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Exploratory Clinical Study of CD19-targeted CAR-T and CAR-DC in the Treatment of Relapsed and Refractory B-cell Lymphoma

Primary Purpose

Relapsed and Refractory B-cell Lymphoma

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CD19 CAR-T and CD19 CAR-DC
Sponsored by
Second Affiliated Hospital, School of Medicine, Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed and Refractory B-cell Lymphoma

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female participants aged 18 to 75 years old at the time enrollment, with ECOG Score of ≤ 3;
  2. Patients should provide a written informed consent;
  3. Histologically confirmed CD19+ DLBCL, HGBL-DHL, MCL, tFL, PMBL;

    • Confirmation obtained from central pathology review before enrollment;
    • Sufficient formalin-fixed, paraffin-embedded tumor samples were required for histologically confirmed diagnosis and detection of CD19 expression;
    • Relapsed DLBCL and tFL after ≥2 lines of chemotherapy that include rituximab and anthracycline, or refractory disease as defined in the SCHOLAR-1 study: progressive disease after receiving ≥ 4 cycles of first-line therapy or stable disease (received 2 cycles of later-line therapy) as best response to chemotherapy or relapse ≤ 12 months after autologous stem cell transplantation (ASCT);
    • Relapsed/refractory MCL after ≥ 2 lines of prior therapy, including immunochemotheapy and BTK inhibitor such as ibrutinib, or patient did not agree to receive BTK inhibitor treatment;
    • At least one measurable tumor according to revised International Working Group (IWG) Response criteria;
  4. Life expectancy ≥ 3 months;
  5. Adequate cardiac, pulmonary, liver, renal, and bone marrow functions, with the following laboratory values: an absolute neutrophil count > 1,000/mm3, platelets count ≥ 45,000/mm3, and hemoglobin > 8.0g/dl; alanine aminotransferase and aspartate aminotransferase ≤ 2.5 × the upper limit of the normal range (ULN), and total bilirubin ≤ 2.0 mg/dl; a serum creatinine of ≤ 1.5 × ULN; a left ventricular ejection fraction ≥ 50%;

Exclusion Criteria:

  1. Prior treatment that included anti-CD19-targeted therapy, CAR T cell therapy, gene therapy, and allogenic hematopoietic stem cell transplantation (allo-HSCT);
  2. Chemotherapy other than lymphodepleting chemotherapy, therapeutic doses of steroids, immunosuppressive agent, any radiation therapy or anti-tumor targeted therapy including lenalidomide, bortezomib, ibrutinib, received within 2 weeks before cell collection;
  3. Clinical trial with investigational drug was performed within 4 weeks;
  4. History of other cancers;
  5. Active hepatitis B or hepatitis C. Hepatitis B: HBV-DNA ≥ 1,000 IU/ml; Hepatitis C: HCV RNA positive;
  6. HIV infection;
  7. Uncontrollable infection of active bacteria and fungi;
  8. Currently pregnant or refusal to practice birth control within 1 year;
  9. Active autoimmune or inflammatory diseases;
  10. Central nervous system lymphoma.

Sites / Locations

  • 2nd Affiliated Hospital, School of Medicine, Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Combination therapy of CD19 CAR-T and CD19 CAR-DC

Arm Description

6-18 patientsare planned to be enrolled in the dose-escalation trial (0.5×10^6/kg、1×10^6/kg、2×10^6/kg和4×10^6/kg) and 52 patients in the dose-expansion trial.

Outcomes

Primary Outcome Measures

DLT
To evaluate the safety, tolerability, and determine the recommended dosage of combined therapy of CD19 CAR-T and CD19 CAR-DC for Relapsed/Refractory B-cell Non-Hodgkin Lymphoma
MTD
MTD was the highest dose for DLT in ≤1/6 subjects
Incidence of abnormalities
Incidence of abnormalities in AE/SAE/AESI/laboratory tests/electrocardiograms/vital signs.

Secondary Outcome Measures

Overall Response Rate
The proportion of CR or PR patients as assessed by investigators based on Lugano 2014 Response Assessment
Duration of Response
The time from the start of the first assessment of CR or PR to the first assessment as disease recurrence or progression or death
Progression Free Survival
The length of time that a participant's disease did not progress during or after CAR-T treatment.

Full Information

First Posted
October 16, 2022
Last Updated
February 2, 2023
Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT05585996
Brief Title
Exploratory Clinical Study of CD19-targeted CAR-T and CAR-DC in the Treatment of Relapsed and Refractory B-cell Lymphoma
Official Title
Exploratory Clinical Study of CD19-targeted CAR-T and CAR-DC in the Treatment of Relapsed and Refractory B-cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 1, 2022 (Actual)
Primary Completion Date
November 1, 2025 (Anticipated)
Study Completion Date
December 30, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University

