D3-GPC2-Directed CAR T Cells Are Safe and Efficacious in Preclinical Models of Neuroblastoma and Small Cell Lung Cancer.
Anna Maria Giudice, Stephanie Matlaga, Sydney L Roth...
https://pubmed.ncbi.nlm.nih.gov/41026583/Actively Recruiting
Led by Stephan Grupp MD PhD · Updated on 2025-12-29
45
Participants Needed
1
Research Sites
104 weeks
Total Duration
This research aims to evaluate the safety and feasibility of using GPC2-directed CAR T cells in patients with advanced neuroblastoma or retinoblastoma who have relapsed or refractory disease. These children face poor outcomes despite existing intense treatments, and GPC2 is a promising target due to its high expression on tumor cells but low presence on normal tissues. The trial is a first-in-human, open-label, phase 1 dose escalation and expansion study designed to assess safety, tolerability, and manufacturing feasibility of this novel therapy. Participants will receive genetically modified autologous T cells engineered to target GPC2. The study includes two arms a dose escalation arm to determine the maximum tolerated dose using a standard 33 design, followed by a dose expansion arm to further assess safety and preliminary effectiveness at a safe dose. The treatment is given once the dose is established, and further patients may be enrolled to evaluate response rates and safety profiles. During the study, participants will be closely monitored for adverse events and treatment response over five years. Researchers will assess safety outcomes such as maximum tolerated dose and frequency of adverse events, and secondary outcomes including cell manufacturing feasibility, persistence of CAR T cells, and preliminary clinical activity. Participants will undergo regular evaluations including imaging, laboratory tests, and clinical assessments to track disease status and treatment effects throughout the study and follow-up period.
CONDITIONS
GPC2 CAR T Cells for Relapsed or Refractory Neuroblastoma and Metastatic Retinoblastoma
C
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M
Melissa Varghese, M.S.
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Stephan Grupp MD PhD
Lead Sponsor
Children's Hospital of Philadelphia
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | GPC2 CAR T cells (investigational, single-arm trial) | Best available salvage chemotherapy (external current-care context) |
|---|---|---|
| What it is | An investigational therapy using the patient’s own T cells genetically engineered to target glypican 2 (GPC2), a cell surface protein expressed in neuroblastoma and retinoblastoma. The modified T cells are designed to find and attack GPC2-expressing cancer cells. | A combination of chemotherapy drugs chosen based on prior treatments, published regimens, and consensus guidelines, typically using agents such as topotecan, cyclophosphamide, irinotecan, or temozolomide. Used as non-curative salvage therapy for children and adolescents with relapsed/refractory disease. |
| Role in trial | Studied as a single experimental intervention for children and adolescents with relapsed/refractory or metastatic disease who have few or no remaining curative options. | Provided as the typical treatment outside clinical trials for patients with relapsed/refractory high-risk neuroblastoma and metastatic retinoblastoma. |
| Primary use or intent | Intended to achieve anti-tumor activity in children and adolescents whose disease has not responded or has come back after previous treatments. | Used with palliative intent to control symptoms or temporarily shrink tumors in patients whose disease did not respond to or came back after frontline therapy. |
| How it is given or performed | The patient’s T cells are collected (apheresis), engineered in a laboratory to express the anti-GPC2 receptor, expanded, and infused back into the patient following lymphodepleting chemotherapy. Monitoring and potential hospital admission are required. | Administered as intravenous chemotherapy in cycles, often in the hospital or clinic. Drug combinations and specific regimens may vary with patient history and national/institutional protocols. |
| Evidence status | Clinical efficacy and safety are not yet established. Early-phase clinical and preclinical studies suggest feasibility and anti-tumor activity, but no published outcome data from this clinical trial is yet available. | Variable and generally poor outcomes in heavily pretreated children and adolescents. Responses are often short-lived and cure is rare in the relapsed/refractory population. |
| Important limitations | Safety and effectiveness in humans are not yet known; this is an early-phase trial. Risks of CAR T therapy include cytokine release syndrome, neurotoxicity, and unknown long-term effects. | Treatment is largely non-curative in relapsed/refractory settings and often associated with significant toxicity, including infection, organ dysfunction, and quality-of-life impact. Efficacy is limited in most cases. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Duration of treatment depends on dose escalation and response; dosing occurs as per protocol until discontinuation or disease progression.
Participants receive GPC2 CAR T cell therapy to target relapsed or refractory neuroblastoma or metastatic retinoblastoma.
1 baseline visit and multiple follow-up visits as per protocol
Duration - Up to 5 years
Participants are monitored for safety, adverse events, and persistence of GPC2 CAR T cells after treatment ends.
Regular visits for safety and response assessments during follow-up
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NON_RANDOMIZED
Model
SEQUENTIAL
Primary Purpose
TREATMENT
Number of Arms
2
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Anna Maria Giudice, Stephanie Matlaga, Sydney L Roth...
https://pubmed.ncbi.nlm.nih.gov/41026583/Stephan Grupp MD PhD
Lead Sponsor
Children's Hospital of Philadelphia
Collaborating Sponsor