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Anti-CD19 Allo-CAR-T Cells for Relapsed B Cell Malignancies After HSCT

Primary Purpose

Relapsed Adult ALL, B Cell Leukemia

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
anti-CD19 allo-CAR-T cells
Sponsored by
Xinqiao Hospital of Chongqing
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed Adult ALL

Eligibility Criteria

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

Inclusion Criteria:

  1. Diagnosis of relapsed B-cell acute lymphoblastic leukemia (B-ALL).
  2. Patients have received hematologic stem cell transplantation from matching sibling donor or unrelated donor.
  3. CD19-positive tumor (>20% CD19 positive blasts by flow cytometry or immunohistochemistry (tissue))
  4. Hgb ≥ 7.0 (can be transfused)
  5. Life expectancy greater than 12 weeks
  6. Informed consent explained to, understood by and signed by the patient/guardian. The patient/guardian is given a copy of informed consent.

Exclusion Criteria:

  1. Other tumors except cured non-melanoma skin cancer, cervical cancer in situ, superficial bladder cancer, breast duct cancer in situ, or other malignant tumors with complete remission of more than 5 years);
  2. Severe mental disorders;
  3. A history of genetic diseases such as Fanconi anemia, Shudder-Dale syndrome, Costman syndrome, or any other known bone marrow failure syndrome;
  4. Subjects with II-IV grade acute graft versus host disease GVHD (Glucksberg Standrad) or chronic GVHD.
  5. Heart disease with grade III-IV heart failure [NYHA classification], myocardial infarction, angioplasty or stenting, unstable angina or other heart diseases with prominent clinical symptoms within one year before admission;
  6. Subjects with any indwelling catheter or drainage tube (such as percutaneous nephrostomy tube, bile drainage tube or pleura/peritoneum/pericardium catheter), should be excluded. (Special central venous catheter is allowed);
  7. Subjects with a history of CNS lymphoma, CSF malignant cells, or brain metastasis;
  8. Subjects with a history of CNS disease,such as epilepsy, cerebral ischemia/hemorrhage, dementia, cerebellar disease, or any autoimmune disease involving CNS;
  9. Any of the following virological ELISA results are positive: HIV antibody, HCV antibody, TPPA, HBsAg;
  10. Active infection requiring systematic treatment within 2 weeks before single collection;
  11. Subjects with known severe allergic reactions to cyclophosphamide or fludarabine, or diagnosed as the allergy;
  12. History of autoimmune diseases (e.g. Crohn disease, rheumatoid arthritis, systemic lupus erythematosus) that cause end-organ damage or require systemic immunosuppressive medications or systemic disease modifying drugs in the past 2 years;
  13. Presence of pulmonary fibrosis;
  14. Subjects who have received other clinical trial treatment within 4 weeks before participating in this trial should be excluded. Or the signing date of informed consent is within 5 half-lives of the last application of another clinical trial (whichever is longer);
  15. Subjects with poor compliance due to physiological, family, social, geographical and other factors, or those unable to cooperate with the study plan or follow-up;
  16. At the discretion of the investigator, there are complications requiring systemic corticosteroid therapy (≥ 5mg / day of prednisone or equivalent dose of other corticosteroids) or other immunosuppressive drugs within 6 months after this clinical research treatment;
  17. The lactating woman who is reluctant to stop breastfeeding;
  18. Any other condition considered unsuitable by the investigator.

Sites / Locations

  • Department of Hematology, Xinqiao HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

anti-CD19 allo-CAR-T

Arm Description

The study will employ dose level cohorts of three patients that will be treated at each level described below, based on the number of T cells to be infused using the "3 + 3" dose-escalation strategy to find MTD followed by a dose-expansion phase at determining optimal dosage. dosage: the number of anti CD19+CD22 CAR T cells -1(if needed) 1×10^6/KG 3×10^6 /KG 6×10^6 /KG 1×10^7/KG Treatment follows a lymphodepletion, chemotherapy regimen that consists of Fludarabine (30 mg/m2 per day) and Cyclophosphamide (300mg/m2 per day) for 3 days or bendamustione (90mg/m2 per day) for two days prior to cell infusion.

