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A Study of CD19 Targeted CAR T Cell Therapy in Adult Patients With Relapsed or Refractory B Cell Acute Lymphoblastic Leukaemia (ALL)

Primary Purpose

Relapsed or Refractory B Cell Acute Lymphoblastic Leukemia

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
AUTO1
Sponsored by
Autolus Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed or Refractory B Cell Acute Lymphoblastic Leukemia focused on measuring B cell acute lymphoblastic leukemia, Relapsed B cell acute lymphoblastic leukemia, Refractory B cell acute lymphoblastic leukemia, ALL, AUTO1, CD19-positive CAR T cell

Eligibility Criteria

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

Inclusion Criteria:

  • Age 18 years or older Age 18 years or older
  • ECOG performance status of 0 or 1
  • Relapsed or refractory B cell ALL
  • Patients with Ph+ ALL are eligible if intolerant to TKI, failed two lines of any TKI, or failed one line of second-generation TKI, or if TKI is contraindicated
  • Documented CD19 positivity within 1 month of screening
  • Phase Ib: Primary Cohort IA: Presence of ≥5% blasts in BM at screening
  • Phase Ib: Exploratory Cohort IB: MRD-positive defined as ≥ 1E-4 and <5% blasts in the BM at screening
  • Phase II: Primary Cohort IIA: Presence of ≥5% blasts in BM at screening
  • Phase II: Cohort IIB: ≥2nd CR or CRi with MRD-positive defined as ≥1E-3 by central ClonoSEQ® NGS testing and <5% blasts in the BM at screening
  • Adequate renal, hepatic, pulmonary, and cardiac function

Exclusion Criteria:

  • Phase Ib (Cohort IA and Cohort IB) and Phase II (Cohort IIA and Cohort IIB) B-ALL with isolated EM disease
  • Diagnosis of Burkitt's leukaemia/lymphoma or CML lymphoid in blast crisis
  • History or presence of clinically relevant CNS pathology
  • Presence of CNS-3 disease or CNS-2 disease with neurological changes
  • Presence of active or uncontrolled fungal, bacterial, viral, or other infection requiring systemic antimicrobials for management
  • Active or latent Hepatitis B virus or active Hepatitis C virus
  • Human Immunodeficiency Virus (HIV), HTLV-1, HTLV-2, syphilis positive test
  • Prior CD19 targeted therapy other than blinatumomab. Patients who have experienced Grade 3 or higher neurotoxicity following blinatumomab.

Sites / Locations

  • City of Hope National Medical Center
  • University of California San Diego Health (UCSD)
  • University of California Davis (UC Davis)
  • University of California San Francisco (UCSF)
  • Colorado Blood Cancer Institute (CBCI)
  • University of Miami
  • H Lee Moffitt Cancer Center
  • Winship Cancer Institute of Emory University
  • University of Chicago
  • University of Kansas
  • University of Maryland Medical Center
  • Dana-Farber Cancer Institute
  • Mayo Clinic
  • Washington University School of Medicine
  • University of Nebraska
  • Memorial Sloan Kettering Cancer Center
  • University of Rochester
  • Cleveland Clinic
  • TriStar Centennial Medical Center (SCRI)
  • Baylor Scott & White Research Institute
  • MD Anderson Cancer Center
  • TTI-Methodist (Texas Transplant Institute) (SCRI)
  • The Medical College of Wisconsin
  • Fundacio' Hospital Universitari Vall d'Hebron
  • Hospital Universitario Virgen del Rocío
  • Hospital Universitario La Fé
  • Cambridge University Hospitals NHS Foundation Trust
  • University College London Hospitals NHS Foundation Trust
  • King's College Hospital
  • Manchester Royal Infirmary Hospital
  • Queen Elizabeth University Hospital
  • Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust
  • University Hospitals Birmingham NHS Foundation Trust
  • University Hospitals Bristol and Weston NHS Foundation Trust (UHBW)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AUTO1

Arm Description

Outcomes

Primary Outcome Measures

Phase Ib - Frequency and severity of adverse events (AEs) and serious adverse events (SAEs) occurring after AUTO1 infusion
Phase II - Cohort IIA: ORR defined as proportion of patients achieving CR or CRi as assessed by an IRRC. Cohort IIB: Proportion of patients achieving MRD-negative remission by central ClonoSEQ NGS testing (<1e-4 leukemic cells)

