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LMP1 CAR-T for Patients With LMP1 Positive Infectious Diseases and Hematological Malignancies

Primary Purpose

Infectious Diseases, Hematological Malignancies

Status
Not yet recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
LMP1 CAR T-cells
Sponsored by
Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Infectious Diseases focused on measuring Infectious diseases, Hematological Malignancies, CAR T-cell therapy, LMP1

Eligibility Criteria

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

Inclusion Criteria:

Only applicable to the inclusion criteria of CAEBV

  1. Subjects who are diagnosed with CAEBV according to the Okano revised standard proposed by the Japanese Ministry of Health, Labour and Welfare Research Group for the Prevention of Refractory Diseases;
  2. All CAEBV patients who have not achieved complete remission, including:

    1. Active phase: EBV-DNA level in PBMC is higher than 1×10^2.5 copies/μg DNA, with symptoms and signs of active diseases such as fever, hepatomegaly, splenomegaly, abnormal liver function, decrease of blood three lines, lymphadenopathy, and progressive skin lesions with increased EBV titer in peripheral blood;
    2. inactive phase: EBV-DNA level in PBMC is higher than 1×10^2.5 copies/μg DNA, without symptoms and signs of active diseases;
  3. The disease has not yet progressed to hematopoietic lymphohistiocytosis (HLH);

Only applicable to the inclusion criteria of LMP1-positive ENKTL:

  1. According to the 2016 WHO classification criteria for lymphocytic tumors: Subjects diagnosed by histopathology as extranodal NK/T cell lymphoma, nasal type (ENKTL) with LMP1 positive in tumor tissue;
  2. R/R ENKTL (meets one of the following prerequisites)

    1. Without remission or with progression after receiving second-line or higher-line chemotherapy/chemotherapy + radiotherapy;
    2. Primary drug resistance;
    3. With recurrence after receiving autologous/allogeneic hematopoietic stem cell transplantation;
  3. According to 2014 Lugano standard, there should be at least one evaluable tumor lesion.

Only applicable to the inclusion criteria for LMP1-positive HL:

  1. According to the 2016 WHO classification criteria for lymphocytic tumors, subjects with Hodgkin lymphoma diagnosed by histopathology (HD) and LMP1 positive in tumor tissue;
  2. R/R HD (meets one of the following prerequisites):

    1. Without remission or with progression after receiving second-line or higher-line chemotherapy;
    2. Primary resistance Drugs;
    3. With recurrence after receiving autologous hematopoietic stem cell transplantation;
  3. According to the Lugano 2014 standard, there should be at least one evaluable tumor lesion;

Only applicable to the inclusion criteria for LMP1-positive PTLD:

  1. Only PTLD after hematopoietic stem cell transplantation;
  2. According to the 2016 WHO classification criteria for lymphocytic tumors, subjects with PTLD diagnosed by histopathology and LMP1 positive in tumor tissue;
  3. Excluding PTLD of early-stage
  4. R/R PTLD (meets one of the following prerequisites):

    1. Without remission or with progression after receiving rituximab-based standard treatment;
    2. Primary drug resistance;
  5. According to the Lugano 2014 standard, there should be at least one evaluable tumor lesion

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 in haled 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 ofpatients or interfere with the results of study

Sites / Locations

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

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Administration of LMP1 CAR T-cells

