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MB-CART20.1 Lymphoma

Primary Purpose

Relapsed or Refractory B-cell Non-Hodgkin's Lymphoma, Non-Hodgkin's Lymphoma, B-cell Lymphoma Refractory

Status
Unknown status
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
MB-CART20.1
Sponsored by
Miltenyi Biomedicine GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed or Refractory B-cell Non-Hodgkin's Lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  • Refractory/relapsed CD20+ B-NHL (including malignant transformation like Richter's transformation) with no curative treatment option.
  • At least 18 years of age
  • Estimated life expectancy of more than 3 months
  • ECOG performance status (Eastern cooperative oncology group) of 0-2
  • Negative serological HBV (Hepatitis B virus) test, negative testing of HCVAb (Hepatitis C virus Antibody), negative HIV1/2 (Human immunodeficiency virus 1/2 ) test within 6 weeks prior to enrollment
  • No childbearing potential or negative pregnancy test at screening and before chemotherapy in women with childbearing potential.
  • Signed and dated informed consent before conduct of any trial-specific procedure

Exclusion Criteria:

  • Participation in another interventional trial that could interact with this trial
  • Any evidence 0f CNS (Central nervous system) involvement
  • Known history or presence of clinically relevant CNS pathology
  • Patients with history of primary immunodeficiency,
  • Patients with any history of auto-immune induced condition such as those caused by checkpoint inhibitors, MEK inhibitors or BRAF inhibitors, for example pituitary hypophysitis must be excluded
  • Patients with Chronic Lymphocytic Leukemia unless suffering from malignant transformation
  • Active systemic fungal, viral or bacterial infection
  • Serious cardiac functional incapacity (class III or IV as defined by the New York Heart Association Classification)
  • Severe pulmonary disease (DLCO (Transfer factor of the lung for carbon monoxide) and/or FEV1 (Forced expiratory volume in 1 second) < 65%, dyspnea at rest)
  • Liver dysfunction as indicated by a total bilirubin, AST (Aspartate Aminotransferase), and ALT (Alanine aminotransferase) ≥ 2 the institutional ULN (Upper limit of normal) value, unless directly attributable to the patient's tumor
  • Creatinine clearance <50 ml/min calculated according to the modified formula of Cockcroft and Gault
  • Pregnant or lactating women
  • Active secondary malignancy requiring treatment (except basal cell carcinoma or malignant tumor curatively treated by surgery) within the last 5 years before enrollment.
  • Medical condition requiring prolonged use of systemic corticosteroids (> 1 month)
  • Prior therapy with genetically modified substances
  • Use of anti-CD20 antibodies within 4 weeks before leukapheresis
  • Chemotherapy within 4 weeks prior to leukapheresis
  • Other treatment within 4 weeks or two half-lives, whichever is longer before MB-CART20.1 infusion. This pertains to immunomodulatory therapies such as checkpoint inhibitors because of the influence on the immune system
  • Concurrent systemic radiotherapy
  • Hypersensitivity against any drug or its ingredients/impurities that is scheduled or likely to be given during trial participation e.g. as part of the mandatory lymphodepletion protocol, pre-medication for infusion, rescue medication/salvage therapies for treatment of related toxicities
  • Patients in which such medication is contraindicated for other reasons than hypersensitivity (e.g. live vaccines and fludarabine)
  • Patients in which trial related procedures are contraindicated as judged by the investigator, e.g. lumbar punctures for CSF (Cerebrospinal fluid) sampling
  • Patient's lack of accountability, inability to appreciate the nature, meaning and consequence of the trial and to formulate his/her own wishes correspondingly
  • Patients who have a relationship of dependence or employer employee relationship to the sponsor or the investigator
  • Committal to an institution on judicial or official order
  • Cerebral dysfunction, legal incapacity
  • Other investigational treatment within 4 weeks before IMP (Investigational Medicinal Product) infusion
  • Clinically relevant autoimmune diseases or history of autoimmune disease

Sites / Locations

  • University Hospital of Cologne - Clinic for Internal Medicine I
  • Universitätsklikum Leipzig, AöR

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Phase I - Safety Dose Level

Phase I - Dose Level 1

Phase I - Dose Level 2

Phase II

Arm Description

In phase I three (3) + 3 patients will be treated with 1x10^5 MB-CART20.1 cells per kg body weight administered intravenously as single dose in the preceding safety dose level

In phase I six (6) + 3 patients will be treated with 1x10^6 MB-CART20.1 cells per kg body weight administered intravenously as single dose in the dose level 1

In phase I six (6) + 3 patients will be treated with 3x10^6 MB-CART20.1 cells per kg body weight administered intravenously as single dose in the dose level 2

The number of additional patients who will be treated with MB-CART20.1 cells in Phase II is depending on the number of evaluable patients treated with the maximum tolerated dose (MTD) level and the results in Part I

Outcomes

Primary Outcome Measures

Phase I - Determination of the maximum tolerated dose (MTD)
MTD is defined as the highest dose level at which < 33% of patients experience Dose Limiting Toxicity (DLT). Safety and toxicity assessment of MB-CART20.1 per adverse events (AE) reporting classified according to CTCAE version 5.0.
Phase II - Best overall response rate
Response (Complete response (CR), Partial response (PR), Stable disease (SD), Progressive disease (PD)) is defined according to Cheson criteria.

Secondary Outcome Measures

Phase I - Related safety and toxicity of MB-CART20.1
Per adverse events (AE) reporting classified according to CTCAE version 5.0.
Phase I - Best overall response rate over 4 weeks and 3 months
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Phase I - Best overall response rate over 1 year
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Phase I - Occurrence of B-cell aplasia
Circulating B cell numbers in the peripheral blood will be assessed by Flow cytometry.
Phase I - Phenotype and Persistence of MB-CART20.1
Blood samples for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed.
Phase II - Best overall response rate over 1 year
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Phase II - Overall response rate over 4 weeks and 3 months
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Phase II - Overall response rate over 1 year
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Phase II - Number of patients with CR, PR, SD and PD
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Phase II -Percentage of patients with CR, PR, SD and PD
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Phase II - Safety and toxicity assessment of MB-CART20.1
Per adverse events (AE) reporting classified according to CTCAE version 5.0.
Phase II - Occurrence of B-cell aplasia
Circulating B cell numbers in the peripheral blood will be assessed by Flow cytometry.
Phase II - Phenotype and Persistence of MB-CART20.1
Blood samples for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed.

Full Information

First Posted
September 3, 2018
Last Updated
September 20, 2021
Sponsor
Miltenyi Biomedicine GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT03664635
Brief Title
MB-CART20.1 Lymphoma
Official Title
A Phase I/II Safety, Dose Finding and Feasibility Trial of MB-CART20.1 in Patients With Relapsed or Resistant CD20 Positive B-NHL
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Unknown status
Study Start Date
September 25, 2018 (Actual)
Primary Completion Date
February 10, 2022 (Anticipated)
Study Completion Date
November 10, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Miltenyi Biomedicine GmbH

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
This trial is a phase I/II trial to assess safety, dose finding and feasibility of ex vivo generated MB-CART20.1 cells in patients with relapsed or refractory CD20 positive B-NHL.
Detailed Description
MB-CART20.1 consists of autologous Anti-CD20 Chimeric Antigen Receptor (CAR) transduced CD4 /CD8 enriched T cells targeting CD20-positive tumor cells in Non-Hodgkin-Lymphoma (NHL)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed or Refractory B-cell Non-Hodgkin's Lymphoma, Non-Hodgkin's Lymphoma, B-cell Lymphoma Refractory, B-cell Lymphoma Recurrent

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
19 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Phase I - Safety Dose Level
Arm Type
Experimental
Arm Description
In phase I three (3) + 3 patients will be treated with 1x10^5 MB-CART20.1 cells per kg body weight administered intravenously as single dose in the preceding safety dose level
Arm Title
Phase I - Dose Level 1
Arm Type
Experimental
Arm Description
In phase I six (6) + 3 patients will be treated with 1x10^6 MB-CART20.1 cells per kg body weight administered intravenously as single dose in the dose level 1
Arm Title
Phase I - Dose Level 2
Arm Type
Experimental
Arm Description
In phase I six (6) + 3 patients will be treated with 3x10^6 MB-CART20.1 cells per kg body weight administered intravenously as single dose in the dose level 2
Arm Title
Phase II
Arm Type
Experimental
Arm Description
The number of additional patients who will be treated with MB-CART20.1 cells in Phase II is depending on the number of evaluable patients treated with the maximum tolerated dose (MTD) level and the results in Part I
Intervention Type
Biological
Intervention Name(s)
MB-CART20.1
Other Intervention Name(s)
CD20-targeting CAR T Cells, Anti-CD20 CAR T cells
Intervention Description
MB-CART20.1 consists of autologous CD20 Chimeric Antigen Receptor (CAR) transduced CD4 /CD8 enriched T cells targeting CD20-positive tumor cells in NHL
Primary Outcome Measure Information:
Title
Phase I - Determination of the maximum tolerated dose (MTD)
Description
MTD is defined as the highest dose level at which < 33% of patients experience Dose Limiting Toxicity (DLT). Safety and toxicity assessment of MB-CART20.1 per adverse events (AE) reporting classified according to CTCAE version 5.0.
Time Frame
until day 28 after infusion of MB-CART20.1
Title
Phase II - Best overall response rate
Description
Response (Complete response (CR), Partial response (PR), Stable disease (SD), Progressive disease (PD)) is defined according to Cheson criteria.
Time Frame
3 months after infusion of MB-CART20.1
Secondary Outcome Measure Information:
Title
Phase I - Related safety and toxicity of MB-CART20.1
Description
Per adverse events (AE) reporting classified according to CTCAE version 5.0.
Time Frame
months 3, 6, 9 and 12 after infusion of MB-CART20.1
Title
Phase I - Best overall response rate over 4 weeks and 3 months
Description
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Time Frame
4 weeks and 3 months after infusion of MB-CART20.1
Title
Phase I - Best overall response rate over 1 year
Description
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Time Frame
1 year after infusion of MB-CART20.1
Title
Phase I - Occurrence of B-cell aplasia
Description
Circulating B cell numbers in the peripheral blood will be assessed by Flow cytometry.
Time Frame
1 year after infusion of MB-CART20.1
Title
Phase I - Phenotype and Persistence of MB-CART20.1
Description
Blood samples for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed.
Time Frame
1 year after infusion of MB-CART20.1
Title
Phase II - Best overall response rate over 1 year
Description
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Time Frame
1 year after infusion of MB-CART20.1
Title
Phase II - Overall response rate over 4 weeks and 3 months
Description
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Time Frame
4 weeks and 3 months after infusion of MB-CART20.1
Title
Phase II - Overall response rate over 1 year
Description
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Time Frame
1 year after infusion of MB-CART20.1
Title
Phase II - Number of patients with CR, PR, SD and PD
Description
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Time Frame
1 year after infusion of MB-CART20.1
Title
Phase II -Percentage of patients with CR, PR, SD and PD
Description
Response (CR, PR, SD and PD) is defined according to Cheson criteria.
Time Frame
1 year after infusion of MB-CART20.1
Title
Phase II - Safety and toxicity assessment of MB-CART20.1
Description
Per adverse events (AE) reporting classified according to CTCAE version 5.0.
Time Frame
1 year after infusion of MB-CART20.1
Title
Phase II - Occurrence of B-cell aplasia
Description
Circulating B cell numbers in the peripheral blood will be assessed by Flow cytometry.
Time Frame
1 year after infusion of MB-CART20.1
Title
Phase II - Phenotype and Persistence of MB-CART20.1
Description
