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Human CD19 Targeted T Cells Injection(CD19 CAR-T) Therapy for Relapsed and Refractory B-cell Non-Hodgkin's Lymphoma

Primary Purpose

B-cell Non-Hodgkin's Lymphoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Human CD19Targeted T Cells Injection
Sponsored by
Hrain 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 focused on measuring B-cell non-Hodgkin's Lymphoma, CD19, CAR-T, Relapsed/Refractory

Eligibility Criteria

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

Inclusion Criteria:Subjects with relapsed/refractory B-cell non-Hodgkin's lymphoma

  • Age≥18 years old,gender is not limited;
  • Expected survival > 12 weeks;
  • ECOG score 0-2;
  • B-cell non-Hodgkin's lymphoma confirmed by cytology or histopathology according to the 2016 World Health Organization (WHO) classification and diagnostic criteria, including: diffuse large B-cell lymphoma (DLBCL), primary mediastinal large B-cell lymphoma (PMBCL), transformed filter Alveolar lymphoma (TFL) and high-grade B-cell lymphoma (HGBCL);
  • Pathology demonstrated that B-cell non-Hodgkin's lymphoma and who meet one of the following conditions:

    1. Relapsed and refractory B-cell non-Hodgkin's lymphoma, after standard first-line treatment and at least 2 courses of second-line treatment without remission and relapse (the previous use of CD20-targeted drugs and anthracyclines were needed);
    2. Relapse of B-cell non-Hodgkin lymphoma after stem cell transplantation, regardless of previous treatments.
  • The venous access required for collection can be established and leukepheresis can be carried according to the judgement of investigators, satisfying hemoglobin≥80g/L, neutrophils ≥1.0×10^9/L, platelets ≥75×10^9 / L;
  • According to the Lugano 2014 criteria, there should be at least one measurable tumor lesion;
  • Liver, kidney and cardiopulmonary functions meet the following requirements:

    1. Serum creatinine≤1.5×ULN or creatinine clearance rate≥50mL/min (GockcroftGault formula);
    2. Cardiac ejection fraction >50%, no clinically significant pericardial effusion detected, no clinically significant pleural effusion detected;
    3. Baseline blood oxygen saturation>92%;
    4. Total bilirubin≤1.5×ULN(Gilbert syndrome≤5×ULN);
    5. ALT and AST≤3×ULN (AST and ALT ≤5×ULN in patients with liver metastases);
  • Able to understand and sign the Informed Consent Document.

Exclusion Criteria:Any one of the following conditions cannot be selected as a subject:

  • Malignant tumors other than diffuse large B-cell lymphoma (DLBCL), primary mediastinal large B-cell lymphoma (PMBCL), transformed follicular lymphoma (TFL), and high-grade B-cell lymphoma (HGBCL) 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 Hepatitis B surface antigen(HBsAg) or Hepatitis B core antibody (HBcAb) and positive peripheral blood hepatitis B virus (HBV) DNA titers (higher than the upper limit of the normal range of the investigative site); Hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; Human Immunodeficiency Viral (HIV) antibody positive; syphilis positive;
  • Any uncontrolled systemic diseases, including but not limited to active infection (except for localized infection), uncontrolled 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;
  • Any other uncontrolled active disease that precludes participation in the trial;
  • Any circumstances that the investigator believes will compromise the safety of the subject or interfere with the purpose of the study;
  • Pregnant or lactating woman, or planned pregnancy during treatment or within 1 year after treatment, or male subject whose partner plans to have a pregnancy within 1 year after cell transfusion;
  • Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment (except uncomplicated urinary tract infection or upper respiratory tract infection);
  • Subjects who were receiving systemic steroid treatment within 14 days before enrollment and who were judged by the investigator to require long-term use of systemic steroid therapy during treatment (except inhalation or topical use); or subjects who received any systemic anti-tumor therapy ( except for local anti-tumor therapy) ;
  • Subjects who have received CAR-T treatment or other gene-modified cell therapy before enrollment;
  • Patients with symptoms of central nervous system or brain metastasis or have received treatment for central nervous system or brain metastasis (radiotherapy, surgery or other treatment) within 3 months before enrollment;
  • Subjects who have a disease that affects the signing of written informed consent or who are unable to comply with research procedures; or who are unwilling or unable to comply with research requirements;
  • Subjects who are considered unsuitable to participate in this trial by the investigator.

Sites / Locations

  • Zhongshan Hospital, Fudan UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Human CD19 Targeted T Cells Injection

Arm Description

Single administration:2.0×10^6 CAR+T/kg

Outcomes

Primary Outcome Measures

Overall response rate (ORR) at 3 months post infusion
ORR is defined as proportion of subjects who achieved Partial remission(PR) or better at 3 months (D90±7) post infusion as assessed by an independent review committee (IRC) based on Lugano 2014 criteria.

