Anti-CD19 Universal CAR-T Cells for r/r CD19+ B-ALL
Primary Purpose
B-cell Acute Lymphoblastic Leukemia, B-ALL
Status
Withdrawn
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
U-CAR-T Cells (LstCAR019)
Sponsored by
About this trial
This is an interventional treatment trial for B-cell Acute Lymphoblastic Leukemia focused on measuring universal CAR-T, CD19
Eligibility Criteria
Inclusion Criteria:
- Male or female, aged 2-75 years;
- A definite diagnosis of relapsed/refractory B-ALL and a percentage of primitive/naive lymphocytes >5% in bone marrow at baseline (flow cytometry);
- CD19 expression was positive in bone marrow or peripheral blood tumor cells;
- ECOG score 0-2 points;
- Expected survival time ≥3 months;
- Adequate liver, kidney, heart and lung function;
- Patients who have recovered from acute toxic effects of prior chemotherapy should be excluded from the trial at least one week apart;
- Women of childbearing age have negative blood pregnancy test before the start of the trial, and agree to take effective contraceptive measures during the trial until the last follow-up; male subjects with partners of childbearing potential agree to take effective contraceptive measures during the trial until the last follow-up;
- Voluntarily sign the informed consent.
Exclusion Criteria:
- Presence of other concurrent active malignancy;
- People with severe mental disorders;
- A history of any of the following genetic disorders, such as Fanconi anemia, Schu-Day syndrome, Gerstmann syndrome, or any other known bone marrow failure syndrome;
- Acute GVHD of grade II-IV or extensive chronic GVHD;
- Had grade III-IV heart failure or myocardial infarction, cardiac angioplasty or stenting, unstable angina pectoris, or other clinically prominent heart disease within one year prior to enrollment;
- The presence of any indwelling catheter or drainage (e.g., percutaneous nephrostomy, indwelling catheter, bile drainage, or pleural/peritoneal/pericardial catheter), except for patients who are permitted to use dedicated central venous catheters;
- A history or disease of the central nervous system(CNS), such as seizure disease, cerebrovascular ischemia/bleeding, dementia, cerebellar disease, or any autoimmune disease involving the CNS;
- Human immunodeficiency virus (HIV) seropositivity; Hepatitis B surface antigen positive or hepatitis B core antibody positive, and HBV-DNA positive; Patients with hepatitis C (HCV-RNA quantitative test results positive); Or the presence of other serious active viral or bacterial infections or uncontrolled systemic fungal infections;
- Patients with severe history of allergy or allergic constitution;
- A history of autoimmune diseases (e.g., Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus) leading to end-organ damage or requiring systemic immunosuppressive/systemic disease modulating drugs within the past 2 years;
- Had or is suffering from interstitial lung disease (e.g., pneumonia, pulmonary fibrosis);
- Had undergone other clinical trials in the 4 weeks prior to participating in this trial;
- Poor compliance due to physiological, family, social, geographical and other factors, unable to cooperate with the study protocol and follow-up plan;
- For patients contraindicated with cyclophosphamide and fludarabine chemotherapy;
- Subjects requiring systemic corticosteroid therapy (prednisone ≥5mg/ day or equivalent dose of another corticosteroid) or other immunosuppressive agents within 1 month after LstCAR019 cell reinfusion, except for adverse events;
- Receiving donor lymphocyte infusion within 6 weeks before enrollment;
- Pregnant and lactating women;
- Any other condition that the investigator deemed inappropriate for inclusion.
Sites / Locations
- Kunming Hope of Health Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
U-CAR-T Cells (LstCAR019)
Arm Description
Subjects who meet the enrollment conditions will receive intravenous infusion of U-CAR-T Cells (LstCAR019) after lymphodepletion.
Outcomes
Primary Outcome Measures
Dose-limiting toxicity (DLT)
Neurotoxicity and/or CRS≥G3.
Incidence of Treatment Related adverse events (AEs)
The frequency, severity, and laboratory findings of all adverse events/serious adverse events are included.
