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Study of LUCAR-20S in Patients With R/R NHL

Primary Purpose

Diffuse Large B Cell Lymphoma, Follicular Lymphoma, Mantle Cell Lymphoma

Status
Terminated
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
LUCAR-20S CAR-T cells
Sponsored by
The First Affiliated Hospital with Nanjing Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diffuse Large B Cell Lymphoma

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed informed consent form (ICF)
  2. Age 18 Years to 75 Years
  3. Pathological diagnosis of refractory/relapsed CD20+ non-Hodgkin's lymphoma (one of the following):

    1. Diffuse large B-cell lymphoma (DLBCL)
    2. Follicular lymphoma (FL)
    3. Mantle cell lymphoma (MCL)
    4. Small lymphocytic lymphoma (SLL)
  4. Measurable disease as defined by 2014 Lugano criteria at Screening
  5. Refractory/relapsed disease after standard-of- care treatment as following (Undergone at least 2 complete cycle of therapy for each line, unless PD been documented as the best response to the regimen) and not eligible or appropriate for HSCT (Auto/allo). Subject must have documented evidence of progressive disease on or within 12 months of their last regimen.

    1. DLBCL: Refractory/relapsed after at least 1 prior line of therapy, must have been treated with anti-CD20 monoclonal antibody
    2. FL: Refractory/relapsed after at least 2 prior lines of therapy, must have been treated with anti-CD20 monoclonal antibody
    3. MCL: Refractory/relapsed after at least 2 prior lines of therapy
    4. SLL: Refractory/relapsed after at least 2 prior lines of therapy
  6. Laboratory criteria at Screening

    ① Blood routine: NE≥1.0×109/L;HGB≥8g/dL;PLT≥50×109/L

    ② Blood biochemical parameters:

    1. Total bilirubin ≤ 1.5 times of the normal upper limit (ULN)
    2. Aspartate and alanine aminotransferases (AST, ALT) ≤ 3 times ULN (in the presence of liver metastasis, ULN 5 times)
    3. Estimated glomerular filtration rate (eGFR) > 60mL/min
  7. Life expectancy > 12 weeks
  8. Eastern Cooperative Oncology Group (ECOG) Performance Status grade of 0 or 1

Exclusion Criteria:

  1. Any malignancy besides the NHL categories under study, exceptions include

    1. Any other malignancy curatively treated and disease-free for at least 2 years prior to enrollment
    2. History of non-melanoma skin cancer with sufficient treatment and currently no evidence of recurrence
  2. Prior treatment with an allogeneic stem cell transplant
  3. Prior treatment with genetic therapy
  4. Prior treatment with chimeric antigen receptor T (cells) CAR-T therapy directed at CD20 target
  5. Those who are positive for any index of hepatitis B surface antigen (HBsAg), hepatitis B virus deoxyribonucleic acid (HBV DNA), hepatitis C antibody (HCV-Ab), hepatitis C virus ribonucleic acid (HCV RNA), and human immunodeficiency virus antibody (HIV-Ab)
  6. Prior antitumor therapy with insufficient washout period

    1. Targeted therapy, epigenetic therapy, experimental drug therapy or experimental invasive treatment with medical apparatus and instruments 14 days or five half-lives, whichever is shorter before lymphodepletion
    2. Use of monoclonal antibodies 21 days prior to lymphodepletion
    3. Chemotherapy within 14 days prior to lymphodepletion
    4. Radiotherapy within 14 days prior to lymphodepletion
    5. Participated in other clinical trials within 30 days prior to lymphodepletion
  7. With central nervous system involvement
  8. Women in pregnancy or lactation
  9. Being fertile and unable to use effective conception during treatment and 100 days after CAR-T infusion
  10. Active autoimmune disease or history of autoimmune disease within 3 years
  11. With obvious hemorrhagic tendency such as gastrointestinal hemorrhage, coagulation disorders and hypersplenism
  12. The following cardiac conditions

