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Safety Study of CC312 in Adult Patients With Relapsed/Refractory CD19 Positive B-cell Hematologic Malignancies

Primary Purpose

Non-hodgkin Lymphoma, Acute Lymphoblastic Leukaemia, Chronic Lymphocytic Leukemia

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
CC312
Sponsored by
CytoCares Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-hodgkin Lymphoma

Eligibility Criteria

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

Inclusion Criteria: CD19 positive B-cell malignancies confirmed as one of the following: aggressive or indolent B-cell NHL, philadelphia chromosome-positive or -negative B-cell ALL, or B-cell CLL; patient must meet the definition of relapse/refractory before enrollment. ECOG (Eastern Cooperative Oncology Group) performance status 0-2, life expectancy >3 months; Clinical laboratory values as specified below during the Screening period. Total bilirubin <1.5 ULN, may be elevated up to 3 x ULN if the elevation can be reasonably ascribed to the presence of metastatic disease in the liver or in patients with documented Gilbert's Syndrome; ALT or AST <3ULN, may be elevated up to 5 x ULN if the elevation can be reasonably ascribed to the presence of metastatic disease in liver; Calculated creatinine clearance > 50 mL/min (The Cockcroft-Gault formula); Hemoglobin ≥ 7 g/dL; Neutrophil count > 1,000/mm3 for B-cell NHL patient; Platelet count > 75,000/mm3 for B-cell NHL patient; B-ALL patients must have peripheral blast count ≤ 30,000/ mm3 prior to first dose of CC312. Prothrombin time-international normalized ratio (PT-INR) ≤ 1.5ULN. Female patients of childbearing potential or male patients with a partner of childbearing potential must use one or more contraception methods from screening and continued during study treatment until 3 months after the last dose; Ability to understand and willingness to provide written informed consent and to comply with scheduled visits and study procedures. Exclusion Criteria: Systemic anticancer therapy within 5 half-lives of the agent or attending clinical trials 4 weeks prior to beginning CC312; Treatment with radiotherapy within 2 weeks before the study entry; Treatment with CAR-T within 3 months before the study entry; Active serious infection requiring antibiotics within 14 days before study entry; Patients with prior treatment with anti-CD19 directed therapies are eligible only if their tumor cells have been shown to express CD19 after completing the CD19-directed therapy; Patients with brain metastases or other significant neurological conditions, except for brain metastases which are asymptomatic and radiologically stable without need for steroids for 2 weeks before the first dose of CC312; Treatment with corticosteroids (>10mg daily prednisone or equivalent) or immunosuppressive medication ≤ 7 days before the first dose of CC312, with the following exceptions: Topical, ocular, intra-articular, intranasal, or inhalational corticosteroids; Use of dexamethasone to reduce peripheral blast counts in ALL; Vaccination with a live virus vaccine within 4 weeks prior to the study enrollment; Current autoimmune disease or history of autoimmune disease with potential CNS involvement; Known to be allergic to protein drugs or recombinant proteins or excipients in the CC312 drug formulation. Patients who experienced Grade 3 reactions that lasted < 24h may be eligible after discussion with investigator; Except for the tolerable events determined by the investigator, any toxic effects of the prior therapy which have not resolved to Grade 1 (CTCAE v5.0); Admission or evidence of illicit drug use, drug abuse, or alcohol abuse; Cerebrovascular accident (CVA), Transient ischemic attack (TIA), myocardial infarction (MI), unstable angina, or New York Heart Association (NYHA) class III or IV heart failure occurring within <6 months of study entry; uncontrolled arrhythmia within < 3 months of study entry. Patients with rate-controlled arrhythmias may be eligible for study entry at discretion of the Investigator.; Major surgery < 4 weeks or minor surgery < 2 weeks prior to screening; wound must be fully healed (minor surgical procedures such as catheter placement are not exclusionary criteria); Existence of congenital long QT syndrome, QTcF > 450 msec (for male) or 470 msec (for female), use of cardiac pacemaker, left ventricular ejection fraction (LVEF) <50%, clinically significant arrhythmia that requires intervention, cardiac troponin I or T > 2.0 ULN, poorly controlled diabetes (HbA1c > 9%), hypertension (systolic pressure > 160 mmHg or diastolic pressure > 100mmHg), or other medical conditions as determined by the Investigator. Patients with stable atrial fibrillation or flutter are eligible for study entry at the discretion of the Investigator; Any other serious underlying medical (e.g. active gastric ulcer, uncontrolled seizures, cerebrovascular incidents, gastrointestinal bleeding, severe signs and symptoms of coagulation and clotting disorders, cardiac conditions), psychiatric, psychological, familial or geographical condition that, in the judgment of the Investigator, may interfere with the planned staging, treatment and follow-up, affect patient compliance or place the patient at high risk for treatmentrelated complications; Concurrent malignancy < 5 years prior to entry other than adequately treated cervical carcinoma-in-situ, localized squamous cell cancer of the skin, basal cell carcinoma, localized prostate cancer, ductal carcinoma in situ of the breast, or < T1 urothelial carcinoma. Patients with prostate cancer that is under active surveillance are eligible.; Pregnant or nursing women.; Active hepatitis B:HBsAg positive and HBV-DNA>ULN; Active hepatitis C:HCV-Ab positive and HCV-RNA>ULN; Known HIV infection; B-NHL patient that received autologous stem cell transplant 6 months prior to study screening, or historically received organ or allogeneic stem cell/bone marrow transplant; B-ALL patients that received transplantation treatment within 3 months prior to enrollment in the study.; Subjects who in the judgement of the Investigator are not suited to participate in this trial.

