A Study Evaluating Gene Therapy With BB305 Lentiviral Vector in Sickle Cell Disease
Primary Purpose
Sickle Cell Disease
Status
Recruiting
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
bb1111
Sponsored by
About this trial
This is an interventional treatment trial for Sickle Cell Disease
Eligibility Criteria
Inclusion Criteria:
- Have a diagnosis of SCD, with either βS/βS, βS/β0, or βS/β+ genotype.
- Be ≥2 and ≤50 years of age at time of consent.
- Weigh a minimum of 6 kg.
- Have a Karnofsky performance status of ≥60 (≥16 years of age) or a Lansky performance status of ≥60 (<16 years of age).
- Be treated and followed for at least the past 24 months prior to Informed Consent in medical center(s) that maintained detailed records on sickle cell disease history.
- In the setting of appropriate supportive care measures (e.g., pain management plan), have experienced at least 4 protocol-defined VOEs in the 24 months prior to informed consent.
- Have either experienced HU failure at any point in the past or must have intolerance to HU (intolerance is defined as the patient being unable to continue to take HU per PI judgment).
- Female and male subjects of childbearing potential agree to use 1 method of highly effective contraception from Screening to at least 6 months after drug product infusion.
- Provision of written informed consent for this study by subject, or as applicable, subject's parent(s)/legal guardian(s).
Exclusion Criteria:
- Subjects for whom allogeneic hematopoietic stem cell transplantation (allo-HSCT) is medically appropriate per PI judgment and a willing, human leukocyte antigen (HLA)-matched related hematopoietic stem cell donor is available.
- Severe cerebral vasculopathy, defined by any history of overt ischemic or hemorrhagic stroke, a history of abnormal transcranial Doppler (TCD) or TCD imaging (TCDI) for subjects ≤ 16 years of age (e.g. TCD velocity >200 cm/sec) requiring ongoing chronic transfusions, a Screening TCD or TCDI velocity > 200 cm/sec (central read), a Screening MRA showing > 50% stenosis or occlusion in the circle of Willis (central read), or a Screening MRA showing the presence of Moyamoya (central read).
- Positive for presence of human immunodeficiency virus type 1 or 2 (HIV-1 or HIV-2), hepatitis B, hepatitis C, human T-lymphotropic virus-1 (HTLV-1), active syphilis.
- Clinically significant, active bacterial, viral, fungal, or parasitic infection
Advanced liver disease, such as
- clear evidence of liver cirrhosis, active hepatitis or significant fibrosis (based on MRI or liver biopsy)
- liver iron concentration ≥15 mg/g unless liver biopsy shows no evidence of cirrhosis, active hepatitis or significant fibrosis
- Inadequate bone marrow function, as defined by an absolute neutrophil count of <1×10^9/L (<0.5×10^9/L for subjects on hydroxyurea treatment) or a platelet count <100×10^9/L.
- Any contraindications to the use of plerixafor during the mobilization of hematopoietic stem cells and any contraindications to the use of busulfan and any other medicinal products required during the myeloablative conditioning, including hypersensitivity to the active substances or to any of the excipients.
- Patients needing therapeutic anticoagulation treatment during the period of conditioning through platelet engraftment
- Unable to receive pRBC transfusion.
- Prior receipt of an allogeneic transplant.
- Prior receipt of gene therapy.
- Any prior or current malignancy or immunodeficiency disorder, except previously treated, non-life threatening, cured tumors such as squamous cell carcinoma of the skin.
- Immediate family member with a known or suspected Familial Cancer Syndrome.
- Female subject is breastfeeding, pregnant or will attempt to become pregnant from Screening to at least 6 months after drug product infusion.
- Any other condition that would render the subject ineligible for HSCT.
- Participation in another clinical study with an investigational drug within 30 days of screening.
- Presence of a chromosomal abnormality or genetic mutation that may put the subject at an increased risk of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) per Investigator's judgment.