Outcomes

Primary Outcome Measures

the safety of anti-CD19 allo CAR-T cells
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
the efficacy of anti-CD19 allo CAR-T cells
ratio of bone marrow blast cells

Secondary Outcome Measures

The long-term efficiency
ratio of bone marrow blast cells

Full Information

First Posted
August 13, 2020
Last Updated
November 12, 2020
Sponsor
Xinqiao Hospital of Chongqing
Collaborators
Gracell Biotechnology Shanghai Co., Ltd., First Affiliated Hospital of Zhejiang University, The Second Affiliated Hospital of Chongqing Medical University, The Affiliated Hospital Of Guizhou Medical University, The General Hospital of Western Theater Command, Chongqing University Cancer Hospital, The First Affiliated Hospital of Anhui Medical University, Tang-Du Hospital, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China
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1. Study Identification

Unique Protocol Identification Number
NCT04516551
Brief Title
Anti-CD19 Allo-CAR-T Cells for Relapsed B Cell Malignancies After HSCT
Official Title
Anti-CD19 Donor-derived CAR-T Cells for Patients With Relapsed B Cell Malignancies After Hematopoietic Stem Cell Transplantation: a Multi-center, Uncontrolled Trial.
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Unknown status
Study Start Date
November 20, 2020 (Anticipated)
Primary Completion Date
December 1, 2021 (Anticipated)
Study Completion Date
December 1, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Xinqiao Hospital of Chongqing
Collaborators
Gracell Biotechnology Shanghai Co., Ltd., First Affiliated Hospital of Zhejiang University, The Second Affiliated Hospital of Chongqing Medical University, The Affiliated Hospital Of Guizhou Medical University, The General Hospital of Western Theater Command, Chongqing University Cancer Hospital, The First Affiliated Hospital of Anhui Medical University, Tang-Du Hospital, 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China