Sites / Locations

  • InstituteHBDHRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CC312

Arm Description

Outcomes

Primary Outcome Measures

Dose limiting toxicities (DLTs)
Toxicity will be evaluated according to the NCI CTCAE, Version 5.0, except CRS which will be graded according to ASTCT Consensus Grading for CRS.
Incidence and severity of adverse event (AE)
Overall numbers of participants with any AE, including any laboratory abnormality, treatment-emergent adverse event (TEAE), and serious adverse events (SAE). Severity (toxicity grade) for each AE will be determined using the NCI CTCAE, version 5.0; except cytokine release syndrom (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) which will be graded according to ASTCT Consensus Grading.

Secondary Outcome Measures

Pharmacokinetics (PK): serum concentration
Blood samples will be collected to analysis serum concentration of CC312. Derived PK parameters will be calculated using the non-compartmental model.
Pharmacodynamics (PD): cytokine analysis
Peripheral blood will be collected for CRS-related cytokine analysis in all dose escalation cohorts.
Pharmacodynamics (PD): immunophenotyping
Peripheral blood will be collected for immunophenotyping (including the activation of CD4+ and CD8+ T cells, and depletion of B cells) in all dose escalation cohorts.
Immunogenicity: anti-CC312 antibody
The proportions of participants with positive anti-drug antibody (ADA) status and those with positive neutralizing anti-drug antibody (NAb) status will be presented by descriptive statistics.

Full Information

First Posted
August 28, 2023
Last Updated
September 12, 2023
Sponsor
CytoCares Inc
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1. Study Identification

Unique Protocol Identification Number
NCT06037018
Brief Title
Safety Study of CC312 in Adult Patients With Relapsed/Refractory CD19 Positive B-cell Hematologic Malignancies
Official Title
A Phase 1 Study to Evaluate the Safety, Pharmacokinetics, Pharmacodynamics, and Preliminary Anti-tumor Efficacy of CC312 in Adult Patients With Relapsed/Refractory CD19 Positive B-cell Hematologic Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 7, 2023 (Actual)
Primary Completion Date
March 2025 (Anticipated)
Study Completion Date
March 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CytoCares Inc

