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CD19 CAR T-cell Target Relapsed/Refractory Acute B Cell Leukemia/Lymphoma (CAR19T2)

Primary Purpose

B-cell Acute Lymphoblastic Leukemia, B-Cell Lymphoma, Unspecified

Status
Not yet recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CD19 CAR T-Cell(CAT19T2)
Sponsored by
Zhujiang Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-cell Acute Lymphoblastic Leukemia focused on measuring CAR T-cell, CAR19T2 T cell, refractory/relapsed B-cell acute lymphoblastic leukemia, refractory/relapsed Lymphoma

Eligibility Criteria

1 Year - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: ≥1 year old and ≤18 years. Patients with relapsed and/or refractory CD19-positive B-cell acute leukemia/lymphoma. Leukemia/lymphoma relapsed after allogeneic hematopoietic stem cell transplantation within four weeks, all immunosuppressive agents were stopped for at least four weeks, and no active graft-versus-host disease(GVHD) was detonated. Lansky play (≤16 years old) scale ≥60% or Karnofsky (>16 years old) score ≥60% and Eastern Cooperative Oncology Group (ECOG) performance status ≤1. Patients who are unable to walk because of paralysis, but who are up in a wheelchair will be considered ambulatory to assess the performance score. Adequate vascular access leukapheresis procedure. Absolute Lymphocyte count (ALC) greater than or equal to 100 cells/μL. Adequate renal, hepatic, pulmonary, and cardiac function is defined as the following: Serum alanine aminotransferase/aspartate aminotransferase (ALT/AST) ≤ 5 upper limit of normal (ULN), Total bilirubin ≤2 x ULN. A serum creatinine based on age/gender as follows: 1 to < 2 years: maximum serum creatinine 0.6 mg/dL (both male and female);2 to < 6 years: maximum serum creatinine 0.8 mg/dL (both male and female); 6 to < 10 years: maximum serum creatinine 1 mg/dL (both male and female); 10 to < 13 years: maximum serum creatinine 1.2 mg/dL (both male and female); 13 to < 16 years: maximum serum creatinine 1.5 mg/dL (male), 1.4 mg/dL (female); >=16 years: maximum serum creatinine 1.7 mg/dL (male), 1.4 mg/dL (female). Baseline oxygen saturation > 92% on room air. Echocardiogram or left ventricular ejection fraction (LVEF) greater than or equal to 45% confirmed by echocardiogram, no evidence of pericardial effusion (except trace or physiological), and no clinically significant arrhythmias. Life expectancy of greater than or equal to 3 months. Patients or legal guardians must sign an informed consent. Exclusion Criteria: Prior received any other CAR T cell and tumor vaccine treatment. Patient with a previous history of active hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) infection. Patient with uncontrolled systemic fungal, bacterial, viral, or other infection (including tuberculosis) despite appropriate antibiotics or other treatment. Acute GVHD grade II-IV (Glucksberg criteria) or chronic GVHD requiring systemic treatment within 4 weeks before enrollment. History or presence of any CNS disorder such as a seizure disorder, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, etc. (Except for CNS involvement of underlying hematological malignancy) Severe psychological disorder or psychiatric illness. Combined with life-threatening severe organ failure. Major non-medicinal surgery within four weeks. Received other clinical trials within four weeks. 10. Women who are pregnant or breastfeeding. 11. The following drugs patients must be stopped prior to leukapheresis: Tyrosine Kinase Inhibitor (TKI) must be discontinued more than or equal to 3 days before collection. Salvage chemotherapy must be stopped > 2 weeks and intrathecal chemotherapy in the 7 days prior to collection. Systemic steroid therapy exceeding the equivalent of 0.5 mg/kg/day of methylprednisolone in the 7 days before collection. Donor lymphocyte infusions (DLI) and Immunosuppressive therapies within 4 weeks before collection. Received clofarabine or cladribine within 3 months prior to collection. Receive blinatumomab within 4 weeks, inotuzumab ozogamicin, and rituximab within 4 months, and alemtuzumab within 6 months before collection. 12. Tyrosine Kinase Inhibitor within 1 week and asparaginase within 4 weeks prior to CAR T-cell infusion. 13. In the opinion of the PI, patients are present for any condition, not for enrollment.

