ALK inhibitors increase ALK expression and sensitize neuroblastoma cells to ALK.CAR-T cells.
Elisa Bergaggio, Wei-Tien Tai, Andrea Aroldi...
https://pubmed.ncbi.nlm.nih.gov/38039964/Actively Recruiting
Led by Roberto Chiarle · Updated on 2025-12-26
42
Participants Needed
2
Research Sites
104 weeks
Total Duration
Researchers are evaluating the safety and feasibility of using autologous chimeric antigen receptor CAR T cells that target the human Anaplastic Lymphoma Kinase ALK receptor to treat children and young adults with relapsed or refractory high-risk neuroblastoma. This Phase 12 trial aims to find the best dose and assess the response rates to these specialized immune cells. The study is led by Roberto Chiarle and involves careful monitoring of treatment effects and patient outcomes. The trial has two phases Phase 1 uses a dose escalation design to determine the maximum tolerated dose MTD and recommended dose for Phase 2. The treatment involves giving patients their own modified T cells designed to attack cancer cells. Phase 2 then expands to evaluate how well patients respond to this therapy in terms of complete and partial tumor responses. The study focuses on children and young adults up to 29 years old with specific disease criteria. Participants will undergo thorough evaluations including disease status assessments based on the International Neuroblastoma Response Criteria, organ function tests, and performance status checks. Researchers will track the feasibility of manufacturing the CAR T cells, measure response rates, progression-free survival, overall survival, and patient-reported symptoms over up to five years. Blood tests will monitor the persistence of CAR T cells and cytokine levels. The total participation time includes long-term follow-up to assess treatment effects and safety.
CONDITIONS
Study of hALK.CAR T Cells for Patients With Relapsed/Refractory High-risk Neuroblastoma
S
Susanne Baumeister, MD
A
Audra Caine
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Roberto Chiarle
Lead Sponsor
Boston Children's Hospital
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 | hALK.CAR T cell therapy | Standard Salvage Chemotherapy |
|---|---|---|
| What it is | Autologous chimeric antigen receptor T cells engineered to target the human ALK receptor on neuroblastoma cells, given as a cell therapy. | Chemotherapy consisting of various active regimens such as cyclophosphamide/topotecan, irinotecan/temozolomide, or high-dose ifosfamide/carboplatin/etoposide, used as standard salvage treatment for relapsed or refractory high-risk neuroblastoma. |
| Role in trial | Investigational therapy assessed for dose escalation, safety, and early evidence of activity in patients with relapsed/refractory high-risk neuroblastoma. | Routine guideline-based treatment used for patients with relapsed or resistant high-risk neuroblastoma outside clinical trials. |
| Primary use or purpose | Aimed at targeting and destroying neuroblastoma cells in patients whose disease has relapsed or not responded to prior standard therapies. | To attempt disease control or achieve remission in patients with relapsed or refractory high-risk neuroblastoma after prior treatment. |
| How it is given or performed | T cells are collected from the patient, genetically modified to express a chimeric antigen receptor for ALK, expanded in the lab, and infused back as a single or split dose. Patients may receive preparative chemotherapy before infusion. | Given as cycles of intravenous chemotherapy, with drug regimens and schedule chosen according to disease status and protocol. |
| Evidence status | Efficacy and safety are being studied in early-phase clinical trials; mature outcome data are not yet available for this product in neuroblastoma. | Published studies and guideline recommendations show salvage chemotherapy regimens achieve partial disease control or response in some patients, but long-term survival remains limited after relapse. |
| Important limitations | Long-term efficacy and safety are not yet established. Manufacturing feasibility, eligibility limits, and potential for acute complications require ongoing assessment. | Toxicity, myelosuppression, and limited durability of response after relapse restrict the benefit of conventional chemotherapy regimens. |
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.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Up to 5 years depending on participant response and dosing schedule
Participants receive autologous hALK.CAR T cells as an investigational therapy for relapsed or refractory high-risk neuroblastoma.
Visits occur according to dose escalation and monitoring schedules during treatment
Duration - Up to 5 years
Participants are monitored for response to treatment, side effects, and long-term outcomes including survival and persistence of hALK.CAR T cells.
Regular follow-up visits for assessments and monitoring
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SEQUENTIAL
Primary Purpose
TREATMENT
Number of Arms
1
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Elisa Bergaggio, Wei-Tien Tai, Andrea Aroldi...
https://pubmed.ncbi.nlm.nih.gov/38039964/Roberto Chiarle
Lead Sponsor
Boston Children's Hospital
Collaborating Sponsor