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Safety and Efficacy of iPD1 CD19 eCAR T Cells in Relapsed or Refractory B-cell Lymphoma

Primary Purpose

Relapsed or Refractory B-cell Lymphoma

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
iPD1 CD19 eCAR T cells
Fludarabine and cyclophosphamide
Sponsored by
Peking University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed or Refractory B-cell Lymphoma

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. CD19+ B cell lymphoma,verified by IHC or flow cytometry.
  2. a prior history of at least one standard care of medication.
  3. ineligible for allogeneic transplantation or relapsed after transplantation.
  4. patients are 18 years older.
  5. life expectancy > 3months.
  6. ECOG ≤ 2.
  7. satisfactory major organ functions: adequate heart function with LVEF≥50%; pulse oximetry of ≥ 90%; cockcroft-gault creatinine clearance≥40 ml/min; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤3ULN; Bilirubin ≤2.0 mg/dl .
  8. Blood: Hgb ≥ 80 g/L, ANC ≥ 1×10^9/L, PLT ≥ 50×10^9/L.
  9. women of reproductive potential must have a negative pregnancy test. Male and female of reproductive potential must agree to use birth control during the study and one year post study.
  10. measurable tumors.

Exclusion Criteria:

  1. using immunosuppressive drugs or systemic steroids within one week of enrollment.
  2. active infection.
  3. HIV positive.
  4. active hepatitis B virus infection or hepatitis C virus infection.
  5. breastfeeding or pregnant women.
  6. patients refuse to practice birth control during study and one year post study.
  7. patients with a prior history of other malignances will be excluded from this study, but patients who have been cured from skin basal cell carcinoma or cervical cancer, or who have had their tumors removed by surgical resection but without further therapies and have more than 5 years of progression-free survival, can be included into the study.
  8. currently enrolled in other study.
  9. patients, in the opinion of investigators, may not be eligible or are not able to comply with the study.

Sites / Locations

  • Beijing Cancer HospticalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

iPD1 CD19 eCAR T cells

Arm Description

patients will receive a lymphodepletion chemotherapy prior to CAR T cell infusion

Outcomes

Primary Outcome Measures

safety of infusion of iPD1 CD19 eCAR T cells as assessed by the incidents of treatment related adverse events per NCI CTCAE V4.0
incidents of treatment related adverse events per NCI CTCAE V4.0

Secondary Outcome Measures

treatment response
The efficacy of infusion of iPD1 CD19 eCAR T cells is assessed according to the standardized response criteria for malignant lymphoma (Cheson BD, JCO, 2007), which is defined as complete remission (CR), partial remission (PR), stable disease (SD), or progressive disease (PD).
overall survival
Overall survival is defined as the time from receiving iPD1 CD19 eCAR T cells infusion to death for any cause.
progression-free survival
Progression-free survival (PFS) is defined as the time from receiving iPD1 CD19 eCAR T cell infusion to disease progression or death from any cause.