    1. New York Heart Association (NYHA) stage III or IV congestive heart failure
    2. Left ventricular ejection fraction (LVEF) less than (<)45%
    3. Uncontrolled cardiac arrhythmia post-medication
    4. With a history of myocardial infraction or unstable angina pectoris within the past 6 months
    5. Constrictive pericarditis
    6. Cardiomyopathy
  13. Pulse oximetry of <96% on room air
  14. Active or uncontrolled infection requiring parenteral antibiotics, or any evidence of severe active viral/bacterial infection or uncontrolled systemic fungal infection
  15. Uncontrolled diabetes mellitus, defined as fast serum glucose > 1.5 times ULN
  16. Concurrent use of corticosteroids or other immunosuppressant medications for chronic disease
  17. Concurrent use of hematopoietic growth factor
  18. Stroke or seizure within 6 months of signing ICF
  19. Have received any live, attenuated vaccine within 4 weeks prior to lymphodepletion
  20. Have underwent major surgical operation within 2 weeks prior to lymphodepletion, or anticipate to undergo a major surgical operation during the study process or within 2 weeks posterior to study treatment(with the exception of anticipated local anesthesia surgery)
  21. Known life threatening allergies, hypersensitivity, or intolerance to LUCAR-20S CAR-T cells or its excipients, including dimethyl sulfoxide (DMSO)
  22. Presence of any condition that, in the opinion of the investigator, would prohibit the patient from undergoing treatment under this protocol

Sites / Locations

  • Oncology Department,The First Affiliated Hospital of USTC west district
  • Hematological Department, People's Hospital of Jiangsu Province
  • Hematological Department,Beijing Boren Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Anti-CD20 Allogeneic CAR-T Cell Therapy

Arm Description

An open label, single arm Phase I study to evaluate the safety, tolerability, and pharmacokinetics of LUCAR-20S CAR-T cells in relapsed or refractory CD20+ diffuse large B-cell, follicular, mantle cell and small lymphocytic lymphoma.

Outcomes

Primary Outcome Measures

Dose limiting toxicity (DLT)
DLT assessed by NCI-CTCAE 5.0
Adverse events
Incidence and severity of adverse events as assessed by NCI-CTCAE 5.0
Concentration of Pharmacokinetics in blood
PK CAR positive T cells in peripheral blood, PK CAR transgene levels in peripheral blood
Concentration of Pharmacokinetics in bone marrow
PK CAR positive T cells in bone marrow, PK CAR transgene levels in bone marrow

Secondary Outcome Measures

Recommended Phase II dose (RP2D)
RP2D established through ATD+BOIN design and the DLTs occurring following CAR T-cell infusion
Overall response rate (ORR) after administration
Antitumor efficacy by 2014 Lugano criteria
Time to Response (TTR) after administration
Antitumor efficacy by 2014 Lugano criteria
Duration of remission (DOR) after administration
Antitumor efficacy by 2014 Lugano criteria
Progress Free Survival (PFS) after administration
Antitumor efficacy by 2014 Lugano criteria
Overall Survival (OS) after administration
Antitumor efficacy by 2014 Lugano criteria

Full Information

First Posted
November 18, 2019
Last Updated
December 17, 2021
Sponsor
The First Affiliated Hospital with Nanjing Medical University
Collaborators
Nanjing Legend Biotechnology Co.,Ltd.; The First Affiliated Hospital of USTC west district; Beijing Boren Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04176913
Brief Title
Study of LUCAR-20S in Patients With R/R NHL
Official Title
A Study Evaluating the Safety, Tolerability, and Pharmacokinetics of LUCAR-20S in Patients With Relapsed/Refractory Diffuse Large B-Cell, Follicular, Mantle Cell or Small Lymphocytic Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Terminated
Why Stopped
Both the sponsors and collaborator are considering terminating the study
Study Start Date
December 1, 2020 (Actual)
Primary Completion Date
December 9, 2021 (Actual)
Study Completion Date
December 9, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The First Affiliated Hospital with Nanjing Medical University
Collaborators
Nanjing Legend Biotechnology Co.,Ltd.; The First Affiliated Hospital of USTC west district; Beijing Boren Hospital