Arm Description

Each subject receive LMP1 CAR T-cells by intravenous infusion

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

Chronic active EB virus infection (CAEBV), Overall response rate (ORR)
Assessment of ORR (ORR = CR + PR) at Month 1, 3, 6, 12, 18 and 24
CAEBV,Duration of remission(DOR)
From the first remission after LMP1 CAR-T cells to relapse, death or the last visit
CAEBV, Overall survival (OS)
From the first infusion of LMP1 CAR-T cells to death or the last visit
CAEBV, Relapse rate(RR)
From the first remission after LMP1 CAR-T cells to relapse or the last visit
CAEBV, Event-free survival (EFS)
From the first infusion of LMP1 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
Hodgkin's lymphoma(HL), Extranodal NK/T cell lymphoma(ENKTL),Nasal type, Lymphoproliferative disease after hematopoietic stem cell transplantation, (post-HSCT PTLD),Overall response rate (ORR)
Assessment of ORR (ORR = CR + PR) at Month 1, 3, 6, 12, 18 and 24
HL, ENKTL, PTLD, OS
From the first infusion of LMP1 CAR-T cells to death or the last visit
HL, ENKTL, PTLD, EFS
From the first infusion of LMP1 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
Quality of life
Assessment using European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scale [For item1-28: max score: 112, min score: 28, higher scores mean a better outcome; for item 28-29: max score: 14, min score: 2, higher scores mean a worse outcome] to measure Quality of life at Baseline, Month 1, 3, 6, 9 and 12
Activities of Daily Living (ADL) score
Assessment using Activities of Daily Living (ADL) scale (Barthel Index) [max score: 100, min score: 0, higher scores mean a better outcome] at Baseline, Month 1, 3, 6, 9 and 12
Instrumental Activities of Daily Living (IADL) score
Assessment of Instrumental Activities of Daily Living (IADL) scale [max score: 56, min score: 14, higher scores mean a worse outcome] at Baseline, Month 1, 3, 6, 9 and 12
Hospital Anxiety and Depression Scale (HADS) score
Assessment using Hospital Anxiety and Depression Scale (HADS) [max score: 42, min score: 0, higher scores mean a worse outcome] at Baseline, Month 1, 3, 6, 9 and 12

Full Information

First Posted
October 22, 2020
Last Updated
December 5, 2020
Sponsor
Zhejiang University
Collaborators
Yake Biotechnology Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04657965
Brief Title
LMP1 CAR-T for Patients With LMP1 Positive Infectious Diseases and Hematological Malignancies
Official Title
Clinical Trial for the Safety and Efficacy of Sequential of LMP1 CAR-T for Patients With LMP1 Positive Infectious Diseases and Hematological Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Not yet recruiting
Study Start Date
January 15, 2021 (Anticipated)
Primary Completion Date
January 15, 2024 (Anticipated)
Study Completion Date
January 15, 2027 (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 LMP1 CAR-T for patients with LMP1 positive infectious diseases and hematological malignancies
Detailed Description
This is a single arm, open-label, single-center study. This study is indicated for LMP1 positive infectious diseases and hematological malignancies. The selections of dose levels and the number of subjects are based on clinical trials of similar foreign products. 144 patients will be enrolled. 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
Infectious Diseases, Hematological Malignancies
Keywords
Infectious diseases, Hematological Malignancies, CAR T-cell therapy, LMP1

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
144 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Administration of LMP1 CAR T-cells
Arm Type
Experimental
Arm Description
Each subject receive LMP1 CAR T-cells by intravenous infusion
Intervention Type
Drug
Intervention Name(s)
LMP1 CAR T-cells
Other Intervention Name(s)
LMP1 CAR-T cells injection
Intervention Description
Each subject receive LMP1 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 LMP1 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 LMP1 targeted CAR T-cells infusion
Secondary Outcome Measure Information:
Title
Chronic active EB virus infection (CAEBV), Overall response rate (ORR)
Description
Assessment of ORR (ORR = CR + PR) at Month 1, 3, 6, 12, 18 and 24
Time Frame
At Month 1, 3, 6, 12, 18 and 24
Title
CAEBV,Duration of remission(DOR)
Description
From the first remission after LMP1 CAR-T cells to relapse, death or the last visit
Time Frame
Up to 2 years after LMP1 CAR-T cells infusion
Title
CAEBV, Overall survival (OS)
Description
From the first infusion of LMP1 CAR-T cells to death or the last visit
Time Frame
Up to 2 years after LMP1 CAR-T cells infusion
Title
CAEBV, Relapse rate(RR)
Description
From the first remission after LMP1 CAR-T cells to relapse or the last visit
Time Frame
At Month 6, 12, 18 and 24
Title
CAEBV, Event-free survival (EFS)
Description
From the first infusion of LMP1 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 LMP1 CAR-T cells infusion
Title
Hodgkin's lymphoma(HL), Extranodal NK/T cell lymphoma(ENKTL),Nasal type, Lymphoproliferative disease after hematopoietic stem cell transplantation, (post-HSCT PTLD),Overall response rate (ORR)
Description
Assessment of ORR (ORR = CR + PR) at Month 1, 3, 6, 12, 18 and 24
Time Frame
At Month 1, 3, 6, 12, 18 and 24
Title
HL, ENKTL, PTLD, OS
Description
From the first infusion of LMP1 CAR-T cells to death or the last visit
Time Frame
Up to 2 years after LMP1 CAR-T cells infusion
Title
HL, ENKTL, PTLD, EFS
Description
From the first infusion of LMP1 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 LMP3 CAR-T cells infusion
Title
Quality of life
Description
Assessment using European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scale [For item1-28: max score: 112, min score: 28, higher scores mean a better outcome; for item 28-29: max score: 14, min score: 2, higher scores mean a worse outcome] to measure Quality of life at Baseline, Month 1, 3, 6, 9 and 12
Time Frame
At Baseline, Month 1, 3, 6, 9 and 12
Title
Activities of Daily Living (ADL) score
Description
Assessment using Activities of Daily Living (ADL) scale (Barthel Index) [max score: 100, min score: 0, higher scores mean a better outcome] at Baseline, Month 1, 3, 6, 9 and 12
Time Frame
At Baseline, Month 1, 3, 6, 9 and 12
Title
Instrumental Activities of Daily Living (IADL) score
Description
Assessment of Instrumental Activities of Daily Living (IADL) scale [max score: 56, min score: 14, higher scores mean a worse outcome] at Baseline, Month 1, 3, 6, 9 and 12
Time Frame
At Baseline, Month 1, 3, 6, 9 and 12
Title
Hospital Anxiety and Depression Scale (HADS) score
Description
Assessment using Hospital Anxiety and Depression Scale (HADS) [max score: 42, min score: 0, higher scores mean a worse outcome] at Baseline, Month 1, 3, 6, 9 and 12
Time Frame
At Baseline, Month 1, 3, 6, 9 and 12

