to evaluate disease after Courses 2 and 4. Leftover blood samples may be stored for future research per the study record.
How the study is structured. Interventional Phase 1 treatment trial, open-label (not masked). Single experimental arm using a sequential 3+3 dose-escalation to find the tolerated γδ T cell dose. Each treatment course combines standard doses of dinutuximab, temozolomide, irinotecan, and zoledronate with one γδ T cell infusion on Day 6 and a possible second infusion on Day 13; up to four courses may be given. Safety is assessed during the first course and disease response is evaluated after courses 2 and 4.
Questions you could ask
These questions are suggestions for a conversation with the study team or your own clinician, not advice.
- The registry lists this study under Neuroblastoma; Refractory Neuroblastoma; Relapsed Neuroblastoma; Relapsed Osteosarcoma; Refractory Osteosarcoma. Does it apply to my diagnosis?
- This is an early-phase study, mainly about safety and dose. What is already known about this treatment?
- The listed sites are in United States. Is any of them reachable for me, and does the study help with travel?
- Which of the eligibility criteria would need to be checked with tests before I could join?
More on Gaucher disease
Important dates
- Study start
- Nov 6, 2023
- Primary completion
- December 2026 (estimated)
- Study completion
- December 2026 (estimated)
- Target enrollment
- 24 participants (estimated)
- Last updated on registry
- Dec 26, 2025
- Data verified
- Oct 10, 2026
Sponsor and research team
The lead sponsor funds and oversees the trial. A pharmaceutical or biotech company sponsor typically means the study is testing that company's drug or device; a hospital, university, or government agency usually indicates investigator-initiated or publicly funded research.
- Lead sponsor
- Emory University
- Principal investigator
- Kelly Goldsmith, Professor
Emory University
Central study contact
If you're interested in participating, the central contact can answer general questions about the study — including eligibility requirements and how to find a recruiting site near you. Actual eligibility is determined by the site's medical team.
- Kelly Goldsmith, MD 📞 (404) 727-2655 ✉ kgoldsm@emory.edu; mpactcto@choa.org
Participating sites (1)
- Children's Healthcare of AtlantaRecruiting
Atlanta, Georgia, 30322 · United States
- Kelly Goldsmith, MD · mpactcto@choa.org
Terms used on this page · explanations by MedicalUpdates.ai
- maximum tolerated dose
- The highest dose found in a dose-escalation study that can be given without too many dose-limiting side effects.
- Phase II
- A study that tests whether a treatment has the intended effect and continues to check safety, usually in a larger group than phase 1.
- RP2D
- The dose chosen at the end of a phase 1 study for testing in later studies, based on safety and other measurements.
- refractory
- A condition that has not responded to a treatment. 'Relapsed' means it responded and then came back; 'refractory' means it did not respond in the first place.
- relapsed
- A condition that improved with treatment and has since returned or worsened.
- enrollment
- The number of participants a study plans to include, or has included. 'Estimated' means the planned number; 'actual' means the number who joined.
- prior therapy
- Treatment a person has already had for the condition. A 'line of therapy' is one course of treatment; studies often require, or limit, the number of prior lines.
- complete response
- No sign of the condition can be found with the tests used in the study. It does not always mean the condition is gone permanently, and the definition depends on the condition and the study.
- standard treatment
- Treatment generally considered appropriate for a condition in a particular clinical setting. It can vary by patient, place and over time. In many studies the new treatment is added to, or compared with, standard of care.
- Karnofsky
- A scale from 100 (no complaints) down to 0 that describes how well a person can carry out daily activities. Studies often require a minimum score.
- ULN
- The highest value of a blood test that a laboratory considers normal. Criteria such as '≤ 3 × ULN' mean the result must be no more than three times that value.
- echocardiogram
- An ultrasound scan of the heart. A transesophageal echocardiogram is done through a probe passed into the food pipe for a closer view.
- CT
- An X-ray scan that builds detailed cross-section images of the body. 'High-resolution' CT (HRCT) is used to look closely at the lungs.
- MRI
- A scan that uses magnets and radio waves, not X-rays, to make detailed pictures of the inside of the body. Some implants and metal objects mean a person cannot have one.
- allogeneic stem cell transplant
- A procedure that replaces blood-forming cells after high-dose treatment. 'Autologous' uses the person's own cells collected beforehand; 'allogeneic' uses cells from a donor.
- Inclusion Criteria
- The conditions a person must meet to be considered for the study, for example a confirmed diagnosis, an age range or a test result.
- Exclusion Criteria
- The conditions that rule a person out even if they meet the inclusion criteria, for example other illnesses, certain medicines or pregnancy.
- dose escalation
- Groups of participants receive increasing doses of a treatment, one group after another, to find a dose that can be given safely.
- sponsor
- The organisation or person that initiates the study and has authority over it. The sponsor may be a company, hospital, university, government agency or individual, and is not necessarily the organisation that funds the study.
The study record on this page is reproduced from ClinicalTrials.gov, a database of the U.S. National Library of Medicine, where it was submitted by the study sponsor. MedicalUpdates.ai does not own this content, is not affiliated with or endorsed by ClinicalTrials.gov, NIH, or the U.S. Government, and does not verify the record. Plain-language notes, the glossary and the questions above are added by this site; text in the boxes marked "AI summary" was written by an AI model and may contain errors. Registry records change over time. Check the original record for the current version and discuss eligibility or participation with a qualified healthcare professional.
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