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
An open label, single arm Phase I study to evaluate the safety, tolerability, and pharmacokinetics of LUCAR-20S CAR-T cells in relapsed or refractory CD20+ diffuse large B-cell, follicular, mantle cell and small lymphocytic lymphoma.
Detailed Description
This study is an open, dose escalation/dose regimen finding study to assess the safety and pharmacokinetics of donor-derived CD20-directed CAR-T cells administered with lymphodepletion, and to obtain the preliminary efficacy results in subjects who have been diagnosed with relapsed or refractory CD20 positive diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma or small lymphocytic lymphoma. The allo-CAR-T cells will be infused in single-dose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diffuse Large B Cell Lymphoma, Follicular Lymphoma, Mantle Cell Lymphoma, Small Lymphocytic 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
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Anti-CD20 Allogeneic CAR-T Cell Therapy
Arm Type
Experimental
Arm Description
An open label, single arm Phase I study to evaluate the safety, tolerability, and pharmacokinetics of LUCAR-20S CAR-T cells in relapsed or refractory CD20+ diffuse large B-cell, follicular, mantle cell and small lymphocytic lymphoma.
Intervention Type
Drug
Intervention Name(s)
LUCAR-20S CAR-T cells
Intervention Description
An Anti-CD20 Allogeneic CAR-T Cell Therapy in Patients with Relapsed/Refractory Diffuse Large B-Cell, Follicular, Mantle Cell or Small Lymphocytic Lymphoma
Primary Outcome Measure Information:
Title
Dose limiting toxicity (DLT)
Description
DLT assessed by NCI-CTCAE 5.0
Time Frame
30 days post infusion
Title
Adverse events
Description
Incidence and severity of adverse events as assessed by NCI-CTCAE 5.0
Time Frame
90 days post infusion
Title
Concentration of Pharmacokinetics in blood
Description
PK CAR positive T cells in peripheral blood, PK CAR transgene levels in peripheral blood
Time Frame
through study completion, 2 years after infusion of the last subject
Title
Concentration of Pharmacokinetics in bone marrow
Description
PK CAR positive T cells in bone marrow, PK CAR transgene levels in bone marrow
Time Frame
through study completion, 2 years after infusion of the last subject
Secondary Outcome Measure Information:
Title
Recommended Phase II dose (RP2D)
Description
RP2D established through ATD+BOIN design and the DLTs occurring following CAR T-cell infusion
Time Frame
30 days post infusion
Title
Overall response rate (ORR) after administration
Description
Antitumor efficacy by 2014 Lugano criteria
Time Frame
3 months post infusion
Title
Time to Response (TTR) after administration
Description
Antitumor efficacy by 2014 Lugano criteria
Time Frame
3 months post infusion
Title
Duration of remission (DOR) after administration
Description
Antitumor efficacy by 2014 Lugano criteria
Time Frame
through study completion, 2 years after infusion of the last subject
Title
Progress Free Survival (PFS) after administration
Description
Antitumor efficacy by 2014 Lugano criteria
Time Frame
through study completion, 2 years after infusion of the last subject
Title
Overall Survival (OS) after administration
Description
Antitumor efficacy by 2014 Lugano criteria
Time Frame
through study completion, 2 years after infusion of the last subject