- Presence of genetic mutations that result in the inactivation of 2 or more α-globin genes
Sites / Locations
- University of AlabamaRecruiting
- Children's National HospitalRecruiting
- Tufts Medical Center
- University of MinnesotaRecruiting
- Hackensack University Medical CenterRecruiting
- Montefiore Medical CenterRecruiting
- Duke UniversityRecruiting
- Baylor College of Medicine/Texas Children's HospitalRecruiting
- Virginia Commonwealth University (VCU)Recruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
bb1111
Arm Description
Subjects will receive treatment with a single dose of Drug Product manufactured with autologous CD34+ hematopoietic stem cells collected by plerixafor mobilization and apheresis, transduced with BB305 lentiviral vector (LVV) encoding the human beta-A-T87Q globin gene. Plerixafor mobilization and apheresis will also be used for collection of rescue cells.
Outcomes
Primary Outcome Measures
VOE-CR
Proportion of subjects achieving complete resolution of VOEs between 6 months and 18 months after drug product infusion
Secondary Outcome Measures
sVOE-CR
Proportion of subjects achieving complete resolution of severe vaso-occlusive events, between 6 months and 18 months after drug product infusion
Proportion of subjects achieving Globin Response
Globin Response, defined as meeting the following criteria for a continuous period of at least 6 months after drug product infusion:
Weighted average HbAT87Q percentage of non-transfused total Hb* ≥30% AND
Weighted average non-transfused total Hb* increase of ≥3 g/dL compared to baseline total Hb* OR weighted average non-transfused total Hb* ≥10 g/dL
non-transfused total Hb is the total g/dL of HbS + HbF + HbA2 + HbAT87Q
Change in the annualized number of VOEs in the 24 months after drug product infusion compared to the 24 months prior to Informed Consent
Change in the annualized number of severe VOEs in the 24 months after drug product infusion compared to the 24 months prior to Informed Consent.
VOE-CR24
Proportion of subjects achieving complete resolution of VOEs between 6 months and 24 months after drug product infusion
sVOE-CR24
Proportion of subjects achieving complete resolution of severe VOEs between 6 months and 24 months after drug product infusion
sVOE-75
Proportion of subjects achieving at least a 75% reduction in annualized severe VOEs in the 24 months after drug product administration compared to the 24 months prior to Informed Consent.
Weighted average non-transfused total Hb
Weighted average HbS percentage of non-transfused total Hb
Weighted average HbS percentage of non-transfused total Hb ≤70%, ≤60%, ≤50%
Weighted average HbAT87Q percentage of non-transfused total Hb
Weighted average non-HbS percentage of non-transfused total Hb
Average and median of non-transfused total Hb
Average and median of HbS percentage of non-transfused total Hb
Average and median of HbAT87Q percentage of non-transfused total Hb
Average and median of non-HbS percentage of non-transfused total Hb
Change from baseline in absolute reticulocyte count
Change from baseline in percent reticulocytes
Change from baseline in percent erythrocytes
Change from baseline in total bilirubin
Change from baseline in haptoglobin
Change from baseline in lactate dehydrogenase
Change from baseline in ferritin
Change from baseline in liver iron content
Change from baseline in cardiac iron content (if assessed at baseline)
Change from baseline in erythropoietin
Change from baseline in serum transferrin receptor
Change from baseline in annualized frequency of packed red blood cell (pRBC) transfusions
Change from baseline in annualized volume of pRBC transfusions
Change from baseline in TCD velocity at Month 12 and Month 24 (for subjects ≤ 16 years old at Informed Consent)
Change from baseline in meters walked during the 6-minute walk test
Change from baseline in annualized number of SCD-related hospital admissions
Change from baseline in annualized number of total days hospitalized
