Study Evaluating the Efficacy and Safety of JCAR015 in Adult B-cell Acute Lymphoblastic Leukemia (B-ALL) (ROCKET)
Primary Purpose
Acute Lymphoblastic Leukemia
Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
JCAR015 (CD19-targeted CAR T cells)
Sponsored by
About this trial
This is an interventional treatment trial for Acute Lymphoblastic Leukemia focused on measuring acute lymphoblastic leukemia, ALL, chimeric antigen receptor, CAR, CAR T cells, JCAR015, autologous T cell therapy, cell therapy
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years at the time of consent
Relapsed or refractory B-ALL, defined as:
- First or greater bone marrow relapse from CR, or
- Any bone marrow relapse after allogeneic hematopoietic stem cell transplant (HSCT); subjects must be at least 100 days from HSCT at the time of screening and off immunosuppressant medication for at least 1 month at the time of screening, and have no active graft-vs-host disease (GVHD), or
- Refractory B-ALL, defined by not having achieved a CR or CRi after two attempts at remission induction using standard regimens, or
- Ph+ B-ALL if subjects are intolerant to or ineligible for tyrosine kinase inhibitor (TKI) therapy, or have progressed after at least one line of TKI therapy
- Morphological evidence of disease in bone marrow (at least 5% blasts)
- Evidence of CD19 expression
- Eastern Cooperative Oncology Group (ECOG) performance status between 0 and 2 at the time of screening
- Adequate pulmonary, renal, hepatic, and cardiac function
- Adequate central or peripheral vascular access for leukapheresis procedure
Exclusion Criteria:
- Isolated extramedullary disease relapse
- Concomitant genetic syndrome or other known bone marrow failure syndrome
- Burkitt's lymphoma/leukemia or chronic myelogenous leukemia lymphoid blast crisis (p210 BCR-ABL+)
- Prior malignancy, unless treated with curative intent and with no evidence of active disease present for > 5 years before screening
- Prior treatment with any gene therapy product
- Active hepatitis B, active hepatitis C, or any human immunodeficiency virus (HIV) infection at the time of screening
- Systemic fungal, bacterial, viral, or other infection that is not controlled, at the time of screening
- Presence of Grade II-IV (Glucksberg) or B-D (IBMTR) acute or extensive chronic GVHD at the time of screening
- Active central nervous system (CNS) involvement by malignancy (defined as CNS-3 per National Comprehensive Cancer Network [NCCN] guidelines)
- History of any one of the following cardiovascular conditions within the past 6 months: Class III or IV heart failure as defined by the New York Heart Association (NYHA), cardiac angioplasty or stenting, myocardial infarction, unstable angina, or other clinically significant cardiac disease
- History or presence of clinically relevant CNS pathology such as epilepsy, generalized seizure disorder, paresis, aphasia, stroke, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis
- Participation in an investigational research study using an investigational agent within 30 days of screening
- History of treatment with a murine-derived biological product other than blinatumomab unless subject has been shown to be negative for human-anti-mouse-antibodies (HAMA) prior to or during screening
- Pregnant or nursing women
Use of prohibited medications:
- Steroids: Therapeutic doses of corticosteroids are prohibited within 7 days prior to leukapheresis.
- Allogeneic cellular therapy: Donor lymphocyte infusions (DLI) are prohibited within 4 weeks prior to leukapheresis
- GVHD therapies: Any drug used for GVHD within 4 weeks prior to leukapheresis
- Chemotherapies: Salvage chemotherapy must be stopped at least 1 week prior to leukapheresis
- Treatment with alemtuzumab within 6 months prior to leukapheresis, or treatment with clofarabine or cladribine within 3 months prior to leukapheresis
Sites / Locations
- University of Alabama Birmingham Comprehensive Cancer Center
- City of Hope
- University of California
- University of Colorado Denver -- Anschutz Medical Campus
- Sylvester Comprehensive Cancer Center/UMHC
- The Blood and Marrow Transplant Program at Northside Hospital
- Northwestern University Robert H Lurie Comprehensive Cancer Center
- University of Chicago Medical Center
- Sidney Kimmel Comprehensive Cancer Center @ Johns Hopkins
- Massachusetts General Hospital
- Dana-Farber Cancer Institute
- Washington University School of Medicine
- University of Nebraska Medical Center
- Roswell Park Cancer Institute
- Memorial Sloan Kettering Cancer Center
- Cleveland Clinic
- Vanderbilt University Medical Center
- MD Anderson Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
JCAR015 (CD19-targeted CAR T cells)
Arm Description
JCAR015 was administered as two intravenous (IV) infusions separated by 14 to 28 days.