Sites / Locations

  • Guangdong Zhaotai Cell Bio-tech Co., LTD
  • Zhujiang Hospital of Southern Medical University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

humanized CAR19T2 T cell to B-cell acute lymphoblastic leukemia/lymphoma

Arm Description

Patients received fludarabine and cyclophosphamide (Flu/Cy) for lymphodepletion (Cy at 300-500 mg/m2/dose for four days and Flu at 20-30 mg/m2/dose for two days) before CAR19T2 T cells administration. This CAR19T2 T cell will be infused over 30 minutes on days Day 0.

Outcomes

Primary Outcome Measures

Overall response rate
A total number of patients achieved a Complete response (CR) or CR with incomplete blood count recovery (CRi) on Day 28 and three months by an independent review committee(IRC) assessment, as evaluated by peripheral blood, bone marrow, central nervous system (CNS) symptoms, physical exam (PE), and cerebrospinal fluid(CSF).
The maximum tolerated dose(MTD) of CAR19T2 T cells
The maximum tolerated dose(MTD) of CD19-positive relapsed/ refractory acute leukemia/lymphoma treated with CAR19T2 T cells.
Adverse Events (AEs)
Type, frequency and severity of adverse events (AEs), serious adverse events (SAE), and laboratory abnormalities (overall and in clinical, histological and molecular subgroups).

Secondary Outcome Measures

Minimal residual disease (MRD) negative response rate
Patients achieving CR or CRi and a negative MRD bone marrow.
Event-free survival (EFS)
Time from CAR19T2 T cell infusion to progressive disease (PD), disease relapse, start of a new anticancer therapy, or death from any cause, whichever occurs first.
Overall survival (OS)
Time from CAR19T2 T cell infusion to time of death due to any cause.
CAR-T cell expansion level
Copies numbers of CAR in peripheral blood (PB) and/or bone marrow (BM), CSF and lymph nodes, etc.
The duration of CAR T cell persistence
The duration of CAR T cell persistence in peripheral blood(PB) and/or bone marrow(BM), CSF and lymph nodes, etc.
Rate of hematopoietic stem cell transplant (HSCT) after CAR19T2 T cell infusion
Percentage of subjects who achieve a response after CAR19T2 T cell infusion and then proceed to HSCT.
Maximum concentration of CAR19T2 T cell and cytokines.
Pharmacokinetics of CAR19T2 T cell in Maximum concentration.
Time to peak concentration of CAR19T2 T cell and cytokines.
Pharmacokinetics of CAR19T2 T cell in Time to peak concentration.
Area under the curve of CAR19T2 T cell and cytokines.
Pharmacokinetics of CAR19T2 T cell in Area under the curve.
Incidence of hypogammaglobulinaemia
Incidence and duration of hypogammaglobulinaemia.

Full Information

First Posted
October 13, 2022
Last Updated
November 4, 2022
Sponsor
Zhujiang Hospital
Collaborators
Guangdong Zhaotai Cell Bio-tech Co., LTD
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1. Study Identification

Unique Protocol Identification Number
NCT05613348
Brief Title
CD19 CAR T-cell Target Relapsed/Refractory Acute B Cell Leukemia/Lymphoma
Acronym
CAR19T2
Official Title
Humanized CAR19T2 T Cell in Children With Refractory/Relapsed B-cell Leukemia/Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
December 1, 2022 (Anticipated)
Primary Completion Date
December 1, 2025 (Anticipated)
Study Completion Date
December 1, 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zhujiang Hospital
Collaborators
Guangdong Zhaotai Cell Bio-tech Co., LTD

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
This study aims to evaluate the safety and efficacy of humanized Anti-CD19 Chimeric Antigen Receptor-T cell (CAR19T2 T cell) in children with refractory/relapsed B-cell acute lymphoblastic leukemia/lymphoma.
Detailed Description
CD19 CAR-T cells treating B-cell hematological malignancies have achieved unprecedented success. In this study, we investigated new third-generation autologous T cells (CAR19T2 T cells) genetically modified with humanized anti-CD19 construct incorporating CD28 and Toll-like receptor 2 (TLR2) costimulatory domains. CAR19T2 T cells will be modified before the infusion to those which could identify and kill the tumor cells (CD19+ cells). This study aims to evaluate the safety and efficacy of humanized Anti-CD19 Chimeric Antigen Receptor T cell (CAR19T2 T Cell) in children with refractory/relapsed B-cell acute lymphoblastic leukemia/lymphoma.