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
The patients with relapsed B cell acute lymphoblastic leukemia (ALL) after hematopoietic stem cell transplant (HSCT) have a poor prognosis, especially for these relapsed in a short time after transplantation. Nowadays there is no effective way to salvage patients in such conditions. T cells derived from healthy matched sibling or unrelated donors have not been restrained by tumor micro-environment and retain anti-leukemia ability, which makes it serve well for patients with relapsed B-ALL. So we launched a multi-center clinical trial to proved the safety and efficacy of anti-CD19 CAR-T cells for relapsed B cell ALL.
Detailed Description
The stunning response rate of anti-CD19(cluster of differentiation antigen 19) auto-CAR(chimeric antigen receptor)-T cell therapy brings hope to patients with relapsed or refractory B-cell hematologic malignancies. However, for B-ALL patients suffered from relapse after allo-HSCT (hematopoietic stem cell transplant), the T cells derived from healthy donor seems like a better origin for CAR-T cells producing because T cells derived from healthy matched sibling or unrelated donors have not been restrained by tumor micro-environment and retain anti-leukemia ability. So after we designed a clinical trial to manifest the safety and efficacy of anti-CD19 CAR-T cells for patients with relapsed B cell ALL.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed Adult ALL, B Cell 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
18 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
anti-CD19 allo-CAR-T
Arm Type
Experimental
Arm Description
The study will employ dose level cohorts of three patients that will be treated at each level described below, based on the number of T cells to be infused using the "3 + 3" dose-escalation strategy to find MTD followed by a dose-expansion phase at determining optimal dosage. dosage: the number of anti CD19+CD22 CAR T cells -1(if needed) 1×10^6/KG 3×10^6 /KG 6×10^6 /KG 1×10^7/KG Treatment follows a lymphodepletion, chemotherapy regimen that consists of Fludarabine (30 mg/m2 per day) and Cyclophosphamide (300mg/m2 per day) for 3 days or bendamustione (90mg/m2 per day) for two days prior to cell infusion.
Intervention Type
Biological
Intervention Name(s)
anti-CD19 allo-CAR-T cells
Intervention Description
The T cells collected from haploidentical donors have been manufactured to express CAR to binding CD19 on B-cell leukemia.
Primary Outcome Measure Information:
Title
the safety of anti-CD19 allo CAR-T cells
Description
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Time Frame
within 4 weeks after infusion
Title
the efficacy of anti-CD19 allo CAR-T cells
Description
ratio of bone marrow blast cells
Time Frame
4 weeks after infusion
Secondary Outcome Measure Information:
Title
The long-term efficiency
Description
ratio of bone marrow blast cells
Time Frame
up to 2 years after infusion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
14 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of relapsed B-cell acute lymphoblastic leukemia (B-ALL). Patients have received hematologic stem cell transplantation from matching sibling donor or unrelated donor. CD19-positive tumor (>20% CD19 positive blasts by flow cytometry or immunohistochemistry (tissue)) Hgb ≥ 7.0 (can be transfused) Life expectancy greater than 12 weeks Informed consent explained to, understood by and signed by the patient/guardian. The patient/guardian is given a copy of informed consent. Exclusion Criteria: Other tumors except cured non-melanoma skin cancer, cervical cancer in situ, superficial bladder cancer, breast duct cancer in situ, or other malignant tumors with complete remission of more than 5 years); Severe mental disorders; A history of genetic diseases such as Fanconi anemia, Shudder-Dale syndrome, Costman syndrome, or any other known bone marrow failure syndrome; Subjects with II-IV grade acute graft versus host disease GVHD (Glucksberg Standrad) or chronic GVHD. Heart disease with grade III-IV heart failure [NYHA classification], myocardial infarction, angioplasty or stenting, unstable angina or other heart diseases with prominent clinical symptoms within one year before admission; Subjects with any indwelling catheter or drainage tube (such as percutaneous nephrostomy tube, bile drainage tube or pleura/peritoneum/pericardium catheter), should be excluded. (Special central venous catheter is allowed); Subjects with a history of CNS lymphoma, CSF malignant cells, or brain metastasis; Subjects with a history of CNS disease,such as epilepsy, cerebral ischemia/hemorrhage, dementia, cerebellar disease, or any autoimmune disease involving CNS; Any of the following virological ELISA results are positive: HIV antibody, HCV antibody, TPPA, HBsAg; Active infection requiring systematic treatment within 2 weeks before single collection; Subjects with known severe allergic reactions to cyclophosphamide or fludarabine, or diagnosed as the allergy; History of autoimmune diseases (e.g. Crohn disease, rheumatoid arthritis, systemic lupus erythematosus) that cause end-organ damage or require systemic immunosuppressive medications or systemic disease modifying drugs in the past 2 years; Presence of pulmonary fibrosis; Subjects who have received other clinical trial treatment within 4 weeks before participating in this trial should be excluded. Or the signing date of informed consent is within 5 half-lives of the last application of another clinical trial (whichever is longer); Subjects with poor compliance due to physiological, family, social, geographical and other factors, or those unable to cooperate with the study plan or follow-up; At the discretion of the investigator, there are complications requiring systemic corticosteroid therapy (≥ 5mg / day of prednisone or equivalent dose of other corticosteroids) or other immunosuppressive drugs within 6 months after this clinical research treatment; The lactating woman who is reluctant to stop breastfeeding; Any other condition considered unsuitable by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xi Zhang, MD phD
Phone
13808310064
Ext
+86
Email
zhangxxi@sina.com
First Name & Middle Initial & Last Name or Official Title & Degree
Ruihao Huang
Phone
18984398751
Ext
+86
Email
1169731117@qq.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xi Zhang, MD phD
Organizational Affiliation
Xinqiao Hospital of Chongqing
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
He Huang, MD
Organizational Affiliation
First Affiliated Hospital of Zhejiang University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Hematology, Xinqiao Hospital
City
Chongqing
State/Province
Chongqing
ZIP/Postal Code
400037
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ruihao Huang
Phone
18984398751
Ext
+86
Email
1169731117@qq.com

12. IPD Sharing Statement

Plan to Share IPD
No

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Anti-CD19 Allo-CAR-T Cells for Relapsed B Cell Malignancies After HSCT

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