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A Phase 1/2 Study of CT120 in Patient With Relapsed/Refractory B-cell Non-Hodgkin's Lymphoma

Primary Purpose

B-cell Non-Hodgkin's Lymphoma

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Fully Human Anti-CD19/CD22 Dual Target Chimeric Antigen Receptor Autologous T Cell Injection
Sponsored by
Nanjing IASO Biotechnology Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-cell Non-Hodgkin's Lymphoma

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age between 18 and 70 years old.
  2. Pathologically confirmed B-cell non-Hodgkin's lymphoma, including:

(1) Diffuse large B-cell lymphoma (DLBCL); (2) Histopathological Grade 3b follicular lymphoma (FL3b); (3) Follicular lymphoma with diffuse large B cell transformation; (4) Primary mediastinal large B-cell lymphoma (PMBCL). 3. Relapsed/refractory B-cell non-Hodgkin's lymphoma must meet one of the following criteria:

  1. At least 2 failed prior B-cell non-Hodgkin's lymphoma treatment regimens (including relapse, no response, and progression). Prior therapy must have included anti-CD20 monoclonal antibodies (except for CD20-negative subjects) and standard therapies which including anthracyclines;
  2. Recurrence after autologous hematopoietic stem cell transplantation;
  3. Primary resistance: After 2 cycles of initial anti-CD20 monoclonal immunochemotherapy, the best response was stable disease or disease progression.

4. At least 1 measurable lesion as following:

  1. The long axis of the lymph node lesions should be ≥15mm (and the length of the short axis is measurable), or;
  2. The lengths of extra-lymph node lesions should be ≥10mm in both the long and short axis.

5. Expected survival time≥12 weeks. 6. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. 7. Adequate organ function before enrollment, and meet all the following laboratory test results:

  1. Blood routine: neutrophils ≥1.0 ×109/L (granulocyte colony stimulating factor (G-CSF) is allowed within 7 days before the examination), lymphocytes ≥0.3 ×109 /L, platelets ≥50 ×109 /L (must have not received blood transfusion [including component transfusion] or treatments that include thrombopoietin [TPO] for the purpose of raising platelets within 7 days before the examination), hemoglobin ≥80g/L (must have not received blood transfusion [including component blood transfusion] within 7 days before the examination);
  2. Blood coagulation function: fibrinogen≥1.0g/L; activated partial thromboplastin time≤1.5×ULN, prothrombin time (PT)≤1.5×ULN;
  3. Liver function: ALT and AST≤2.5×ULN; serum total bilirubin≤1.5×ULN;
  4. Renal function: creatinine clearance rate CrCl ≥60 mL/min estimated by Cockcroft-Gault;
  5. Left ventricular ejection fraction (LVEF)≥50% estimated by echocardiography;
  6. Baseline oxygen saturation > 91% on room air. 8. Females and males with childbearing potential should take effective contraception from the day of signing the informed consent form to 365 days after the CT120 infusion. Effective contraception is defined as: abstinence or contraceptive methods with an annual failure rate of <1% indicated in section 9.8 of this protocol.

9. Subject is willing to participate in this trial and sign an informed consent form.

Exclusion Criteria:

  1. Subjects who have received or require the following treatments:

(1) Prior CAR-T cell therapy before enrollment; (2) Presence of acute or chronic graft-versus-host disease (GVHD) requires systemic treatment within 4 weeks before enrollment; (3) History of immunodeficiency or other diseases and autoimmune diseases (eg Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus, etc.) received immunosuppressive therapy within 2 years before enrollment; (4) Autologous hematopoietic stem cell transplantation (autoSCT) within 12 weeks before enrollment and history of allogeneic stem cell transplantation (HSCT); (5) Live vaccines injection within 4 weeks before enrollment; (6) According to investigator's discretion, there is a need to use systemic corticosteroid therapy within 12 weeks after the administration of the study drug (except for hydrocortisone ≤12mg/m2/day or other hormones converting into the same dose range for physiological replacement therapy) or other immunosuppressive drug therapy (except local therapy).