Change from baseline in patient-reported quality of life, as measured by PROMIS-57 Version 2.1 for subjects ≥ 18 years of age and PROMIS Pediatric Profile/Parent Proxy Profile 49 Version 2.0 for subjects < 18 years of age
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04293185
Brief Title
A Study Evaluating Gene Therapy With BB305 Lentiviral Vector in Sickle Cell Disease
Official Title
A Phase 3 Study Evaluating Gene Therapy by Transplantation of Autologous CD34+ Stem Cells Transduced Ex Vivo With the BB305 Lentiviral Vector in Subjects With Sickle Cell Disease
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 14, 2020 (Actual)
Primary Completion Date
October 2026 (Anticipated)
Study Completion Date
April 2027 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
bluebird bio
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a non-randomized, open-label, multi-site, single-dose, Phase 3 study in approximately 35 adults and pediatric subjects ≥2 and ≤50 years of age with sickle cell disease (SCD). The study will evaluate hematopoietic stem cell (HSC) transplantation (HSCT) using bb1111 (also known as LentiGlobin BB305 Drug Product for SCD).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sickle Cell Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
35 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
bb1111
Arm Type
Experimental
Arm Description
Subjects will receive treatment with a single dose of Drug Product manufactured with autologous CD34+ hematopoietic stem cells collected by plerixafor mobilization and apheresis, transduced with BB305 lentiviral vector (LVV) encoding the human beta-A-T87Q globin gene.
Plerixafor mobilization and apheresis will also be used for collection of rescue cells.
Intervention Type
Genetic
Intervention Name(s)
bb1111
Other Intervention Name(s)
lovotibeglogene autotemcel, lovo-cel, LentiGlobin BB305 Drug Product for SCD, autologous CD34+ cell-enriched population from patients with SCD that contains HSCs transduced with BB305 LVV encoding the βA-T87Q-globin gene, suspended in cryopreservation solution
Intervention Description
Drug Product is administered by IV infusion following myeloablative conditioning with busulfan.
Primary Outcome Measure Information:
Title
VOE-CR
Description
Proportion of subjects achieving complete resolution of VOEs between 6 months and 18 months after drug product infusion
Time Frame
6-18 months post-transplant
Secondary Outcome Measure Information:
Title
sVOE-CR
Description
Proportion of subjects achieving complete resolution of severe vaso-occlusive events, between 6 months and 18 months after drug product infusion
Time Frame
6-18 months post-transplant
Title
Proportion of subjects achieving Globin Response
Description
Globin Response, defined as meeting the following criteria for a continuous period of at least 6 months after drug product infusion:
Weighted average HbAT87Q percentage of non-transfused total Hb* ≥30% AND
Weighted average non-transfused total Hb* increase of ≥3 g/dL compared to baseline total Hb* OR weighted average non-transfused total Hb* ≥10 g/dL
non-transfused total Hb is the total g/dL of HbS + HbF + HbA2 + HbAT87Q
Time Frame
6-24 months post-transplant
Title
Change in the annualized number of VOEs in the 24 months after drug product infusion compared to the 24 months prior to Informed Consent
Time Frame
1-24 months post-transplant
Title
Change in the annualized number of severe VOEs in the 24 months after drug product infusion compared to the 24 months prior to Informed Consent.
Time Frame
1-24 months post-transplant
Title
VOE-CR24
Description
Proportion of subjects achieving complete resolution of VOEs between 6 months and 24 months after drug product infusion
Time Frame
6-24 months post-transplant
Title
sVOE-CR24
Description
Proportion of subjects achieving complete resolution of severe VOEs between 6 months and 24 months after drug product infusion
Time Frame
6-24 months post-transplant
Title
sVOE-75
Description
Proportion of subjects achieving at least a 75% reduction in annualized severe VOEs in the 24 months after drug product administration compared to the 24 months prior to Informed Consent.
