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CD19-targeting CAR T Cells in Relapsed or Refractory CD19 Positive B-cell Malignancies

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ClinicalTrials.gov Identifier: NCT03559439
Recruitment Status : Recruiting
First Posted : June 18, 2018
Last Update Posted : June 19, 2018
Sponsor:
Collaborator:
Gracell Biotechnology Ltd.
Information provided by (Responsible Party):
Liu Ligen, Shanghai Tong Ren Hospital

Brief Summary:
This is a single center, single arm, open-label phase 1 study to determine the safety and efficacy of autologous T cells expressing CD19 chimeric antigen receptors in adults with CD19+ B cell malignancies.

Condition or disease Intervention/treatment Phase
B-cell Malignancy B-cell Lymphoma B-Cell Acute Lymphoblastic Leukaemia Biological: CD19 CAR T Phase 1

Detailed Description:
This is a single-center, Open Label phase I clinical trial, 9 subjects planned to be enrolled. The subjects will be divided into low-dose group, medium-dose group and high-dose group.Dose CAR+ cells/kg Low 1×105 Medium 2×106 High 6×106

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 9 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: CD19-targeting CAR T Cell Therapy in the Treatment of Relapsed or Refractory CD19 Positive B-cell Malignancies
Actual Study Start Date : April 24, 2018
Estimated Primary Completion Date : September 30, 2019
Estimated Study Completion Date : December 31, 2019


Arm Intervention/treatment
Experimental: CD19 CAR T
CD19 CAR T cells transduced with a lentiviral vector to express anti-CD19 scFv CD3z:CD28 administered by IV infusion.
Biological: CD19 CAR T
CD19 CAR T cells transduced with a lentiviral vector to express anti-CD19 scFv CD3z:CD28 administered by IV infusion. Subjects will receive 0.1-10 x 10^6 transduced CAR T cells as a split dose over three days as follows:Day 1, 10% fraction, Day 2, 30% fraction, Day 3, 60% fraction.




Primary Outcome Measures :
  1. Frequency and severity of toxicities and adverse events [ Time Frame: 24 weeks ]
    To assess the frequency and severity of toxicities and adverse events according to NCI CTC v4.0


Secondary Outcome Measures :
  1. overall response rate [ Time Frame: 24 week ]
    To assess the overall response rate after CD19 CAR T infusion in R/R B cell malignancies

  2. overall survival [ Time Frame: 24 week ]
    To assess the overall survival in patients with R/R B cell malignancies



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. CD19+ relapsed or refractory B cell malignancies:

    • Relapsed or refractory B acute lymphocytic leukemia.

      • Relapse was defined as presence of > 5% blasts at screening, or second or subsequent bone marrow relapse, or any bone marrow relapse after allogeneic stem cell transplant and must be ≥ 6 months from stem cell transplant at the time of infusion.
      • Refractory was defined by not achieving an initial complete response after 2 cycles of a standard chemotherapy regimen . Patients who were refractory to subsequent chemotherapy regimens after an initial remission were considered chemorefractory
    • Patients with Ph+ acute lymphocytic leukemia were eligible if they are intolerant to or have not achieved a remission after two lines of tyrosine kinase inhibitor therapy, or if tyrosine kinase inhibitor therapy is contraindicated, or ineligible for allogeneic stem cell transplant because of:

      • Comorbid disease
      • Other contraindications to allogeneic stem cell transplant conditioning regimen
      • Lack of suitable donor
      • Prior hematopoietic stem cell transplant
      • Declined allogeneichematopoietic stem cell transplant as a therapeutic option
    • Relapsed or refractory non-Hodgkin's lymphoma

      • Histopathological CD19+.
      • No response to last line of therapy i. partial response as best response to most recent therapy regimen ii. partial response as best response to most recent therapy with duration no longer than 6 month from last dose of therapy
      • Refractory post-Autologous stem cell transplant i. Disease progression or relapsed less than or equal to 12 months of Autologous stem cell transplant (must have biopsy proven recurrence in relapsed subjects) ii. If salvage therapy is given post-Autologous stem cell transplant, the subject must have had no response to or relapsed after the last line of therapy
      • Subjects must have received adequate prior therapy including at a minimum: anti-CD20 monoclonal antibody unless investigator determines that tumor is CD20-negative and an anthracycline containing chemotherapy regimen for subjects with transformed follicular lymphoma must have received prior chemotherapy for follicular lymphoma and subsequently have chemorefractory disease after transformation to Diffuse large B-cell lymphoma
    • At least one measurable lesion per revised IWG Response Criteria
  2. 18-75 years old
  3. Expected survival ≥ 12 weeks
  4. Adequate renal, hepatic, pulmonary and cardiac function defined as:

    • Creatinine clearance (as estimated by Cockcroft Gault) > 60 mL/min
    • Serum ALT/AST <2.5 ULN
    • Total bilirubin <1.5 mg/dl, except in subjects with Gilbert's syndrome
    • Cardiac ejection fraction >50%, no evidence of pericardial effusion as determined by an echocardiogram, and no clinically significant pleural effusion
    • Baseline oxygen saturation >92% on room air
  5. Eastern cooperative oncology group (ECOG) performance status of 0 - 2
  6. Pregnant or lactating women must have a negative pregnancy test before infusion, and agree to take effective contraception during the trial
  7. Apheresis product received and accepted
  8. Written informed consent

Exclusion Criteria:

  1. Isolated extra-medullary relapse leukemia
  2. Other malignancies
  3. Concomitant genetic syndrome, with the exception of Down Syndrome
  4. Burkitt's lymphoma/leukemia
  5. Treatment with any prior gene therapy product, anti-CD19/anti-CD3 therapy, or any other anti-CD19 therapy
  6. Active hepatitis B, C, or any uncontrolled infection
  7. Grade 2 to 4 Graft versus Host Disease (GVHD)
  8. Medications or treatments that were to be excluded:

    • Corticosteroids within 72 hours of infusion, with the exception of physiologic replacement
    • Allogeneic cellular therapy, such as donor lymphocyte infusion within 6 weeks prior to infusion
    • Graft versus Host Disease therapies
    • Chemotherapy stopped prior to lymphodepletion based on clearance
    • central nervous system prophylaxis treatment
  9. Active central nervous system disease (central nervous system 2 disease [Cerebral spinal fluid containing blasts, but < 5 WBCs/microliter] patients were eligible)
  10. Any condition that investigator considered may increase the risk of the subjects or interfere with the trial results

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03559439


Contacts
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Contact: Ligen Liu 18017337037 llg3532@shtrhospital.com

Locations
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China
Shanghai Tong Ren hospital Recruiting
Shanghai, China
Contact: Ligen Liu    18017337037    llg3532@shtrhospital.com   
Sponsors and Collaborators
Shanghai Tong Ren Hospital
Gracell Biotechnology Ltd.
Investigators
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Principal Investigator: Ligen Liu Shanghai Tong Ren Hospital

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Responsible Party: Liu Ligen, Principal Investigator, Shanghai Tong Ren Hospital
ClinicalTrials.gov Identifier: NCT03559439     History of Changes
Other Study ID Numbers: PTA001
First Posted: June 18, 2018    Key Record Dates
Last Update Posted: June 19, 2018
Last Verified: June 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
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Neoplasms
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia, Lymphoid
Lymphoma, B-Cell
Burkitt Lymphoma
Leukemia
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Lymphoma, Non-Hodgkin
Lymphoma
Epstein-Barr Virus Infections
Herpesviridae Infections
DNA Virus Infections
Virus Diseases
Tumor Virus Infections