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A Study of Fully Human BCMA CAR-T (CT103A) in Patients With Newly Diagnosed High-risk Multiple Myeloma (FUMANBA-2)

Primary Purpose

Multiple Myeloma

Status
Not yet recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Fully human BCMA chimeric antigen receptor autologous T cell injection (CT103A)
Sponsored by
Nanjing IASO Biotechnology Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring newly diagnosed, multiple myeloma, treatment naive, CAR-T

Eligibility Criteria

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

Inclusion Criteria:

  1. 18 to 70 years old, male or female;
  2. Newly diagnosed as high-risk multiple myeloma:

    • Revised Multiple Myeloma International Staging System (R-ISS) stage 3;
    • Double-hit or triple-hit according to FISH test.
  3. Presence of measurable lesions during screening according to any of the following criteria:

    • The proportion of primitive naive or monoclonal plasma cells ≥ 5% by bone marrow cytology, bone marrow biopsy histology or flow cytometry;
    • Serum monoclonal protein (M-protein) level: M protein ≥10 g/L for IgG type, M protein ≥5g/L for IgA, IgD, IgM, and IgE type;
    • Urine M protein level ≥200 mg/24 hours;
    • Light chain multiple myeloma without measurable lesions in serum or urine: the affected serum free light chain ≥100 mg/L with abnormal serum κ/λ free light chain ratio;
  4. ECOG score of 0 or 1;
  5. Expected survival time ≥ 12 weeks;
  6. Subjects must have appropriate organ functions and meet all the following laboratory test requirements before enrollment:

    • Hematology: Absolute neutrophil count (ANC) ≥ 1×10^9/L (prior growth factor support is allowed, but supportive treatment within 7 days before laboratory test is not allowed); Absolute lymphocyte count (ALC) )≥0.3×10^9/L; platelets≥75×10^9/L (blood transfusion support within 7 days before laboratory test is not allowed); hemoglobin ≥60 g/L (without red blood cell [RBC] transfusion within 7 days before laboratory test; recombinant human erythropoietin is allowed);
    • Liver function: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)≤2.5×upper limit of normal (ULN); serum total bilirubin≤1.5×ULN;
    • Renal function: creatinine clearance calculated according to Cockcroft-Gault formula≥ 40 ml/min.
    • Coagulation function: fibrinogen ≥1.0 g/L; activated partial thromboplastin time≤1.5×ULN, prothrombin time (PT)≤1.5×ULN;
    • Blood oxygen saturation>91%;
    • Left ventricular ejection fraction (LVEF) ≥50%;
  7. Subjects and their spouses agree to take effective tools or contraceptive measures (safe period contraception is not included) from the time the subject signs the informed consent form until one year after the CAR-T cell infusion.

Exclusion Criteria:

  1. Patient who needs chronic use of immunosuppressive agents;
  2. Patient with hypertension that cannot be controlled by medication;
  3. 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;
  4. Unstable systemic diseases judged by the investigator: including but not limited to severe liver, kidney or metabolic diseases that require drug treatment;
  5. Patients with malignant tumors other than multiple myeloma within 5 years before screening, excluding fully treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after radical resection, and those after radical resection Ductal carcinoma in situ of breast;
  6. Patient with a history of solid organ transplantation;
  7. Patient who is suspected with or with symptoms of central nervous system invasion by plasma cell tumors;
  8. Multiple myeloma patients with plasma cell leukemia;
  9. Positive hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and detectable hepatitis B virus (HBV) DNA in peripheral blood; hepatitis C virus (HCV) antibody positive and peripheral blood hepatitis C virus ( HCV) RNA positive; human immunodeficiency virus (HIV) antibody positive; cytomegalovirus (CMV) DNA test positive; syphilis test positive;
  10. Women who are pregnant or breastfeeding;
  11. Patient with mental illness or disturbance of consciousness or central nervous system disease;
  12. Major surgery history within 2 weeks before entering the study, or scheduled surgery during the study period or within 2 weeks after the study treatment;
  13. Other situations considered unsuitable by the investigator.

