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Study of TBI-2001(Autologous CD19 Specific Chimeric Antigen Receptor (CAR) Gene-transduced T Lymphocytes) for Relapsed or Refractory CD19+ B-cell Lymphoma, CLL/SLL

Primary Purpose

Relapsed or Refractory CD19+ B-cell Lymphoma, Relapsed or Refractory Chronic Lymphocytic Leukemia, Relapsed or Refractory Small Lymphocytic Lymphoma

Status
Recruiting
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
TBI-2001
Cyclophosphamide
Fludarabine
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed or Refractory CD19+ B-cell Lymphoma focused on measuring CD19+ B-cell Lymphoma, Chronic Lymphocytic Leukemia, CLL, Small Lymphocytic Lymphoma, SLL, Lymphoma, TBI-2001, Anti-CD19 CAR Expressing T cell Therapy, CD19 CAR Gene-Transduced Lymphocyte, Adoptive Immunotherapy, Genetically Engineered Lymphocyte Therapy, Retroviral Vector, Neoplasms by Histologic Type, Neoplasms, Neoplasms, Experimental, Immune System Diseases, Chimeric Antigen Receptor

Eligibility Criteria

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

Inclusion Criteria: Patients with histologically or cytologically confirmed CD19 positive B cell Non-Hodgkin Lymphoma (NHL), Chronic Lymphocytic Leukemia (CLL), or Small Lymphocytic Lymphoma (SLL) who have received at least 2 prior therapies. Phase Ib cohort will enroll CLL/SLL patients only. ECOG Performance Status 0 or 1. Age ≥18 years at time of consent. Life expectancy greater than 4 months. No anti-cancer chemotherapy, radiation therapy or immunotherapy within 2 weeks prior to apheresis for generation of TBI-2001. Patients must have adequate key organ function (bone marrow, heart, lung, liver, renal, etc) Consent must be appropriately obtained in accordance with applicable local and regulatory requirements. The treating investigator should consider the patient to have disease that is incurable, and that the patient would be a reasonable candidate for future treatment with TBI-2001 within the next 3 months Exclusion Criteria: Uncontrolled intercurrent illnesses or medical conditions that may interfere with trial participation. Active or prior documented autoimmune disease within the past 2 years. History of primary immunodeficiency. History of organ transplant that requires use of immunosuppressive medications. History hypersensitivity to components of manufacture or excipients of investigational drug. Untreated central nervous system (CNS) metastases requiring concurrent treatment, inclusive of but not limited to surgery, radiation, and/or corticosteroids. Other invasive malignancy within 2 years except for noninvasive malignancies Current or prior use of immunosuppressive medication within 14 days before apheresis. Any condition that, in the opinion of the investigator, would interfere with the evaluation of TBI-2001 or interpretation of subject safety or study results. Known history of untreated active tuberculosis. HIV positivity. Active HTLV or syphilis infection. Active hepatitis B or active hepatitis C. Subjects with a negative PCR assay for viral load for hepatitis B or C are permitted. Pregnant or lactating women. Received allogeneic-HSCT. Any prior CD19 directed therapy.

Sites / Locations

  • Princess Margaret Cancer CentreRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental: Dose Level 1 to 3

Arm Description

0.3 to 3 x 10^6 autologous CD19-CAR-T cells/kg per patient will be administered intravenously after a conditioning chemotherapy with cyclophosphamide and fludarabine.

Outcomes

Primary Outcome Measures

Safety of TBI-2001
Dose Limiting Toxicities (DLTs)
Safety of TBI-2001
Adverse event (AEs)
Safety of TBI-2001
Laboratory testing- RCR appearance and Clonality
Recommended phase 2 dose (RP2D) of TBI-2001
RP2D to be determined during the dose escalation cohort

Secondary Outcome Measures

Efficacy of TBI-2001; Overall Response Rate (ORR)
Overall Response Rate (ORR) (Complete Response (CR)+Partial Response(PR))
Efficacy of TBI-2001; Durable Response Rate (DRR)
Durable Response Rate (DRR) as defined as CR or PR sustained for at least 6 months
Efficacy of TBI-2001; Progression free survival (PFS)
Progression free survival
Efficacy of TBI-2001; Overall survival (OS)
Overall survival

Full Information

First Posted
June 27, 2023
Last Updated
July 26, 2023
Sponsor
University Health Network, Toronto
Collaborators
Takara Bio Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05963217
Brief Title
Study of TBI-2001(Autologous CD19 Specific Chimeric Antigen Receptor (CAR) Gene-transduced T Lymphocytes) for Relapsed or Refractory CD19+ B-cell Lymphoma, CLL/SLL
Official Title
Phase I/Ib Study of TBI-2001 for Patients With Relapsed or Refractory CD19+ B-cell Lymphoma, Chronic Lymphocytic Leukemia (CLL), Small Lymphocytic Lymphoma (SLL)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 26, 2023 (Actual)
Primary Completion Date
November 30, 2024 (Anticipated)
Study Completion Date
November 30, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto
Collaborators
Takara Bio Inc.