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent form (ICF) Age 18 Years to 75 Years Pathological diagnosis of refractory/relapsed CD20+ non-Hodgkin's lymphoma (one of the following): Diffuse large B-cell lymphoma (DLBCL) Follicular lymphoma (FL) Mantle cell lymphoma (MCL) Small lymphocytic lymphoma (SLL) Measurable disease as defined by 2014 Lugano criteria at Screening Refractory/relapsed disease after standard-of- care treatment as following (Undergone at least 2 complete cycle of therapy for each line, unless PD been documented as the best response to the regimen) and not eligible or appropriate for HSCT (Auto/allo). Subject must have documented evidence of progressive disease on or within 12 months of their last regimen. DLBCL: Refractory/relapsed after at least 1 prior line of therapy, must have been treated with anti-CD20 monoclonal antibody FL: Refractory/relapsed after at least 2 prior lines of therapy, must have been treated with anti-CD20 monoclonal antibody MCL: Refractory/relapsed after at least 2 prior lines of therapy SLL: Refractory/relapsed after at least 2 prior lines of therapy Laboratory criteria at Screening ① Blood routine: NE≥1.0×109/L;HGB≥8g/dL;PLT≥50×109/L ② Blood biochemical parameters: Total bilirubin ≤ 1.5 times of the normal upper limit (ULN) Aspartate and alanine aminotransferases (AST, ALT) ≤ 3 times ULN (in the presence of liver metastasis, ULN 5 times) Estimated glomerular filtration rate (eGFR) > 60mL/min Life expectancy > 12 weeks Eastern Cooperative Oncology Group (ECOG) Performance Status grade of 0 or 1 Exclusion Criteria: Any malignancy besides the NHL categories under study, exceptions include Any other malignancy curatively treated and disease-free for at least 2 years prior to enrollment History of non-melanoma skin cancer with sufficient treatment and currently no evidence of recurrence Prior treatment with an allogeneic stem cell transplant Prior treatment with genetic therapy Prior treatment with chimeric antigen receptor T (cells) CAR-T therapy directed at CD20 target Those who are positive for any index of hepatitis B surface antigen (HBsAg), hepatitis B virus deoxyribonucleic acid (HBV DNA), hepatitis C antibody (HCV-Ab), hepatitis C virus ribonucleic acid (HCV RNA), and human immunodeficiency virus antibody (HIV-Ab) Prior antitumor therapy with insufficient washout period Targeted therapy, epigenetic therapy, experimental drug therapy or experimental invasive treatment with medical apparatus and instruments 14 days or five half-lives, whichever is shorter before lymphodepletion Use of monoclonal antibodies 21 days prior to lymphodepletion Chemotherapy within 14 days prior to lymphodepletion Radiotherapy within 14 days prior to lymphodepletion Participated in other clinical trials within 30 days prior to lymphodepletion With central nervous system involvement Women in pregnancy or lactation Being fertile and unable to use effective conception during treatment and 100 days after CAR-T infusion Active autoimmune disease or history of autoimmune disease within 3 years With obvious hemorrhagic tendency such as gastrointestinal hemorrhage, coagulation disorders and hypersplenism The following cardiac conditions New York Heart Association (NYHA) stage III or IV congestive heart failure Left ventricular ejection fraction (LVEF) less than (<)45% Uncontrolled cardiac arrhythmia post-medication With a history of myocardial infraction or unstable angina pectoris within the past 6 months Constrictive pericarditis Cardiomyopathy Pulse oximetry of <96% on room air Active or uncontrolled infection requiring parenteral antibiotics, or any evidence of severe active viral/bacterial infection or uncontrolled systemic fungal infection Uncontrolled diabetes mellitus, defined as fast serum glucose > 1.5 times ULN Concurrent use of corticosteroids or other immunosuppressant medications for chronic disease Concurrent use of hematopoietic growth factor Stroke or seizure within 6 months of signing ICF Have received any live, attenuated vaccine within 4 weeks prior to lymphodepletion Have underwent major surgical operation within 2 weeks prior to lymphodepletion, or anticipate to undergo a major surgical operation during the study process or within 2 weeks posterior to study treatment(with the exception of anticipated local anesthesia surgery) Known life threatening allergies, hypersensitivity, or intolerance to LUCAR-20S CAR-T cells or its excipients, including dimethyl sulfoxide (DMSO) Presence of any condition that, in the opinion of the investigator, would prohibit the patient from undergoing treatment under this protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wei Xu, PhD& MD
Organizational Affiliation
The first Affiliated Hospital Of Nanjing Medical University(JiangSu Province Hospital)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Kaiyang Ding, PhD& MD
Organizational Affiliation
Anhui Provincial Cancer Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Kai Hu, PhD& MD
Organizational Affiliation
Beijing Boren Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oncology Department,The First Affiliated Hospital of USTC west district
City
Hefei
State/Province
Anhui
ZIP/Postal Code
230000
Country
China
Facility Name
Hematological Department, People's Hospital of Jiangsu Province
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210029
Country
China
Facility Name
Hematological Department,Beijing Boren Hospital
City
Beijing
ZIP/Postal Code
100070
Country
China

12. IPD Sharing Statement

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Study of LUCAR-20S in Patients With R/R NHL

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