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A Study of Humanized CD19 CAR-T Cells Therapy for Patients With Relapsed and/or Refractory B-cell ALL and B-cell NHL

Primary Purpose

Acute Lymphoblastic Leukemia, Non-hodgkin Lymphoma,B Cell

Status
Recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
Humanized CD19 CAR-T cells
Sponsored by
Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Lymphoblastic Leukemia focused on measuring Acute Lymphoblastic Leukemia, Non-Hodgkin's Lymphoma, CAR T-cell therapy

Eligibility Criteria

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

Inclusion Criteria:

  • Inclusion criteria only for B-ALL:

    1. Male or female aged 3-70 years;
    2. Histologically confirmed diagnosis of CD19+ B-ALL per the US National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Acute Lymphoblastic Leukemia (2016.v1);
    3. Relapsed or refractory CD19+ B-ALL (meeting one of the following conditions):

      1. CR not achieved after standardized chemotherapy;
      2. CR achieved following the first induction, but CR duration is less than 12 months;
      3. Ineffectively after first or multiple remedial treatments;
      4. 2 or more relapses;
    4. The number of primordial cells (lymphoblast and prolymphocyte) in bone marrow is >5% (by morphology), and/or >1% (by flow cytometry);
    5. Philadelphia-chromosome-negative (Ph-) patients; or Philadelphia-chromosome-positive (Ph+) patients who cannot tolerate TKI treatments or do not respond to 2 TKI treatments;
  • Inclusion criteria only for B-NHL:

    1. Male or female aged 18-75 years;
    2. Histologically confirmed diagnosis of DLBCL (NOS), FL, DLBCL transformed from CLL/SLL, PMBCL, and HGBCL per the WHO Classification Criteria for Lymphoma (2016);
    3. Relapsed or refractory B-NHL (meeting one of the following conditions):

      1. No response or relapse after second-line or above chemotherapy regimens;
      2. Primary drug resistance;
      3. Relapse after auto-HSCT;
    4. At least one assessable tumor lesion per Lugano 2014 criteria;
  • Common inclusion criteria for B-ALL and B-NHL:

    1. Total bilirubin ≤ 51 umol/L, ALT and AST ≤ 3 times of upper limit of normal, creatinine ≤ 176.8 umol/L;
    2. Echocardiogram shows left ventricular ejection fraction (LVEF) ≥ 50%;
    3. No active infection in the lungs, blood oxygen saturation in indoor air is ≥ 92%;
    4. Estimated survival time ≥ 3 months;
    5. ECOG performance status 0 to 2;
    6. Patients or their legal guardians volunteer to participate in the study and sign the informed consent.

Exclusion Criteria:

Subjects with any of the following exclusion criteria were not eligible for this trial:

  1. History of craniocerebral trauma, conscious disturbance, epilepsy, cerebrovascular ischemia, and cerebrovascular hemorrhagic diseases;
  2. Electrocardiogram shows prolonged QT interval, severe heart diseases such as severe arrhythmia in the past;
  3. Pregnant (or lactating) women;
  4. Patients with severe active infections (excluding simple urinary tract infection and bacterial pharyngitis);
  5. Active infection of hepatitis B virus or hepatitis C virus;
  6. Concurrent therapy with systemic steroids within 2 weeks prior to screening, except for the patients recently or currently receiving inhaled steroids;
  7. Previously treated with any CAR-T cell product or other genetically-modified T cell therapies;
  8. Creatinine >2.5mg/dl, or ALT / AST>3 times of normal amounts, or bilirubin>2.0 mg/dl;
  9. Other uncontrolled diseases that were not suitable for this trial;
  10. Patients with HIV infection;
  11. Any situations that the investigator believes may increase the risk of patients or interfere with the results of study.

Sites / Locations

  • The First Affiliated Hospital,College of Medicine, Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Administration of Humanized CD19 CAR T-cells

Arm Description

Dose escalation follows the standard 3+3 dose escalation design. A total of 3 dose levels are set for subjects.