Outcomes
Primary Outcome Measures
Percentage of Participants With Complete Remission (CR) or Complete Remission With Incomplete Hematopoietic Recovery (CRi), as Determined by an Independent Review Committee (IRC)
Overall remission rate (ORR) is defined as the percentage of participants with CR or CRi based on IRC assessment. For CR, all of the following must be met: (1) in bone marrow, trilineage hematopoiesis and < 5% blasts; (2) in peripheral blood, neutrophils > 1,000/µL, platelets > 100,000/µL, and circulating blasts < 1%; (3) no clinical evidence of extramedullary disease by physical examination and no symptoms suggestive of CNS involvement (if additional assessments such as CSF assessment by lumbar puncture or Ommaya reservoir tap, CNS imaging, or biopsy are performed, results must show no evidence of disease); (4) no platelet and/or neutrophil transfusions ≤ 7 days before the date of peripheral blood sampling, and (5) no clinical evidence of recurrence for 4 weeks. For CRi, all criteria for CR are met except that one or more of the following exists in the peripheral blood: neutrophils ≤ 1,000/µL, platelets ≤ 100,000/µL, or platelet transfusions ≤ 7 days before blood sampling.
Secondary Outcome Measures
Percentage of Participants With CR or CRi, as Determined by an IRC
ORR is defined as the percentage of participants with CR or CRi based on IRC assessment (refer to criteria in Outcome Measure #1)
Percentage of Participants Who Achieved a CR or CRi, as Determined by an IRC
Best overall response (BOR) is defined as the best disease response recorded from the time of the last JCAR015 infusion until the start of another anticancer therapy (refer to Outcome Measure #1 for criteria for CR and CRi).
Percentage of Participants Who Achieved a CR or CRi, as Determined by an IRC
BOR is defined as the best disease response recorded from the time of the last JCAR015 infusion until the start of another anticancer therapy (refer to Outcome Measure #1 for criteria for CR and CRi).
Percentage of Participants Who Achieved a Minimal Residual Disease (MRD)-Negative CR or CRi
Percentage of participants who achieved a CR or CRi, as determined by an IRC, with no evidence of MRD in the bone marrow (refer to Outcome Measure #1 for criteria for CR and CRi). MRD-negative is defined as undetectable leukemic cells in the bone marrow as determined by a polymerase chain reaction (PCR)-based assay.
Percentage of Participants Who Achieved a MRD-Negative CR or CRi
Percentage of participants who achieved a CR or CRi, as determined by an IRC, with no evidence of MRD in the bone marrow (refer to Outcome Measure #1 for criteria for CR and CRi). MRD-negative is defined as undetectable leukemic cells in the bone marrow as determined by a PCR-based assay.
Relapse-Free Survival (RFS), as Determined by an IRC
RFS is defined as the interval from the first documentation of CR or CRi (refer to Outcome Measure #1) to the earlier date of relapse or death due to any cause. Participants who proceeded to hematopoietic stem cell transplant (HSCT) after JCAR015 infusion were censored at the time of HSCT.
RFS, as Determined by an IRC
RFS is defined as the interval from the first documentation of CR or CRi (refer to Outcome Measure #1) to the earlier date of relapse or death due to any cause. Participants who proceeded to HSCT after JCAR015 infusion were censored at the time of HSCT.
Event-Free Survival (EFS)
EFS is defined as the time from the date of the first JCAR015 infusion to the earliest of the following events: death from any cause, relapse, or treatment failure (defined as no response and subsequent discontinuation from the study for adverse event, lack of efficacy or progressive disease, or new anticancer therapy). Participants who proceeded to HSCT after JCAR015 infusion were censored at the time of HSCT.
EFS
EFS is defined as the time from the date of the first JCAR015 infusion to the earliest of the following events: death from any cause, relapse, or treatment failure (defined as no response and subsequent discontinuation from the study for adverse event, lack of efficacy or progressive disease, or new anticancer therapy). Participants who proceeded to HSCT after JCAR015 infusion were censored at the time of HSCT.
Overall Survival (OS)
OS is defined as the interval from the date of the first JCAR015 infusion to the date of death due to any reason.
