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Human BCMA Targeted T Cells Injection(BCMA CAR-T)for Subjects With R/R MM

Primary Purpose

Multiple Myeloma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Human BCMA Targeted 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 Multiple Myeloma focused on measuring BCMA, CAR-T, Relapsed/Refractory, Multiple Myeloma

Eligibility Criteria

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

Inclusion Criteria:Subjects must meet all of the following criteria to be enrolled:

  • Subjects volunteer to participate in clinical trails, understand and inform the trials and sign informed consent form, be willing to complete all the trial procedures;
  • 18 to 75 years old (including cut-off value),gender is not limited;
  • Expected survival > 12 weeks;
  • Previously diagnosed as multiple myeloma by the International Myeloma Working Group(IMWG) updated criteria;
  • One of the following indicators is satisfied:

    1. Serum M protein ≥ 5 g/L;
    2. Urine M protein ≥ 200 mg/24h;
    3. Affected serum free light chain ≥ 100 mg/L and Serum free light chain ratio is abnormal ;
  • Patients with relapsed/refractory multiple myeloma, satisfying:

    1. Patients have received at least 3 prior MM treatment regimens containing at least one proteasome inhibitor and one immunomodulator;
    2. Progress is documented within 12 months of the most recent antimyeloma treatment, or efficacy assessment does not reach minimal response(MR) or above or progression within 60 days of the most recent antimyeloma treatment;
  • ECOG score 0-2;
  • Autologous hematopoietic stem cell transplantation is not possible or relapses after autologous hematopoietic stem cell transplantation, but requires further treatment at the investigator's discretion;
  • Liver, kidney and cardiopulmonary functions meet the following requirements:

    1. Creatinine clearance rate (estimated by CockcroftGault formula)≥40mL/min;
    2. Total bilirubin≤2×ULN; Alanine aminotransferase (ALT) ≤2.5×ULN and aspartate aminotransferase (AST)≤2.5×ULN;
    3. Left ventricular ejection fraction >50%;
    4. Baseline peripheral oxygen saturation>95%;
  • The venous access required for collection can be established, no contraindications to leukocyte collection, and leukepheresis can be carried according to the judgement of investigators, satisfying hemoglobin≥70g/L,platelets ≥50×10^9 / L, neutrophils ≥1.0×10^9/L.

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

  • Subjects have a history of central nervous system (CNS) diseases such as seizures, paralysis, aphasia, stroke, severe brain injury, dementia, Parkinson's disease, psychosis; known or history of active central nervous system (CNS) involvement or presentation of multiple myeloma meninge/meningeal involvement;
  • Subjects with plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome, or primary light chain amyloidosis;
  • Accompanied by other uncontrolled malignancies, 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 ;
  • Any uncontrollable active infection, including but not limited to active tuberculosis; fungal, bacterial, viral, or other infections that are uncontrollable or require systemic intravenous therapy are present or suspected within 14 days prior to enrollment;
  • Subjects with positive Hepatitis B surface antigen(HBsAg) or Hepatitis B core antibody (HBcAb) and hepatitis B virus (HBV) DNA titers higher than the lower 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 unstable angina pectoris, 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), uncontrolled diabetes mellitus (glycosylated hemoglobin HbAlc >8% at screening),severe arrhythmia, liver, kidney, or metabolic diseases that are poorly controlled by medications;
  • Subjects who have a history of pacemaker and brain pacemaker implantation;
  • Subjects who have received CAR-T treatment or other genetically modified cell therapies, as well as other BCMA-targeting drugs;
  • Subjects with any hematopoietic stem cell transplant performed within the first two months of screening, or any immunosuppressive therapy due to graft-versus-host disease performed during the screening period;
  • Subjects who were receiving systemic steroid treatment within 14 days before the screening period 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 live attenuated vaccine within 4 weeks prior to apheresis;
  • In the past two years, the terminal organ was damaged due to autoimmune diseases (such as Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus), or the systemic use of immunosuppressive or other systemic disease control drugs was required;
  • 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; except participants of childbearing age are willing to use a very effective and reliable method of contraception for 1 year after study treatment;
  • 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 have had severe immediate hypersensitivity reactions to any drugs used in this research;
  • Subjects who are considered unsuitable to participate in this trial by the investigator.

Sites / Locations

  • Shanghai Changzheng HospitalRecruiting
  • The First Affiliated Hospital of Wenzhou Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Human BCMA Targeted T Cells Injection

Arm Description

Single administration:6.0×10^6 CAR+T/kg

Outcomes

Primary Outcome Measures

Objective Response Rate (ORR) at 3 months post infusion as evaluated by the Independent Review Committee
ORR at 3 months post infusion as evaluated by the Independent Review Committee (IRC) includes stringent complete response (sCR), complete response (CR), very good partial response (VGPR), and partial response (PR).

