To Evaluate the Safety and Tolerability of Human CD19-CD22 Targeted T Cells Injection for Subjects With R/R B-ALL.
Primary Purpose
Acute Lymphoblastic Leukemia
Status
Not yet recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Human CD19-CD22 Targeted T Cells Injection
Sponsored by
About this trial
This is an interventional treatment trial for Acute Lymphoblastic Leukemia focused on measuring Acute Lymphoblastic Leukemia, CD19-CD22, CAR-T, relapsed/refractory
Eligibility Criteria
Inclusion Criteria:
Subjects with Relapsed/Refractory B-cell Acute Lymphoblastic Leukemia:
- 18~70 years old (including cut-off value), male and female;
- Expected survival > 12 weeks;
- ECOG score 0-1;
Bone marrow examination clearly diagnosed as B-cell acute lymphoblastic leukemia , CD19 or/and CD22 positive , and who met one of the following conditions:
- Those who failed to achieve CR after at least 2 courses of standard chemotherapy or had early relapse after complete remission (<12 months) or late relapse after complete remission (≥ 12 months) and failed to achieve CR after 1 course of standard chemotherapy;
- For Ph+ ALL: in addition to receiving at least 2 courses of standard chemotherapy, at least two TKIs should be treated with no complete remission or relapse after complete remission; (Patients who cannot tolerate TKI therapy or have TKI treatment contraindications or have T315i mutation are excluded);
- Those who relapse after stem cell transplantation are not affected by previous treatments;
- The venous access required for collection can be established and mononuclear cell collection can be determined by the investigators;
Liver, kidney and cardiopulmonary functions meet the following requirements:
- Serum creatinine≤1.5×ULN;
- Left ventricular ejection fraction>50%;
- Baseline blood oxygen saturation>96%;
- Total bilirubin≤2×ULN; ALT and AST≤3×ULN (As judged by the investigator, the elevation of transaminase caused by the ALL disease itself, ALT and AST≤5×ULN);
- Able to understand and sign the Informed Consent Document.
Exclusion Criteria:
Any one of the following conditions cannot be selected as a subject:
- Graft-versus-host disease (GVHD), or need to use immunosuppressants after transplantation;
- Patients with hyperleukocytosis (white blood cell count ≥50×10^9/L) or whose disease progressed rapidly according to the investigator's judgment at the time of enrollment and cannot ensure the completion of a complete treatment cycle;
- Malignant tumors other than acute lymphoblastic leukemia within 5 years prior to screening, in addition to adequately treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, localized prostate cancer after radical resection, ductal carcinoma in situ after radical resection and thyroid cancer after radical resection ;
- Subjects with positive HBsAg or HBcAb and peripheral blood HBV DNA titer detection higher than the lower limit of the research center can detect; HCV antibody positive and peripheral blood HCV RNA positive; HIV antibody positive; syphilis positive;
- Any instability of systemic disease, including but not limited to unstable angina, cerebrovascular accident, or transient cerebral ischemic (within 6 months prior to screening), myocardial infarction (within 6 months prior to screening), congestive heart failure (New York heart association (NYHA) classification ≥ III), need drug therapy of severe arrhythmia, liver, kidney, or metabolic disease;
- Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment;
- Pregnant or lactating woman, and female subject who plans to have a pregnancy within 1 year after cell transfusion, or male subject whose partner plans to have a pregnancy within 1 year after cell transfusion;
- Received CAR-T treatment or other gene therapies before enrollment;
- Patients with symptoms of central nervous system;
- Subjects who are receiving systemic steroid treatment and requiring long-term systemic steroid treatment during the treatment as determined by the investigator before screening (except inhalation or topical use);
- The investigators consider other conditions unsuitable for enrollment.
Sites / Locations
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Human CD19-CD22 Targeted T Cells Injection
Arm Description
Single administration:1.0×10^6 CAR+T, 3.0×10^6 CAR+T,6.0×10^6 CAR+T
Outcomes
Primary Outcome Measures
Dose limited toxicity(DLT)
Safety indicators
Secondary Outcome Measures
Adverse events;
Safety indicators
Pharmacokinetic parameters: the highest concentration of anti-human CD19-CD22 T cells amplified in peripheral blood after reinfusion;
Effectiveness Metrics
Pharmacokinetic parameters: the time to reach the highest concentration of anti-human CD19-CD22 T cells amplified in peripheral blood after reinfusion;
Effectiveness Metrics
Pharmacokinetic parameters: the 28-day area under the curve of anti-human CD19-CD22 T cells amplified in peripheral blood after reinfusion;
Effectiveness Metrics
Pharmacodynamic parameters: the detection counts of CD19 or CD22 positive B cells in peripheral blood;
Effectiveness Metrics
Pharmacodynamicparameters: the detection values of IL-6, CRP, and IL-15 cytokines in peripheral blood;
Effectiveness Metrics
Overall response rate (ORR) after administration
Effectiveness Metrics
Duration of remission (DOR) after administration
Effectiveness Metrics
Progress Free Survival (PFS) after administration
Effectiveness Metrics
Overall Survival (OS) after administration
Effectiveness Metrics
The immunogenicity of Human CD19-CD22 Targeted T Cells Injection. (the detection of human anti-mouse antibody)
Safety indicators
Full Information
NCT ID
NCT05223686
First Posted
January 10, 2022
Last Updated
January 24, 2022
Sponsor
Hrain Biotechnology Co., Ltd.