Secondary Outcome Measures
Persistence of CAR-T cells
The persistence over time of CAR-T cells in the peripheral blood as determined by flow cytometry and qPCR.
Objective response rate (ORR)
Patients who achieve CR(complete response) or CRi after infusion
Progression-free survival (PFS)
Progression-free survival (PFS) is the time between the time a patient with tumor disease receives treatment and the time between the observation of disease progression or death from any cause.
Overall survival (OS)
Overall survival (OS) is the time from randomization to death from any cause.
Duration of remission (DOR)
Duration of remission (DOR) is the time from the first detection of CR or PR to the discovery of PD.
Full Information
NCT ID
NCT05571540
First Posted
October 4, 2022
Last Updated
November 27, 2022
Sponsor
Kunming Hope of Health Hospital
1. Study Identification
Unique Protocol Identification Number
NCT05571540
Brief Title
Anti-CD19 Universal CAR-T Cells for r/r CD19+ B-ALL
Official Title
An Investigator-initiated Trial to Evaluate the Efficacy and Safety of Anti-CD19 Universal CAR-T Cells in the Treatment of Relapsed/Refractory(r/r) CD19+ B-cell Acute Lymphoblastic Leukemia(B-ALL)
Study Type
Interventional
2. Study Status
Record Verification Date
November 2022
Overall Recruitment Status
Withdrawn
Why Stopped
The PI decides to stop.
Study Start Date
October 1, 2022 (Actual)
Primary Completion Date
January 31, 2024 (Anticipated)
Study Completion Date
October 31, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kunming Hope of Health Hospital
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 is a single-arm, single-center, open-labeled clinical study to evaluate the safety and efficacy of LstCAR019 injection for patients with relapsed/refractory(r/r) B-cell Acute Lymphoblastic Leukemia(B-ALL).
Detailed Description
Although the anti-CD19 CAR-T cell therapies have gained significant clinical outcome in patients with r/r B-ALL,autologous CAR-T is not feasible for some patients. To make further improvement, the investigators are going to conduct a clinical trial using universal CAR-T cells(LstCAR019) targeting CD19 for r/r B-ALL patients.
After enrollment, patients will get a 3-5 days lymphodepletion therapy, then the LstCAR019 will be infused by vein. Subjects will be followed for safety and efficacy up to 12 weeks. For those with a durable remission 12 weeks after infusion, the follow-up will last for at least 12 months for disease control.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
B-cell Acute Lymphoblastic Leukemia, B-ALL
Keywords
universal CAR-T, CD19
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
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
U-CAR-T Cells (LstCAR019)
Arm Type
Experimental
Arm Description
Subjects who meet the enrollment conditions will receive intravenous infusion of U-CAR-T Cells (LstCAR019) after lymphodepletion.
Intervention Type
Biological
Intervention Name(s)
U-CAR-T Cells (LstCAR019)
Intervention Description
LstCAR019 will be administered by vein. The trial includes two portions. The first portion is a"3+3"dose escalation study, in which three dose groups are set:Dose level one: 1×10^6 cells/kg;Dose level two: 2×10^6 cells/kg;Dose level three: 5×10^6 cells/kg. Each dose group requires at least three subjects. The trial will start from dose level one. The second portion includes a dosage extended cohort and will start after the finish of the"3+3"dose escalation study. Twelve subjects will get infusion of LstCAR019 at the best dose verified in the first portion.
Primary Outcome Measure Information:
Title
Dose-limiting toxicity (DLT)
Description
Neurotoxicity and/or CRS≥G3.
Time Frame
Up to 28 days after LstCAR019 infusion
Title
Incidence of Treatment Related adverse events (AEs)
Description
The frequency, severity, and laboratory findings of all adverse events/serious adverse events are included.
Time Frame
Up to 12 months after LstCAR019 infusion
Secondary Outcome Measure Information:
Title
Persistence of CAR-T cells
Description
The persistence over time of CAR-T cells in the peripheral blood as determined by flow cytometry and qPCR.