Sites / Locations

  • Anhui Provincial Cancer Hospital
  • The First People's Hospital of Changzhou
  • Jiangsu Province Hospital
  • Nanjing Drum Tower Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CT103A in Newly Diagnosed Subjects With High-risk Multiple Myeloma

Arm Description

Fully Human BCMA Chimeric Antigen Receptor Autologous T Cell Injection(CT103A)will be infused at 1.0 x 10^6 CAR+ T cells/kg in newly diagnosed subjects with high-risk multiple myeloma

Outcomes

Primary Outcome Measures

Proportion of Minimal Residual Disease (MRD)-negative subjects
The proportion of subjects who achieve MRD-negativity after CT103A infusion.
Median progression-free survival (mPFS)
The median time from the date of CT103A infusion to the date of first disease progression or death from any cause.

Secondary Outcome Measures

Best overall response (BOR)
The proportion of subjects who achieve stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR) after CT103A infusion.
Median survival (mOS)
The median time from the date of CT103A infusion to the date of death from any reason.
Event-free survival (EFS)
The time from date of CT103A infusion to the date of death from any reason, relapse, treatment failure, disease progression or initiation of other anti-tumor treatment, whichever comes first;
Duration of response (DOR)
The time from the first assessment of sCR or CR or VGPR or PR to the first assessment of disease progression or death from any cause;
Safety endpoint
Incidence of treatment-emergent adverse events (TEAE) and Treatment-related adverse events (TRAE).
Pharmacokinetic(PK) endpoint
The maximum CT103A concentration and the copy number of the lentiviral vector (vector copy number, VCN) in peripheral blood (Cmax)
PK endpoint - Tmax
The time to reach the maximum concentration (Tmax)
PK endpoint - AUC 0 to 28d and AUC 0 to 90d
The area under the concentration time curve from time zero to day 28 (AUC0-28d) and from time zero to day 90 (AUC0-90d)
Levels of Soluable BCMA
The levels of soluble BCMA in peripheral blood at each time point.
PD endpoint
The levels of cytokines (IL-6, serum ferritin, etc.) in peripheral blood at each time point

Full Information

First Posted
November 21, 2021
Last Updated
January 3, 2022
Sponsor
Nanjing IASO Biotechnology Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05181501
Brief Title
A Study of Fully Human BCMA CAR-T (CT103A) in Patients With Newly Diagnosed High-risk Multiple Myeloma (FUMANBA-2)
Official Title
A Multi-center Clinical Study of Fully Human BCMA Chimeric Antigen Receptor Autologous T (CAR-T) Cell Injection (CT103A) in the Treatment of Newly Diagnosed Subjects With High-risk Multiple Myeloma (FUMANBA-2)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
April 2022 (Anticipated)
Primary Completion Date
April 2024 (Anticipated)
Study Completion Date
April 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
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
This study is a multi-center, single-arm clinical study to evaluate the efficacy, safety, pharmacokinetics and pharmacodynamic characteristics of CT103A as the first-line treatment in newly diagnosed high-risk multiple myeloma subjects with induction chemotherapy as bridging therapy.
Detailed Description
Before enrollment, subjects will receive chemotherapy regimen of either Bortezomib-Lenalidomide-Dexamethasone (VRD), Bortezomib-Cyclophosphamide-Dexamethasone (PCD) or Bortezomib-Adriamycin-Dexamethasone (PAD) as induction therapy for 3 cycles. Evaluation will be made after 2 cycles of chemotherapy. If the subject is not intended to have stem cell transplantation or unsuitable for autologous hematopoietic stem cell transplantation (ASCT) as judged by the investigator, he/she will receive the 3rd cycle of chemotherapy. If the subject meets the inclusion criteria, he/she will be enrolled in the study. Peripheral blood mononuclear cell (PBMC) will be collected to manufacture CT103A. After PBMC collection, the subject will receive another cycle of chemotherapy and evaluated. Lymphodepletion with fludarabine and cyclophosphamide will be performed for three consecutive days. After 1-day rest, subjects will receive a single infusion of CT103A at 1.0 ×10^6 /kg. Subjects will be followed in the study for a minimum of 2 years after CT103A infusion. Long-term follow-up for lentiviral vector safety will be followed for up to 15 years after CT103A infusion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
newly diagnosed, multiple myeloma, treatment naive, CAR-T