Full Information

First Posted
June 27, 2017
Last Updated
September 12, 2017
Sponsor
Peking University
Collaborators
Marino Biotechnology Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03208556
Brief Title
Safety and Efficacy of iPD1 CD19 eCAR T Cells in Relapsed or Refractory B-cell Lymphoma
Official Title
Pilot Study of Autologous Anti-CD19 4-1BB CAR T Cells With Cell-intrinsic PD1 Inhibition in Relapsed or Refractory B-cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Unknown status
Study Start Date
June 21, 2017 (Actual)
Primary Completion Date
June 1, 2019 (Anticipated)
Study Completion Date
June 1, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking University
Collaborators
Marino Biotechnology Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
PD1 pathway is critical in determining the response to CAR T cell therapy. Emerging data suggested that Inhibition of PD1 could enhance the efficacy of CAR T cell therapy. iPD1 CD19 eCAR T cells is an enhanced version of the classical 2nd generation anti-CD19 4-1BB-costimulatory chimeric antigen receptor engineered T cells with cell-intrinsic PD1 inhibition by incorporation of a PD1 shRNA-expressing cassette in the CAR lentivector. This design will enhance the anti-tumor activities of CAR T cells by inhibiting PD1 induction after CAR T cell activation. This pilot, single arm, one center, dose-escalation, open label study is to determine the safety and efficacy of iPD1 CD19 eCAR T cells in relapsed or refractory CD19 positive lymphoma. Subjects will be given a lymphodepletion chemotherapy comprised of Fludarabine and cyclophosphamide prior to CAR T cell infusion. The chemotherapy is completed 1 to 4 days before the first dost of iPD1 CD19 eCAR T cells.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed or Refractory B-cell Lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
iPD1 CD19 eCAR T cells
Arm Type
Experimental
Arm Description
patients will receive a lymphodepletion chemotherapy prior to CAR T cell infusion
Intervention Type
Biological
Intervention Name(s)
iPD1 CD19 eCAR T cells
Intervention Description
iPD1 CD19 eCAR T cells are administrated in a 3-day split-dose regimen (d0, 30%; d1, 30%; d2, 40%). CAR T cell dose escalation: 1×10^5 /kg,1×10^6 /kg,3×10^6 /kg,and 6×10^6 CAR T cells/kg
Intervention Type
Drug
Intervention Name(s)
Fludarabine and cyclophosphamide
Intervention Description
Fludarabine 25 mg/m2 d1-3; cyclophosphamide 250 mg/m2 d1-3. Lymphodepletion chemotherapy is completed 1 to 4 days before CAR T cell infusion
Primary Outcome Measure Information:
Title
safety of infusion of iPD1 CD19 eCAR T cells as assessed by the incidents of treatment related adverse events per NCI CTCAE V4.0
Description
incidents of treatment related adverse events per NCI CTCAE V4.0
Time Frame
2 years
Secondary Outcome Measure Information:
Title
treatment response
Description
The efficacy of infusion of iPD1 CD19 eCAR T cells is assessed according to the standardized response criteria for malignant lymphoma (Cheson BD, JCO, 2007), which is defined as complete remission (CR), partial remission (PR), stable disease (SD), or progressive disease (PD).
Time Frame
6 months
Title
overall survival
Description
Overall survival is defined as the time from receiving iPD1 CD19 eCAR T cells infusion to death for any cause.
Time Frame
3 years
Title
progression-free survival
Description
Progression-free survival (PFS) is defined as the time from receiving iPD1 CD19 eCAR T cell infusion to disease progression or death from any cause.
Time Frame
2 years
Other Pre-specified Outcome Measures:
Title
Persistence of iPD1 CD19 eCAR T cells in patients
Description
measured by quantitative PCR
Time Frame
2 years
Title
proliferation of iPD1 CD19 eCAR T cells in patients
Description
measured by flow cytometry
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: CD19+ B cell lymphoma,verified by IHC or flow cytometry. a prior history of at least one standard care of medication. ineligible for allogeneic transplantation or relapsed after transplantation. patients are 18 years older. life expectancy > 3months. ECOG ≤ 2. satisfactory major organ functions: adequate heart function with LVEF≥50%; pulse oximetry of ≥ 90%; cockcroft-gault creatinine clearance≥40 ml/min; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤3ULN; Bilirubin ≤2.0 mg/dl . Blood: Hgb ≥ 80 g/L, ANC ≥ 1×10^9/L, PLT ≥ 50×10^9/L. women of reproductive potential must have a negative pregnancy test. Male and female of reproductive potential must agree to use birth control during the study and one year post study. measurable tumors. Exclusion Criteria: using immunosuppressive drugs or systemic steroids within one week of enrollment. active infection. HIV positive. active hepatitis B virus infection or hepatitis C virus infection. breastfeeding or pregnant women. patients refuse to practice birth control during study and one year post study. patients with a prior history of other malignances will be excluded from this study, but patients who have been cured from skin basal cell carcinoma or cervical cancer, or who have had their tumors removed by surgical resection but without further therapies and have more than 5 years of progression-free survival, can be included into the study. currently enrolled in other study. patients, in the opinion of investigators, may not be eligible or are not able to comply with the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jun Zhu, MD
Phone
+86-10-88196596
Email
zj@bjcancer.org
First Name & Middle Initial & Last Name or Official Title & Degree
Zhitao Ying, MD
Email
yingzhitao001@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jun Zhu, MD
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Zhitao Ying, MD
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Xiaoyu Xiang, PhD
Organizational Affiliation
Marino Biotechnology Co., Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Beijing Cancer Hosptical
City
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhitao Ying, MD
Email
yingzhitao001@163.com
First Name & Middle Initial & Last Name & Degree
Jun Zhu, MD
First Name & Middle Initial & Last Name & Degree
Zhitao Ying, MD
First Name & Middle Initial & Last Name & Degree
Xiaoyu Xiang, PhD

12. IPD Sharing Statement

Learn more about this trial

Safety and Efficacy of iPD1 CD19 eCAR T Cells in Relapsed or Refractory B-cell Lymphoma

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