Outcomes

Primary Outcome Measures

Dose-limiting toxicity (DLT)
Adverse events assessed according to NCI-CTCAE v5.0 criteria
Incidence of treatment-emergent adverse events (TEAEs)
Incidence of treatment-emergent adverse events [Safety and Tolerability]

Secondary Outcome Measures

B-cell acute lymphocytic leukemia(B-ALL), Overall response rate (ORR)
Assessment of ORR (ORR = CR + CRi) at Month 6, 12, 18 and 24
B-ALL, Overall survival (OS)
From the first infusion of humanized CD19 CAR-T cells to death or the last visit
B-ALL, Event-free survival (EFS)
From the first infusion of humanized CD19 CAR-T cells to the occurrence of any event, including death, relapse or gene relapse, disease progression (any one occurs first), and the last visit
B cell non-hodgkin's lymphoma (B-NHL), Overall response rate (ORR)
Assessment of ORR (ORR = CR + PR) per Lugano 2014 criteria
B-NHL, disease control rate (DCR)
Assessment of DCR (DCR=CR+PR+SD) per Lugano 2014 criteria
Quality of life
Assessment of Quality of life using Research and Treatment of Cancer QOL Core Questionnaire 30 (EORTC QLQ-30) at Baseline, Month 1, 3, 6, 9 and 12
IADL score
Assessment of IADL score at Baseline, Month 1, 3, 6, 9 and 12
ADL score
Assessment of ADL score at Baseline, Month 1, 3, 6, 9 and 12
HADS score
Assessment of Hospital Anxiety and Depression Scale (HADS) score at Baseline, Month 1, 3, 6, 9 and 12

Full Information

First Posted
August 20, 2020
Last Updated
August 25, 2020
Sponsor
Zhejiang University
Collaborators
Yake Biotechnology Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04532268
Brief Title
A Study of Humanized CD19 CAR-T Cells Therapy for Patients With Relapsed and/or Refractory B-cell ALL and B-cell NHL
Official Title
Clinical Trial for the Safety and Efficacy of Humanized CD19 CAR-T Cells Therapy for Patients With Relapsed and/or Refractory B-cell Acute Lymphoblastic Leukemia and B-cell Non-Hodgkin's Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Recruiting
Study Start Date
August 23, 2020 (Anticipated)
Primary Completion Date
August 23, 2023 (Anticipated)
Study Completion Date
August 23, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Zhejiang University
Collaborators
Yake Biotechnology Ltd.

