E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Prevention of immune mediated allograft rejection in patients with end-stage renal disease (ESRD) who are tissue typed as HLA-A*02 negative and have received a kidney transplant from an HLA-A*02 positive living donor. |
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E.1.1.1 | Medical condition in easily understood language |
Prevention of kidney graft rejection in patients who have received a kidney transplant due to chronic renal insufficiency. |
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E.1.1.2 | Therapeutic area | Body processes [G] - Immune system processes [G12] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10050436 |
E.1.2 | Term | Prophylaxis against renal transplant rejection |
E.1.2 | System Organ Class | 100000004865 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the short-term safety and tolerability of TX200-TR101 from the day of TX200-TR101 infusion within 28 days post TX200-TR101 infusion. |
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E.2.2 | Secondary objectives of the trial |
• To evaluate the effect of TX200-TR101 on acute graft-related outcomes from the day of TX200-TR101 infusion through to Week 84 in terms of biopsy-confirmed acute rejection (BCAR). • To evaluate the effect of TX200-TR101 on long-term safety outcomes from the day of TX200-TR101 infusion through to Week 84 in terms of treatment emergent adverse events(TEAEs). • To evaluate the reduction of immunosuppression over time through to Week 84. • To evaluate TX200-TR101 localisation in the graft at Week 16. • To evaluate the effect of TX200-TR101 on chronic graft-related outcomes from the day of TX200-TR101 infusion through to Week 84.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
The following inclusion criteria must be met for all transplant recipients (i.e., recipients to be administered TX200-TR101 and control recipients): Inclusion Criteria (All Transplant Recipients) 1. Willing and able to provide written informed consent (IC) in accordance with local regulations and governing Independent Ethics Committee (IEC)/Institutional Review Board (IRB) requirements prior to any procedure or evaluation performed specifically for the sole purpose of the study. 2. Male or female aged between 18 and 70 (inclusive) years. 3. Have diagnosis of ESRD and currently waiting for a new kidney from an identified live donor. 4. Subjects who will be single organ recipients (kidney). 5. Women who are of childbearing potential must have a negative serum pregnancy test at screening and before transplantation. 6. Able and willing to use a highly effective method of contraception from the signing of the informed consent through the last study visit, for male and female subjects with reproductive potential.
Additional Inclusion Criteria (Transplant Recipients to be Administered TX200-TR101 Only) The following additional criteria must be met for transplant recipients to be administered TX200- TR101: 1. HLA-A*02 negative typing (the kidney graft needs to be HLA A*02 positive). 2. HLA-A*69 negative typing. 3. Adequate venous access for leukapheresis, and no other contraindications for leukapheresis.
Additional Inclusion Criteria (Transplant Donors for Transplant Recipients to be Administered TX200- TR101 Only) The following additional inclusion criterion must be met for transplant donors for transplant recipients to be administered TX200-TR101: 1. HLA-A*02 positive typing.
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E.4 | Principal exclusion criteria |
Exclusion Criteria (All Transplant Recipients) 1.HLA identical to the prospective organ donor. 2.Subjects with prior organ transplant. 3.Positive flow cytometric crossmatch using donor lymphocytes and recipient serum. 4.Subjects with panel-reactive antibody (PRA) >20% within 6 months prior to enrolment. 5. Subjects with current or recent (within 6 months) donor-specific antibodies. 6. Subjects with underlying renal disease with a high risk of disease reoccurrence in the transplanted kidney including primary focal segmental glomerulosclerosis, types I or II membranoproliferative glomerulonephritis, C3 glomerulopathy, or haemolytic-uraemic syndrome (HUS), including atypical HUS. 7. Concomitant clinically active local or systemic infection. 8. Clinical evidence of significant unstable or uncontrolled acute or chronic diseases (i.e., cardiovascular, pulmonary, haematologic, gastrointestinal, hepatic, neurological, malignancy or infectious diseases) or laboratory abnormality (except ESRD) which, in the opinion of the investigator, could confound the results of the study or put the subject at undue risk. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Incidence and grade of TEAEs, including serious adverse events (SAEs) throughout 28 days post TX200-TR101 infusion. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
The timepoint of evaluation of the primary endpoint is given in the section above ( E.5.1) |
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E.5.2 | Secondary end point(s) |
From the day of TX200-TR101 infusion through to Week 84 unless otherwise specified below: •Incidence of BCAR according to the Banff criteria. •Time to first BCAR episode. •Type and severity of any BCAR episodes according to the Banff criteria. •Incidence and grade of TEAEs, including SAEs. •Incidence of opportunistic infections, specifically BK virus (BKV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV) reactivation •Incidence of neoplasia. •Proportion of subjects who are receiving tacrolimus monotherapy at Week 84. •Cumulative dose of immunosuppression, including but not limited to mycophenolic acid (MPA)/mycophenolate mofetil (MMF) and tacrolimus through to Week 84. •Presence of CD4 RNA transcript positive cells that are also positive for HLA-A2 CAR RNA transcripts in the renal transplant biopsy at Week 16. •Incidence and severity of chronic graft dysfunction, as measured by estimated glomerular filtration rate (eGFR). •Incidence and severity of chronic graft dysfunction, as measured by the Banff criteria for chronic rejection including the Banff lesion score inflammation in area of interstitial fibrosis and tubular atrophy (i-IFTA). •Incidence of graft loss due to rejection. •Incidence and (semi-quantitative) intensity of de novo DSA. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
The timepoint of evaluation of each secondary endpoint is given in the section above (E.5.2). |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | Yes |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 5 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LVLS (Last visit of the last subject) |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |