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Anti-CD22 Chimeric Antigen Receptor (CAR)-Modified T Cell Therapy for Relapsed Refractory B-cell Malignancies

Primary Purpose

B Cell Lymphoma, Acute Lymphoblastic Leukemia

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Third generation CAR-T cells
Sponsored by
Wuhan Union Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B Cell Lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient or his or her legal guardian voluntarily participates in and signs an informed consent form.
  2. Male or female patients aged 14 to 70 years (including 14 and 70 years old).
  3. Pathological and histological examination confirmed CD22+ B-cell malignancies, and patients met the following criteria for refractory or relapsed B-cell malignancies.

    A.Refractory/relapsed B-cell lymphoblastic leukemia (Meeting one of the following)

    i. Recurrence within 6 months after first remission.

    ii. Primary refractory disease which cannnot achieve complete remission (CR) after 2 cycles of standardized chemotherapy regimen.

    iii. Failure to achieve CR or relapse after one line or multiple lines of salvage chemotherapy.

    iv. Not suitable for hematopoietic stem cell transplantation (HSCT), or abandon HSCT due to various restrictions, or relapse after HSCT.

    B.Refractory/relapsed B-cell lymphoma (Meeting 1 of the first 4 items plus item 5)

    i. Tumor shrinkage less than 50% or disease progression after 4 cycles of standard chemotherapy.

    ii. Achieved CR after standard chemotherapy, but relapsed within 6 months.

    iii. 2 or more relapses after CR.

    iv. Not suitable for HSCT, or abandon HSCT due to various restrictions, or relapse after HSCT.

    v. Subjects must have received adequate treatment in the past, including anti-CD20 monoclonal antibody and combination chemotherapy with anthracyclines.

  4. B-cell malignancies include the following three types

    A. B-cell acute lymphoblastic leukemia (B-ALL)

    B. Indolent B-cell lymphoma (CLL, FL, MZL, LPL, HCL)

    C. Invasive B-cell lymphoma (DLBCL, BL, MCL)

  5. Having a measurable or evaluable lesion

    A. Patients with lymphoma require a single lesion≥15mm or 2 or more lesions≥10mm.

    B. Patients with leukemia require persistent positive or positive relapse of bone marrow MRD.

  6. Patient's main organs functioning well

    A. Liver function: ALT/AST < 3 times the upper limit of normal (ULN) and total bilirubin≤34.2μmol/L

    B. Renal function: Creatinine < 220μmol/L.

    C. Pulmonary function: Indoor oxygen saturation≥95%.

    D. Cardiac Function: Left ventricular ejection fraction (LVEF) ≥40%.

  7. The patients did not receive any antitumor treatments such as chemotherapy, radiotherapy and immunotherapy (such as immunosuppressive drugs) within 4 weeks before enrollment, and the toxicity related to previous treatments had returned to < 1 level at enrollment (except for low grade toxicity such as alopecia).
  8. The patient's peripheral superficial venous blood flow smoothly, which can meet the needs of intravenous drip.
  9. Patient ECOG score≤ 2, estimated survival time≥3 months.

Exclusion Criteria:

  1. Have a history of epilepsy or other central nervous system diseases.
  2. Women who are pregnant (urine/blood pregnancy test positive) or lactating.
  3. Male or female with a pregnancy plan in the next 1 year.
  4. Patients cannot guarantee effective contraception (condom or contraceptives, etc.) within 1 year after enrollment.
  5. Uncontrolled infectious disease within 4 weeks prior to enrollment.
  6. Active hepatitis B/C virus infection.
  7. HIV infected patients.
  8. Suffering from a serious autoimmune disease or immunodeficiency disease.
  9. The patient is allergic to macromolecular biopharmaceuticals such as antibodies or cytokines.
  10. The patient participated in other clinical trials within 6 weeks prior to enrollment.
  11. Systemic use of corticosteroids within 4 weeks prior to enrollment (except for patients with inhaled corticosteroids).
  12. Suffering from mental diseases.
  13. Patient has drug abuse/addiction.
  14. According to the researcher's judgment, the patient has other unsuitable enrollment conditions.

Sites / Locations

  • Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Third generation CAR-T cells

Arm Description

Patients receive CD22 CAR-T cells transduced with a lentiviral vector on day 0 in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Number of participants with adverse events
Therapy-related adverse events were recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0).

Secondary Outcome Measures

One-month remission rate
Response of B-ALL to CAR-T therapy was assessed on day 30 (±2), against the National Comprehensive Cancer Network (NCCN, Version 1.2015).
Overall survival
OS was calculated from the first CAR-T cell infusion to death or last follow-up (censored).
Event-free survival
EFS was calculated from the first CAR-T cell infusion to death, progression of the disease, relapse or gene recurrence, whichever came first, or last visit (censored).
Relapse-free survival
RFS was calculated from the first CAR-T cell infusion to relapse or last visit (censored).
Rate of anti-CD22 CAR-T cells in bone marrow cells and peripheral blood cells
In vivo (bone marrow and peripheral blood) rate of CAR-T cells were determined by means of flow cytometry.
Quantity of anti-CD22 CAR-T cells in bone marrow cells and peripheral blood cells
In vivo (bone marrow and peripheral blood) quantity of CAR-T cells were determined by means of flow cytometry.
Quantity of anti-CD22 CAR copies in bone marrow cells and peripheral blood cells
In vivo (bone marrow and peripheral blood) quantity of anti-CD22 CAR copies were determined by means of qPCR.

Full Information

First Posted
June 28, 2019
Last Updated
August 5, 2019
Sponsor
Wuhan Union Hospital, China
Collaborators
Wuhan Bio-Raid Biotechnology Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04007978
Brief Title
Anti-CD22 Chimeric Antigen Receptor (CAR)-Modified T Cell Therapy for Relapsed Refractory B-cell Malignancies
Official Title
Efficacy and Safety of Anti-CD22 CAR-T Therapy in Patients With Relapsed/Refractory B-cell Malignancies: a Single-center, Open-label, Single-arm Clinical Study
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Unknown status
Study Start Date
August 5, 2019 (Actual)
Primary Completion Date
June 30, 2022 (Anticipated)
Study Completion Date
December 30, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Wuhan Union Hospital, China
Collaborators
Wuhan Bio-Raid Biotechnology Co., Ltd.

4. Oversight

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

5. Study Description

Brief Summary
This is a single-center, open-label, single-arm study to evaluate the safety and efficacy of anti-CD22 CAR-T cells in patients with relapsed or refractory B-cell Malignancies.
Detailed Description
Chimeric antigen receptor (CAR)-modified T cells (CAR-T cells) have the capabilities to recognize tumor associated antigen and kill tumor cells specifically. CAR-T therapy showed great effect on patients with relapsed or refractory B-cell malignancies. CAR consists of single chain variable fragment (scFv) and activation domain of T cell. In preclinical study, the researchers constructed a third generation CAR containing CD137 and CD28 costimulatory domains. This study aims to evaluate the safety and effectiveness of anti-CD22 CAR-T cells in patients with relapsed or refractory B-cell Malignancies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
B Cell Lymphoma, Acute Lymphoblastic Leukemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Third generation CAR-T cells
Arm Type
Experimental
Arm Description
Patients receive CD22 CAR-T cells transduced with a lentiviral vector on day 0 in the absence of disease progression or unacceptable toxicity.
Intervention Type
Genetic
Intervention Name(s)
Third generation CAR-T cells
Intervention Description
Patients receive CD22 CAR-T cells transduced with a lentiviral vector on day 0 in the absence of disease progression or unacceptable toxicity.
Primary Outcome Measure Information:
Title
Number of participants with adverse events
Description
Therapy-related adverse events were recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0).
Time Frame
3 years
Secondary Outcome Measure Information:
Title
One-month remission rate
Description
Response of B-ALL to CAR-T therapy was assessed on day 30 (±2), against the National Comprehensive Cancer Network (NCCN, Version 1.2015).
Time Frame
1 month
Title
Overall survival
Description
OS was calculated from the first CAR-T cell infusion to death or last follow-up (censored).
Time Frame
3 years
Title
Event-free survival
Description
EFS was calculated from the first CAR-T cell infusion to death, progression of the disease, relapse or gene recurrence, whichever came first, or last visit (censored).
Time Frame
3 years
Title
Relapse-free survival
Description
RFS was calculated from the first CAR-T cell infusion to relapse or last visit (censored).
Time Frame
3 years
Title
Rate of anti-CD22 CAR-T cells in bone marrow cells and peripheral blood cells
Description
In vivo (bone marrow and peripheral blood) rate of CAR-T cells were determined by means of flow cytometry.
Time Frame
3 years
Title
Quantity of anti-CD22 CAR-T cells in bone marrow cells and peripheral blood cells
Description
In vivo (bone marrow and peripheral blood) quantity of CAR-T cells were determined by means of flow cytometry.
Time Frame
3 years
Title
Quantity of anti-CD22 CAR copies in bone marrow cells and peripheral blood cells
Description
In vivo (bone marrow and peripheral blood) quantity of anti-CD22 CAR copies were determined by means of qPCR.
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
14 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient or his or her legal guardian voluntarily participates in and signs an informed consent form. Male or female patients aged 14 to 70 years (including 14 and 70 years old). Pathological and histological examination confirmed CD22+ B-cell malignancies, and patients met the following criteria for refractory or relapsed B-cell malignancies. A.Refractory/relapsed B-cell lymphoblastic leukemia (Meeting one of the following) i. Recurrence within 6 months after first remission. ii. Primary refractory disease which cannnot achieve complete remission (CR) after 2 cycles of standardized chemotherapy regimen. iii. Failure to achieve CR or relapse after one line or multiple lines of salvage chemotherapy. iv. Not suitable for hematopoietic stem cell transplantation (HSCT), or abandon HSCT due to various restrictions, or relapse after HSCT. B.Refractory/relapsed B-cell lymphoma (Meeting 1 of the first 4 items plus item 5) i. Tumor shrinkage less than 50% or disease progression after 4 cycles of standard chemotherapy. ii. Achieved CR after standard chemotherapy, but relapsed within 6 months. iii. 2 or more relapses after CR. iv. Not suitable for HSCT, or abandon HSCT due to various restrictions, or relapse after HSCT. v. Subjects must have received adequate treatment in the past, including anti-CD20 monoclonal antibody and combination chemotherapy with anthracyclines. B-cell malignancies include the following three types A. B-cell acute lymphoblastic leukemia (B-ALL) B. Indolent B-cell lymphoma (CLL, FL, MZL, LPL, HCL) C. Invasive B-cell lymphoma (DLBCL, BL, MCL) Having a measurable or evaluable lesion A. Patients with lymphoma require a single lesion≥15mm or 2 or more lesions≥10mm. B. Patients with leukemia require persistent positive or positive relapse of bone marrow MRD. Patient's main organs functioning well A. Liver function: ALT/AST < 3 times the upper limit of normal (ULN) and total bilirubin≤34.2μmol/L B. Renal function: Creatinine < 220μmol/L. C. Pulmonary function: Indoor oxygen saturation≥95%. D. Cardiac Function: Left ventricular ejection fraction (LVEF) ≥40%. The patients did not receive any antitumor treatments such as chemotherapy, radiotherapy and immunotherapy (such as immunosuppressive drugs) within 4 weeks before enrollment, and the toxicity related to previous treatments had returned to < 1 level at enrollment (except for low grade toxicity such as alopecia). The patient's peripheral superficial venous blood flow smoothly, which can meet the needs of intravenous drip. Patient ECOG score≤ 2, estimated survival time≥3 months. Exclusion Criteria: Have a history of epilepsy or other central nervous system diseases. Women who are pregnant (urine/blood pregnancy test positive) or lactating. Male or female with a pregnancy plan in the next 1 year. Patients cannot guarantee effective contraception (condom or contraceptives, etc.) within 1 year after enrollment. Uncontrolled infectious disease within 4 weeks prior to enrollment. Active hepatitis B/C virus infection. HIV infected patients. Suffering from a serious autoimmune disease or immunodeficiency disease. The patient is allergic to macromolecular biopharmaceuticals such as antibodies or cytokines. The patient participated in other clinical trials within 6 weeks prior to enrollment. Systemic use of corticosteroids within 4 weeks prior to enrollment (except for patients with inhaled corticosteroids). Suffering from mental diseases. Patient has drug abuse/addiction. According to the researcher's judgment, the patient has other unsuitable enrollment conditions.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yu Hu, M.D., Ph.D
Phone
86-13986183871
Email
dr_huyu@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Heng Mei, M.D., Ph.D
Phone
86-13886160811
Email
hmei@hust.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Heng Mei, M.D., Ph.D
Organizational Affiliation
Wuhan Union Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430022
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yu Hu, M.D., Ph.D
Phone
86-13986183871
Email
dr_huyu@126.com
First Name & Middle Initial & Last Name & Degree
Heng Mei, M.D., Ph.D
Phone
86-13886160811
Email
hmei@hust.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Anti-CD22 Chimeric Antigen Receptor (CAR)-Modified T Cell Therapy for Relapsed Refractory B-cell Malignancies

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