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Only applicable to the inclusion criteria of CAEBV Subjects who are diagnosed with CAEBV according to the Okano revised standard proposed by the Japanese Ministry of Health, Labour and Welfare Research Group for the Prevention of Refractory Diseases; All CAEBV patients who have not achieved complete remission, including: Active phase: EBV-DNA level in PBMC is higher than 1×10^2.5 copies/μg DNA, with symptoms and signs of active diseases such as fever, hepatomegaly, splenomegaly, abnormal liver function, decrease of blood three lines, lymphadenopathy, and progressive skin lesions with increased EBV titer in peripheral blood; inactive phase: EBV-DNA level in PBMC is higher than 1×10^2.5 copies/μg DNA, without symptoms and signs of active diseases; The disease has not yet progressed to hematopoietic lymphohistiocytosis (HLH); Only applicable to the inclusion criteria of LMP1-positive ENKTL: According to the 2016 WHO classification criteria for lymphocytic tumors: Subjects diagnosed by histopathology as extranodal NK/T cell lymphoma, nasal type (ENKTL) with LMP1 positive in tumor tissue; R/R ENKTL (meets one of the following prerequisites) Without remission or with progression after receiving second-line or higher-line chemotherapy/chemotherapy + radiotherapy; Primary drug resistance; With recurrence after receiving autologous/allogeneic hematopoietic stem cell transplantation; According to 2014 Lugano standard, there should be at least one evaluable tumor lesion. Only applicable to the inclusion criteria for LMP1-positive HL: According to the 2016 WHO classification criteria for lymphocytic tumors, subjects with Hodgkin lymphoma diagnosed by histopathology (HD) and LMP1 positive in tumor tissue; R/R HD (meets one of the following prerequisites): Without remission or with progression after receiving second-line or higher-line chemotherapy; Primary resistance Drugs; With recurrence after receiving autologous hematopoietic stem cell transplantation; According to the Lugano 2014 standard, there should be at least one evaluable tumor lesion; Only applicable to the inclusion criteria for LMP1-positive PTLD: Only PTLD after hematopoietic stem cell transplantation; According to the 2016 WHO classification criteria for lymphocytic tumors, subjects with PTLD diagnosed by histopathology and LMP1 positive in tumor tissue; Excluding PTLD of early-stage R/R PTLD (meets one of the following prerequisites): Without remission or with progression after receiving rituximab-based standard treatment; Primary drug resistance; According to the Lugano 2014 standard, there should be at least one evaluable tumor lesion 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 in haled 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 ofpatients 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

12. IPD Sharing Statement

Plan to Share IPD
No

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LMP1 CAR-T for Patients With LMP1 Positive Infectious Diseases and Hematological Malignancies

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