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CT103A in Newly Diagnosed Subjects With High-risk Multiple Myeloma
Arm Type
Experimental
Arm Description
Fully Human BCMA Chimeric Antigen Receptor Autologous T Cell Injection(CT103A)will be infused at 1.0 x 10^6 CAR+ T cells/kg in newly diagnosed subjects with high-risk multiple myeloma
Intervention Type
Drug
Intervention Name(s)
Fully human BCMA chimeric antigen receptor autologous T cell injection (CT103A)
Other Intervention Name(s)
CT103A
Intervention Description
CT103A is a customized, BCMA-targeted genetically modified autologous T cell immunotherapy, which can identify and eliminate malignant and normal cells expressing BCMA. CAR specifically recognizes BCMA with single chain fragment variable (ScFv), and promotes the activation, proliferation, cytokine secretion and target cell killing of CAR-T through the CD3ζ domain. And 4-1BB enhances the expansion and persistence of CT103A. CT103A will be infused at 1.0×10^6 /kg via intravenous drip within 24h to 72h after chemotherapy conditioning regimen at the recommended infusion rate of 3-5 mL/min.
Primary Outcome Measure Information:
Title
Proportion of Minimal Residual Disease (MRD)-negative subjects
Description
The proportion of subjects who achieve MRD-negativity after CT103A infusion.
Time Frame
Up to 2 years after CT103A infusion
Title
Median progression-free survival (mPFS)
Description
The median time from the date of CT103A infusion to the date of first disease progression or death from any cause.
Time Frame
Up to 2 years after CT103A infusion
Secondary Outcome Measure Information:
Title
Best overall response (BOR)
Description
The proportion of subjects who achieve stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR) after CT103A infusion.
Time Frame
Up to 2 years after CT103A infusion
Title
Median survival (mOS)
Description
The median time from the date of CT103A infusion to the date of death from any reason.
Time Frame
Up to 2 years after CT103A infusion
Title
Event-free survival (EFS)
Description
The time from date of CT103A infusion to the date of death from any reason, relapse, treatment failure, disease progression or initiation of other anti-tumor treatment, whichever comes first;
Time Frame
Up to 2 years after CT103A infusion
Title
Duration of response (DOR)
Description
The time from the first assessment of sCR or CR or VGPR or PR to the first assessment of disease progression or death from any cause;
Time Frame
Up to 2 years after CT103A infusion
Title
Safety endpoint
Description
Incidence of treatment-emergent adverse events (TEAE) and Treatment-related adverse events (TRAE).
Time Frame
Up to 2 years after CT103A infusion
Title
Pharmacokinetic(PK) endpoint
Description
The maximum CT103A concentration and the copy number of the lentiviral vector (vector copy number, VCN) in peripheral blood (Cmax)
Time Frame
Up to 90 days after CT103A infusion
Title
PK endpoint - Tmax
Description
The time to reach the maximum concentration (Tmax)
Time Frame
Up to 90 days after CT103A infusion
Title
PK endpoint - AUC 0 to 28d and AUC 0 to 90d
Description
The area under the concentration time curve from time zero to day 28 (AUC0-28d) and from time zero to day 90 (AUC0-90d)
Time Frame
Up to 90 days after CT103A infusion
Title
Levels of Soluable BCMA
Description
The levels of soluble BCMA in peripheral blood at each time point.
Time Frame
Up to 90 days after CT103A infusion
Title
PD endpoint
Description
The levels of cytokines (IL-6, serum ferritin, etc.) in peripheral blood at each time point
Time Frame
Up to 90 days after CT103A 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: 18 to 70 years old, male or female; Newly diagnosed as high-risk multiple myeloma: Revised Multiple Myeloma International Staging System (R-ISS) stage 3; Double-hit or triple-hit according to FISH test. Presence of measurable lesions during screening according to any of the following criteria: The proportion of primitive naive or monoclonal plasma cells ≥ 5% by bone marrow cytology, bone marrow biopsy histology or flow cytometry; Serum monoclonal protein (M-protein) level: M protein ≥10 g/L for IgG type, M protein ≥5g/L for IgA, IgD, IgM, and IgE type; Urine M protein level ≥200 mg/24 hours; Light chain multiple myeloma without measurable lesions in serum or urine: the affected serum free light