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Allogeneic γδ T Cells Immunotherapy in r/r Non-Hodgkin's Lymphoma (NHL) or Peripheral T Cell Lymphomas (PTCL) Patients

Primary Purpose

Non-Hodgkin's Lymphoma (NHL), Peripheral T Cell Lymphoma (PTCL)

Status
Recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
Ex-vivo expanded allogeneic γδT cells
Sponsored by
Institute of Hematology & Blood Diseases Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Hodgkin's Lymphoma (NHL)

Eligibility Criteria

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

Inclusion Criteria:

  • Patient Inclusion Criteria:

    1. Patients should sign informed consent form voluntarily before the trail and comply with the requirements of this study.
    2. Age≥18 years old, gender unlimited.
    3. Patients whose relatives are willing to donate PBMCs voluntarily.
    4. Patients with relapsed or refractory B cell non-Hodgkin's lymphoma (B-NHL) or peripheral T cell lymphoma (PTCL) expect for γδT lymphoma.
    5. Patients had an evaluable imaging lesion of at least greater than 1.5 cm.
    6. Eastern Cooperative Oncology Group (ECOG) Performance score≤2.
    7. Adequate bone marrow function:

      • Absolute neutrophil count (ANC) >1000/mm3;
      • Absolute lymphocyte count (ALC)≥300/mm3;
      • PLT≥50,000/mm3;
      • Hb >8.0g/dl.
    8. Adequate organ function:

      • Alanine aminotransferase (ALT)≤3 times the upper limit of normal (ULN);
      • Aspartate aminotransferase (AST)≤3 times ULN
      • TBIL≤1.5 times ULN (Gilbert syndrome patients TBIL≤3 times ULN and DBIL≤1.5 times ULN)
      • Scr≤1.5 times ULN or CCR≥60 mL/min/1.73m3 Note: apart from tumor infiltrated liver dysfunction.
    9. Male and female patients of reproductive potential must agree to use birth control during the study and for at least 12 weeks post study.
  • Donor Inclusion Criteria:

    1. Sign informed consent form.
    2. Age 18 years up to the age of 60 (≤60), gender unlimited.
    3. Relatives of patients (unrestricted to blood relationship).
    4. Apheresis available.
    5. PLT≥100×109/L with normal APTT or PT.

Exclusion Criteria:

  • Patient Exclusion Criteria:

    1. Patients with other available treatment drugs or treatment options.
    2. Patients with history of allogeneic hematopoietic stem cell transplantation (Allo-HSCT).
    3. Active central nervous system (CNS) lymphoma.
    4. Patients receiving chemotherapy within 1 week prior to γδT cell transfusion, with the following exceptions:

      • Pretreatment chemotherapy prescribed by the protocol
      • Other exploratory combined medications
    5. Systemic glucocorticoid treatment 72h prior to γδT cell transfusion (apart from physiological replacement dosage).
    6. Biphosphonates were used 2 months prior to γδT cell transfusion.
    7. Patients with systemic vasculitis, or with active or uncontrolled autoimmune diseases, as well as primary or secondary immunodeficiency diseases.
    8. Active HBV, HCV, HIV, TP, CMV or EBV infection.
    9. Major surgery that was evaluated by the investigator as unsuitable for inclusion within 4 weeks prior to screening.
    10. Patients with malignant tumors, apart from those who has been cured for at least 2 years.
    11. Patient's cardiac function meets any of the following conditions:

      • Left ventricular ejection fraction (LVEF)≤45%
      • Class III or IV heart failure according to the NYHA Heart Failure Classifications
      • QTcB>450 msec
      • Other cardiac disease that investigators judge is not suitable for enrollment
    12. History of epilepsy or other active central nervous system disorders.
    13. Inoculated live vaccine within 6 weeks before screening.
    14. Uncontrolled serious active infection (such as sepsis, bacteremia and fungemia).
    15. Life expectancy < 3 months
    16. Participated in any other interventional clinical trial within 3 months prior to γδT cell transfusion.
    17. Any situation that investigators believe the risk of the subjects is increased or results of the trial are disturbed: patients with any serious acute or chronic physical or mental illness, or laboratory abnormalities.
  • Donor Exclusion Criteria:

    1. History of any severe clinical diseases or other severe organic diseases, including any history of clinically significant systematic diseases such as cardiovascular, urinary, circulatory, respiratory, neurological, psychiatric, digestive and endocrine diseases. History of high blood pressure or systolic pressure>140 mmHg, diastolic pressure>90 mmHg in screening stage. Any situation that investigators believe is clinically significant or with other severe diseases unsuitable of apheresis.
    2. Arterial thrombosis or venous thrombosis history 12 months prior to the trial or hemorrhagic tendency or history 2 months prior to the trial; oral administration of anticoagulation drugs (e. g. aspirin and warfarin).
    3. Active or history of autoimmune diseases including but not restricted to SLE, psoriasis, RA, IBD and HT. Apart from hypothyrosis which can be controlled by hormone replacement therapy, skin diseases without systemic therapy and celiac disease which is fully controlled.
    4. HIV-Ab, TP-Ab, HCV-Ab, HBsAg, HBeAg, HBeAb or HBcAb positive.
    5. Any symptom, sign or laboratory examination abnormality suggesting acute or subacute infection (e.g. fever, cough, urinary irritation, skin infectious wound).
    6. Female who are pregnant or cannot stop lactating.
    7. Those who cannot communicate with medical staff due to mental illness or language disabilities.
    8. Other unsuitable conditions that investigators believe unsuitable for the donation.

Sites / Locations

  • Institute of Hematology & Blood Disease HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Allogeneic γδT cell immunotherapy

Arm Description

Patients will receive 2 cycles of ex-vivo expanded allogeneic γδT cells treatments, at 14 days' intervals, each cycle has 2 infusions. Ex-vivo expanded γδT cells are transfused to patients in a dosage escalated manner (Dose escalation, 1×107, 3×107, 9×107 per kg of body weight).

Outcomes

Primary Outcome Measures

Safety evaluation: Incidence of Adverse events (AEs)
Therapy-related adverse events will be recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0).
Safety evaluation: Dose limited toxicity (DLTs)
The incidence of DLTs will be recorded and assessed.
Safety evaluation: Maximum-tolerated dose (MTD)
MTD or clinical recommended dose will be recorded and evaluated.

Secondary Outcome Measures

Efficacy evaluation:Overall response rate (ORR)
ORR is defined as the incidence of either a CR or a partial response (PR) per the Lugano Classification as determined by study investigators.
Efficacy evaluation:Disease control rate (DCR)
DCR is defined as the incidence of either a CR, a partial response (PR) or stable disease (SD) per the Lugano Classification as determined by study investigators.
Efficacy evaluation:Duration of remission (DOR)
DOR is defined only for participants who experience an objective response after γδT cells infusion and is the time from the first objective response to disease progression or death from any cause.
Efficacy evaluation:Progression free survival (PFS)
PFS is defined as the time from the γδT cells infusion date to the date of disease progression or death from any cause.
Efficacy evaluation:Overall survival (OS)
OS is defined as the time from γδT cells infusion to the date of death from any cause.
Pharmacokinetics (PK) evaluation :γδT cells in peripheral blood
Number of γδT cells in peripheral blood will be assessed by flow cytometry.

Full Information

First Posted
December 23, 2020
Last Updated
January 5, 2021
Sponsor
Institute of Hematology & Blood Diseases Hospital, China
Collaborators
Beijing GD Initiative Cell Therapy Technology Co., Ltd., Chinese Academy of Medical Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT04696705
Brief Title
Allogeneic γδ T Cells Immunotherapy in r/r Non-Hodgkin's Lymphoma (NHL) or Peripheral T Cell Lymphomas (PTCL) Patients
Official Title
The Safety and Efficacy Assessment of Ex-Vivo Expanded Allogeneic γδT Cells Immunotherapy in Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma (NHL) and Peripheral T Cell Lymphomas (PTCL)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Recruiting
Study Start Date
December 31, 2020 (Actual)
Primary Completion Date
December 25, 2021 (Anticipated)
Study Completion Date
December 25, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Institute of Hematology & Blood Diseases Hospital, China
Collaborators
Beijing GD Initiative Cell Therapy Technology Co., Ltd., Chinese Academy of Medical Sciences