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
This is a Phase 1/1b, open-label, dose-escalation study to evaluate the safety and the efficacy of anti-CD19 chimeric antigen receptor (CAR) (TBI-2001) for relapsed or refractory CD19+ B-cell lymphoma Chronic Lymphocytic Leukemia (CLL), Small Lymphocytic Lymphoma (SLL).
Detailed Description
TBI-2001 is a next-generation CAR-T product including costimulatory sequences that lead to the activation of cytokine-related JAK/STAT signaling pathways. This is a first-in-human study of TBI-2001 and will follow a 3+3 design of dose-escalation cohorts. Additional subjects will be treated with TBI-2001 at the determined recommended phase 2 dose (RP2D) following cyclophosphamide and fludarabine pre-treatment. Long-term follow-up is conducted for 5 years following the infusion of TBI-2001

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed or Refractory CD19+ B-cell Lymphoma, Relapsed or Refractory Chronic Lymphocytic Leukemia, Relapsed or Refractory Small Lymphocytic Lymphoma
Keywords
CD19+ B-cell Lymphoma, Chronic Lymphocytic Leukemia, CLL, Small Lymphocytic Lymphoma, SLL, Lymphoma, TBI-2001, Anti-CD19 CAR Expressing T cell Therapy, CD19 CAR Gene-Transduced Lymphocyte, Adoptive Immunotherapy, Genetically Engineered Lymphocyte Therapy, Retroviral Vector, Neoplasms by Histologic Type, Neoplasms, Neoplasms, Experimental, Immune System Diseases, Chimeric Antigen Receptor

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Experimental: Dose Level 1 to 3
Arm Type
Experimental
Arm Description
0.3 to 3 x 10^6 autologous CD19-CAR-T cells/kg per patient will be administered intravenously after a conditioning chemotherapy with cyclophosphamide and fludarabine.
Intervention Type
Biological
Intervention Name(s)
TBI-2001
Intervention Description
Phase-I portion: cohort 1: 3×10^5 cells/kg, cohort 2: 1×10^6 cells/kg, cohort 3: 3×10^6 cells/kg). Phase-Ib portion: The dose of Phase-Ib will be determined during the phase I portion.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
IV Cyclophosphamide (for 3 days) will be administered as conditioning before cell infusion with TBI-2001.
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Intervention Description
IV Fludarabine (for 3 days) will be administered as conditioning before cell infusion with TBI-2001.
Primary Outcome Measure Information:
Title
Safety of TBI-2001
Description
Dose Limiting Toxicities (DLTs)
Time Frame
One month
Title
Safety of TBI-2001
Description
Adverse event (AEs)
Time Frame
One year
Title
Safety of TBI-2001
Description
Laboratory testing- RCR appearance and Clonality
Time Frame
One year
Title
Recommended phase 2 dose (RP2D) of TBI-2001
Description
RP2D to be determined during the dose escalation cohort
Time Frame
One year
Secondary Outcome Measure Information:
Title
Efficacy of TBI-2001; Overall Response Rate (ORR)
Description
Overall Response Rate (ORR) (Complete Response (CR)+Partial Response(PR))
Time Frame
One year
Title
Efficacy of TBI-2001; Durable Response Rate (DRR)
Description
Durable Response Rate (DRR) as defined as CR or PR sustained for at least 6 months
Time Frame
One year
Title
Efficacy of TBI-2001; Progression free survival (PFS)
Description
Progression free survival
Time Frame
One year
Title
Efficacy of TBI-2001; Overall survival (OS)
Description
Overall survival
Time Frame
One year
Other Pre-specified Outcome Measures:
Title
Persistence of TBI-2001
Description
Percentage of CAR T in peripheral blood and bone marrow using PCR and Flow cytometry.
Time Frame
One year
Title
Minimal residual disease (MRD) negative rate (in CLL patients)
Description
MRD negative rate
Time Frame
One year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with histologically or cytologically confirmed CD19 positive B cell Non-Hodgkin Lymphoma (NHL), Chronic Lymphocytic Leukemia (CLL), or Small Lymphocytic Lymphoma (SLL) who have received at least 2 prior therapies. Phase Ib cohort will enroll CLL/SLL patients only. ECOG Performance Status 0 or 1. Age ≥18 years at time of consent. Life expectancy greater than 4 months. No anti-cancer chemotherapy, radiation therapy or immunotherapy within 2 weeks prior to apheresis for generation of TBI-2001. Patients must have adequate key organ function (bone marrow, heart, lung, liver, renal, etc) Consent must be appropriately obtained in accordance with applicable local and regulatory requirements. The treating investigator should consider the patient to have disease that is incurable, and that the patient would be a reasonable candidate for future treatment with TBI-2001 within the next 3 months Exclusion Criteria: Uncontrolled intercurrent illnesses or medical conditions that may interfere with trial participation. Active or prior documented autoimmune disease within the past 2 years. History of primary immunodeficiency. History of organ transplant that requires use of immunosuppressive medications. History hypersensitivity to components of manufacture or excipients of investigational drug. Untreated central nervous system (CNS) metastases requiring concurrent treatment, inclusive of but not limited to surgery, radiation, and/or corticosteroids. Other invasive malignancy within 2 years except for noninvasive malignancies Current or prior use of immunosuppressive medication within 14 days before apheresis. Any condition that, in the opinion of the investigator, would interfere with the evaluation of TBI-2001 or interpretation of subject safety or study results. Known history of untreated active tuberculosis. HIV positivity. Active HTLV or syphilis infection. Active hepatitis B or active hepatitis C. Subjects with a negative PCR assay for viral load for hepatitis B or C are permitted. Pregnant or lactating women. Received allogeneic-HSCT. Any prior CD19 directed therapy.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Marcus Butler, M.D.
Phone
416-946-4501
Ext
2911
Email
tip@uhn.ca
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marcus Butler, M.D.
Organizational Affiliation
Princess Margaret Cancer Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marcus Butler, M.D.
Phone
416-946-4501
Ext
5485
Email
marcus.butler@uhn.ca
First Name & Middle Initial & Last Name & Degree
Marcus Butler, M.D.

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of TBI-2001(Autologous CD19 Specific Chimeric Antigen Receptor (CAR) Gene-transduced T Lymphocytes) for Relapsed or Refractory CD19+ B-cell Lymphoma, CLL/SLL

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