OS
OS is defined as the interval from the date of the first JCAR015 infusion to the date of death due to any reason.
Duration of Remission (DOR) as Determined by an IRC
DOR is defined as the interval from the first documentation of CR or CRi to the earlier date of relapse or death due to ALL.
Percentage of Participants Who Achieved a CR or CRi, as Determined by an IRC, at Month 6 After the Final JCAR015 Infusion
ORR at Month 6 is defined as the percentage of participants who achieved a CR or CRi at Month 6 after the final JCAR015 infusion without HSCT during the time period between the final JCAR015 infusion and the Month 6 response assessment (refer to Outcome Measure #1 for criteria for CR and CRi).
Percentage of Participants Who Achieved a Morphologic Remission Within 6 Months After the Final JCAR015 Infusion and Then Proceeded to HSCT
Percentage of participants who achieved a morphologic remission within 6 months after the final JCAR015 infusion and then proceeded to HSCT prior to 12 months after the final JCAR015 infusion
Maximum Concentration of JCAR015 (Cmax) in the Peripheral Blood by Quantitative Polymerase Chain Reaction (qPCR)
Cmax is defined as the highest measured number of copies of JCAR015 transgene per microgram of genomic DNA in peripheral blood cells as assessed by qPCR.
Maximum Concentration of JCAR015 (Cmax) in the Peripheral Blood by Flow Cytometry
Cmax is defined as the highest measured concentration of JCAR015 CAR T cells per microliter of peripheral blood as measured by flow cytometry.
Time to Maximum Concentration of JCAR015 (Tmax) in the Peripheral Blood as Measured by qPCR
Tmax is defined as the time after the JCAR015 infusion at which the maximum concentration (Cmax) as measured by qPCR is observed. If Cmax occurred after the second infusion, Tmax was calculated from the time of the second infusion.
Tmax in the Peripheral Blood as Measured by Flow Cytometry
Tmax is defined as the time after the JCAR015 infusion at which the Cmax as measured by flow cytometry of the JCAR015 CAR is observed. If Cmax occurred after the second infusion, Tmax was calculated from the time of the second infusion.
Area Under the Concentration-vs-Time Curve (AUC) for JCAR015 in the Peripheral Blood as Measured by qPCR
AUC is defined as the area under the concentration-vs-time curve from Day 1 to Day 29 after the first JCAR015 infusion as measured by qPCR of the JCAR015 transgene. AUC calculation includes pharmacokinetic (PK) results up to the second JCAR015 infusion for subjects who received the second infusion prior to Day 29 after the first JCAR015 infusion.
AUC for JCAR015 in the Peripheral Blood as Measured by Flow Cytometry
AUC is defined as the area under the concentration-vs-time curve from Day 1 to Day 29 after the first JCAR015 infusion as measured by flow cytometry of the JCAR015 CAR. AUC calculation includes PK results up to the second JCAR015 infusion for subjects who received the second infusion prior to Day 29 after the first JCAR015 infusion.
Percentage of Participants Who Developed Anti-Therapeutic Antibodies Against JCAR015
Percentage of participants who developed anti-therapeutic antibodies against JCAR015
Full Information
NCT ID
NCT02535364
First Posted
August 24, 2015
Last Updated
April 30, 2020
Sponsor
Juno Therapeutics, a Subsidiary of Celgene
1. Study Identification
Unique Protocol Identification Number
NCT02535364
Brief Title
Study Evaluating the Efficacy and Safety of JCAR015 in Adult B-cell Acute Lymphoblastic Leukemia (B-ALL)
Acronym
ROCKET
Official Title
A Phase 2, Single-arm, Multicenter Trial to Determine the Efficacy and Safety of JCAR015 in Adult Subjects With Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia
Study Type
Interventional
2. Study Status
Record Verification Date
April 2020
Overall Recruitment Status
Terminated
Why Stopped
Safety reasons
Study Start Date
August 21, 2015 (Actual)
Primary Completion Date
April 24, 2017 (Actual)
Study Completion Date
September 1, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Juno Therapeutics, a Subsidiary of Celgene
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This single-arm, multicenter Phase 2 trial will treat adult patients who have relapsed or refractory B-ALL with an infusion of the patient's own T cells that have been genetically modified to express a chimeric antigen receptor (CAR) that will bind to leukemia cells that express the CD19 protein on the cell surface. The study will determine if these modified T cells (called JCAR015) help the body's immune system eliminate leukemia cells. The trial will also study the safety of treatment with JCAR015, how long JCAR015 cells stay in the patient's body, the extent to which JCAR015 eliminates minimal residual disease, and the impact of this treatment on survival.
