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A Clinical Study of ONCT-808 in Subjects With Relapsed or Refractory B-Cell Malignancies

Primary Purpose

Relapsed/Refractory Aggressive B-Cell Malignancies

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ONCT-808
Bridging Therapy
Sponsored by
Oncternal Therapeutics, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed/Refractory Aggressive B-Cell Malignancies focused on measuring Lymphoma, Lymphoma, B-Cell, Lymphoma, Large B-Cell, Diffuse, Lymphoma, Mantle Cell, Lymphoproliferative Disorders, Lymphatic Diseases, Immunoproliferative Disorders, Immune System Diseases, Lymphoma, Non-Hodgkin, ROR1, CAR-T cell therapy, Autologous CAR-T cell therapy, Adoptive cellular therapy, Cellular immunotherapy

Eligibility Criteria

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

Key Inclusion Criteria:

  • Over 18 years old
  • Histologically confirmed aggressive B-cell NHL, including:

    • MCL, with diagnosis confirmed by cyclin D1 overexpression or evidence of t (11;14) translocation
    • LBCL, including:

      • DLBCL NOS
      • Primary mediastinal LBCL
      • High-grade BCL
      • DLBCL arising from follicular lymphoma
      • Follicular lymphoma grade 3B
      • Richter's syndrome
  • Availability of archival tissue for immunohistology, or willing to undergo baseline biopsy if not available
  • R/R with no available therapy. Subject must have:

    • Received prior systemic therapy that has included an alkylating agent, anthracycline, and an anti-CD20 mAb
    • Received and progressed after autologous hematopoietic stem cell transplant (HSCT) or is ineligible for or has refused to receive HSCT
    • Received prior approved CD19 CAR T-cell therapy or is ineligible for or has refused CD19 CAR-T
  • Minimum washout period between previous systemic therapy and leukapheresis includes:

    • Chemotherapy: at least 14 days or 5 half-lives, whichever is shorter
    • Autologous HSCT: at least 3 months
    • CD19 CAR T-cell therapy: at least 6 months
  • ≥1 measurable lesion per Lugano criteria (Cheson, 2014)
  • Subject has Fluorodeoxyglucose (FDG)-avid disease.
  • Subject has an ECOG performance status of 0 or 1.
  • Subject has adequate organ function:

    • ALC ≥100/uL
    • ANC ≥1000/uL (≥500/uL if due to lymphoma; growth factors allowed)
    • Hgb ≥8 g/dL (transfusion allowed)
    • Platelets ≥75,000/uL (≥50,000/uL if due to lymphoma; transfusion allowed)
    • CrCL ≥50 ml/min; AST/ALT ≤2.5x ULN, T. bili ≤1.5 mg/dl (except Gilbert's)
    • EF ≥50% by ECHO/MUGA; NCS ECG, NCS pleural effusion; O2 sat >92%
  • Subject has an estimated life expectancy of >12 weeks

Key Exclusion Criteria:

  • Prior ROR1-targeted therapy
  • Current or anticipated systemic immunosuppressive therapy (e.g., prednisone >5 mg) from LD chemo until Day 28 post ONCT-808 dosing
  • If receiving anticoagulation therapy, subject is unable to hold therapy for 3 days prior and 28 days following ONCT-808 administration
  • Known CNS involvement by malignancy within 6 months
  • H/o or current CNS disorder (e.g., seizure, CVA, dementia, cerebellar disease, cerebral edema, posterior reversible encephalopathy syndrome or any autoimmune disease with CNS involvement) within 6 months of study entry
  • Clinically significant cardiovascular disease (e.g., MI, UA, CABG, or CHF grade ≥2 NYHA within 12 months of planned ONCT-808 dosing) or serious arrhythmia requiring medication
  • Evidence of HIV infection or active HBV, HCV
  • Systemic fungal infection requiring medication in the last 12 months
  • H/o Covid-19 infection with residual lung infiltrate/fibrosis
  • H/o other malignancy except non-melanoma skin cancer or carcinoma in situ not in remission for ≥2 years
  • H/o autoimmune disease resulting in end organ injury or require systemic immunosuppression within last 2 years
  • H/o allogeneic HSCT or organ transplant

Sites / Locations

  • City of Hope National Medical CenterRecruiting
  • The University of Texas MD Anderson Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Phase 1: Dose Escalation

Phase 2: Dose Expansion

Arm Description

Patients will receive a conditioning regimen of cyclophosphamide and fludarabine intravenously (IV) followed by ONCT-808 IV infusion escalated sequentially with a target dose consistent with the dose required by cohort being enrolled to determine Phase 2 dose (RP2d) regimen(s). Participants may receive bridging therapy that is appropriate to the subject's disease and treatment history if clinically indicated to maintain disease stability.

