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Efficacy of Axicabtagene Ciloleucel Compared to Standard of Care Therapy in Subjects With Relapsed/Refractory Diffuse Large B Cell Lymphoma (ZUMA-7)

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ClinicalTrials.gov Identifier: NCT03391466
Recruitment Status : Recruiting
First Posted : January 5, 2018
Last Update Posted : December 10, 2018
Sponsor:
Information provided by (Responsible Party):
Kite, A Gilead Company

Brief Summary:
The purpose of this study is to evaluate whether axicabtagene ciloleucel therapy improves the clinical outcome compared with standard of care second-line therapy in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).

Condition or disease Intervention/treatment Phase
Relapsed/Refractory Diffuse Large B-Cell Lymphoma (DLBCL) Biological: Axicabtagene Ciloleucel Drug: Platinum-containing salvage chemotherapy (eg, R-ICE) followed by high dose therapy (eg, BEAM) and autologous stem cell transplant in responders. Drug: Cyclophosphamide Drug: Fludarabine Phase 3

Detailed Description:

This is a phase 3 randomized, open-label, multicenter study evaluating the efficacy of axicabtagene ciloleucel versus standard of care therapy in subjects with relapsed/refractory DLBCL. Adult subjects with relapsed/refractory DLBCL after first-line rituximab and anthracycline-based chemotherapy will be randomized in a 1:1 ratio to receive axicabtagene ciloleucel or standard of care second-line therapy.

Standard of care will consist of a protocol-defined, platinum-based salvage combination chemotherapy regimen followed by high-dose therapy and autologous stem cell transplant in those who respond to salvage chemotherapy.


Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 350 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Two arms, SOC and experimental treatment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 3, Randomized, Open-Label Study Evaluating Efficacy of Axicabtagene Ciloleucel Versus Standard of Care Therapy in Subjects With Relapsed/Refractory Diffuse Large B Cell Lymphoma
Actual Study Start Date : December 14, 2017
Estimated Primary Completion Date : January 15, 2022
Estimated Study Completion Date : January 15, 2035


Arm Intervention/treatment
Experimental: Axicabtagene Ciloleucel Treatment Biological: Axicabtagene Ciloleucel
A single infusion of chimeric antigen receptor (CAR)-transduced autologous T cells administered intravenously following a conditioning chemotherapy regimen of fludarabine and cyclophosphamide
Other Names:
  • KTE-C19
  • axi-cel

Drug: Cyclophosphamide
Administered intravenously

Drug: Fludarabine
Administered intravenously

Active Comparator: Standard of Care Therapy Drug: Platinum-containing salvage chemotherapy (eg, R-ICE) followed by high dose therapy (eg, BEAM) and autologous stem cell transplant in responders.
Platinum-containing salvage chemotherapy (R-ICE, R-DHAP, R-ESHAP, or R-GDP as selected by treating investigator) followed by high dose therapy (eg, BEAM) and autologous stem cell transplant in responders.




Primary Outcome Measures :
  1. Event Free Survival [ Time Frame: Up to 5 years ]
    Event free survival is defined as the time from randomization to the earliest date of disease progression per Lugano Classification (Cheson et al, 2014), commencement of new lymphoma therapy, or death from any cause as determined by blinded central review


Secondary Outcome Measures :
  1. Objective Response Rate (ORR) [ Time Frame: Up to 5 years ]
    Objective response rate is defined as the incidence of either a complete response or a partial response by the Lugano Classification (Cheson et al, 2014) as determined by blinded central review

  2. Overall Survival [ Time Frame: Up to 5 years ]
    Overall survival is defined as the time from randomization to death from any cause



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

Key Inclusion Criteria:

  1. Histologically proven DLBCL, including transformation from follicular lymphoma
  2. Relapsed or refractory disease after first-line chemoimmunotherapy

    • Refractory disease is defined as no complete remission to first-line therapy; individuals who are intolerant to first-line therapy are excluded.