2. B-cell non-Hodgkin's lymphoma patients with active central nervous system or intestinal parenchyma invasion.

3. Excessive tumor burden and any lesions with a long axis ≥10cm. 4. Other active malignant tumors in the past 5 years, except for curable tumor that has been completely cured, such as basal or squamous cell carcinoma, cervical or breast carcinoma in situ, etc.

5. Positive hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and an abnormal HBV DNA result detected by peripheral blood test (abnormal HBV DNA result is defined as: the quantitative detection of HBV DNA is over the detectable lower limit or beyond the normal reference of the testing center or HBV viral DNA positive); Hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; Human immunodeficiency virus (HIV) antibody positive; Cytomegalovirus (CMV) DNA test positive; syphilis test positive.

6. Uncontrollable active infections (except for genitourinary system infections and upper respiratory tract infections < CTCAE Grade 2).

7. Severe heart disease: including but not limited to unstable angina, myocardial infarction (within 6 months before screening), congestive heart failure (New York Heart Association [NYHA] classification ≥ Grade III), severe arrhythmia.

8. Hypertension that cannot be controlled by medication. 9. Adverse events during prior therapies have not relieved to baseline or ≤1 (according to NCI-CTCAE v5.0, except for alopecia).

10. Major surgery within 2 weeks before enrollment, or surgeries that were planed while waiting for infusion or within 12 weeks after receiving investigational product (except planned local anesthesia surgery).

11. History of organ transplant. 12. Pregnant or lactating women. 13. Previous central nervous system diseases (such as cerebral aneurysm, epilepsy, stroke, Alzheimer's disease, mental illness, etc.) or mental disorders.

14. Unstable systemic diseases judged by other researchers: including but not limited to severe liver, kidney, or metabolic diseases that require medication.

15. Other unsuitable situations for enrollment judged by investigators.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    CT120 in relapsed/refractory B-cell non-Hodgkin's lymphoma patients

    Arm Description

    Fully Human Anti-CD19/CD22 Dual Target Chimeric Antigen Receptor Autologous T Cell Injection(CT120)will be infused at 1.0 x 10^6 CAR+ T cells/kg、3.0 x 10^6 CAR+ T cells/kg、6.0 x 10^6 CAR+ T cells/kg in relapsed/refractory B-cell non-Hodgkin's lymphoma patients

    Outcomes

    Primary Outcome Measures

    Phase 1: Types and incidence of Dose-limiting toxicity (DLT)
    Dose-limiting toxicity (DLT) will be collected and graded according to American Society for Transplantation and Cellular Therapy (ASTCT) consensus (for CRS/ICANS) and CTCAE v5.0(for AE except CRS/ICANS)
    Phase 1:Types and incidence of adverse events (AEs) ,serious adverse events (SAEs) and adverse events of special interest (AESI)
    AE will be collected and graded according to American Society for Transplantation and Cellular Therapy (ASTCT) consensus (for CRS/ICANS) and CTCAE v5.0(for AE except CRS/ICANS)
    Phase 2:Overall response rate (ORR) at Day 90
    ORR will be calculated as the percentage of patients who achieved partial response (PR) or better at Day 90

    Secondary Outcome Measures

    Overall response rate (ORR)
    ORR will be calculated as the percentage of patients who achieved partial response (PR) or better.
    Time to Response (TTR)
    Time from CT120 infusion to first documentation of response.
    Time to complete Response (TTCR)
    Time from CT120 infusion to first documentation of complete response.
    Duration of Response (DOR)
    Time from first response to disease progression or death from any cause
    Progression-free Survival (PFS)
    PFS will be calculated as the time from CT120 infusion to disease progression or death from any cause (whichever occurs first).
    Overall Survival (OS)
    Time from CT120 infusion to time of death due to any cause
    Quantity of CAR copies in peripheral blood
    CAR copies in peripheral blood will be measured by quantitative polymerase chain reaction (qPCR) in 2 years.
    Quantity of CAR T-cells level in peripheral blood
    CAR T-cells in peripheral blood will be measured by flow cytometry (FCM) in 2 years
    Laboratory tests
    Abnormal results of laboratory tests
    Vital signs
    Abnormal results of vital signs
    Physical examination
    Abnormal results of physical examination