Time Frame
1-24 months post-transplant
Title
Weighted average non-transfused total Hb
Time Frame
Month 6, 12, 18 and 24 post-transplant
Title
Weighted average HbS percentage of non-transfused total Hb
Time Frame
Month 6, 12, 18 and 24 post-transplant
Title
Weighted average HbS percentage of non-transfused total Hb ≤70%, ≤60%, ≤50%
Time Frame
Month 6, 12, 18 and 24 post-transplant
Title
Weighted average HbAT87Q percentage of non-transfused total Hb
Time Frame
Month 6, 12, 18 and 24 post-transplant
Title
Weighted average non-HbS percentage of non-transfused total Hb
Time Frame
Month 6, 12, 18 and 24 post-transplant
Title
Average and median of non-transfused total Hb
Time Frame
1-24 months post-transplant
Title
Average and median of HbS percentage of non-transfused total Hb
Time Frame
1-24 months post-transplant
Title
Average and median of HbAT87Q percentage of non-transfused total Hb
Time Frame
1-24 months post-transplant
Title
Average and median of non-HbS percentage of non-transfused total Hb
Time Frame
1-24 months post-transplant
Title
Change from baseline in absolute reticulocyte count
Time Frame
1-24 months post-transplant
Title
Change from baseline in percent reticulocytes
Time Frame
1-24 months post-transplant
Title
Change from baseline in percent erythrocytes
Time Frame
1-24 months post-transplant
Title
Change from baseline in total bilirubin
Time Frame
1-24 months post-transplant
Title
Change from baseline in haptoglobin
Time Frame
1-24 months post-transplant
Title
Change from baseline in lactate dehydrogenase
Time Frame
1-24 months post-transplant
Title
Change from baseline in ferritin
Time Frame
1-24 months post-transplant
Title
Change from baseline in liver iron content
Time Frame
1-24 months post-transplant
Title
Change from baseline in cardiac iron content (if assessed at baseline)
Time Frame
1-24 months post-transplant
Title
Change from baseline in erythropoietin
Time Frame
1-24 months post-transplant
Title
Change from baseline in serum transferrin receptor
Time Frame
1 - 24 months post-transplant
Title
Change from baseline in annualized frequency of packed red blood cell (pRBC) transfusions
Time Frame
6-24 months post-transplant
Title
Change from baseline in annualized volume of pRBC transfusions
Time Frame
6-24 months post-transplant
Title
Change from baseline in TCD velocity at Month 12 and Month 24 (for subjects ≤ 16 years old at Informed Consent)
Time Frame
Month 12 and Month 24 post-transplant
Title
Change from baseline in meters walked during the 6-minute walk test
Time Frame
1 - 24 months post-transplant
Title
Change from baseline in annualized number of SCD-related hospital admissions
Time Frame
1 - 24 months post-transplant
Title
Change from baseline in annualized number of total days hospitalized
Time Frame
1 - 24 months post-transplant
Title
Change from baseline in patient-reported quality of life, as measured by PROMIS-57 Version 2.1 for subjects ≥ 18 years of age and PROMIS Pediatric Profile/Parent Proxy Profile 49 Version 2.0 for subjects < 18 years of age
Time Frame
1 - 24 months post-transplant
10. Eligibility
Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Have a diagnosis of SCD, with either βS/βS, βS/β0, or βS/β+ genotype.
Be ≥2 and ≤50 years of age at time of consent.
Weigh a minimum of 6 kg.
Have a Karnofsky performance status of ≥60 (≥16 years of age) or a Lansky performance status of ≥60 (<16 years of age).
Be treated and followed for at least the past 24 months prior to Informed Consent in medical center(s) that maintained detailed records on sickle cell disease history.
In the setting of appropriate supportive care measures (e.g., pain management plan), have experienced at least 4 protocol-defined VOEs in the 24 months prior to informed consent.
Have either experienced HU failure at any point in the past or must have intolerance to HU (intolerance is defined as the patient being unable to continue to take HU per PI judgment).
Female and male subjects of childbearing potential agree to use 1 method of highly effective contraception from Screening to at least 6 months after drug product infusion.