Blood samples for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed.
Time Frame
1 year after infusion of MB-CART20.1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Refractory/relapsed CD20+ B-NHL (including malignant transformation like Richter's transformation) with no curative treatment option. At least 18 years of age Estimated life expectancy of more than 3 months ECOG performance status (Eastern cooperative oncology group) of 0-2 Negative serological HBV (Hepatitis B virus) test, negative testing of HCVAb (Hepatitis C virus Antibody), negative HIV1/2 (Human immunodeficiency virus 1/2 ) test within 6 weeks prior to enrollment No childbearing potential or negative pregnancy test at screening and before chemotherapy in women with childbearing potential. Signed and dated informed consent before conduct of any trial-specific procedure Exclusion Criteria: Participation in another interventional trial that could interact with this trial Any evidence 0f CNS (Central nervous system) involvement Known history or presence of clinically relevant CNS pathology Patients with history of primary immunodeficiency, Patients with any history of auto-immune induced condition such as those caused by checkpoint inhibitors, MEK inhibitors or BRAF inhibitors, for example pituitary hypophysitis must be excluded Patients with Chronic Lymphocytic Leukemia unless suffering from malignant transformation Active systemic fungal, viral or bacterial infection Serious cardiac functional incapacity (class III or IV as defined by the New York Heart Association Classification) Severe pulmonary disease (DLCO (Transfer factor of the lung for carbon monoxide) and/or FEV1 (Forced expiratory volume in 1 second) < 65%, dyspnea at rest) Liver dysfunction as indicated by a total bilirubin, AST (Aspartate Aminotransferase), and ALT (Alanine aminotransferase) ≥ 2 the institutional ULN (Upper limit of normal) value, unless directly attributable to the patient's tumor Creatinine clearance <50 ml/min calculated according to the modified formula of Cockcroft and Gault Pregnant or lactating women Active secondary malignancy requiring treatment (except basal cell carcinoma or malignant tumor curatively treated by surgery) within the last 5 years before enrollment. Medical condition requiring prolonged use of systemic corticosteroids (> 1 month) Prior therapy with genetically modified substances Use of anti-CD20 antibodies within 4 weeks before leukapheresis Chemotherapy within 4 weeks prior to leukapheresis Other treatment within 4 weeks or two half-lives, whichever is longer before MB-CART20.1 infusion. This pertains to immunomodulatory therapies such as checkpoint inhibitors because of the influence on the immune system Concurrent systemic radiotherapy Hypersensitivity against any drug or its ingredients/impurities that is scheduled or likely to be given during trial participation e.g. as part of the mandatory lymphodepletion protocol, pre-medication for infusion, rescue medication/salvage therapies for treatment of related toxicities Patients in which such medication is contraindicated for other reasons than hypersensitivity (e.g. live vaccines and fludarabine) Patients in which trial related procedures are contraindicated as judged by the investigator, e.g. lumbar punctures for CSF (Cerebrospinal fluid) sampling Patient's lack of accountability, inability to appreciate the nature, meaning and consequence of the trial and to formulate his/her own wishes correspondingly Patients who have a relationship of dependence or employer employee relationship to the sponsor or the investigator Committal to an institution on judicial or official order Cerebral dysfunction, legal incapacity Other investigational treatment within 4 weeks before IMP (Investigational Medicinal Product) infusion Clinically relevant autoimmune diseases or history of autoimmune disease
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Borchmann, Prof. Dr.
Organizational Affiliation
Universitätsklinikum Köln
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital of Cologne - Clinic for Internal Medicine I
City
Cologne
ZIP/Postal Code
50937
Country
Germany
Facility Name
Universitätsklikum Leipzig, AöR
City
Leipzig
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No

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MB-CART20.1 Lymphoma

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