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CD19 CAR-T Expressing IL7 and CCL19 Combined With PD1 mAb for Relapsed or Refractory Diffuse Large B Cell Lymphoma (CICPD)

Primary Purpose

Diffuse Large B-cell Lymphoma

Status
Enrolling by invitation
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CD19-7×19 CAR-T plus PD1 monoclonal antibody
Sponsored by
Second Affiliated Hospital, School of Medicine, Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diffuse Large B-cell Lymphoma focused on measuring diffuse large B-cell lymphoma, Chimeric antigen receptor T cell, PD1 monoclonal antibody

Eligibility Criteria

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

Inclusion Criteria:

  • (1) Age ≥ 18, upper limit 75, unlimited for men and women;

    (2) ECOG score 0-3;

    (3) Histologically confirmed diffuse large B-cell lymphoma (DLBCL) [according to who 2008];

    (4) CD19 was positive (immunohistochemistry or flow cytometry).

    (5) The definition of refractory or relapse of DLBCL is: no complete remission after 2-line treatment; disease progression in any treatment process, or disease stabilization time equal to or less than 6 months; or disease progression or relapse within 12 months after hematopoietic stem cell transplantation;

    (6) The previous treatment of diffuse large B cell lymphoma must include rituximab (CD20 mAb) and anthracycline;

    (7) There should be at least one measurable focus. It is required that any length of lymph node focus should be greater than 1.5cm or any length of extranodal focus should be greater than 1.0cm. PET-CT scan focuses should have uptake (SUV is greater than liver blood pool);

    (8) The absolute value of neutrophils in peripheral blood ≥ 1000 / μ L, platelet ≥ 45000 / μ L;

    (9) Heart, liver and kidney function: creatinine < 1.5mg/dl; ALT (alanine aminotransferase) / AST (aspartate aminotransferase) 2.5 times lower than the normal upper limit; total bilirubin < 1.5mg/dl; heart ejection fraction (EF) ≥ 50%;

    (10) Sufficient understanding ability and voluntary signing of informed consent;

    (11) Those with fertility must be willing to use contraceptive methods;

    (12) According to the judgment of the researchers, the expected survival time is more than 4 months;

    (13) Willing to follow visit schedule, administration plan, laboratory inspection and other test steps.

Exclusion Criteria:

  • (1) History of other tumors;

    (2) Hematopoietic stem cell transplantation was performed within 6 weeks;

    (3) Any target car-t treatment was performed within 3 months before the car-t treatment;

    (4) Previous use of any commercially available PD-1 mAb;

    (5) Cytotoxic drugs, glucocorticoids and other targeted drugs were received within 2 weeks before cell collection;

    (6) Active autoimmune diseases;

    (7) Uncontrollable infection of active bacteria and fungi;

    (8) HIV infection, syphilis infection; active hepatitis B or C: hepatitis B: HBV-DNA ≥ 1000IU / ml; hepatitis C: HCV RNA positive and liver function abnormal.

    (9) Known central nervous system lymphoma.

Sites / Locations

  • 2nd Affiliated Hospital, School of Medicine, Zhejiang University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CD19-7×19 CAR-T plus PD1 monoclonal antibody

Arm Description

Outcomes

Primary Outcome Measures

Objective response rate
Objective response rate of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb

Secondary Outcome Measures

progression-free survival
progression-free survival of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb
overall survival
overall survival of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb
Duration of Overall Response
Duration of Overall Response of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb
Relapse rate
Relapse rate of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb

Full Information

First Posted
May 6, 2020
Last Updated
February 2, 2023
Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT04381741
Brief Title
CD19 CAR-T Expressing IL7 and CCL19 Combined With PD1 mAb for Relapsed or Refractory Diffuse Large B Cell Lymphoma
Acronym
CICPD
Official Title
CD19 CAR-T Expressing IL7 and CCL19 Combined With PD1 mAb for Relapsed or Refractory Diffuse Large B Cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Enrolling by invitation
Study Start Date
June 18, 2020 (Actual)
Primary Completion Date
September 1, 2023 (Anticipated)
Study Completion Date
September 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University