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-Cell Lymphoma, Unspecified
Keywords
CAR T-cell, CAR19T2 T cell, refractory/relapsed B-cell acute lymphoblastic leukemia, refractory/relapsed Lymphoma

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
70 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
humanized CAR19T2 T cell to B-cell acute lymphoblastic leukemia/lymphoma
Arm Type
Experimental
Arm Description
Patients received fludarabine and cyclophosphamide (Flu/Cy) for lymphodepletion (Cy at 300-500 mg/m2/dose for four days and Flu at 20-30 mg/m2/dose for two days) before CAR19T2 T cells administration. This CAR19T2 T cell will be infused over 30 minutes on days Day 0.
Intervention Type
Biological
Intervention Name(s)
CD19 CAR T-Cell(CAT19T2)
Intervention Description
Drug: Fludarabine, Administered intravenously Drug: Cyclophosphamide, Administered intravenously
Primary Outcome Measure Information:
Title
Overall response rate
Description
A total number of patients achieved a Complete response (CR) or CR with incomplete blood count recovery (CRi) on Day 28 and three months by an independent review committee(IRC) assessment, as evaluated by peripheral blood, bone marrow, central nervous system (CNS) symptoms, physical exam (PE), and cerebrospinal fluid(CSF).
Time Frame
3 months
Title
The maximum tolerated dose(MTD) of CAR19T2 T cells
Description
The maximum tolerated dose(MTD) of CD19-positive relapsed/ refractory acute leukemia/lymphoma treated with CAR19T2 T cells.
Time Frame
24 weeks
Title
Adverse Events (AEs)
Description
Type, frequency and severity of adverse events (AEs), serious adverse events (SAE), and laboratory abnormalities (overall and in clinical, histological and molecular subgroups).
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Minimal residual disease (MRD) negative response rate
Description
Patients achieving CR or CRi and a negative MRD bone marrow.
Time Frame
Up to 12 months after infusion
Title
Event-free survival (EFS)
Description
Time from CAR19T2 T cell infusion to progressive disease (PD), disease relapse, start of a new anticancer therapy, or death from any cause, whichever occurs first.
Time Frame
Up to 3 years after infusion
Title
Overall survival (OS)
Description
Time from CAR19T2 T cell infusion to time of death due to any cause.
Time Frame
Up to 3 years after infusion
Title
CAR-T cell expansion level
Description
Copies numbers of CAR in peripheral blood (PB) and/or bone marrow (BM), CSF and lymph nodes, etc.
Time Frame
24 months
Title
The duration of CAR T cell persistence
Description
The duration of CAR T cell persistence in peripheral blood(PB) and/or bone marrow(BM), CSF and lymph nodes, etc.
Time Frame
24 months
Title
Rate of hematopoietic stem cell transplant (HSCT) after CAR19T2 T cell infusion
Description
Percentage of subjects who achieve a response after CAR19T2 T cell infusion and then proceed to HSCT.
Time Frame
Up to 3 years after CAR19T2 T infusion
Title
Maximum concentration of CAR19T2 T cell and cytokines.
Description
Pharmacokinetics of CAR19T2 T cell in Maximum concentration.
Time Frame
12 months
Title
Time to peak concentration of CAR19T2 T cell and cytokines.
Description
Pharmacokinetics of CAR19T2 T cell in Time to peak concentration.
Time Frame
12 months
Title
Area under the curve of CAR19T2 T cell and cytokines.
Description
Pharmacokinetics of CAR19T2 T cell in Area under the curve.
Time Frame
12 months
Title
Incidence of hypogammaglobulinaemia
Description