Detailed Description
This is a single-arm, multicenter Phase 2 study to determine the efficacy and safety of JCAR015 in adult patients with relapsed or refractory B-ALL. The study will have the following sequential phases: Part A (screening, leukapheresis, cell product preparation, and cytoreductive chemotherapy) and Part B (treatment and follow-up). The follow-up period for each participant is approximately 12 months after the final JCAR015 infusion. The total duration of the study is expected to be approximately 3 years. Long-term follow-up for survival, toxicity, and viral vector safety will continue under a separate long-term follow-up protocol per health regulatory authority guidelines, currently up to 15 years after the last JCAR015 infusion.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Lymphoblastic Leukemia
Keywords
acute lymphoblastic leukemia, ALL, chimeric antigen receptor, CAR, CAR T cells, JCAR015, autologous T cell therapy, cell therapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
82 (Actual)
8. Arms, Groups, and Interventions
Arm Title
JCAR015 (CD19-targeted CAR T cells)
Arm Type
Experimental
Arm Description
JCAR015 was administered as two intravenous (IV) infusions separated by 14 to 28 days.
Intervention Type
Biological
Intervention Name(s)
JCAR015 (CD19-targeted CAR T cells)
Intervention Description
Part A: Following leukapheresis and concurrent with generation of JCAR015, participants received, at the Investigator's discretion, cytoreductive chemotherapy based on the Investigator's choice of regimens and/or supportive care.
Part B: Participants who were eligible for treatment in Part B received two IV doses of JCAR015 CAR T cells separated by 14 to 28 days. JCAR015 infusion was preceded by lymphodepleting chemotherapy with cyclophosphamide alone or cyclophosphamide + fludarabine.
Primary Outcome Measure Information:
Title
Percentage of Participants With Complete Remission (CR) or Complete Remission With Incomplete Hematopoietic Recovery (CRi), as Determined by an Independent Review Committee (IRC)
Description
Overall remission rate (ORR) is defined as the percentage of participants with CR or CRi based on IRC assessment. For CR, all of the following must be met: (1) in bone marrow, trilineage hematopoiesis and < 5% blasts; (2) in peripheral blood, neutrophils > 1,000/µL, platelets > 100,000/µL, and circulating blasts < 1%; (3) no clinical evidence of extramedullary disease by physical examination and no symptoms suggestive of CNS involvement (if additional assessments such as CSF assessment by lumbar puncture or Ommaya reservoir tap, CNS imaging, or biopsy are performed, results must show no evidence of disease); (4) no platelet and/or neutrophil transfusions ≤ 7 days before the date of peripheral blood sampling, and (5) no clinical evidence of recurrence for 4 weeks. For CRi, all criteria for CR are met except that one or more of the following exists in the peripheral blood: neutrophils ≤ 1,000/µL, platelets ≤ 100,000/µL, or platelet transfusions ≤ 7 days before blood sampling.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Secondary Outcome Measure Information:
Title
Percentage of Participants With CR or CRi, as Determined by an IRC
Description
ORR is defined as the percentage of participants with CR or CRi based on IRC assessment (refer to criteria in Outcome Measure #1)
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Percentage of Participants Who Achieved a CR or CRi, as Determined by an IRC
Description
Best overall response (BOR) is defined as the best disease response recorded from the time of the last JCAR015 infusion until the start of another anticancer therapy (refer to Outcome Measure #1 for criteria for CR and CRi).
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Percentage of Participants Who Achieved a CR or CRi, as Determined by an IRC
Description
BOR is defined as the best disease response recorded from the time of the last JCAR015 infusion until the start of another anticancer therapy (refer to Outcome Measure #1 for criteria for CR and CRi).