    Full Information

    First Posted
    September 15, 2021
    Last Updated
    October 12, 2021
    Sponsor
    Nanjing IASO Biotechnology Co., Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05091541
    Brief Title
    A Phase 1/2 Study of CT120 in Patient With Relapsed/Refractory B-cell Non-Hodgkin's Lymphoma
    Official Title
    A Multicenter Phase I/II Clinical Study on Fully Human Anti-CD19/CD22 Dual Target Chimeric Antigen Receptor Autologous T Cell Injection (CT120) for the Treatment of Relapsed/Refractory B-cell Non-Hodgkin's Lymphoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2021
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    October 20, 2021 (Anticipated)
    Primary Completion Date
    October 20, 2024 (Anticipated)
    Study Completion Date
    October 20, 2039 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Nanjing IASO Biotechnology Co., 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
    This study is a single-armed, open-label,multicenter Phase 1/2 study to evaluate the safety and efficacy of CT120 in subjects with relapsed/refractory B-cell non-Hodgkin's lymphoma.
    Detailed Description
    Leukapheresis procedure will be performed to manufacture CT120. Bridging therapy is allowed between PBMC collection and lymphodepletion. Lymphodepletion with fludarabine and cyclophosphamide was performed for three consecutive days. After 1-day rest, subjects will receive a single dose infusion of CT120. Subjects will be followed in the study for a minimum of 2 years after CT120 infusion. Long-term follow-up for lentiviral vector safety will be followed for up to 15 years after CT120 infusion.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    B-cell Non-Hodgkin's Lymphoma