4. Oversight

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

5. Study Description

Brief Summary
A Study of Humanized CD19 CAR-T Cells Therapy for Patients With Relapsed and/or Refractory B-cell Acute Lymphoblastic Leukemia and B-cell Non-Hodgkin's Lymphoma.
Detailed Description
This is a single arm, open-label, single-center study. This study is indicated for relapsed or refractory CD19+ B-cell hematological malignancies, including acute lymphoblastic leukemia and B-cell non-Hodgkin's lymphoma. The selections of dose levels and the numberof subjects are based on clinical trials of similar foreign products. Two groups of patients will be enrolled, 36 in each group. Primary objective is to explore the safety, main consideration is dose-related safety.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Lymphoblastic Leukemia, Non-hodgkin Lymphoma,B Cell
Keywords
Acute Lymphoblastic Leukemia, Non-Hodgkin's Lymphoma, CAR T-cell therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
72 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Administration of Humanized CD19 CAR T-cells
Arm Type
Experimental
Arm Description
Dose escalation follows the standard 3+3 dose escalation design. A total of 3 dose levels are set for subjects.
Intervention Type
Drug
Intervention Name(s)
Humanized CD19 CAR-T cells
Other Intervention Name(s)
Humanized CD19 CAR-T cells injection
Intervention Description
Each subject receive humanized CD19 CAR T-cells by intravenous infusion
Primary Outcome Measure Information:
Title
Dose-limiting toxicity (DLT)
Description
Adverse events assessed according to NCI-CTCAE v5.0 criteria
Time Frame
Baseline up to 28 days after humanized CD19 targeted CAR T-cells infusion
Title
Incidence of treatment-emergent adverse events (TEAEs)
Description
Incidence of treatment-emergent adverse events [Safety and Tolerability]
Time Frame
Up to 2 years after humanized CD19 targeted CAR T-cells infusion
Secondary Outcome Measure Information:
Title
B-cell acute lymphocytic leukemia(B-ALL), Overall response rate (ORR)
Description
Assessment of ORR (ORR = CR + CRi) at Month 6, 12, 18 and 24
Time Frame
At Month 1, 3, 6, 12, 18 and 24
Title
B-ALL, Overall survival (OS)
Description
From the first infusion of humanized CD19 CAR-T cells to death or the last visit
Time Frame
Up to 2 years after humanized CD19 CAR-T cells infusion
Title
B-ALL, Event-free survival (EFS)
Description
From the first infusion of humanized CD19 CAR-T cells to the occurrence of any event, including death, relapse or gene relapse, disease progression (any one occurs first), and the last visit
Time Frame
Up to 2 years after humanized CD19 CAR-T cells infusion
Title
B cell non-hodgkin's lymphoma (B-NHL), Overall response rate (ORR)
Description
Assessment of ORR (ORR = CR + PR) per Lugano 2014 criteria
Time Frame
At Week 4, 12, and Month 6, 12, 18, 24
Title
B-NHL, disease control rate (DCR)
Description
Assessment of DCR (DCR=CR+PR+SD) per Lugano 2014 criteria
Time Frame
At Week 12 and Month 6, 12, 18, 24
Title
Quality of life
Description
Assessment of Quality of life using Research and Treatment of Cancer QOL Core Questionnaire 30 (EORTC QLQ-30) at Baseline, Month 1, 3, 6, 9 and 12
Time Frame
At Baseline, Month 1, 3, 6, 9 and 12
Title
IADL score
Description
Assessment of IADL score at Baseline, Month 1, 3, 6, 9 and 12
Time Frame
At Baseline, Month 1, 3, 6, 9 and 12
Title
ADL score
Description
Assessment of ADL score at Baseline, Month 1, 3, 6, 9 and 12
Time Frame
At Baseline, Month 1, 3, 6, 9 and 12
Title
HADS score
Description
Assessment of Hospital Anxiety and Depression Scale (HADS) score at Baseline, Month 1, 3, 6, 9 and 12
Time Frame
At Baseline, Month 1, 3, 6, 9 and 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Inclusion criteria only for B-ALL: Male or female aged 3-70 years; Histologically confirmed diagnosis of CD19+ B-ALL per the US National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Acute Lymphoblastic Leukemia (2016.v1); Relapsed or refractory CD19+ B-ALL (meeting one of the following conditions): CR not achieved after standardized chemotherapy; CR achieved following the first induction, but CR duration is less than 12 months; Ineffectively after first or multiple remedial treatments; 2 or more relapses; The number of primordial cells (lymphoblast and prolymphocyte) in bone marrow is >5% (by morphology), and/or >1% (by flow cytometry); Philadelphia-chromosome-negative (Ph-) patients; or Philadelphia-chromosome-positive (Ph+) patients who cannot tolerate TKI treatments or do not respond to 2 TKI treatments; Inclusion criteria only for B-NHL: Male or female aged 18-75 years; Histologically confirmed diagnosis of DLBCL (NOS), FL, DLBCL transformed from CLL/SLL, PMBCL, and HGBCL per the WHO Classification Criteria for Lymphoma (2016); Relapsed or refractory B-NHL (meeting one of the following conditions): No response or relapse after second-line or above chemotherapy regimens; Primary drug resistance; Relapse after auto-HSCT; At least one assessable tumor lesion per Lugano 2014 criteria; Common inclusion criteria for B-ALL and B-NHL: Total bilirubin ≤ 51 umol/L, ALT and AST ≤ 3 times of upper limit of normal, creatinine ≤ 176.8 umol/L; Echocardiogram shows left ventricular ejection fraction (LVEF) ≥ 50%; No active infection in the lungs, blood oxygen saturation in indoor air is ≥ 92%; Estimated survival time ≥ 3 months; ECOG performance status 0 to 2; Patients or their legal guardians volunteer to participate in the study and sign the informed consent. Exclusion Criteria: Subjects with any of the following exclusion criteria were not eligible for this trial: History of craniocerebral trauma, conscious disturbance, epilepsy, cerebrovascular ischemia, and cerebrovascular hemorrhagic diseases; Electrocardiogram shows prolonged QT interval, severe heart diseases such as severe arrhythmia in the past; Pregnant (or lactating) women; Patients with severe active infections (excluding simple urinary tract infection and bacterial pharyngitis); Active infection of hepatitis B virus or hepatitis C virus; Concurrent therapy with systemic steroids within 2 weeks prior to screening, except for the patients recently or currently receiving inhaled steroids; Previously treated with any CAR-T cell product or other genetically-modified T cell therapies; Creatinine >2.5mg/dl, or ALT / AST>3 times of normal amounts, or bilirubin>2.0 mg/dl; Other uncontrolled diseases that were not suitable for this trial; Patients with HIV infection; Any situations that the investigator believes may increase the risk of patients or interfere with the results of study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
He Huang, PhD
Phone
86-13605714822
Email
hehuangyu@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yongxian Hu, PhD
Phone
86-15957162012
Email
huyongxian2000@aliyun.com
Facility Information:
Facility Name
The First Affiliated Hospital,College of Medicine, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
He Huang, PhD
Phone
86-13605714822
Email
hehuangyu@126.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of Humanized CD19 CAR-T Cells Therapy for Patients With Relapsed and/or Refractory B-cell ALL and B-cell NHL

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