Secondary Outcome Measures

Duration of remission (DOR) after administration
DOR refers to the time from the first assessment of complete response or partial response to the first assessment of disease progression or death from any cause.
Progression-free Survival (PFS) after administration
PFS refers to the time from the start of cell infusion to the first assessment of tumor progression or death from any cause.
Overall Survival (OS) after administration
OS refers to the time from cell infusion to death due to any cause.
Disease control rate (DCR)
The best overall response is the ratio of partial response(PR) or complete response(CR) or stable disease(SD) patients to the total number of cases.
Safety evaluation
The occurrence and outcome of adverse events evaluated by physical examination, laboratory examination, electrocardiogram, imaging scan, etc.
Pharmacokinetic (PK) parameters: Maximum CAR level inperipheral blood
The highest concentration of Human CD19 Targeted T Cells Injection amplified in peripheral blood after infusion (Cmax) .
Pharmacokinetics(PK) parameters: Time to peak CAR level in blood (Tmax)
The time to reach the highest concentration of Human CD19 Targeted T Cells Injection in peripheral blood after infusion (Tmax) .
Pharmacokinetics(PK) parameters: 28-day Area under the curve of the CAR level in blood(AUC0-28)
The 28-day area under the curve of Human CD19 Targeted T Cells Injection in peripheral blood after infusion(AUC0-28d).
Pharmacodynamic (PD) parameters
The clearance degree of CD19 positive B cells in peripheral blood at respective time point.

Full Information

First Posted
June 23, 2022
Last Updated
June 29, 2022
Sponsor
Hrain Biotechnology Co., Ltd.
Collaborators
Shanghai Zhongshan Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05436223
Brief Title
Human CD19 Targeted T Cells Injection(CD19 CAR-T) Therapy for Relapsed and Refractory B-cell Non-Hodgkin's Lymphoma
Official Title
A Phase Ⅱ Clinical Study Evaluating the Efficacy and Safety of Human CD19 Targeted T Cells Injection (CD19 CAR-T) Therapy for Relapsed and Refractory B-cell Non-Hodgkin's Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 9, 2021 (Actual)
Primary Completion Date
August 9, 2024 (Anticipated)
Study Completion Date
August 9, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hrain Biotechnology Co., Ltd.
Collaborators
Shanghai Zhongshan 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
A Phase Ⅱ Clinical Study Evaluating the Efficacy and Safety of Human CD19 Targeted T Cells Injection (CD19 CAR-T) Therapy for R/R B-NHL. Patients will be given a conditioning chemotherapy regimen of fludarabine and cyclophosphamide followed by a single infusion of CD19 CAR+ T cells.
Detailed Description
Subjects with relapsed and refractory B-cell non-Hodgkin's lymphoma would be selected if subjects meet all criteria evaluated by physical exams, blood tests, electrocardiograph, computedtomography (CT)/magnetic resonance Imaging(MRI)/positron emission tomography(PET), tumor assessments, etc. Subjects would be hospitalized to receive the infusion of CD19 CAR+ T cells after lymphodepleting regimen, with the observation and evaluation of efficacy and safety.

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
Keywords
B-cell non-Hodgkin's Lymphoma, CD19, CAR-T, Relapsed/Refractory

