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Study of Cord Blood-derived CAR NK Cells Targeting CD19/CD70 in Refractory/Relapsed B-cell Non-Hodgkin Lymphoma

Primary Purpose

Refractory or Relapsed B-cell Non-Hodgkin Lymphoma

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
dualCAR-NK19/70 cell
Sponsored by
Aibin Liang,MD,Ph.D.
About
Eligibility
Locations
Arms
Outcomes
Full info

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

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

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

Arm Type

Experimental

Arm Label

Part 1 (dose escalation) and Part 2 (dose expansion)

Arm Description

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.

Outcomes

Primary Outcome Measures

incidence of dose limiting toxicity(DLTs)
To evaluate the safety,tolerabitility,and determine the recommended dosage of cord blood-derived CAR NK cells targeting CD19/CD70

Secondary Outcome Measures

Objective Response Rate(ORR)
To determine the anti-tumor effectivity of CB dualCAR-NK19/70
Complete Remission Rate(CRR)
To determine the anti-tumor effectivity of CB dualCAR-NK19/70
Overall survival(OS)
To determine the anti-tumor effectivity of CB dualCAR-NK19/70
Duration of Response(DOR)
To determine the anti-tumor effectivity of CB dualCAR-NK19/70
progression-free survival(PFS)
To determine the anti-tumor effectivity of CB dualCAR-NK19/70

Full Information

First Posted
March 25, 2023
Last Updated
April 24, 2023
Sponsor
Aibin Liang,MD,Ph.D.
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1. Study Identification

Unique Protocol Identification Number
NCT05842707
Brief Title
Study of Cord Blood-derived CAR NK Cells Targeting CD19/CD70 in Refractory/Relapsed B-cell Non-Hodgkin Lymphoma
Official Title
Study of Cord Blood-derived CAR NK Cells Targeting CD19/CD70 in Refractory/Relapsed B-cell Non-Hodgkin Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 18, 2023 (Actual)
Primary Completion Date
January 18, 2028 (Anticipated)
Study Completion Date
January 18, 2029 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Aibin Liang,MD,Ph.D.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To find the highest tolerable dose of dualCAR-NK19/70 (a type of cell therapy) that can be given to patients who have B-cell lymphoma that is relapsed or refractory.
Detailed Description
Primary Objectives: --The primary objective is to determine the safety and identify the maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D) of dualCAR-NK19/70 in patients with r/r B-cell lymphomas. Hypothesis: DualCAR-NK19/70 will be safe, well-tolerated, and effective in patients with r/r B-cell lymphomas. Secondary Objectives: --The secondary objective is to determine the efficacy in adults with r/r LBCL and FL grade 3B treated at the MTD or RP2D of dualCAR-NK19/70. Although the clinical benefit of dualCAR-NK19/70 has not yet been established, the intent of offering this treatment is to provide a possible therapeutic benefit, and thus the patient will be carefully monitored for tumor response and symptom relief in addition to safety and tolerability. Secondary endpoints include overall response rate (ORR; including CR + PR) and CR rate as defined by the Lugano Classification response criteria for malignant lymphoma, DOR, PFS, and OS. Exploratory Objectives: --The exploratory objectives are to assess the cellular kinetics and pharmacodynamic effects of dualCAR-NK19/70 and to evaluate biomarkers associated with response, resistance, and toxicity after administration of dualCAR-NK19/70 in blood and tumor samples.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Refractory or Relapsed B-cell Non-Hodgkin Lymphoma
Keywords
B-cell Non-Hodgkin Lymphoma, CAR NK Cells Targeting CD19/CD70, Cord Blood-derived

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
48 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Part 1 (dose escalation) and Part 2 (dose expansion)
Arm Type
Experimental
Arm Description
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.
Intervention Type
Drug
Intervention Name(s)
dualCAR-NK19/70 cell
Other Intervention Name(s)
CAR-NK cell
Intervention Description
Given by IV (vein)
Primary Outcome Measure Information:
Title
incidence of dose limiting toxicity(DLTs)
Description
To evaluate the safety,tolerabitility,and determine the recommended dosage of cord blood-derived CAR NK cells targeting CD19/CD70
Time Frame
up to 28 days
Secondary Outcome Measure Information:
Title
Objective Response Rate(ORR)
Description
To determine the anti-tumor effectivity of CB dualCAR-NK19/70
Time Frame
6 months
Title
Complete Remission Rate(CRR)
Description
To determine the anti-tumor effectivity of CB dualCAR-NK19/70
Time Frame
3 months
Title
Overall survival(OS)
Description
To determine the anti-tumor effectivity of CB dualCAR-NK19/70
Time Frame
Up to 3 years
Title
Duration of Response(DOR)
Description
To determine the anti-tumor effectivity of CB dualCAR-NK19/70
Time Frame
Up to 3 years
Title
progression-free survival(PFS)
Description
To determine the anti-tumor effectivity of CB dualCAR-NK19/70
Time Frame
Up to 3 years
Other Pre-specified Outcome Measures:
Title
Incidence of Adverse Events
Description
Type, frequency, and severity of adverse events,Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5
Time Frame
through study completion; an average of 1 year,up to 3 years
Title
Exploratory Objectives
Description
The exploratory objectives are to assess the cellular kinetics and pharmacodynamic effects of dualCAR-NK19/70 and to evaluate biomarkers associated with response, resistance, and toxicity after administration of dualCAR-NK19/70 in blood and tumor samples.
Time Frame
Up to 3 years

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: 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.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
aibin Liang
Phone
18601670600
Email
lab7182@tongji.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Ping Li
Phone
13564181131
Email
lilyforever76@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
aibin Liang
Organizational Affiliation
Shanghai Tongji Hospital, Tongji University School of Medicine
Official's Role
Study Chair
Facility Information:
Facility Name
Shanghai Tongji Hospital, Tongji University School of Medicine
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200065
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aibin Liang, MD, Ph.D
Phone
0086-021-66111019
Email
lab7182@tongji.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of Cord Blood-derived CAR NK Cells Targeting CD19/CD70 in Refractory/Relapsed B-cell Non-Hodgkin Lymphoma

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