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 is a Phase 1, open-label, dose-escalation study to evaluate the safety, PK, PD and immunogenicity of CC312 following intravenous doses of CC312 in patients with relapsed and refractory (r/r) CD19 expressing B-cell non-Hodgkin lymphoma and B-cell lymphocytic leukemia.
Detailed Description
This study is an accelerated dose titration design divided into 2 parts. Part 1 of the study is an accelerated dose-escalation design involving 5 dose levels: 0.3, 0.6, 1.2, 2.4 and 4.8 mcg given intravenously (IV) with cohorts of one patient per dose level. Patients in this part will receive 1 priming dose (D-7) and 1 intermediate dose of CC312 (D-3) on the first week, followed by twice weekly dosing of escalated dose for three weeks beginning on the second week. The dose limiting toxicity (DLT) observation period will be 28 days. The optimal priming dose and intermediate dose level will be determined in this part. Part 2-A will follow a standard 3 + 3 dose escalation design using five dose levels: 9.6, 16, 24, 34 and 45 μg to obtain data on the safety and tolerability of CC312. Patients in this part will receive priming dose and intermediate dose of CC312 established in Part 1 before given the treatment dose. MTD or RP2D will be determined in Part 2-A and tested in expanded population(Part 2-B). Part 2-B is planned for cohorts of 6-10 patients with B-cell non-Hodgkin lymphoma or B-cell lymphocytic leukemia receiving priming/ treatment dose levels as defined in the Part 1 and Part 2-A study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-hodgkin Lymphoma, Acute Lymphoblastic Leukaemia, Chronic Lymphocytic Leukemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CC312
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
CC312
Intervention Description
Doses from 0.3 to 45 µg/dose by intravenous infusion
Primary Outcome Measure Information:
Title
Dose limiting toxicities (DLTs)
Description
Toxicity will be evaluated according to the NCI CTCAE, Version 5.0, except CRS which will be graded according to ASTCT Consensus Grading for CRS.
Time Frame
From the first infusion of CC312 till the end of the 28 days DLT(Dose Limiting Toxicity)observation period.
Title
Incidence and severity of adverse event (AE)
Description
Overall numbers of participants with any AE, including any laboratory abnormality, treatment-emergent adverse event (TEAE), and serious adverse events (SAE). Severity (toxicity grade) for each AE will be determined using the NCI CTCAE, version 5.0; except cytokine release syndrom (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) which will be graded according to ASTCT Consensus Grading.
Time Frame
From the first infusion of CC312 until 28 days following the end of treatment.
Secondary Outcome Measure Information:
Title
Pharmacokinetics (PK): serum concentration
Description
Blood samples will be collected to analysis serum concentration of CC312. Derived PK parameters will be calculated using the non-compartmental model.
Time Frame
Cycle 1: baseline (Day -10~Day -8); 1 hour-pre-dose and multiple-timepoints-post-dose; Cycle 2 and subsequent cycle: 1 hour-pre-dose; after the end of treatment (EOT)/withdraw/at the end of study (EOS). Length of each cycle: 28 days.
Title
Pharmacodynamics (PD): cytokine analysis
Description
Peripheral blood will be collected for CRS-related cytokine analysis in all dose escalation cohorts.
Time Frame
Cycle 1: baseline (Day -10~Day -8); 1 hour-pre-dose and multiple-timepoints-post-dose; Cycle 2 and subsequent cycle: 1 hour-pre-dose; after the end of treatment (EOT)/withdraw/at the end of study (EOS). Length of each cycle: 28 days.
Title
Pharmacodynamics (PD): immunophenotyping
Description
Peripheral blood will be collected for immunophenotyping (including the activation of CD4+ and CD8+ T cells, and depletion of B cells) in all dose escalation cohorts.
Time Frame
Cycle 1: baseline (Day -10~Day -8); 1 hour-pre-dose and multiple-timepoints-post-dose; Cycle 2 and subsequent cycle: 1 hour-pre-dose; after the end of treatment (EOT)/withdraw/at the end of study (EOS). Length of each cycle: 28 days.
Title
Immunogenicity: anti-CC312 antibody
Description
The proportions of participants with positive anti-drug antibody (ADA) status and those with positive neutralizing anti-drug antibody (NAb) status will be presented by descriptive statistics.
Time Frame
Cycle 1: baseline (Day -10~Day -8); 1 hour-pre-dose on Day-7/Day 8. Cycle 2 and subsequent cycle: within 1 hour before infusion on Day 1/Day 15; after the end of treatment (EOT)/withdraw/at the end of study (EOS). Length of each cycle: 28 days.
Other Pre-specified Outcome Measures:
Title
Tumor response to CC312
Description
B-NHL, B-ALL and CLL will be evaluated by Lugano criteria, NCCN Guidelines 2021, and iwCLL guidelines 2008, respectively. Therapeutic endpoints includes: overall response rate [ORR] (including complete remission [CR] and partial remission [PR]), duration of overall response [DOR], disease control rate [DCR], and relapse-free survival [RFS] in participants.
Time Frame