    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
    125 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    CT120 in relapsed/refractory B-cell non-Hodgkin's lymphoma patients
    Arm Type
    Experimental
    Arm Description
    Fully Human Anti-CD19/CD22 Dual Target Chimeric Antigen Receptor Autologous T Cell Injection(CT120)will be infused at 1.0 x 10^6 CAR+ T cells/kg、3.0 x 10^6 CAR+ T cells/kg、6.0 x 10^6 CAR+ T cells/kg in relapsed/refractory B-cell non-Hodgkin's lymphoma patients
    Intervention Type
    Drug
    Intervention Name(s)
    Fully Human Anti-CD19/CD22 Dual Target Chimeric Antigen Receptor Autologous T Cell Injection
    Other Intervention Name(s)
    CT120
    Intervention Description
    CT120 is an autologous CD19/22 targeted CAR-T cells injection. The dosage form is a cryopreserved injection solution. The T cells aphesis from subjects then been manufactured to express CAR to binding CD19 and CD22 on B-cell lymphoma.
    Primary Outcome Measure Information:
    Title
    Phase 1: Types and incidence of Dose-limiting toxicity (DLT)
    Description
    Dose-limiting toxicity (DLT) will be collected and graded according to American Society for Transplantation and Cellular Therapy (ASTCT) consensus (for CRS/ICANS) and CTCAE v5.0(for AE except CRS/ICANS)
    Time Frame
    up to 28 days after CT120 infusion
    Title
    Phase 1:Types and incidence of adverse events (AEs) ,serious adverse events (SAEs) and adverse events of special interest (AESI)
    Description
    AE will be collected and graded according to American Society for Transplantation and Cellular Therapy (ASTCT) consensus (for CRS/ICANS) and CTCAE v5.0(for AE except CRS/ICANS)
    Time Frame
    Up to 2 years after CT120 CAR T-cells infusion
    Title
    Phase 2:Overall response rate (ORR) at Day 90
    Description
    ORR will be calculated as the percentage of patients who achieved partial response (PR) or better at Day 90
    Time Frame
    Up to 90 Days after CT120 infusion
    Secondary Outcome Measure Information:
    Title
    Overall response rate (ORR)
    Description
    ORR will be calculated as the percentage of patients who achieved partial response (PR) or better.
    Time Frame
    Up to Day 28、Day 90、Day180 after CT120 infusion
    Title
    Time to Response (TTR)
    Description
    Time from CT120 infusion to first documentation of response.
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Time to complete Response (TTCR)
    Description
    Time from CT120 infusion to first documentation of complete response.
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Duration of Response (DOR)
    Description
    Time from first response to disease progression or death from any cause
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Progression-free Survival (PFS)
    Description
    PFS will be calculated as the time from CT120 infusion to disease progression or death from any cause (whichever occurs first).
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Overall Survival (OS)
    Description
    Time from CT120 infusion to time of death due to any cause
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Quantity of CAR copies in peripheral blood
    Description
    CAR copies in peripheral blood will be measured by quantitative polymerase chain reaction (qPCR) in 2 years.
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Quantity of CAR T-cells level in peripheral blood
    Description
    CAR T-cells in peripheral blood will be measured by flow cytometry (FCM) in 2 years
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Laboratory tests
    Description
    Abnormal results of laboratory tests
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Vital signs
    Description
    Abnormal results of vital signs
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Physical examination
    Description
    Abnormal results of physical examination
    Time Frame
    Up to 2 years after CT120 infusion
    Other Pre-specified Outcome Measures:
    Title
    Immunogenicity
    Description
    Development of an anti-CAR antibody response
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Replication competent lentivirus (RCL)
    Description
    The incidence of replication competent lentivirus (RCL)
    Time Frame
    Up to 15 years after CT120 infusion
    Title
    Changes in the proportion of peripheral blood lymphocyte subsets
    Description
    Changes in the proportion of lymphocyte subsets in the peripheral blood will be analyzed by immune cell phenotyping using flow cytometry.
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Correlation between cytokines/inflammation-related proteins and Incidence of Adverse Event
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Correlation between cytokines/inflammation-related proteins and efficacy
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Correlation between efficacy and CD19/CD22 antigen expression in tumor tissues
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Correlation between efficacy and gene mutations including MYC, BCL2 and BCL6 rearrangements
    Time Frame
    Up to 2 years after CT120 infusion
    Title
    Correlation between efficacy and and the expression of oncogenes including C-myc and BCL
    Time Frame
    Up to 2 years after CT120 infusion