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Percentage of Participants Who Achieved a Minimal Residual Disease (MRD)-Negative CR or CRi
Description
Percentage of participants who achieved a CR or CRi, as determined by an IRC, with no evidence of MRD in the bone marrow (refer to Outcome Measure #1 for criteria for CR and CRi). MRD-negative is defined as undetectable leukemic cells in the bone marrow as determined by a polymerase chain reaction (PCR)-based assay.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Percentage of Participants Who Achieved a MRD-Negative CR or CRi
Description
Percentage of participants who achieved a CR or CRi, as determined by an IRC, with no evidence of MRD in the bone marrow (refer to Outcome Measure #1 for criteria for CR and CRi). MRD-negative is defined as undetectable leukemic cells in the bone marrow as determined by a PCR-based assay.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Relapse-Free Survival (RFS), as Determined by an IRC
Description
RFS is defined as the interval from the first documentation of CR or CRi (refer to Outcome Measure #1) to the earlier date of relapse or death due to any cause. Participants who proceeded to hematopoietic stem cell transplant (HSCT) after JCAR015 infusion were censored at the time of HSCT.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
RFS, as Determined by an IRC
Description
RFS is defined as the interval from the first documentation of CR or CRi (refer to Outcome Measure #1) to the earlier date of relapse or death due to any cause. Participants who proceeded to HSCT after JCAR015 infusion were censored at the time of HSCT.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Event-Free Survival (EFS)
Description
EFS is defined as the time from the date of the first JCAR015 infusion to the earliest of the following events: death from any cause, relapse, or treatment failure (defined as no response and subsequent discontinuation from the study for adverse event, lack of efficacy or progressive disease, or new anticancer therapy). Participants who proceeded to HSCT after JCAR015 infusion were censored at the time of HSCT.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
EFS
Description
EFS is defined as the time from the date of the first JCAR015 infusion to the earliest of the following events: death from any cause, relapse, or treatment failure (defined as no response and subsequent discontinuation from the study for adverse event, lack of efficacy or progressive disease, or new anticancer therapy). Participants who proceeded to HSCT after JCAR015 infusion were censored at the time of HSCT.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Overall Survival (OS)
Description
OS is defined as the interval from the date of the first JCAR015 infusion to the date of death due to any reason.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
OS
Description
OS is defined as the interval from the date of the first JCAR015 infusion to the date of death due to any reason.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Duration of Remission (DOR) as Determined by an IRC
Description
DOR is defined as the interval from the first documentation of CR or CRi to the earlier date of relapse or death due to ALL.
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Percentage of Participants Who Achieved a CR or CRi, as Determined by an IRC, at Month 6 After the Final JCAR015 Infusion
Description
ORR at Month 6 is defined as the percentage of participants who achieved a CR or CRi at Month 6 after the final JCAR015 infusion without HSCT during the time period between the final JCAR015 infusion and the Month 6 response assessment (refer to Outcome Measure #1 for criteria for CR and CRi).
Time Frame
Day 1 (first JCAR015 infusion) up to 6 months after the last JCAR015 infusion
Title
Percentage of Participants Who Achieved a Morphologic Remission Within 6 Months After the Final JCAR015 Infusion and Then Proceeded to HSCT
Description
Percentage of participants who achieved a morphologic remission within 6 months after the final JCAR015 infusion and then proceeded to HSCT prior to 12 months after the final JCAR015 infusion
Time Frame
Day 1 (first JCAR015 infusion) up to 12 months after the last JCAR015 infusion
Title
Maximum Concentration of JCAR015 (Cmax) in the Peripheral Blood by Quantitative Polymerase Chain Reaction (qPCR)
Description
Cmax is defined as the highest measured number of copies of JCAR015 transgene per microgram of genomic DNA in peripheral blood cells as assessed by qPCR.
Time Frame
Pre-dose Day 1 of each JCAR015 infusion; Day 4, Day 7, Day 14, Day 21, and Day 28 after the first JCAR015 infusion until receipt of the second infusion; and Day 4, Day 7, Day 14, Day 21, and Day 28 after the second JCAR015 infusion (if applicable)
Title
Maximum Concentration of JCAR015 (Cmax) in the Peripheral Blood by Flow Cytometry
Description
Cmax is defined as the highest measured concentration of JCAR015 CAR T cells per microliter of peripheral blood as measured by flow cytometry.
Time Frame
Pre-dose Day 1 of each JCAR015 infusion; Day 4, Day 7, Day 14, Day 21, and Day 28 after the first JCAR015 infusion until receipt of the second infusion; and Day 4, Day 7, Day 14, Day 21, and Day 28 after the second JCAR015 infusion (if applicable)
Title
Time to Maximum Concentration of JCAR015 (Tmax) in the Peripheral Blood as Measured by qPCR
Description
Tmax is defined as the time after the JCAR015 infusion at which the maximum concentration (Cmax) as measured by qPCR is observed. If Cmax occurred after the second infusion, Tmax was calculated from the time of the second infusion.