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Human CD19 Targeted T Cells Injection
Arm Type
Experimental
Arm Description
Single administration:2.0×10^6 CAR+T/kg
Intervention Type
Drug
Intervention Name(s)
Human CD19Targeted T Cells Injection
Other Intervention Name(s)
CD19 CAR-T
Intervention Description
A single dose of predetermined level CAR-positive T cells will be infused.
Primary Outcome Measure Information:
Title
Overall response rate (ORR) at 3 months post infusion
Description
ORR is defined as proportion of subjects who achieved Partial remission(PR) or better at 3 months (D90±7) post infusion as assessed by an independent review committee (IRC) based on Lugano 2014 criteria.
Time Frame
3 months post infusion
Secondary Outcome Measure Information:
Title
Duration of remission (DOR) after administration
Description
DOR refers to the time from the first assessment of complete response or partial response to the first assessment of disease progression or death from any cause.
Time Frame
2 years post infusion
Title
Progression-free Survival (PFS) after administration
Description
PFS refers to the time from the start of cell infusion to the first assessment of tumor progression or death from any cause.
Time Frame
2 years post infusion
Title
Overall Survival (OS) after administration
Description
OS refers to the time from cell infusion to death due to any cause.
Time Frame
2 years post infusion
Title
Disease control rate (DCR)
Description
The best overall response is the ratio of partial response(PR) or complete response(CR) or stable disease(SD) patients to the total number of cases.
Time Frame
2 years post infusion
Title
Safety evaluation
Description
The occurrence and outcome of adverse events evaluated by physical examination, laboratory examination, electrocardiogram, imaging scan, etc.
Time Frame
2 years post infusion
Title
Pharmacokinetic (PK) parameters: Maximum CAR level inperipheral blood
Description
The highest concentration of Human CD19 Targeted T Cells Injection amplified in peripheral blood after infusion (Cmax) .
Time Frame
2 years post infusion
Title
Pharmacokinetics(PK) parameters: Time to peak CAR level in blood (Tmax)
Description
The time to reach the highest concentration of Human CD19 Targeted T Cells Injection in peripheral blood after infusion (Tmax) .
Time Frame
2 years post infusion
Title
Pharmacokinetics(PK) parameters: 28-day Area under the curve of the CAR level in blood(AUC0-28)
Description
The 28-day area under the curve of Human CD19 Targeted T Cells Injection in peripheral blood after infusion(AUC0-28d).
Time Frame
2 years post infusion
Title
Pharmacodynamic (PD) parameters
Description
The clearance degree of CD19 positive B cells in peripheral blood at respective time point.
Time Frame
2 years post infusion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:Subjects with relapsed/refractory B-cell non-Hodgkin's lymphoma Age≥18 years old,gender is not limited; Expected survival > 12 weeks; ECOG score 0-2; B-cell non-Hodgkin's lymphoma confirmed by cytology or histopathology according to the 2016 World Health Organization (WHO) classification and diagnostic criteria, including: diffuse large B-cell lymphoma (DLBCL), primary mediastinal large B-cell lymphoma (PMBCL), transformed filter Alveolar lymphoma (TFL) and high-grade B-cell lymphoma (HGBCL); Pathology demonstrated that B-cell non-Hodgkin's lymphoma and who meet one of the following conditions: Relapsed and refractory B-cell non-Hodgkin's lymphoma, after standard first-line treatment and at least 2 courses of second-line treatment without remission and relapse (the previous use of CD20-targeted drugs and anthracyclines were needed); Relapse of B-cell non-Hodgkin lymphoma after stem cell transplantation, regardless of previous treatments. The venous access required for collection can be established and leukepheresis can be carried according to the judgement of investigators, satisfying hemoglobin≥80g/L, neutrophils ≥1.0×10^9/L, platelets ≥75×10^9 / L; According to the Lugano 2014 criteria, there should be at least one measurable tumor lesion; Liver, kidney and cardiopulmonary functions meet the following requirements: Serum creatinine≤1.5×ULN or creatinine clearance rate≥50mL/min (GockcroftGault formula); Cardiac ejection fraction >50%, no clinically significant pericardial effusion detected, no clinically significant pleural effusion detected; Baseline blood oxygen saturation>92%; Total bilirubin≤1.5×ULN(Gilbert syndrome≤5×ULN); ALT and AST≤3×ULN (AST and ALT ≤5×ULN in patients with liver metastases); Able to understand and sign the Informed Consent Document. Exclusion Criteria:Any one of the following conditions cannot be selected as a subject: Malignant tumors other than diffuse large B-cell lymphoma (DLBCL), primary mediastinal large B-cell lymphoma (PMBCL), transformed follicular lymphoma (TFL), and high-grade B-cell lymphoma (HGBCL) 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 Hepatitis B surface antigen(HBsAg) or Hepatitis B core antibody (HBcAb) and positive peripheral blood hepatitis B virus (HBV) DNA titers (higher than the upper limit of the normal range of the investigative site); Hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; Human Immunodeficiency Viral (HIV) antibody positive; syphilis positive; Any uncontrolled systemic diseases, including but not limited to active infection (except for localized infection), uncontrolled 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; Any other uncontrolled active disease that precludes participation in the trial; Any circumstances that the investigator believes will compromise the safety of the subject or interfere with the purpose of the study; Pregnant or lactating woman, or planned pregnancy during treatment or within 1 year after treatment, or male subject whose partner plans to have a pregnancy within 1 year after cell transfusion; Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment (except uncomplicated urinary tract infection or upper respiratory tract infection); Subjects who were receiving systemic steroid treatment within 14 days before enrollment and who were judged by the investigator to require long-term use of systemic steroid therapy during treatment (except inhalation or topical use); or subjects who received any systemic anti-tumor therapy ( except for local anti-tumor therapy) ; Subjects who have received CAR-T treatment or other gene-modified cell therapy before enrollment; Patients with symptoms of central nervous system or brain metastasis or have received treatment for central nervous system or brain metastasis (radiotherapy, surgery or other treatment) within 3 months before enrollment; Subjects who have a disease that affects the signing of written informed consent or who are unable to comply with research procedures; or who are unwilling or unable to comply with research requirements; Subjects who are considered unsuitable to participate in this trial by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xuedong Sun, M.D.
Phone
+8615811287219
Email
sunxuedong@dashengbio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peng Liu, M.D. & Ph.D.
Organizational Affiliation
Shanghai Zhongshan Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Zhongshan Hospital, Fudan University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Peng Liu, M.D. & Ph.D.
Phone
0086-021-60267405
Email
liu.peng@zs-hospital.sh.cn

12. IPD Sharing Statement

Plan to Share IPD
No

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Human CD19 Targeted T Cells Injection(CD19 CAR-T) Therapy for Relapsed and Refractory B-cell Non-Hodgkin's Lymphoma

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