Collaborators
Ruijin Hospital
1. Study Identification
Unique Protocol Identification Number
NCT05223686
Brief Title
To Evaluate the Safety and Tolerability of Human CD19-CD22 Targeted T Cells Injection for Subjects With R/R B-ALL.
Official Title
A Phase I Clinical Study To Evaluate the Safety and Tolerability of Human CD19-CD22 Targeted T Cells Injection for In Subjects With Relapsed/Refractory B-cell Acute Lymphoblastic Leukemia.
Study Type
Interventional
2. Study Status
Record Verification Date
January 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
February 10, 2022 (Anticipated)
Primary Completion Date
June 10, 2023 (Anticipated)
Study Completion Date
March 10, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hrain Biotechnology Co., Ltd.
Collaborators
Ruijin Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
To evaluate the safety and tolerability of Human CD19-CD22 Targeted T Cells Injection for the treatment of Relapsed/Refractory B-cell Acute Lymphoblastic Leukemia. Patients will be given a conditioning chemotherapy regimen of fludarabine and cyclophosphamide followed by a single infusion of CD19-CD22 CAR+ T cells.
Detailed Description
This is a single-arm, open-label, dose-escalation phase I clinical study to explore the safety, tolerability and pharmacokinetic characteristics of Human CD19-CD22 Targeted T Cells Injection. To preliminary observe the effect of Human CD19-CD22 Targeted T Cells Injection in relapsed/refractory B-cell acute lymphoblastic leukemia, and to explore the clinically applicable dose and reinfusion regimen for phase II.
Participants with relapsed/refractory B-cell Acute Lymphoblastic Leukemia can participate if all eligibility criteria are met. Tests required to determine eligibility include disease assessments, a physical exam, Electrocardiograph, Computedtomography (CT)/ Magnetic Resonance Imaging(MRI) / Positron Emission Tomography(PET), and blood draws. Participants receive chemotherapy prior to the infusion of CD19-CD22 CAR+ T cells. After the infusion, participants will be followed for side effects and effect of CD19-CD22 CAR+ T cells. Study procedures may be performed while hospitalized.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Lymphoblastic Leukemia
Keywords
Acute Lymphoblastic Leukemia, CD19-CD22, CAR-T, relapsed/refractory
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Human CD19-CD22 Targeted T Cells Injection
Arm Type
Experimental
Arm Description
Single administration:1.0×10^6 CAR+T, 3.0×10^6 CAR+T,6.0×10^6 CAR+T
Intervention Type
Drug
Intervention Name(s)
Human CD19-CD22 Targeted T Cells Injection
Other Intervention Name(s)
CD19-CD22 CAR-T
Intervention Description
One time single predetermined dose level CAR-positive T cells will be utilized based on the NMPA approved product label.
