Study of Cord Blood-derived CAR NK Cells Targeting CD19/CD70 in Refractory/Relapsed B-cell Non-Hodgkin Lymphoma
Refractory or Relapsed B-cell Non-Hodgkin Lymphoma
About this trial
This is an interventional treatment trial for Refractory or Relapsed B-cell Non-Hodgkin Lymphoma focused on measuring B-cell Non-Hodgkin Lymphoma, CAR NK Cells Targeting CD19/CD70, Cord Blood-derived
Eligibility Criteria
Inclusion Criteria: Voluntarily participate in the study and sign the informed consent; Age 18-75, male and female; Histologically confirmed diffuse large B-cell lymphoma (DLBCL), transformed follicular lymphoma (tFL), primary mediastinal B-cell lymphoma (PMBCL), mantle cell lymphoma (MCL), and other Indolent B-cell NHL transforming types: (A) Relapsed or Refractory DLBCL and tFL after 2 lines Immunotherapy or chemotherapy ; (B) Definition of Refractory large B cell lymphoma (SCHOLAR - 1 Research Standard) : disease progression after more than 4 courses of standard Immunotherapy or chemotherapy; Or the time of disease stabilization ≤ 6 months; Or disease progression or recurrence within 12 months after autologous hematopoietic stem cell transplantation (auto-HSCT); (C) Relapsed or Refractory MCL must be 1 line with immune chemotherapy; BTK inhibitors are resistant or intolerant as 2-line therapy; (D) Relapsed or Refractory disease after chemotherapy including rituximab and anthracycline. There was at least one measurable lesion with the longest diameter ≥ 1.5cm; Estimated life expectancy of more than 12 weeks other than primary disease; Previously confirmed diagnosis as CD19+ or CD70+ B-NHL. Eastern Cooperative Oncology Group (ECOG) performance status of 0 - 3. Adequate reserve of organ function: (A) Serum alanine aminotransferase (ALT) / aspartate aminotransferase (AST) ≤2.5 times the Upper Limit of Normal (ULN) for age; (B) A creatinine clearance (as estimated either by a direct urine collection or Cockcroft-Gault Equation) > 60mL/min; (C) Total bilirubin and alkaline phosphatase ≤1.5 times the Upper Limit of Normal (ULN) for age; (D) glomerular filtration rate > 50 ml/min (E) Cardiac ejection fraction (EF) ≥ 45% as determined by an echocardiogram (ECHO) or Multigated Radionuclide Angiography (MUGA); (F) Baseline oxygen saturation >92% on room air (G) Absolute neutrophil count > 1000/μL, Platelet count > 45,000/μL ,Hemoglobin > 80g/L; Once previous autologous hematopoietic stem cell transplantation (auto-HSCT) is allowed; For systemic therapy(Such as systemic chemotherapy, systemic radiotherapy and immunotherapy), at least 3 weeks,for Targeted drug therapy alone,at least 2 weeks,must have elapsed at the time of cell infusion; Either having failed or Relapsed after CAR-T therapy at 3 months of assessment; Subjects of child-bearing or child-fathering potential must be willing to practice birth control from the time of enrollment on this study until the follow-up period of the study. Women of childbearing potential must have a negative serum or urine pregnancy test. The viral load of severe coronavirus disease 2019 (COVID-19) is undetectable per quantitative PCR and/or nucleic acid testing for two tests. Exclusion Criteria: Allergic to any of the components of cell products; Previous or concurrent of other type of maligant tumors; Acute GvHD or generalized chronic GvHD with grade II-IV (Glucksberg standard) after previous autologous hematopoietic stem cell transplantation (auto-HSCT); Or receiving of anti-GVHD therapy; Known history of systemic gene therapy within the prior 3 months; Active systemic fungal, viral, or bacterial infection (except for simple urinary tract infections and bacterial pharyngitis), however, Preventive treatment is permitted; Known history of infection with hepatitis B (HBsAg positive, but HBV-DNA<1000 is not excluded) or hepatitis C virus (including virus carriers), syphilis and other acquired and congenital immunodeficiency diseases, including but not limited to HIV infection; Class III or IV heart failure as defined by the New York Heart Association; Persisting toxicities (>grade 1, except for clinically non-significant toxicities such as alopecia, fatigue, and anorexia) due to prior trerapy; Known history of active seizures or presence of seizure activities or other central nervous system disease; Have evidence of central nervous system lymphoma(CNS lymphoma) on CT or MRI; Breast-feeding woman; Any circumstances that possibly increase the risk of subjects or interfere with study results, which judged by investigator.
Sites / Locations
- Shanghai Tongji Hospital, Tongji University School of MedicineRecruiting
Arms of the Study
Arm 1
Experimental
Part 1 (dose escalation) and Part 2 (dose expansion)
Part 1 (dose escalation) the dose of dualCAR-NK19/70 participants receive will depend on when you join this study. Up to 3 dose levels of dualCAR-NK19/70 will be tested. About 3-6 participants will be enrolled at each dose level. The first group of participants will receive the lowest dose level of dualCAR-NK19/70. Each new group will receive a higher dose of dualCAR-NK19/70 than the group before it, if no intolerable side effects were seen. This will continue until the highest tolerable dose of dualCAR-NK19/70 is found. Part 2 (dose expansion) Participants will receive dualCAR-NK19/70 at the recommended dose that was found in Part 1.