Patients with LBCL or MCL will receive ONCT-808 for each RP2D regimen determined in Phase 1.

Outcomes

Primary Outcome Measures

To evaluate the incidence, severity, and relationship of Dose Limiting Toxicities (DLT)
To evaluate the incidence, severity, and relationship of Treatment Emergent Adverse Events (TEAE)
To select a RP2D of ONCT-808

Secondary Outcome Measures

To evaluate the Overall Response Rate (ORR) of ONCT-808
Evaluate ORR rate according to Lugano 2014 (Cheson, 2014)
To evaluate the Complete Response (CR) of ONCT-808
Evaluate CR rate according to Lugano 2014 (Cheson, 2014)
To evaluate the Duration of Response (DOR) of ONCT-808
Evaluate DOR according to Lugano 2014 (Cheson, 2014)
Pharmacokinetics of ONCT-808
Evaluate the expansion and persistence of ROR1 CAR-positive T cells in peripheral blood
Safety and Tolerability of ONCT-808
Objective to further characterize the safety profile, including incidence, severity, and relationship of TEAEs

Full Information

First Posted
September 23, 2022
Last Updated
June 13, 2023
Sponsor
Oncternal Therapeutics, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT05588440
Brief Title
A Clinical Study of ONCT-808 in Subjects With Relapsed or Refractory B-Cell Malignancies
Official Title
Phase 1/2 Multi-Center Study to Evaluate the Safety and Efficacy of ONCT-808 in Adult Subjects With Relapsed or Refractory Aggressive B-Cell Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 9, 2023 (Actual)
Primary Completion Date
December 2026 (Anticipated)
Study Completion Date
December 2037 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Oncternal Therapeutics, Inc