4. Oversight

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

5. Study Description

Brief Summary
Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin's lymphoma, accounting for 35% of lymphoma. Chimeric antigen receptor T cell (CAR-T) therapy is a new method to treat DLBCL. KTE-C19, published in the New England Medical Journal in December 2017, was used to treat relapsed and refractory B-cell lymphoma. One year of treatment for 111 patients, the total response rate was 82%, and the complete remission rate was 54%. However, a large number of clinical studies have shown that about 20% of patients with B-ALL and 50% of patients with B-NHL cannot achieve complete remission (CR) after CD19-CAR-T treatment. Targeting tumor microenvironment is an important new method to overcome the drug resistance of CAR-T cells. In this study, IL-7 and CCL19 were connected on the basis of traditional second generation CD19 CAR-T cells to construct novel fourth generation CAR-T cells, which can promote the infiltration, accumulation and survival of CAR-T cells in lymphoma tissue, and further enhance the anti-tumor effect of traditional CAR-T cells. At the same time, combined with four generations of CAR-T cells and PD1 monoclonal antibody, PD1 / PDL1 signal pathway was blocked, anti-tumor effect of CAR-T was improved, and immune response and long-term remission rate of DLBCL were improved.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diffuse Large B-cell Lymphoma
Keywords
diffuse large B-cell lymphoma, Chimeric antigen receptor T cell, PD1 monoclonal antibody

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CD19-7×19 CAR-T plus PD1 monoclonal antibody
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
CD19-7×19 CAR-T plus PD1 monoclonal antibody
Intervention Description
Three different doses of CD19-7×19 CAR-T (1×106/kg、2×106/kg、3×106/kg) plus 200mg Tislelizumab every 3 weeks for 6 times
Primary Outcome Measure Information:
Title
Objective response rate
Description
Objective response rate of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb
Time Frame
3 months
Secondary Outcome Measure Information:
Title
progression-free survival
Description
progression-free survival of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb
Time Frame
2 years
Title
overall survival
Description
overall survival of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb
Time Frame
2 years
Title
Duration of Overall Response
Description
Duration of Overall Response of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb
Time Frame
2 years
Title
Relapse rate
Description
Relapse rate of the combination of CD19 CAR-T Expressing IL7 and CCL19 and PD1 mAb
Time Frame
2 years

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: (1) Age ≥ 18, upper limit 75, unlimited for men and women; (2) ECOG score 0-3; (3) Histologically confirmed diffuse large B-cell lymphoma (DLBCL) [according to who 2008]; (4) CD19 was positive (immunohistochemistry or flow cytometry). (5) The definition of refractory or relapse of DLBCL is: no complete remission after 2-line treatment; disease progression in any treatment process, or disease stabilization time equal to or less than 6 months; or disease progression or relapse within 12 months after hematopoietic stem cell transplantation; (6) The previous treatment of diffuse large B cell lymphoma must include rituximab (CD20 mAb) and anthracycline; (7) There should be at least one measurable focus. It is required that any length of lymph node focus should be greater than 1.5cm or any length of extranodal focus should be greater than 1.0cm. PET-CT scan focuses should have uptake (SUV is greater than liver blood pool); (8) The absolute value of neutrophils in peripheral blood ≥ 1000 / μ L, platelet ≥ 45000 / μ L; (9) Heart, liver and kidney function: creatinine < 1.5mg/dl; ALT (alanine aminotransferase) / AST (aspartate aminotransferase) 2.5 times lower than the normal upper limit; total bilirubin < 1.5mg/dl; heart ejection fraction (EF) ≥ 50%; (10) Sufficient understanding ability and voluntary signing of informed consent; (11) Those with fertility must be willing to use contraceptive methods; (12) According to the judgment of the researchers, the expected survival time is more than 4 months; (13) Willing to follow visit schedule, administration plan, laboratory inspection and other test steps. Exclusion Criteria: (1) History of other tumors; (2) Hematopoietic stem cell transplantation was performed within 6 weeks; (3) Any target car-t treatment was performed within 3 months before the car-t treatment; (4) Previous use of any commercially available PD-1 mAb; (5) Cytotoxic drugs, glucocorticoids and other targeted drugs were received within 2 weeks before cell collection; (6) Active autoimmune diseases; (7) Uncontrollable infection of active bacteria and fungi; (8) HIV infection, syphilis infection; active hepatitis B or C: hepatitis B: HBV-DNA ≥ 1000IU / ml; hepatitis C: HCV RNA positive and liver function abnormal. (9) Known central nervous system lymphoma.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wenbin Qian, MD, PhD
Organizational Affiliation
2nd Affiliated Hospital, School of Medicine, Zhejiang University, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
2nd Affiliated Hospital, School of Medicine, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310009
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34515338
Citation
Ernst M, Oeser A, Besiroglu B, Caro-Valenzuela J, Abd El Aziz M, Monsef I, Borchmann P, Estcourt LJ, Skoetz N, Goldkuhle M. Chimeric antigen receptor (CAR) T-cell therapy for people with relapsed or refractory diffuse large B-cell lymphoma. Cochrane Database Syst Rev. 2021 Sep 13;9(9):CD013365. doi: 10.1002/14651858.CD013365.pub2.
Results Reference
derived

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CD19 CAR-T Expressing IL7 and CCL19 Combined With PD1 mAb for Relapsed or Refractory Diffuse Large B Cell Lymphoma

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