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 an open, single-arm, prospective, dose-escalation clinical trial designed to evaluate the safety and the preliminary efficacy of CD19-targeted CAR-T combined with CAR-DC in the treatment of relapsed and refractory B-cell lymphoma
Detailed Description
6-18 patients are planned to be enrolled in the dose-escalation trial. The dose of CD19-CAR-DC was according to the 3+3 dose-escalation principle (0.25×10^6/kg, 0.5×10^6/kg, 0.75×10^6/kg ( ±20%) . CAR-T was 2×10^6/kg . The primary endpoints are DLT, MTD, and the second endpionts are the overall response rates (CR and PR), overall survival, and progression-free survival. Based on the results in the dose-escalation trial, the recommended dose will be determined. Another 52 patients will be enrolled to continue estimating the safety and efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed and Refractory B-cell Lymphoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Combination therapy of CD19 CAR-T and CD19 CAR-DC
Arm Type
Experimental
Arm Description
6-18 patientsare planned to be enrolled in the dose-escalation trial (0.5×10^6/kg、1×10^6/kg、2×10^6/kg和4×10^6/kg) and 52 patients in the dose-expansion trial.
Intervention Type
Biological
Intervention Name(s)
CD19 CAR-T and CD19 CAR-DC
Intervention Description
Intravenously injected CAR DC cells and followed by CAR T cells 4 hours later
Primary Outcome Measure Information:
Title
DLT
Description
To evaluate the safety, tolerability, and determine the recommended dosage of combined therapy of CD19 CAR-T and CD19 CAR-DC for Relapsed/Refractory B-cell Non-Hodgkin Lymphoma
Time Frame
Up to 28 days
Title
MTD
Description
MTD was the highest dose for DLT in ≤1/6 subjects
Time Frame
Up to 28 days
Title
Incidence of abnormalities
Description
Incidence of abnormalities in AE/SAE/AESI/laboratory tests/electrocardiograms/vital signs.
Time Frame
Up to 28 days
Secondary Outcome Measure Information:
Title
Overall Response Rate
Description
The proportion of CR or PR patients as assessed by investigators based on Lugano 2014 Response Assessment
Time Frame
Up to 2 years
Title
Duration of Response
Description
The time from the start of the first assessment of CR or PR to the first assessment as disease recurrence or progression or death
Time Frame
Up to 2 years
Title
Progression Free Survival
Description
The length of time that a participant's disease did not progress during or after CAR-T treatment.
Time Frame
Up to 2 years

10. Eligibility

Sex
All
Gender Based
Yes
Gender Eligibility Description
18-75 years
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female participants aged 18 to 75 years old at the time enrollment, with ECOG Score of ≤ 3; Patients should provide a written informed consent; Histologically confirmed CD19+ DLBCL, HGBL-DHL, MCL, tFL, PMBL; Confirmation obtained from central pathology review before enrollment; Sufficient formalin-fixed, paraffin-embedded tumor samples were required for histologically confirmed diagnosis and detection of CD19 expression; Relapsed DLBCL and tFL after ≥2 lines of chemotherapy that include rituximab and anthracycline, or refractory disease as defined in the SCHOLAR-1 study: progressive disease after receiving ≥ 4 cycles of first-line therapy or stable disease (received 2 cycles of later-line therapy) as best response to chemotherapy or relapse ≤ 12 months after autologous stem cell transplantation (ASCT); Relapsed/refractory MCL after ≥ 2 lines of prior therapy, including immunochemotheapy and BTK inhibitor such as ibrutinib, or patient did not agree to receive BTK inhibitor treatment; At least one measurable tumor according to revised International Working Group (IWG) Response criteria; Life expectancy ≥ 3 months; Adequate cardiac, pulmonary, liver, renal, and bone marrow functions, with the following laboratory values: an absolute neutrophil count > 1,000/mm3, platelets count ≥ 45,000/mm3, and hemoglobin > 8.0g/dl; alanine aminotransferase and aspartate aminotransferase ≤ 2.5 × the upper limit of the normal range (ULN), and total bilirubin ≤ 2.0 mg/dl; a serum creatinine of ≤ 1.5 × ULN; a left ventricular ejection fraction ≥ 50%; Exclusion Criteria: Prior treatment that included anti-CD19-targeted therapy, CAR T cell therapy, gene therapy, and allogenic hematopoietic stem cell transplantation (allo-HSCT); Chemotherapy other than lymphodepleting chemotherapy, therapeutic doses of steroids, immunosuppressive agent, any radiation therapy or anti-tumor targeted therapy including lenalidomide, bortezomib, ibrutinib, received within 2 weeks before cell collection; Clinical trial with investigational drug was performed within 4 weeks; History of other cancers; Active hepatitis B or hepatitis C. Hepatitis B: HBV-DNA ≥ 1,000 IU/ml; Hepatitis C: HCV RNA positive; HIV infection; Uncontrollable infection of active bacteria and fungi; Currently pregnant or refusal to practice birth control within 1 year; Active autoimmune or inflammatory diseases; Central nervous system lymphoma.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wenbin Qian, PhD
Phone
13605801032
Email
qianwb@zju.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Wen Lei, PhD
Phone
18258448016
Email
leiwen2017@zju.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wenbin Qian, MD, PhD
Organizational Affiliation
2nd Affiliated Hospital, School of Medicine, Zhejiang Universit
Official's Role
Principal Investigator
Facility Information:
Facility Name
2nd Affiliated Hospital, School of Medicine, Zhejiang University
City
Hanzhou
State/Province
Zhejiang
ZIP/Postal Code
310009
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wenbin Qian, PhD
Phone
+8613605801032
Email
qianwb@zju.edu.cn
First Name & Middle Initial & Last Name & Degree
Hui Liu, PhD
Phone
13819198629
Email
sylen@zju.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Exploratory Clinical Study of CD19-targeted CAR-T and CAR-DC in the Treatment of Relapsed and Refractory B-cell Lymphoma

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