Primary Outcome Measure Information:
Title
Dose limited toxicity(DLT)
Description
Safety indicators
Time Frame
28 days post infusion
Secondary Outcome Measure Information:
Title
Adverse events;
Description
Safety indicators
Time Frame
28 days post infusion
Title
Pharmacokinetic parameters: the highest concentration of anti-human CD19-CD22 T cells amplified in peripheral blood after reinfusion;
Description
Effectiveness Metrics
Time Frame
2 years post infusion(the last subject will be followed up to 15 years after infusion)
Title
Pharmacokinetic parameters: the time to reach the highest concentration of anti-human CD19-CD22 T cells amplified in peripheral blood after reinfusion;
Description
Effectiveness Metrics
Time Frame
2 years post infusion(the last subject will be followed up to 15 years after infusion)
Title
Pharmacokinetic parameters: the 28-day area under the curve of anti-human CD19-CD22 T cells amplified in peripheral blood after reinfusion;
Description
Effectiveness Metrics
Time Frame
2 years post infusion(the last subject will be followed up to 15 years after infusion)
Title
Pharmacodynamic parameters: the detection counts of CD19 or CD22 positive B cells in peripheral blood;
Description
Effectiveness Metrics
Time Frame
2 years post infusion(the last subject will be followed up to 15 years after infusion)
Title
Pharmacodynamicparameters: the detection values of IL-6, CRP, and IL-15 cytokines in peripheral blood;
Description
Effectiveness Metrics
Time Frame
2 years post infusion(the last subject will be followed up to 15 years after infusion)
Title
Overall response rate (ORR) after administration
Description
Effectiveness Metrics
Time Frame
3 months post infusion
Title
Duration of remission (DOR) after administration
Description
Effectiveness Metrics
Time Frame
2 years post infusion(the last subject will be followed up to 15 years after infusion)
Title
Progress Free Survival (PFS) after administration
Description
Effectiveness Metrics
Time Frame
2 years post infusion(the last subject will be followed up to 15 years after infusion)
Title
Overall Survival (OS) after administration
Description
Effectiveness Metrics
Time Frame
2 years post infusion(the last subject will be followed up to 15 years after infusion)
Title
The immunogenicity of Human CD19-CD22 Targeted T Cells Injection. (the detection of human anti-mouse antibody)
Description
Safety indicators
Time Frame
2 years post infusion(the last subject will be followed up to 15 years after 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:
Subjects with Relapsed/Refractory B-cell Acute Lymphoblastic Leukemia:
18~70 years old (including cut-off value), male and female;
Expected survival > 12 weeks;
ECOG score 0-1;
Bone marrow examination clearly diagnosed as B-cell acute lymphoblastic leukemia , CD19 or/and CD22 positive , and who met one of the following conditions:
Those who failed to achieve CR after at least 2 courses of standard chemotherapy or had early relapse after complete remission (<12 months) or late relapse after complete remission (≥ 12 months) and failed to achieve CR after 1 course of standard chemotherapy;
For Ph+ ALL: in addition to receiving at least 2 courses of standard chemotherapy, at least two TKIs should be treated with no complete remission or relapse after complete remission; (Patients who cannot tolerate TKI therapy or have TKI treatment contraindications or have T315i mutation are excluded);
Those who relapse after stem cell transplantation are not affected by previous treatments;
The venous access required for collection can be established and mononuclear cell collection can be determined by the investigators;
Liver, kidney and cardiopulmonary functions meet the following requirements:
Serum creatinine≤1.5×ULN;
Left ventricular ejection fraction>50%;
Baseline blood oxygen saturation>96%;
Total bilirubin≤2×ULN; ALT and AST≤3×ULN (As judged by the investigator, the elevation of transaminase caused by the ALL disease itself, ALT and AST≤5×ULN);
Able to understand and sign the Informed Consent Document.
Exclusion Criteria:
Any one of the following conditions cannot be selected as a subject:
Graft-versus-host disease (GVHD), or need to use immunosuppressants after transplantation;
Patients with hyperleukocytosis (white blood cell count ≥50×10^9/L) or whose disease progressed rapidly according to the investigator's judgment at the time of enrollment and cannot ensure the completion of a complete treatment cycle;
Malignant tumors other than acute lymphoblastic leukemia within 5 years prior to screening, in addition to adequately treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, localized prostate cancer after radical resection, ductal carcinoma in situ after radical resection and thyroid cancer after radical resection ;
Subjects with positive HBsAg or HBcAb and peripheral blood HBV DNA titer detection higher than the lower limit of the research center can detect; HCV antibody positive and peripheral blood HCV RNA positive; HIV antibody positive; syphilis positive;
Any instability of systemic disease, including but not limited to unstable angina, cerebrovascular accident, or transient cerebral ischemic (within 6 months prior to screening), myocardial infarction (within 6 months prior to screening), congestive heart failure (New York heart association (NYHA) classification ≥ III), need drug therapy of severe arrhythmia, liver, kidney, or metabolic disease;
Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment;
Pregnant or lactating woman, and female subject who plans to have a pregnancy within 1 year after cell transfusion, or male subject whose partner plans to have a pregnancy within 1 year after cell transfusion;
Received CAR-T treatment or other gene therapies before enrollment;
Patients with symptoms of central nervous system;
Subjects who are receiving systemic steroid treatment and requiring long-term systemic steroid treatment during the treatment as determined by the investigator before screening (except inhalation or topical use);
The investigators consider other conditions unsuitable for enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xuedong Sun, Doctor
Phone
+8615811287219
Email
sunxuedong@dashengbio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jianqing Mi, Doctor
Organizational Affiliation
Ruijin Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200025
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jianqing Mi, Doctor
Phone
+8613524488296
Email
jianqingmi@shsmu.edu.cn
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
To Evaluate the Safety and Tolerability of Human CD19-CD22 Targeted T Cells Injection for Subjects With R/R B-ALL.
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