Time Frame
Pre-dose Day 1 of each JCAR015 infusion; Day 4, Day 7, Day 14, Day 21, and Day 28 after the first JCAR015 infusion until receipt of the second infusion; and Day 4, Day 7, Day 14, Day 21, and Day 28 after the second JCAR015 infusion (if applicable)
Title
Tmax in the Peripheral Blood as Measured by Flow Cytometry
Description
Tmax is defined as the time after the JCAR015 infusion at which the Cmax as measured by flow cytometry of the JCAR015 CAR is observed. If Cmax occurred after the second infusion, Tmax was calculated from the time of the second infusion.
Time Frame
Pre-dose Day 1 of each JCAR015 infusion; Day 4, Day 7, Day 14, Day 21, and Day 28 after the first JCAR015 infusion until receipt of the second infusion; and Day 4, Day 7, Day 14, Day 21, and Day 28 after the second JCAR015 infusion (if applicable)
Title
Area Under the Concentration-vs-Time Curve (AUC) for JCAR015 in the Peripheral Blood as Measured by qPCR
Description
AUC is defined as the area under the concentration-vs-time curve from Day 1 to Day 29 after the first JCAR015 infusion as measured by qPCR of the JCAR015 transgene. AUC calculation includes pharmacokinetic (PK) results up to the second JCAR015 infusion for subjects who received the second infusion prior to Day 29 after the first JCAR015 infusion.
Time Frame
Pre-dose Day 1 of the first JCAR015 infusion; Day 4, Day 7, Day 14, Day 21, and Day 28 after the first JCAR015 infusion until receipt of the second infusion
Title
AUC for JCAR015 in the Peripheral Blood as Measured by Flow Cytometry
Description
AUC is defined as the area under the concentration-vs-time curve from Day 1 to Day 29 after the first JCAR015 infusion as measured by flow cytometry of the JCAR015 CAR. AUC calculation includes PK results up to the second JCAR015 infusion for subjects who received the second infusion prior to Day 29 after the first JCAR015 infusion.
Time Frame
Pre-dose Day 1 of the first JCAR015 infusion; Day 4, Day 7, Day 14, Day 21, and Day 28 after the first JCAR015 infusion until receipt of the second infusion
Title
Percentage of Participants Who Developed Anti-Therapeutic Antibodies Against JCAR015
Description
Percentage of participants who developed anti-therapeutic antibodies against JCAR015
Time Frame
Part B Screening; Day 14 after the first JCAR015 infusion; Pre-Dose Day 1 of the second JCAR015 infusion; Day 14 after the second JCAR015 infusion; and Day 28, Month 3, Month 6, and Month 12 after the last JCAR015 infusion
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥ 18 years at the time of consent
Relapsed or refractory B-ALL, defined as:
First or greater bone marrow relapse from CR, or
Any bone marrow relapse after allogeneic hematopoietic stem cell transplant (HSCT); subjects must be at least 100 days from HSCT at the time of screening and off immunosuppressant medication for at least 1 month at the time of screening, and have no active graft-vs-host disease (GVHD), or
Refractory B-ALL, defined by not having achieved a CR or CRi after two attempts at remission induction using standard regimens, or
Ph+ B-ALL if subjects are intolerant to or ineligible for tyrosine kinase inhibitor (TKI) therapy, or have progressed after at least one line of TKI therapy
Morphological evidence of disease in bone marrow (at least 5% blasts)
Evidence of CD19 expression
Eastern Cooperative Oncology Group (ECOG) performance status between 0 and 2 at the time of screening
Adequate pulmonary, renal, hepatic, and cardiac function
Adequate central or peripheral vascular access for leukapheresis procedure
Exclusion Criteria:
Isolated extramedullary disease relapse
Concomitant genetic syndrome or other known bone marrow failure syndrome
Burkitt's lymphoma/leukemia or chronic myelogenous leukemia lymphoid blast crisis (p210 BCR-ABL+)
Prior malignancy, unless treated with curative intent and with no evidence of active disease present for > 5 years before screening
Prior treatment with any gene therapy product
Active hepatitis B, active hepatitis C, or any human immunodeficiency virus (HIV) infection at the time of screening
Systemic fungal, bacterial, viral, or other infection that is not controlled, at the time of screening
Presence of Grade II-IV (Glucksberg) or B-D (IBMTR) acute or extensive chronic GVHD at the time of screening
Active central nervous system (CNS) involvement by malignancy (defined as CNS-3 per National Comprehensive Cancer Network [NCCN] guidelines)
History of any one of the following cardiovascular conditions within the past 6 months: Class III or IV heart failure as defined by the New York Heart Association (NYHA), cardiac angioplasty or stenting, myocardial infarction, unstable angina, or other clinically significant cardiac disease
History or presence of clinically relevant CNS pathology such as epilepsy, generalized seizure disorder, paresis, aphasia, stroke, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis
Participation in an investigational research study using an investigational agent within 30 days of screening
History of treatment with a murine-derived biological product other than blinatumomab unless subject has been shown to be negative for human-anti-mouse-antibodies (HAMA) prior to or during screening
Pregnant or nursing women
Use of prohibited medications:
Steroids: Therapeutic doses of corticosteroids are prohibited within 7 days prior to leukapheresis.