Provision of written informed consent for this study by subject, or as applicable, subject's parent(s)/legal guardian(s).
Exclusion Criteria:
Subjects for whom allogeneic hematopoietic stem cell transplantation (allo-HSCT) is medically appropriate per PI judgment and a willing, human leukocyte antigen (HLA)-matched related hematopoietic stem cell donor is available.
Severe cerebral vasculopathy, defined by any history of overt ischemic or hemorrhagic stroke, a history of abnormal transcranial Doppler (TCD) or TCD imaging (TCDI) for subjects ≤ 16 years of age (e.g. TCD velocity >200 cm/sec) requiring ongoing chronic transfusions, a Screening TCD or TCDI velocity > 200 cm/sec (central read), a Screening MRA showing > 50% stenosis or occlusion in the circle of Willis (central read), or a Screening MRA showing the presence of Moyamoya (central read).
Positive for presence of human immunodeficiency virus type 1 or 2 (HIV-1 or HIV-2), hepatitis B, hepatitis C, human T-lymphotropic virus-1 (HTLV-1), active syphilis.
Clinically significant, active bacterial, viral, fungal, or parasitic infection
Advanced liver disease, such as
clear evidence of liver cirrhosis, active hepatitis or significant fibrosis (based on MRI or liver biopsy)
liver iron concentration ≥15 mg/g unless liver biopsy shows no evidence of cirrhosis, active hepatitis or significant fibrosis
Inadequate bone marrow function, as defined by an absolute neutrophil count of <1×10^9/L (<0.5×10^9/L for subjects on hydroxyurea treatment) or a platelet count <100×10^9/L.
Any contraindications to the use of plerixafor during the mobilization of hematopoietic stem cells and any contraindications to the use of busulfan and any other medicinal products required during the myeloablative conditioning, including hypersensitivity to the active substances or to any of the excipients.
Patients needing therapeutic anticoagulation treatment during the period of conditioning through platelet engraftment
Unable to receive pRBC transfusion.
Prior receipt of an allogeneic transplant.
Prior receipt of gene therapy.
Any prior or current malignancy or immunodeficiency disorder, except previously treated, non-life threatening, cured tumors such as squamous cell carcinoma of the skin.
Immediate family member with a known or suspected Familial Cancer Syndrome.
Female subject is breastfeeding, pregnant or will attempt to become pregnant from Screening to at least 6 months after drug product infusion.
Any other condition that would render the subject ineligible for HSCT.
Participation in another clinical study with an investigational drug within 30 days of screening.
Presence of a chromosomal abnormality or genetic mutation that may put the subject at an increased risk of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) per Investigator's judgment.
Presence of genetic mutations that result in the inactivation of 2 or more α-globin genes
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
bluebird bio
Phone
+1-833-999-6378
Email
clinicaltrials@bluebirdbio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anjulika Chawla, MD, FAAP
Organizational Affiliation
bluebird bio, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Individual Site Status
Recruiting
Facility Name
Children's National Hospital
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Individual Site Status
Recruiting
Facility Name
Tufts Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Individual Site Status
Recruiting
Facility Name
Hackensack University Medical Center
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Individual Site Status
Recruiting
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Individual Site Status
Recruiting
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Individual Site Status
Recruiting
Facility Name
Baylor College of Medicine/Texas Children's Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Name
Virginia Commonwealth University (VCU)
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23219
Country
United States
Individual Site Status
Recruiting
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Bluebird bio is committed to transparency and appropriately de-identified patient-level datasets and supporting documents may be shared upon completion of study participation and following attainment of applicable marketing approvals associated with this study and consistent with criteria established by bluebird bio and/or industry best practices to maintain the privacy of study participants. For enquiries, please contact us at datasharing@bluebirdbio.com.
Learn more about this trial
A Study Evaluating Gene Therapy With BB305 Lentiviral Vector in Sickle Cell Disease
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