Secondary Outcome Measures

Duration of remission (DOR) after administration
DOR refers to the time from the first assessment of the tumor for complete response and above efficacy to the first assessment of disease progression or death of 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;
Objective Response Rate (ORR) at 3 months post infusion as evaluated by the Investigator
ORR at 3 months post infusion as evaluated by the Investigator;
Objective Response Rate (ORR) at 6 months post infusion as evaluated by the Independent Review Committee
ORR at 6 months post infusion as evaluated by the Independent Review Committee (IRC);
Percentage of Subjects With Negative Minimal Residual Disease (MRD)
MRD negative rate is defined as the proportion of subjects who achieve MRD negative status;
Duration of Subjects With Negative Minimal Residual Disease (MRD)
MRD duration will calculated among MRD negative responders fom the date of initial MRD negative to the date of first documented evidence of MRD positive, as defined in the International Myeloma Working Group(IMWG) criteria (2016);
Number of Subjects with Adverse Events
Adverse event is any untoward medical event that occurs in a subject administered an investigational drug.
Change from Baseline in Perform Status as Measured by Eastern Cooperative Oncology Group(ECOG)Score(0-2)
Eastern Cooperative Oncology Group(ECOG) Performance Status Score(0-2) will be assessed by the inverstigator at baseline and the respective time point, higher scores mean a worse performance status.
The occurrence rate of adverse events grade ≥ 3 assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0.
Safety Indicators
Change in body weight over time after reinfusion
Safety Indicators
Pharmacokinetic indicators:Maximum CAR level inperipheral blood or bone marrow (Cmax)
The highest concentration of Human BCMA Targeted T Cells Injection amplified in peripheral blood or bone marrow after infusion (Cmax) ;
Pharmacokinetic indicators: Time to peak CAR level in blood or bone marrow (Tmax)
The time to reach the highest concentration of Human BCMA Targeted T Cells Injection in peripheral blood or bone marrow after infusion (Tmax) ;
Pharmacokinetic indicators: 28-day Area under the curve of the CAR level in blood or bone marrow (AUC0-28d)
The 28-day area under the curve of Human BCMA Targeted T Cells Injection in peripheral blood or bone marrow after infusion(AUC0-28d);
Pharmacodynamic indicators: the concentration level of soluble BCMA (sBCMA) in peripheral blood
The concentration level of soluble BCMA (sBCMA) in peripheral blood at various time points after infusion of Human BCMA Targeted T Cells Injection;
Pharmacodynamic indicators: the concentration level of CAR-T cell-related serum cytokines such as C-Reactive Protein(CRP) in peripheral blood;
Effectiveness Metrics
Pharmacodynamic indicators: the concentration level of CAR-T cell-related serum cytokines such as Interleukin-6(IL-6), IL-2, IL-10, Tumor Necrosis Factor (TNF-α),Interferon-γ(IFN-γ)in peripheral blood;
Effectiveness Metrics
Immunogenicity: Anti-drug antibody(ADA) positive ratio
Immunogenicity study evaluated the immune responses to anti-BCMA scFV including the detection of anti-scFV antibodies;
Immunogenicity: Neutralizing Antibody(Nab) positive ratio
Immunogenicity study evaluated the immune responses to anti-BCMA scFV including the detection of neutralizing antibodies (NAbs) against scFV.

Full Information

First Posted
October 18, 2022
Last Updated
December 7, 2022
Sponsor
Hrain Biotechnology Co., Ltd.
Collaborators
Shanghai Changzheng Hospital, First Affiliated Hospital of Wenzhou Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT05594797
Brief Title
Human BCMA Targeted T Cells Injection(BCMA CAR-T)for Subjects With R/R MM
Official Title
A Phase Ⅱ Clinical Study Evaluating the Efficacy and Safety of Human BCMA Targeted T Cells Injection Therapy for Relapsed/Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 12, 2022 (Actual)
Primary Completion Date
July 31, 2025 (Anticipated)
Study Completion Date
July 31, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hrain Biotechnology Co., Ltd.
Collaborators
Shanghai Changzheng Hospital, First Affiliated Hospital of Wenzhou Medical University

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 BCMA Targeted T Cells Injection(BCMA CAR-T) Therapy for R/R MM. Patients will be given a conditioning chemotherapy regimen of fludarabine and cyclophosphamide followed by a single infusion of BCMA CAR+ T cells.
Detailed Description
Participants with relapsed/refractory multiple myeloma 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 BCMA CAR+ T cells. After the infusion, participants will be followed for side effects and effect of BCMA 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
Multiple Myeloma
Keywords
BCMA, CAR-T, Relapsed/Refractory, Multiple Myeloma

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 BCMA Targeted T Cells Injection
Arm Type
Experimental
Arm Description
Single administration:6.0×10^6 CAR+T/kg
Intervention Type
Drug
Intervention Name(s)
Human BCMA Targeted T Cells Injection
Other Intervention Name(s)
BCMA CAR-T
Intervention Description
A single dose of predetermined level CAR-positive T cells will be infused.
Primary Outcome Measure Information:
Title
Objective Response Rate (ORR) at 3 months post infusion as evaluated by the Independent Review Committee
Description
ORR at 3 months post infusion as evaluated by the Independent Review Committee (IRC) includes stringent complete response (sCR), complete response (CR), very good partial response (VGPR), and partial response (PR).
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 the tumor for complete response and above efficacy to the first assessment of disease progression or death of any cause;
Time Frame
2~3 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
2~3 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
2~3 years post infusion
Title
Objective Response Rate (ORR) at 3 months post infusion as evaluated by the Investigator
Description
ORR at 3 months post infusion as evaluated by the Investigator;
Time Frame
3 months post infusion
Title
Objective Response Rate (ORR) at 6 months post infusion as evaluated by the Independent Review Committee
Description
ORR at 6 months post infusion as evaluated by the Independent Review Committee (IRC);
Time Frame
6 months post infusion
Title
Percentage of Subjects With Negative Minimal Residual Disease (MRD)
Description
MRD negative rate is defined as the proportion of subjects who achieve MRD negative status;
Time Frame
2~3 years post infusion
Title
Duration of Subjects With Negative Minimal Residual Disease (MRD)
Description
MRD duration will calculated among MRD negative responders fom the date of initial MRD negative to the date of first documented evidence of MRD positive, as defined in the International Myeloma Working Group(IMWG) criteria (2016);
Time Frame
2~3 years post infusion
Title
Number of Subjects with Adverse Events
Description
Adverse event is any untoward medical event that occurs in a subject administered an investigational drug.
Time Frame
2~3 years post infusion
Title
Change from Baseline in Perform Status as Measured by Eastern Cooperative Oncology Group(ECOG)Score(0-2)
Description
Eastern Cooperative Oncology Group(ECOG) Performance Status Score(0-2) will be assessed by the inverstigator at baseline and the respective time point, higher scores mean a worse performance status.
Time Frame
2~3 years post infusion
Title
The occurrence rate of adverse events grade ≥ 3 assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0.
Description
Safety Indicators
Time Frame
2~3 years post infusion
Title
Change in body weight over time after reinfusion
Description
Safety Indicators
Time Frame
2~3 years post infusion
Title
Pharmacokinetic indicators:Maximum CAR level inperipheral blood or bone marrow (Cmax)
Description
The highest concentration of Human BCMA Targeted T Cells Injection amplified in peripheral blood or bone marrow after infusion (Cmax) ;
Time Frame
2~3 years post infusion
Title
Pharmacokinetic indicators: Time to peak CAR level in blood or bone marrow (Tmax)
Description
The time to reach the highest concentration of Human BCMA Targeted T Cells Injection in peripheral blood or bone marrow after infusion (Tmax) ;
Time Frame
2~3 years post infusion
Title
Pharmacokinetic indicators: 28-day Area under the curve of the CAR level in blood or bone marrow (AUC0-28d)
Description
The 28-day area under the curve of Human BCMA Targeted T Cells Injection in peripheral blood or bone marrow after infusion(AUC0-28d);
Time Frame
2~3 years post infusion
Title
Pharmacodynamic indicators: the concentration level of soluble BCMA (sBCMA) in peripheral blood
Description
The concentration level of soluble BCMA (sBCMA) in peripheral blood at various time points after infusion of Human BCMA Targeted T Cells Injection;
Time Frame
2~3 years post infusion
Title
Pharmacodynamic indicators: the concentration level of CAR-T cell-related serum cytokines such as C-Reactive Protein(CRP) in peripheral blood;
Description
Effectiveness Metrics
Time Frame
2~3 years post infusion
Title
Pharmacodynamic indicators: the concentration level of CAR-T cell-related serum cytokines such as Interleukin-6(IL-6), IL-2, IL-10, Tumor Necrosis Factor (TNF-α),Interferon-γ(IFN-γ)in peripheral blood;
Description
Effectiveness Metrics
Time Frame
2~3 years post infusion
Title
Immunogenicity: Anti-drug antibody(ADA) positive ratio
Description
Immunogenicity study evaluated the immune responses to anti-BCMA scFV including the detection of anti-scFV antibodies;
Time Frame
2~3 years post infusion
Title
Immunogenicity: Neutralizing Antibody(Nab) positive ratio
Description
Immunogenicity study evaluated the immune responses to anti-BCMA scFV including the detection of neutralizing antibodies (NAbs) against scFV.
Time Frame
2~3 years post infusion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:Subjects must meet all of the following criteria to be enrolled: Subjects volunteer to participate in clinical trails, understand and inform the trials and sign informed consent form, be willing to complete all the trial procedures; 18 to 75 years old (including cut-off value),gender is not limited; Expected survival > 12 weeks; Previously diagnosed as multiple myeloma by the International Myeloma Working Group(IMWG) updated criteria; One of the following indicators is satisfied: Serum M protein ≥ 5 g/L; Urine M protein ≥ 200 mg/24h; Affected serum free light chain ≥ 100 mg/L and Serum free light chain ratio is abnormal ; Patients with relapsed/refractory multiple myeloma, satisfying: Patients have received at least 3 prior MM treatment regimens containing at least one proteasome inhibitor and one immunomodulator; Progress is documented within 12 months of the most recent antimyeloma treatment, or efficacy assessment does not reach minimal response(MR) or above or progression within 60 days of the most recent antimyeloma treatment; ECOG score 0-2; Autologous hematopoietic stem cell transplantation is not possible or relapses after autologous hematopoietic stem cell transplantation, but requires further treatment at the investigator's discretion; Liver, kidney and cardiopulmonary functions meet the following requirements: Creatinine clearance rate (estimated by CockcroftGault formula)≥40mL/min; Total bilirubin≤2×ULN; Alanine aminotransferase (ALT) ≤2.5×ULN and aspartate aminotransferase (AST)≤2.5×ULN; Left ventricular ejection fraction >50%; Baseline peripheral oxygen saturation>95%; The venous access required for collection can be established, no contraindications to leukocyte collection, and leukepheresis can be carried according to the judgement of investigators, satisfying hemoglobin≥70g/L,platelets ≥50×10^9 / L, neutrophils ≥1.0×10^9/L. Exclusion Criteria:Any one of the following conditions cannot be selected as a subject: Subjects have a history of central nervous system (CNS) diseases such as seizures, paralysis, aphasia, stroke, severe brain injury, dementia, Parkinson's disease, psychosis; known or history of active central nervous system (CNS) involvement or presentation of multiple myeloma meninge/meningeal involvement; Subjects with plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome, or primary light chain amyloidosis; Accompanied by other uncontrolled malignancies, 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 ; Any uncontrollable active infection, including but not limited to active tuberculosis; fungal, bacterial, viral, or other infections that are uncontrollable or require systemic intravenous therapy are present or suspected within 14 days prior to enrollment; Subjects with positive Hepatitis B surface antigen(HBsAg) or Hepatitis B core antibody (HBcAb) and hepatitis B virus (HBV) DNA titers higher than the lower 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 unstable angina pectoris, 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), uncontrolled diabetes mellitus (glycosylated hemoglobin HbAlc >8% at screening),severe arrhythmia, liver, kidney, or metabolic diseases that are poorly controlled by medications; Subjects who have a history of pacemaker and brain pacemaker implantation; Subjects who have received CAR-T treatment or other genetically modified cell therapies, as well as other BCMA-targeting drugs; Subjects with any hematopoietic stem cell transplant performed within the first two months of screening, or any immunosuppressive therapy due to graft-versus-host disease performed during the screening period; Subjects who were receiving systemic steroid treatment within 14 days before the screening period 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 live attenuated vaccine within 4 weeks prior to apheresis; In the past two years, the terminal organ was damaged due to autoimmune diseases (such as Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus), or the systemic use of immunosuppressive or other systemic disease control drugs was required; 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; except participants of childbearing age are willing to use a very effective and reliable method of contraception for 1 year after study treatment; 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 have had severe immediate hypersensitivity reactions to any drugs used in this research; 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
Juan Du, Ph.D.
Organizational Affiliation
Shanghai Changzheng Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Songfu Jiang, Professor
Organizational Affiliation
First Affiliated Hospital of Wenzhou Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shanghai Changzheng Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Juan Du, Ph.D.
Phone
021-81885423
Email
juan_du@live.com
Facility Name
The First Affiliated Hospital of Wenzhou Medical University
City
Wenzhou
State/Province
Zhejiang
ZIP/Postal Code
325000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Songfu Jiang, Professor
Phone
+8615305770033
Email
Jiangsongfu@189.cn

12. IPD Sharing Statement

Plan to Share IPD
No

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Human BCMA Targeted T Cells Injection(BCMA CAR-T)for Subjects With R/R MM

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