Secondary Outcome Measures

Phase II - Proportion of patients achieving MRD-negative CR by NGS (<1e-4 leukemic cells)
Phase II - Complete remission rate
Phase II - Response to AUTO1 treatment measured as duration of remission (DOR)
Phase II - Response to AUTO1 measured as progression-free survival (PFS).
Phase II -Response to AUTO1 treatment measured as overall survival (OS)
Phase II - Frequency and severity of AEs and SAEs
Phase II - Incidence of severe hypogammaglobulinaemia
Phase II - Duration of severe hypogammaglobulinaemia
Phase II - Detection of CAR T cells measured by PCR following AUTO1 infusion

Full Information

First Posted
May 12, 2020
Last Updated
August 24, 2023
Sponsor
Autolus Limited
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1. Study Identification

Unique Protocol Identification Number
NCT04404660
Brief Title
A Study of CD19 Targeted CAR T Cell Therapy in Adult Patients With Relapsed or Refractory B Cell Acute Lymphoblastic Leukaemia (ALL)
Official Title
An Open-Label, Multi-Centre, Phase Ib/II Study Evaluating the Safety and Efficacy of AUTO1, a CAR T Cell Treatment Targeting CD19, in Adult Patients With Relapsed or Refractory B Cell Acute Lymphoblastic Leukaemia
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 4, 2020 (Actual)
Primary Completion Date
May 2025 (Anticipated)
Study Completion Date
May 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Autolus Limited

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 Phase Ib/II study to evaluate the safety and efficacy of autologous T cells engineered with a chimeric antigen receptor (CAR) targeting CD19 in adult patients with relapsed or refractory B cell acute lymphoblastic leukemia (ALL).
Detailed Description
This Phase Ib/II, open-label, multi-center, single arm study is designed to evaluate the safety and efficacy of AUTO1 in adult patients with B-cell ALL by determining the overall response rate (ORR). Adult patients with relapsed or refractory ALL will be enrolled in both phases of the study. Consented patients will go through the following five sequential stages: screening, leukapheresis, pre-conditioning, treatment, and follow-up. All patients will receive a total target dose of 410E+6 of CAR T cells as a split dose on Day 1 and on Day 10 (±2 days).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed or Refractory B Cell Acute Lymphoblastic Leukemia
Keywords
B cell acute lymphoblastic leukemia, Relapsed B cell acute lymphoblastic leukemia, Refractory B cell acute lymphoblastic leukemia, ALL, AUTO1, CD19-positive CAR T cell