Incidence and duration of hypogammaglobulinaemia.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: ≥1 year old and ≤18 years. Patients with relapsed and/or refractory CD19-positive B-cell acute leukemia/lymphoma. Leukemia/lymphoma relapsed after allogeneic hematopoietic stem cell transplantation within four weeks, all immunosuppressive agents were stopped for at least four weeks, and no active graft-versus-host disease(GVHD) was detonated. Lansky play (≤16 years old) scale ≥60% or Karnofsky (>16 years old) score ≥60% and Eastern Cooperative Oncology Group (ECOG) performance status ≤1. Patients who are unable to walk because of paralysis, but who are up in a wheelchair will be considered ambulatory to assess the performance score. Adequate vascular access leukapheresis procedure. Absolute Lymphocyte count (ALC) greater than or equal to 100 cells/μL. Adequate renal, hepatic, pulmonary, and cardiac function is defined as the following: Serum alanine aminotransferase/aspartate aminotransferase (ALT/AST) ≤ 5 upper limit of normal (ULN), Total bilirubin ≤2 x ULN. A serum creatinine based on age/gender as follows: 1 to < 2 years: maximum serum creatinine 0.6 mg/dL (both male and female);2 to < 6 years: maximum serum creatinine 0.8 mg/dL (both male and female); 6 to < 10 years: maximum serum creatinine 1 mg/dL (both male and female); 10 to < 13 years: maximum serum creatinine 1.2 mg/dL (both male and female); 13 to < 16 years: maximum serum creatinine 1.5 mg/dL (male), 1.4 mg/dL (female); >=16 years: maximum serum creatinine 1.7 mg/dL (male), 1.4 mg/dL (female). Baseline oxygen saturation > 92% on room air. Echocardiogram or left ventricular ejection fraction (LVEF) greater than or equal to 45% confirmed by echocardiogram, no evidence of pericardial effusion (except trace or physiological), and no clinically significant arrhythmias. Life expectancy of greater than or equal to 3 months. Patients or legal guardians must sign an informed consent. Exclusion Criteria: Prior received any other CAR T cell and tumor vaccine treatment. Patient with a previous history of active hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) infection. Patient with uncontrolled systemic fungal, bacterial, viral, or other infection (including tuberculosis) despite appropriate antibiotics or other treatment. Acute GVHD grade II-IV (Glucksberg criteria) or chronic GVHD requiring systemic treatment within 4 weeks before enrollment. History or presence of any CNS disorder such as a seizure disorder, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, etc. (Except for CNS involvement of underlying hematological malignancy) Severe psychological disorder or psychiatric illness. Combined with life-threatening severe organ failure. Major non-medicinal surgery within four weeks. Received other clinical trials within four weeks. 10. Women who are pregnant or breastfeeding. 11. The following drugs patients must be stopped prior to leukapheresis: Tyrosine Kinase Inhibitor (TKI) must be discontinued more than or equal to 3 days before collection. Salvage chemotherapy must be stopped > 2 weeks and intrathecal chemotherapy in the 7 days prior to collection. Systemic steroid therapy exceeding the equivalent of 0.5 mg/kg/day of methylprednisolone in the 7 days before collection. Donor lymphocyte infusions (DLI) and Immunosuppressive therapies within 4 weeks before collection. Received clofarabine or cladribine within 3 months prior to collection. Receive blinatumomab within 4 weeks, inotuzumab ozogamicin, and rituximab within 4 months, and alemtuzumab within 6 months before collection. 12. Tyrosine Kinase Inhibitor within 1 week and asparaginase within 4 weeks prior to CAR T-cell infusion. 13. In the opinion of the PI, patients are present for any condition, not for enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lihua Yang, Dr.
Phone
008602062783466
Email
dryanglihua@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Peng Li, Dr.
Phone
008602032093613
Email
li_peng@gibh.ac.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lihua Yang
Organizational Affiliation
Zhujiang Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Guangdong Zhaotai Cell Bio-tech Co., LTD
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhaoyang Tang
Email
tang_gongsi@163.com
Facility Name
Zhujiang Hospital of Southern Medical University
City
Guanzhou
State/Province
Guangdong
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

CD19 CAR T-cell Target Relapsed/Refractory Acute B Cell Leukemia/Lymphoma

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