      • Progressive disease (PD) as best response to first-line therapy
      • Stable disease (SD) as best response after at least 4 cycles of first-line therapy
      • Partial response (PR) as best response after at least 6 cycles and biopsy-proven residual disease or disease progression ≤ 12 months from initiation of therapy
    • Relapsed disease defined as complete remission to first-line therapy followed by biopsy-proven relapse ≤ 12 months of initiating first-line therapy
  3. Individuals must have received adequate first-line therapy including at a minimum:

    • Anti-CD20 monoclonal antibody unless investigator determines that tumor is CD20 negative, and
    • An anthracycline containing chemotherapy regimen
  4. No known history or suspicion of central nervous system involvement by lymphoma
  5. Eastern cooperative oncology group (ECOG) performance status of 0 or 1
  6. Adequate bone marrow function as evidenced by:

    • Absolute neutrophil count (ANC) ≥ 1000/uL
    • Platelet ≥ 75,000/uL
    • Absolute lymphocyte count ≥ 100/uL
  7. Adequate renal, hepatic, cardiac, and pulmonary function as evidenced by:

    • Creatinine clearance (Cockcroft Gault) ≥ 60 mL/min
    • Serum Alanine aminotransferase/Aspartate aminotransferase (ALT/AST) ≤ 2.5 Upper limit of normal (ULN)
    • Total bilirubin ≤ 1.5 mg/dl
    • Cardiac ejection fraction ≥ 50%, no evidence of pericardial effusion as determined by an Echocardiogram (ECHO), and no clinically significant Electrocardiogram (ECG) findings
    • No clinically significant pleural effusion
    • Baseline oxygen saturation > 92% on room air

Key Exclusion Criteria:

  1. History of malignancy other than nonmelanoma skin cancer or carcinoma in situ (eg cervix, bladder, breast) unless disease free for at least 3 years
  2. Received more than one line of therapy for DLBCL
  3. History of autologous or allogeneic stem cell transplant
  4. Presence of fungal, bacterial, viral, or other infection that is uncontrolled or requiring intravenous antimicrobials for management.
  5. Known history of infection with human immunodeficiency virus (HIV) or hepatitis B (HBsAg positive) or hepatitis C virus (anti-HCV positive). If there is a positive history of treated hepatitis B or hepatitis C, the viral load must be undetectable per quantitative polymerase chain reaction (PCR) and/or nucleic acid testing.
  6. Individuals with detectable cerebrospinal fluid malignant cells or known brain metastases, or with a history of cerebrospinal fluid malignant cells or brain metastases.
  7. History or presence of non-malignant central nervous system (CNS) disorder such as seizure disorder, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or any autoimmune disease with CNS involvement
  8. Presence of any indwelling line or drain. Dedicated central venous access catheter such as a Port-a-Cath or Hickman catheter are permitted.
  9. History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, New York Heart Association Class II or greater congestive heart failure, or other clinically significant cardiac diseases within 12 months of enrollment
  10. History of symptomatic deep vein thrombosis or pulmonary embolism within 6 months of enrollment
  11. History of autoimmune disease, requiring systemic immunosuppression and/or systemic disease modifying agents within the last 2 years
  12. History of anti-CD19 or CAR-T therapy or history of prior randomization in ZUMA-7

Note: Other protocol defined Inclusion/Exclusion criteria may apply


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): NCT03391466


Contacts
Contact: Medical Information 844-454-KITE medinfo@kitepharma.com

  Show 44 Study Locations
Sponsors and Collaborators
Kite, A Gilead Company
Investigators
Study Director: Kite Study Director Kite, A Gilead Company

Publications:
Responsible Party: Kite, A Gilead Company
ClinicalTrials.gov Identifier: NCT03391466     History of Changes
Other Study ID Numbers: KTE-C19-107
2017-002261-22 ( EudraCT Number )
First Posted: January 5, 2018    Key Record Dates
Last Update Posted: December 10, 2018
Last Verified: December 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes

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

Additional relevant MeSH terms:
Lymphoma
Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Lymphoma, Non-Hodgkin
Cyclophosphamide
Fludarabine phosphate
Fludarabine
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Myeloablative Agonists
Antimetabolites, Antineoplastic
Antimetabolites