4. Oversight

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

5. Study Description

Brief Summary
This study aims to evaluate the safety, tolerability and efficacy of ex-vivo expanded allogeneic γδT cells obtained from a blood-related donor of patients with relapsed or refractory B cell non-Hodgkin's lymphoma (B-NHL) or peripheral T cell lymphoma (PTCL) expect for γδT lymphoma.
Detailed Description
This study is a single-center, non-randomized, open label, no control, prospective clinical trial to evaluate the safety, tolerability and efficacy of ex-vivo expanded allogeneic γδT cells from a blood-related donor of NHL or PTCL patients(except for γδT lymphoma). This study will include the following sequential phases: sign informed consent, γδT cell pre-culture, screening and registration to the trial, apheresis, γδT cell preparation, pre-treatment for lymphodepleting chemotherapy (selectable plan), treatments and follow-ups. The study will evaluate the safety and efficacy of the ex-vivo expanded allogeneic γδT cells in patients with relapsed or refractory non-Hodgkin's lymphoma (NHL) or peripheral T cell lymphoma (PTCL) expect for γδT lymphoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Hodgkin's Lymphoma (NHL), Peripheral T Cell Lymphoma (PTCL)

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
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Allogeneic γδT cell immunotherapy
Arm Type
Experimental
Arm Description
Patients will receive 2 cycles of ex-vivo expanded allogeneic γδT cells treatments, at 14 days' intervals, each cycle has 2 infusions. Ex-vivo expanded γδT cells are transfused to patients in a dosage escalated manner (Dose escalation, 1×107, 3×107, 9×107 per kg of body weight).
Intervention Type
Biological
Intervention Name(s)
Ex-vivo expanded allogeneic γδT cells
Intervention Description
Cells will be extracted from a healthy donor by apheresis, followed by ex-vivo expansion and activation. The ex-vivo expanded γδT cells from donors will be adoptively transfused.
Primary Outcome Measure Information:
Title
Safety evaluation: Incidence of Adverse events (AEs)
Description
Therapy-related adverse events will be recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0).
Time Frame
2 years post γδT cells infusion
Title
Safety evaluation: Dose limited toxicity (DLTs)
Description
The incidence of DLTs will be recorded and assessed.
Time Frame
28 days
Title
Safety evaluation: Maximum-tolerated dose (MTD)
Description
MTD or clinical recommended dose will be recorded and evaluated.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Efficacy evaluation:Overall response rate (ORR)
Description
ORR is defined as the incidence of either a CR or a partial response (PR) per the Lugano Classification as determined by study investigators.
Time Frame
2 years post γδT cells infusion
Title
Efficacy evaluation:Disease control rate (DCR)
Description
DCR is defined as the incidence of either a CR, a partial response (PR) or stable disease (SD) per the Lugano Classification as determined by study investigators.
Time Frame
2 years post γδT cells infusion
Title
Efficacy evaluation:Duration of remission (DOR)
Description
DOR is defined only for participants who experience an objective response after γδT cells infusion and is the time from the first objective response to disease progression or death from any cause.
Time Frame
2 years post γδT cells infusion
Title
Efficacy evaluation:Progression free survival (PFS)
Description
PFS is defined as the time from the γδT cells infusion date to the date of disease progression or death from any cause.
Time Frame
2 years post γδT cells infusion
Title
Efficacy evaluation:Overall survival (OS)
Description
OS is defined as the time from γδT cells infusion to the date of death from any cause.
Time Frame
2 years post γδT cells infusion
Title
Pharmacokinetics (PK) evaluation :γδT cells in peripheral blood
Description
Number of γδT cells in peripheral blood will be assessed by flow cytometry.
Time Frame
2 years post γδT cells infusion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient Inclusion Criteria: Patients should sign informed consent form voluntarily before the trail and comply with the requirements of this study. Age≥18 years old, gender unlimited. Patients whose relatives are willing to donate PBMCs voluntarily. Patients with relapsed or refractory B cell non-Hodgkin's lymphoma (B-NHL) or peripheral T cell lymphoma (PTCL) expect for γδT lymphoma. Patients had an evaluable imaging lesion of at least greater than 1.5 cm. Eastern Cooperative Oncology Group (ECOG) Performance score≤2. Adequate bone marrow function: Absolute neutrophil count (ANC) >1000/mm3; Absolute lymphocyte count (ALC)≥300/mm3; PLT≥50,000/mm3; Hb >8.0g/dl. Adequate organ function: Alanine aminotransferase (ALT)≤3 times the upper limit of normal (ULN); Aspartate aminotransferase (AST)≤3 times ULN TBIL≤1.5 times ULN (Gilbert syndrome patients TBIL≤3 times ULN and DBIL≤1.5 times ULN) Scr≤1.5 times ULN or CCR≥60 mL/min/1.73m3 Note: apart from tumor infiltrated liver dysfunction. Male and female patients of reproductive potential must agree to use birth control during the study and for at least 12 weeks post study. Donor Inclusion Criteria: Sign informed consent form. Age 18 years up to the age of 60 (≤60), gender unlimited. Relatives of patients (unrestricted to blood relationship). Apheresis available. PLT≥100×109/L with normal APTT or PT. Exclusion Criteria: Patient Exclusion Criteria: Patients with other available treatment drugs or treatment options. Patients with history of allogeneic hematopoietic stem cell transplantation (Allo-HSCT). Active central nervous system (CNS) lymphoma. Patients receiving chemotherapy within 1 week prior to γδT cell transfusion, with the following exceptions: Pretreatment chemotherapy prescribed by the protocol Other exploratory combined medications Systemic glucocorticoid treatment 72h prior to γδT cell transfusion (apart from physiological replacement dosage). Biphosphonates were used 2 months prior to γδT cell transfusion. Patients with systemic vasculitis, or with active or uncontrolled autoimmune diseases, as well as primary or secondary immunodeficiency diseases. Active HBV, HCV, HIV, TP, CMV or EBV infection. Major surgery that was evaluated by the investigator as unsuitable for inclusion within 4 weeks prior to screening. Patients with malignant tumors, apart from those who has been cured for at least 2 years. Patient's cardiac function meets any of the following conditions: Left ventricular ejection fraction (LVEF)≤45% Class III or IV heart failure according to the NYHA Heart Failure Classifications QTcB>450 msec Other cardiac disease that investigators judge is not suitable for enrollment History of epilepsy or other active central nervous system disorders. Inoculated live vaccine within 6 weeks before screening. Uncontrolled serious active infection (such as sepsis, bacteremia and fungemia). Life expectancy < 3 months Participated in any other interventional clinical trial within 3 months prior to γδT cell transfusion. Any situation that investigators believe the risk of the subjects is increased or results of the trial are disturbed: patients with any serious acute or chronic physical or mental illness, or laboratory abnormalities. Donor Exclusion Criteria: History of any severe clinical diseases or other severe organic diseases, including any history of clinically significant systematic diseases such as cardiovascular, urinary, circulatory, respiratory, neurological, psychiatric, digestive and endocrine diseases. History of high blood pressure or systolic pressure>140 mmHg, diastolic pressure>90 mmHg in screening stage. Any situation that investigators believe is clinically significant or with other severe diseases unsuitable of apheresis. Arterial thrombosis or venous thrombosis history 12 months prior to the trial or hemorrhagic tendency or history 2 months prior to the trial; oral administration of anticoagulation drugs (e. g. aspirin and warfarin). Active or history of autoimmune diseases including but not restricted to SLE, psoriasis, RA, IBD and HT. Apart from hypothyrosis which can be controlled by hormone replacement therapy, skin diseases without systemic therapy and celiac disease which is fully controlled. HIV-Ab, TP-Ab, HCV-Ab, HBsAg, HBeAg, HBeAb or HBcAb positive. Any symptom, sign or laboratory examination abnormality suggesting acute or subacute infection (e.g. fever, cough, urinary irritation, skin infectious wound). Female who are pregnant or cannot stop lactating. Those who cannot communicate with medical staff due to mental illness or language disabilities. Other unsuitable conditions that investigators believe unsuitable for the donation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Dehui Zou, MD
Phone
86-022-23909283
Email
zoudehui@ihcams.ac.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Wei Liu, MD
Phone
86-022-23909282
Email
liuwei@ihcams.ac.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jianmin Zhang, PhD
Organizational Affiliation
Chinese Academy of Medical Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Institute of Hematology & Blood Disease Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300020
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wei Liu, MD
Phone
86-022-23909282
Email
liuwei@ihcams.ac.cn
First Name & Middle Initial & Last Name & Degree
Shuhua Yi, MD
Phone
86-022-23909106
Email
yishuhua@ihcams.ac.cn
First Name & Middle Initial & Last Name & Degree
Dehui Zou, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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Allogeneic γδ T Cells Immunotherapy in r/r Non-Hodgkin's Lymphoma (NHL) or Peripheral T Cell Lymphomas (PTCL) Patients

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