From the first infusion of CC312 until 28 days following the end of treatment.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: CD19 positive B-cell malignancies confirmed as one of the following: aggressive or indolent B-cell NHL, philadelphia chromosome-positive or -negative B-cell ALL, or B-cell CLL; patient must meet the definition of relapse/refractory before enrollment. ECOG (Eastern Cooperative Oncology Group) performance status 0-2, life expectancy >3 months; Clinical laboratory values as specified below during the Screening period. Total bilirubin <1.5 ULN, may be elevated up to 3 x ULN if the elevation can be reasonably ascribed to the presence of metastatic disease in the liver or in patients with documented Gilbert's Syndrome; ALT or AST <3ULN, may be elevated up to 5 x ULN if the elevation can be reasonably ascribed to the presence of metastatic disease in liver; Calculated creatinine clearance > 50 mL/min (The Cockcroft-Gault formula); Hemoglobin ≥ 7 g/dL; Neutrophil count > 1,000/mm3 for B-cell NHL patient; Platelet count > 75,000/mm3 for B-cell NHL patient; B-ALL patients must have peripheral blast count ≤ 30,000/ mm3 prior to first dose of CC312. Prothrombin time-international normalized ratio (PT-INR) ≤ 1.5ULN. Female patients of childbearing potential or male patients with a partner of childbearing potential must use one or more contraception methods from screening and continued during study treatment until 3 months after the last dose; Ability to understand and willingness to provide written informed consent and to comply with scheduled visits and study procedures. Exclusion Criteria: Systemic anticancer therapy within 5 half-lives of the agent or attending clinical trials 4 weeks prior to beginning CC312; Treatment with radiotherapy within 2 weeks before the study entry; Treatment with CAR-T within 3 months before the study entry; Active serious infection requiring antibiotics within 14 days before study entry; Patients with prior treatment with anti-CD19 directed therapies are eligible only if their tumor cells have been shown to express CD19 after completing the CD19-directed therapy; Patients with brain metastases or other significant neurological conditions, except for brain metastases which are asymptomatic and radiologically stable without need for steroids for 2 weeks before the first dose of CC312; Treatment with corticosteroids (>10mg daily prednisone or equivalent) or immunosuppressive medication ≤ 7 days before the first dose of CC312, with the following exceptions: Topical, ocular, intra-articular, intranasal, or inhalational corticosteroids; Use of dexamethasone to reduce peripheral blast counts in ALL; Vaccination with a live virus vaccine within 4 weeks prior to the study enrollment; Current autoimmune disease or history of autoimmune disease with potential CNS involvement; Known to be allergic to protein drugs or recombinant proteins or excipients in the CC312 drug formulation. Patients who experienced Grade 3 reactions that lasted < 24h may be eligible after discussion with investigator; Except for the tolerable events determined by the investigator, any toxic effects of the prior therapy which have not resolved to Grade 1 (CTCAE v5.0); Admission or evidence of illicit drug use, drug abuse, or alcohol abuse; Cerebrovascular accident (CVA), Transient ischemic attack (TIA), myocardial infarction (MI), unstable angina, or New York Heart Association (NYHA) class III or IV heart failure occurring within <6 months of study entry; uncontrolled arrhythmia within < 3 months of study entry. Patients with rate-controlled arrhythmias may be eligible for study entry at discretion of the Investigator.; Major surgery < 4 weeks or minor surgery < 2 weeks prior to screening; wound must be fully healed (minor surgical procedures such as catheter placement are not exclusionary criteria); Existence of congenital long QT syndrome, QTcF > 450 msec (for male) or 470 msec (for female), use of cardiac pacemaker, left ventricular ejection fraction (LVEF) <50%, clinically significant arrhythmia that requires intervention, cardiac troponin I or T > 2.0 ULN, poorly controlled diabetes (HbA1c > 9%), hypertension (systolic pressure > 160 mmHg or diastolic pressure > 100mmHg), or other medical conditions as determined by the Investigator. Patients with stable atrial fibrillation or flutter are eligible for study entry at the discretion of the Investigator; Any other serious underlying medical (e.g. active gastric ulcer, uncontrolled seizures, cerebrovascular incidents, gastrointestinal bleeding, severe signs and symptoms of coagulation and clotting disorders, cardiac conditions), psychiatric, psychological, familial or geographical condition that, in the judgment of the Investigator, may interfere with the planned staging, treatment and follow-up, affect patient compliance or place the patient at high risk for treatmentrelated complications; Concurrent malignancy < 5 years prior to entry other than adequately treated cervical carcinoma-in-situ, localized squamous cell cancer of the skin, basal cell carcinoma, localized prostate cancer, ductal carcinoma in situ of the breast, or < T1 urothelial carcinoma. Patients with prostate cancer that is under active surveillance are eligible.; Pregnant or nursing women.; Active hepatitis B:HBsAg positive and HBV-DNA>ULN; Active hepatitis C:HCV-Ab positive and HCV-RNA>ULN; Known HIV infection; B-NHL patient that received autologous stem cell transplant 6 months prior to study screening, or historically received organ or allogeneic stem cell/bone marrow transplant; B-ALL patients that received transplantation treatment within 3 months prior to enrollment in the study.; Subjects who in the judgement of the Investigator are not suited to participate in this trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
ZHEN JING, MM
Phone
86-21-50582090
Email
zhen.jing@cytocares.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
JUNYUAN QI, MD
Organizational Affiliation
Institute of Hematology & Blood Diseases Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
InstituteHBDH
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300020
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
ZHEN JING, MM
Phone
86-21-50582090
Email
jing.zhen@cytocares.com
First Name & Middle Initial & Last Name & Degree
JUNYUAN QI, MD

12. IPD Sharing Statement

Learn more about this trial

Safety Study of CC312 in Adult Patients With Relapsed/Refractory CD19 Positive B-cell Hematologic Malignancies

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