Allogeneic cellular therapy: Donor lymphocyte infusions (DLI) are prohibited within 4 weeks prior to leukapheresis
GVHD therapies: Any drug used for GVHD within 4 weeks prior to leukapheresis
Chemotherapies: Salvage chemotherapy must be stopped at least 1 week prior to leukapheresis
Treatment with alemtuzumab within 6 months prior to leukapheresis, or treatment with clofarabine or cladribine within 3 months prior to leukapheresis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nikolaus Trede, MD, PhD
Organizational Affiliation
Juno Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama Birmingham Comprehensive Cancer Center
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35295
Country
United States
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
University of California
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
University of Colorado Denver -- Anschutz Medical Campus
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Sylvester Comprehensive Cancer Center/UMHC
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
The Blood and Marrow Transplant Program at Northside Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Northwestern University Robert H Lurie Comprehensive Cancer Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Chicago Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Sidney Kimmel Comprehensive Cancer Center @ Johns Hopkins
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
University of Nebraska Medical Center
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68198
Country
United States
Facility Name
Roswell Park Cancer Institute
City
Buffalo
State/Province
New York
ZIP/Postal Code
14263
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
24553386
Citation
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Results Reference
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PubMed Identifier
23550147
Citation
Sadelain M, Brentjens R, Riviere I. The basic principles of chimeric antigen receptor design. Cancer Discov. 2013 Apr;3(4):388-98. doi: 10.1158/2159-8290.CD-12-0548. Epub 2013 Apr 2.
Results Reference
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PubMed Identifier
23515080
Citation
Brentjens RJ, Davila ML, Riviere I, Park J, Wang X, Cowell LG, Bartido S, Stefanski J, Taylor C, Olszewska M, Borquez-Ojeda O, Qu J, Wasielewska T, He Q, Bernal Y, Rijo IV, Hedvat C, Kobos R, Curran K, Steinherz P, Jurcic J, Rosenblat T, Maslak P, Frattini M, Sadelain M. CD19-targeted T cells rapidly induce molecular remissions in adults with chemotherapy-refractory acute lymphoblastic leukemia. Sci Transl Med. 2013 Mar 20;5(177):177ra38. doi: 10.1126/scitranslmed.3005930.
Results Reference
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PubMed Identifier
21849486
Citation
Brentjens RJ, Riviere I, Park JH, Davila ML, Wang X, Stefanski J, Taylor C, Yeh R, Bartido S, Borquez-Ojeda O, Olszewska M, Bernal Y, Pegram H, Przybylowski M, Hollyman D, Usachenko Y, Pirraglia D, Hosey J, Santos E, Halton E, Maslak P, Scheinberg D, Jurcic J, Heaney M, Heller G, Frattini M, Sadelain M. Safety and persistence of adoptively transferred autologous CD19-targeted T cells in patients with relapsed or chemotherapy refractory B-cell leukemias. Blood. 2011 Nov 3;118(18):4817-28. doi: 10.1182/blood-2011-04-348540. Epub 2011 Aug 17.
Results Reference
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Learn more about this trial
Study Evaluating the Efficacy and Safety of JCAR015 in Adult B-cell Acute Lymphoblastic Leukemia (B-ALL)
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