Multi-institutional Phase I/II Trial Evaluating the Treatment of SCID-X1 Patients With Retrovirus-mediated Gene Transfer
Severe combined immunodeficiencies (SCID) are a heterogeneous group of inherited disorders
characterized by a profound reduction or absence of T lymphocyte function. They arise from a
variety of molecular defects which affect lymphocyte development and function. The most
common form of SCID is an X-linked form (SCID-X1) which accounts for 40-50% of all cases.
SCID-X1 is caused by defects in the common cytokine receptor chain, which was originally
identified as a component of the high affinity interleukin-2 receptor (IL-2RG), but is now
known to be an essential component of the IL-4, -7, -9 -15, and -21 cytokine receptor
complexes. Classic SCID-X1 has an extremely poor prognosis without treatment. Death usually
occurs in the first year of life from infectious complications unless definitive treatment
can be administered. Until the recent advent of somatic gene therapy, hematopoietic stem
cell transplantation (HSCT) offered the only curative option for patients with any form of
SCID. If a genotypically matched sibling donor is available, HSCT is a highly successful
procedure. However a genotypically matched family donor is only available for approximately
30% of patients. For the remaining individuals, alternative donor transplants, principally
from matched unrelated or haploidentical parental donors have been performed. These
approaches are still problematic with toxicity from ablative therapy, graft-versus-host
disease and incomplete lymphoid reconstitution. Recent gene transfer trials have documented
the efficacy of gene transfer in this disease, albeit with toxicity related to insertional
mutagenesis. A new generation of self-inactivating (SIN) vectors has been developed which
lack all enhancer-promoter elements of the LTR U3 region and are also devoid of all
gammaretroviral coding regions. A SIN vector expressing the IL-2RG gene,
pSRS11.EFS.IL2RG.pre* has been developed and has shown a reduction in mutagenic potential
compared to LTR configuration in non-clinical studies. The current study is a phase I/II
trial of somatic gene therapy for patients with SCID-X1.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
CD3 cell count post transfusion
Immunological reconstitution defined as absolute CD3 cells of >300/μl and PHA stimulation index >15 at 6 months post infusion
6 Months Post Gene Transfer
No
Luigi Notarangelo, MD
Principal Investigator
Children's Hospital Boston
United States: Food and Drug Administration
IND14067
NCT01129544
April 2010
April 2030
Name | Location |
---|---|
Children's Hospital Boston | Boston, Massachusetts 02115 |
Cincinnati Children's Medical Center | Cincinnati, Ohio 45267 |
Mattel Children's Hospital - UCLA | Los Angeles, California 90095 |