B7-H3-Specific Chimeric Antigen Receptor Autologous T-Cell Therapy for Pediatric Patients With Solid Tumors (3CAR)

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Active drug More information Started >3 years ago More information High burden on patient More information

Trial Details

Sponsor: St. Jude Children's Research Hospital (other)

Phase: 1

Start date: July 6, 2022

Planned enrollment: 32

Trial ID: NCT04897321
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More trial details at ClinicalTrials.gov More info

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Investigational Drug AI Analysis

chevron Show for: B7-H3 CAR-T (B7-H3CART, B7-H3-CAR T Cells, TX103, 4SCAR-276, anti-B7-H3 CAR T cells)

TrialFetch AI Analysis

Goal: Determine the safety profile and maximum tolerated dose of a single intravenous infusion of autologous B7-H3–directed CAR T cells following lymphodepleting chemotherapy in pediatric and young adult patients with relapsed/refractory B7-H3–positive solid tumors, and to explore preliminary antitumor activity and biologic correlates.

Patients: Children, adolescents, and young adults aged 21 years or younger with measurable, relapsed or refractory B7-H3–positive solid tumors confirmed by IHC (H-score ≥100), adequate organ function, performance status ≥50, and an estimated life expectancy >8–12 weeks depending on stage. Key exclusions include primary immunodeficiency, HIV infection, severe uncontrolled infections (including active hepatitis B/C), hypersensitivity to murine proteins, rapidly progressive disease, and recent/high-dose systemic steroids or therapies expected to interfere with CAR T activity.

Design: Single-center, phase 1, nonrandomized, dose-escalation study using a standard 3+3 design with a 6-week DLT evaluation window to define the maximum tolerated dose. Total study duration is 1 year, after which patients transition to a long-term follow-up protocol for recipients of gene-modified cell products.

Treatments: Lymphodepleting chemotherapy with fludarabine and cyclophosphamide with MESNA support followed by a single intravenous infusion of autologous B7-H3 CAR T cells. B7-H3 CAR T cells are engineered autologous T cells expressing a CAR against CD276 (B7-H3), a checkpoint-like antigen broadly overexpressed across pediatric solid and CNS tumors with limited normal tissue expression. Second-generation B7-H3 CAR constructs have shown preclinical potency and emerging clinical activity, particularly in locoregional CNS delivery settings; early phase studies in pediatric DIPG and recurrent glioblastoma have reported feasible administration, manageable toxicity, and signals of antitumor activity. Safety profiles to date are consistent with CAR T–related inflammatory toxicities, with variable rates of neuroinflammatory events depending on route and disease context.

Outcomes: Primary: safety and maximum tolerated dose based on dose-limiting toxicities within 6 weeks; dose levels include 3×10^5/kg, 1×10^6/kg, 3×10^6/kg, and 1×10^7/kg CAR+ T cells. Secondary: objective response rate per RECIST v1.1 at 6 weeks. Exploratory: changes in tumor microenvironment; immunophenotype, clonal structure, and repertoire of CAR and non-CAR T cells; and peripheral blood cytokine profiling after infusion.

Burden on patient: High. Participants undergo leukapheresis for cell manufacture (if not previously collected), lymphodepleting chemotherapy requiring inpatient or intensive outpatient monitoring, and a single CAR T infusion followed by close observation during a 6-week DLT window with frequent clinic visits, labs, and potential cytokine/immune monitoring. Additional imaging for response assessment at 6 weeks and research blood draws for correlative studies are expected. Management of potential acute toxicities such as cytokine release syndrome or neurotoxicity may necessitate hospitalization, adding travel and time demands. Transition to long-term follow-up for gene-modified cell recipients increases duration of monitoring beyond the primary study year.

Last updated: Oct 2025

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St. Jude Children's Research Hospital

Memphis, Tennessee, 38105, United States

[email protected] / 866-278-5833

Status: Recruiting