Time Frame
Up to 24 weeks after infusion
Title
Objective response rate (ORR)
Description
Patients who achieve CR(complete response) or CRi after infusion
Time Frame
At 4 ,8 , 12 weeks after infusion
Title
Progression-free survival (PFS)
Description
Progression-free survival (PFS) is the time between the time a patient with tumor disease receives treatment and the time between the observation of disease progression or death from any cause.
Time Frame
Up to 24 weeks after infusion
Title
Overall survival (OS)
Description
Overall survival (OS) is the time from randomization to death from any cause.
Time Frame
Up to 24 weeks after infusion
Title
Duration of remission (DOR)
Description
Duration of remission (DOR) is the time from the first detection of CR or PR to the discovery of PD.
Time Frame
Up to 24 weeks after infusion
10. Eligibility
Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female, aged 2-75 years;
A definite diagnosis of relapsed/refractory B-ALL and a percentage of primitive/naive lymphocytes >5% in bone marrow at baseline (flow cytometry);
CD19 expression was positive in bone marrow or peripheral blood tumor cells;
ECOG score 0-2 points;
Expected survival time ≥3 months;
Adequate liver, kidney, heart and lung function;
Patients who have recovered from acute toxic effects of prior chemotherapy should be excluded from the trial at least one week apart;
Women of childbearing age have negative blood pregnancy test before the start of the trial, and agree to take effective contraceptive measures during the trial until the last follow-up; male subjects with partners of childbearing potential agree to take effective contraceptive measures during the trial until the last follow-up;
Voluntarily sign the informed consent.
Exclusion Criteria:
Presence of other concurrent active malignancy;
People with severe mental disorders;
A history of any of the following genetic disorders, such as Fanconi anemia, Schu-Day syndrome, Gerstmann syndrome, or any other known bone marrow failure syndrome;
Acute GVHD of grade II-IV or extensive chronic GVHD;
Had grade III-IV heart failure or myocardial infarction, cardiac angioplasty or stenting, unstable angina pectoris, or other clinically prominent heart disease within one year prior to enrollment;
The presence of any indwelling catheter or drainage (e.g., percutaneous nephrostomy, indwelling catheter, bile drainage, or pleural/peritoneal/pericardial catheter), except for patients who are permitted to use dedicated central venous catheters;
A history or disease of the central nervous system(CNS), such as seizure disease, cerebrovascular ischemia/bleeding, dementia, cerebellar disease, or any autoimmune disease involving the CNS;
Human immunodeficiency virus (HIV) seropositivity; Hepatitis B surface antigen positive or hepatitis B core antibody positive, and HBV-DNA positive; Patients with hepatitis C (HCV-RNA quantitative test results positive); Or the presence of other serious active viral or bacterial infections or uncontrolled systemic fungal infections;
Patients with severe history of allergy or allergic constitution;
A history of autoimmune diseases (e.g., Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus) leading to end-organ damage or requiring systemic immunosuppressive/systemic disease modulating drugs within the past 2 years;
Had or is suffering from interstitial lung disease (e.g., pneumonia, pulmonary fibrosis);
Had undergone other clinical trials in the 4 weeks prior to participating in this trial;
Poor compliance due to physiological, family, social, geographical and other factors, unable to cooperate with the study protocol and follow-up plan;
For patients contraindicated with cyclophosphamide and fludarabine chemotherapy;
Subjects requiring systemic corticosteroid therapy (prednisone ≥5mg/ day or equivalent dose of another corticosteroid) or other immunosuppressive agents within 1 month after LstCAR019 cell reinfusion, except for adverse events;
Receiving donor lymphocyte infusion within 6 weeks before enrollment;
Pregnant and lactating women;
Any other condition that the investigator deemed inappropriate for inclusion.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Li Li, MD
Organizational Affiliation
Kunming Hope of Health Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kunming Hope of Health Hospital
City
Kunming
State/Province
Yunnan
ZIP/Postal Code
650000
Country
China
12. IPD Sharing Statement
Learn more about this trial
Anti-CD19 Universal CAR-T Cells for r/r CD19+ B-ALL
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