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age between 18 and 70 years old. Pathologically confirmed B-cell non-Hodgkin's lymphoma, including: (1) Diffuse large B-cell lymphoma (DLBCL); (2) Histopathological Grade 3b follicular lymphoma (FL3b); (3) Follicular lymphoma with diffuse large B cell transformation; (4) Primary mediastinal large B-cell lymphoma (PMBCL). 3. Relapsed/refractory B-cell non-Hodgkin's lymphoma must meet one of the following criteria: At least 2 failed prior B-cell non-Hodgkin's lymphoma treatment regimens (including relapse, no response, and progression). Prior therapy must have included anti-CD20 monoclonal antibodies (except for CD20-negative subjects) and standard therapies which including anthracyclines; Recurrence after autologous hematopoietic stem cell transplantation; Primary resistance: After 2 cycles of initial anti-CD20 monoclonal immunochemotherapy, the best response was stable disease or disease progression. 4. At least 1 measurable lesion as following: The long axis of the lymph node lesions should be ≥15mm (and the length of the short axis is measurable), or; The lengths of extra-lymph node lesions should be ≥10mm in both the long and short axis. 5. Expected survival time≥12 weeks. 6. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. 7. Adequate organ function before enrollment, and meet all the following laboratory test results: Blood routine: neutrophils ≥1.0 ×109/L (granulocyte colony stimulating factor (G-CSF) is allowed within 7 days before the examination), lymphocytes ≥0.3 ×109 /L, platelets ≥50 ×109 /L (must have not received blood transfusion [including component transfusion] or treatments that include thrombopoietin [TPO] for the purpose of raising platelets within 7 days before the examination), hemoglobin ≥80g/L (must have not received blood transfusion [including component blood transfusion] within 7 days before the examination); Blood coagulation function: fibrinogen≥1.0g/L; activated partial thromboplastin time≤1.5×ULN, prothrombin time (PT)≤1.5×ULN; Liver function: ALT and AST≤2.5×ULN; serum total bilirubin≤1.5×ULN; Renal function: creatinine clearance rate CrCl ≥60 mL/min estimated by Cockcroft-Gault; Left ventricular ejection fraction (LVEF)≥50% estimated by echocardiography; Baseline oxygen saturation > 91% on room air. 8. Females and males with childbearing potential should take effective contraception from the day of signing the informed consent form to 365 days after the CT120 infusion. Effective contraception is defined as: abstinence or contraceptive methods with an annual failure rate of <1% indicated in section 9.8 of this protocol. 9. Subject is willing to participate in this trial and sign an informed consent form. Exclusion Criteria: Subjects who have received or require the following treatments: (1) Prior CAR-T cell therapy before enrollment; (2) Presence of acute or chronic graft-versus-host disease (GVHD) requires systemic treatment within 4 weeks before enrollment; (3) History of immunodeficiency or other diseases and autoimmune diseases (eg Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus, etc.) received immunosuppressive therapy within 2 years before enrollment; (4) Autologous hematopoietic stem cell transplantation (autoSCT) within 12 weeks before enrollment and history of allogeneic stem cell transplantation (HSCT); (5) Live vaccines injection within 4 weeks before enrollment; (6) According to investigator's discretion, there is a need to use systemic corticosteroid therapy within 12 weeks after the administration of the study drug (except for hydrocortisone ≤12mg/m2/day or other hormones converting into the same dose range for physiological replacement therapy) or other immunosuppressive drug therapy (except local therapy). 2. B-cell non-Hodgkin's lymphoma patients with active central nervous system or intestinal parenchyma invasion. 3. Excessive tumor burden and any lesions with a long axis ≥10cm. 4. Other active malignant tumors in the past 5 years, except for curable tumor that has been completely cured, such as basal or squamous cell carcinoma, cervical or breast carcinoma in situ, etc. 5. Positive hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and an abnormal HBV DNA result detected by peripheral blood test (abnormal HBV DNA result is defined as: the quantitative detection of HBV DNA is over the detectable lower limit or beyond the normal reference of the testing center or HBV viral DNA positive); Hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; Human immunodeficiency virus (HIV) antibody positive; Cytomegalovirus (CMV) DNA test positive; syphilis test positive. 6. Uncontrollable active infections (except for genitourinary system infections and upper respiratory tract infections < CTCAE Grade 2). 7. Severe heart disease: including but not limited to unstable angina, myocardial infarction (within 6 months before screening), congestive heart failure (New York Heart Association [NYHA] classification ≥ Grade III), severe arrhythmia. 8. Hypertension that cannot be controlled by medication. 9. Adverse events during prior therapies have not relieved to baseline or ≤1 (according to NCI-CTCAE v5.0, except for alopecia). 10. Major surgery within 2 weeks before enrollment, or surgeries that were planed while waiting for infusion or within 12 weeks after receiving investigational product (except planned local anesthesia surgery). 11. History of organ transplant. 12. Pregnant or lactating women. 13. Previous central nervous system diseases (such as cerebral aneurysm, epilepsy, stroke, Alzheimer's disease, mental illness, etc.) or mental disorders. 14. Unstable systemic diseases judged by other researchers: including but not limited to severe liver, kidney, or metabolic diseases that require medication. 15. Other unsuitable situations for enrollment judged by investigators.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Ming Wu
    Phone
    +86 0531-58287610
    Email
    ming.wu@iasobio.com

    12. IPD Sharing Statement

    Learn more about this trial

    A Phase 1/2 Study of CT120 in Patient With Relapsed/Refractory B-cell Non-Hodgkin's Lymphoma

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