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
153 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AUTO1
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
AUTO1
Other Intervention Name(s)
Obecabtagene autoleucel (obe-cel)
Intervention Description
Following pre-conditioning with chemotherapy (cyclophosphamide and fludarabine) patients will be treated with a total target dose of 410E+6 of CD19-positive CAR T cells as a split dose on Day 1 and on Day 10 (±2 days).
Primary Outcome Measure Information:
Title
Phase Ib - Frequency and severity of adverse events (AEs) and serious adverse events (SAEs) occurring after AUTO1 infusion
Time Frame
Up to 24 months
Title
Phase II - Cohort IIA: ORR defined as proportion of patients achieving CR or CRi as assessed by an IRRC. Cohort IIB: Proportion of patients achieving MRD-negative remission by central ClonoSEQ NGS testing (<1e-4 leukemic cells)
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
Phase II - Proportion of patients achieving MRD-negative CR by NGS (<1e-4 leukemic cells)
Time Frame
Up to 24 months
Title
Phase II - Complete remission rate
Time Frame
Up to 24 months
Title
Phase II - Response to AUTO1 treatment measured as duration of remission (DOR)
Time Frame
Up to 24 months
Title
Phase II - Response to AUTO1 measured as progression-free survival (PFS).
Time Frame
Up to 24 months
Title
Phase II -Response to AUTO1 treatment measured as overall survival (OS)
Time Frame
Up to 24 months
Title
Phase II - Frequency and severity of AEs and SAEs
Time Frame
Up to 24 months
Title
Phase II - Incidence of severe hypogammaglobulinaemia
Time Frame
Up to 24 months
Title
Phase II - Duration of severe hypogammaglobulinaemia
Time Frame
Up to 24 months
Title
Phase II - Detection of CAR T cells measured by PCR following AUTO1 infusion
Time Frame
Up to 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18 years or older Age 18 years or older ECOG performance status of 0 or 1 Relapsed or refractory B cell ALL Patients with Ph+ ALL are eligible if intolerant to TKI, failed two lines of any TKI, or failed one line of second-generation TKI, or if TKI is contraindicated Documented CD19 positivity within 1 month of screening Phase Ib: Primary Cohort IA: Presence of ≥5% blasts in BM at screening Phase Ib: Exploratory Cohort IB: MRD-positive defined as ≥ 1e-4 and <5% blasts in the BM at screening Phase II: Primary Cohort IIA: Presence of ≥5% blasts in BM at screening Phase II: Cohort IIB: ≥2nd CR or CRi with MRD-positive defined as ≥1e-3 by central ClonoSEQ® NGS testing and <5% blasts in the BM at screening Adequate renal, hepatic, pulmonary, and cardiac function Exclusion Criteria: Phase Ib (Cohort IA and Cohort IB) and Phase II (Cohort IIA and Cohort IIB) B-ALL with isolated EM disease Diagnosis of Burkitt's leukaemia/lymphoma or CML lymphoid in blast crisis History or presence of clinically relevant CNS pathology Presence of CNS-3 disease or CNS-2 disease with neurological changes Presence of active or uncontrolled fungal, bacterial, viral, or other infection requiring systemic antimicrobials for management Active or latent Hepatitis B virus or active Hepatitis C virus Human Immunodeficiency Virus (HIV), HTLV-1, HTLV-2, syphilis positive test Prior CD19 targeted therapy other than blinatumomab. Patients who have experienced Grade 3 or higher neurotoxicity following blinatumomab.
Facility Information:
Facility Name
City of Hope National Medical Center
City
Duarte
State/Province
California
ZIP/Postal Code
93534
Country
United States
Facility Name
University of California San Diego Health (UCSD)
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
University of California Davis (UC Davis)
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
University of California San Francisco (UCSF)
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Colorado Blood Cancer Institute (CBCI)
City
Denver
State/Province
Colorado
ZIP/Postal Code
80218
Country
United States
Facility Name
University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
H Lee Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Winship Cancer Institute of Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
University of Kansas
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
University of Maryland Medical Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
University of Nebraska
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68105
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
University of Rochester
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
TriStar Centennial Medical Center (SCRI)
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Baylor Scott & White Research Institute
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
TTI-Methodist (Texas Transplant Institute) (SCRI)
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
The Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Facility Name
Fundacio' Hospital Universitari Vall d'Hebron
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital Universitario Virgen del Rocío
City
Sevilla
ZIP/Postal Code
41013
Country
Spain
Facility Name
Hospital Universitario La Fé
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Facility Name
Cambridge University Hospitals NHS Foundation Trust
City
Cambridge
State/Province
Cambridgeshire
ZIP/Postal Code
CB2 0QQ
Country
United Kingdom
Facility Name
University College London Hospitals NHS Foundation Trust
City
London
State/Province
Greater London
ZIP/Postal Code
NW1 2PG
Country
United Kingdom
Facility Name
King's College Hospital
City
London
State/Province
Greater London
ZIP/Postal Code
SE5 9RS
Country
United Kingdom
Facility Name
Manchester Royal Infirmary Hospital
City
Manchester
State/Province
Greater Manchester
ZIP/Postal Code
M13 9WL
Country
United Kingdom
Facility Name
Queen Elizabeth University Hospital
City
Glasgow
State/Province
Scotland
ZIP/Postal Code
G514TF
Country
United Kingdom
Facility Name
Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust
City
Newcastle upon Tyne
State/Province
Tyne And Wear
ZIP/Postal Code
NE7 7DN
Country
United Kingdom
Facility Name
University Hospitals Birmingham NHS Foundation Trust
City
Birmingham
State/Province
West Midlands
ZIP/Postal Code
B15 2GW
Country
United Kingdom
Facility Name
University Hospitals Bristol and Weston NHS Foundation Trust (UHBW)
City
Bristol
ZIP/Postal Code
BS2 8ED
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

A Study of CD19 Targeted CAR T Cell Therapy in Adult Patients With Relapsed or Refractory B Cell Acute Lymphoblastic Leukaemia (ALL)

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