chain ≥100 mg/L with abnormal serum κ/λ free light chain ratio; ECOG score of 0 or 1; Expected survival time ≥ 12 weeks; Subjects must have appropriate organ functions and meet all the following laboratory test requirements before enrollment: Hematology: Absolute neutrophil count (ANC) ≥ 1×10^9/L (prior growth factor support is allowed, but supportive treatment within 7 days before laboratory test is not allowed); Absolute lymphocyte count (ALC) )≥0.3×10^9/L; platelets≥75×10^9/L (blood transfusion support within 7 days before laboratory test is not allowed); hemoglobin ≥60 g/L (without red blood cell [RBC] transfusion within 7 days before laboratory test; recombinant human erythropoietin is allowed); Liver function: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)≤2.5×upper limit of normal (ULN); serum total bilirubin≤1.5×ULN; Renal function: creatinine clearance calculated according to Cockcroft-Gault formula≥ 40 ml/min. Coagulation function: fibrinogen ≥1.0 g/L; activated partial thromboplastin time≤1.5×ULN, prothrombin time (PT)≤1.5×ULN; Blood oxygen saturation>91%; Left ventricular ejection fraction (LVEF) ≥50%; Subjects and their spouses agree to take effective tools or contraceptive measures (safe period contraception is not included) from the time the subject signs the informed consent form until one year after the CAR-T cell infusion. Exclusion Criteria: Patient who needs chronic use of immunosuppressive agents; Patient with hypertension that cannot be controlled by medication; 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; Unstable systemic diseases judged by the investigator: including but not limited to severe liver, kidney or metabolic diseases that require drug treatment; Patients with malignant tumors other than multiple myeloma within 5 years before screening, excluding fully treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after radical resection, and those after radical resection Ductal carcinoma in situ of breast; Patient with a history of solid organ transplantation; Patient who is suspected with or with symptoms of central nervous system invasion by plasma cell tumors; Multiple myeloma patients with plasma cell leukemia; Positive hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and detectable hepatitis B virus (HBV) DNA in peripheral blood; hepatitis C virus (HCV) antibody positive and peripheral blood hepatitis C virus ( HCV) RNA positive; human immunodeficiency virus (HIV) antibody positive; cytomegalovirus (CMV) DNA test positive; syphilis test positive; Women who are pregnant or breastfeeding; Patient with mental illness or disturbance of consciousness or central nervous system disease; Major surgery history within 2 weeks before entering the study, or scheduled surgery during the study period or within 2 weeks after the study treatment; Other situations considered unsuitable by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lijuan Chen, M.D.
Phone
025-68306091
Email
chenljb@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lijuan Chen, M.D.
Organizational Affiliation
The First Affiliated Hospital with Nanjing Medical University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Bing Chen, M.D.
Organizational Affiliation
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Official's Role
Principal Investigator
Facility Information:
Facility Name
Anhui Provincial Cancer Hospital
City
Hefei
State/Province
Anhui
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kaiyang Ding, M.D.
Phone
13966672170
Email
dingkaiy@126.com
Facility Name
The First People's Hospital of Changzhou
City
Changzhou
State/Province
Jiangsu
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Weiying Gu, M.D.
Phone
0519-68871092
Email
guweiying2001@163.com
Facility Name
Jiangsu Province Hospital
City
Nanjing
State/Province
Jiangsu
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lijuan Chen, M.D.
Phone
025-68306091
Email
chenljb@126.com
Facility Name
Nanjing Drum Tower Hospital
City
Nanjing
State/Province
Jiangsu
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bing Chen, M.D.
Phone
025-83106666
Email
chenbing2004@126.com

12. IPD Sharing Statement

Learn more about this trial

A Study of Fully Human BCMA CAR-T (CT103A) in Patients With Newly Diagnosed High-risk Multiple Myeloma (FUMANBA-2)

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