4. Oversight

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

5. Study Description

Brief Summary
This is a Phase 1/2 study to investigate the safety and efficacy of the CAR-T therapy, ONCT-808, in patients with relapsed/refractory (R/R) aggressive B cell malignancies.
Detailed Description
Study ONCT-808-101 is a Phase 1/2, single-arm, open-label, multi-center study to evaluate the safety and tolerability, pharmacokinetics, and anti-tumor activity of ONCT-808 in subjects with aggressive B cell lymphoma (BCL), including large B-cell lymphoma (LBCL) and mantle cell lymphoma (MCL). The study will be separated into two distinct phases designated as Phase 1 and Phase 2. After the safety and tolerability of ONCT-808 have been assessed to select the recommended Phase 2 dose (RP2D) in Phase 1, Phase 2 will commence to further validate the dose and evaluate the safety and efficacy of ONCT-808. In Phase 2, subjects with LBCL or MCL will be enrolled into 2 separate dose expansion cohorts.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed/Refractory Aggressive B-Cell Malignancies
Keywords
Lymphoma, Lymphoma, B-Cell, Lymphoma, Large B-Cell, Diffuse, Lymphoma, Mantle Cell, Lymphoproliferative Disorders, Lymphatic Diseases, Immunoproliferative Disorders, Immune System Diseases, Lymphoma, Non-Hodgkin, ROR1, CAR-T cell therapy, Autologous CAR-T cell therapy, Adoptive cellular therapy, Cellular immunotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
57 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Phase 1: Dose Escalation
Arm Type
Experimental
Arm Description
Patients will receive a conditioning regimen of cyclophosphamide and fludarabine intravenously (IV) followed by ONCT-808 IV infusion escalated sequentially with a target dose consistent with the dose required by cohort being enrolled to determine Phase 2 dose (RP2d) regimen(s). Participants may receive bridging therapy that is appropriate to the subject's disease and treatment history if clinically indicated to maintain disease stability.
Arm Title
Phase 2: Dose Expansion
Arm Type
Experimental
Arm Description
Patients with LBCL or MCL will receive ONCT-808 for each RP2D regimen determined in Phase 1.
Intervention Type
Biological
Intervention Name(s)
ONCT-808
Intervention Description
A single infusion of ONCT-808 autologous CAR-T cell infusion will be administered intravenously Phase 1: Dose Escalation with bridging therapy as needed Phase 2: Patients with LBCL or MCL will be enrolled into two separate dose expansion cohorts.
Intervention Type
Drug
Intervention Name(s)
Bridging Therapy
Intervention Description
Bridging therapy can be oral chemotherapy or IV radiotherapy/chemotherapy per institution's guidelines
Primary Outcome Measure Information:
Title
To evaluate the incidence, severity, and relationship of Dose Limiting Toxicities (DLT)
Time Frame
28 days after last dose of ONCT-808
Title
To evaluate the incidence, severity, and relationship of Treatment Emergent Adverse Events (TEAE)
Time Frame
Up to 24 months
Title
To select a RP2D of ONCT-808
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
To evaluate the Overall Response Rate (ORR) of ONCT-808
Description
Evaluate ORR rate according to Lugano 2014 (Cheson, 2014)
Time Frame
Up to 48 months
Title
To evaluate the Complete Response (CR) of ONCT-808
Description
Evaluate CR rate according to Lugano 2014 (Cheson, 2014)
Time Frame
Up to 48 months
Title
To evaluate the Duration of Response (DOR) of ONCT-808
Description
Evaluate DOR according to Lugano 2014 (Cheson, 2014)
Time Frame
Up to 48 months
Title
Pharmacokinetics of ONCT-808
Description
Evaluate the expansion and persistence of ROR1 CAR-positive T cells in peripheral blood
Time Frame
Up to 15 years
Title
Safety and Tolerability of ONCT-808
Description
Objective to further characterize the safety profile, including incidence, severity, and relationship of TEAEs
Time Frame
Up to 15 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Over 18 years old Histologically confirmed aggressive B-cell NHL, including: MCL, with diagnosis confirmed by cyclin D1 overexpression or evidence of t (11;14) translocation LBCL, including: DLBCL NOS Primary mediastinal LBCL High-grade BCL DLBCL arising from follicular lymphoma Follicular lymphoma grade 3B Richter's syndrome Availability of archival tissue for immunohistology, or willing to undergo baseline biopsy if not available R/R with no available therapy. Subject must have: Received prior systemic therapy that has included an alkylating agent, anthracycline, and an anti-CD20 mAb Received and progressed after autologous hematopoietic stem cell transplant (HSCT) or is ineligible for or has refused to receive HSCT Received prior approved CD19 CAR T-cell therapy or is ineligible for or has refused CD19 CAR-T Minimum washout period between previous systemic therapy and leukapheresis includes: Chemotherapy: at least 14 days or 5 half-lives, whichever is shorter Autologous HSCT: at least 3 months CD19 CAR T-cell therapy: at least 6 months ≥1 measurable lesion per Lugano criteria (Cheson, 2014) Subject has Fluorodeoxyglucose (FDG)-avid disease. Subject has an ECOG performance status of 0 or 1. Subject has adequate organ function: ALC ≥100/uL ANC ≥1000/uL (≥500/uL if due to lymphoma; growth factors allowed) Hgb ≥8 g/dL (transfusion allowed) Platelets ≥75,000/uL (≥50,000/uL if due to lymphoma; transfusion allowed) CrCL ≥50 ml/min; AST/ALT ≤2.5x ULN, T. bili ≤1.5 mg/dl (except Gilbert's) EF ≥50% by ECHO/MUGA; NCS ECG, NCS pleural effusion; O2 sat >92% Subject has an estimated life expectancy of >12 weeks Key Exclusion Criteria: Prior ROR1-targeted therapy Current or anticipated systemic immunosuppressive therapy (e.g., prednisone >5 mg) from LD chemo until Day 28 post ONCT-808 dosing If receiving anticoagulation therapy, subject is unable to hold therapy for 3 days prior and 28 days following ONCT-808 administration Known CNS involvement by malignancy within 6 months H/o or current CNS disorder (e.g., seizure, CVA, dementia, cerebellar disease, cerebral edema, posterior reversible encephalopathy syndrome or any autoimmune disease with CNS involvement) within 6 months of study entry Clinically significant cardiovascular disease (e.g., MI, UA, CABG, or CHF grade ≥2 NYHA within 12 months of planned ONCT-808 dosing) or serious arrhythmia requiring medication Evidence of HIV infection or active HBV, HCV Systemic fungal infection requiring medication in the last 12 months H/o Covid-19 infection with residual lung infiltrate/fibrosis H/o other malignancy except non-melanoma skin cancer or carcinoma in situ not in remission for ≥2 years H/o autoimmune disease resulting in end organ injury or require systemic immunosuppression within last 2 years H/o allogeneic HSCT or organ transplant
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ariadne Jerue
Phone
858-761-8062
Email
ajerue@oncternal.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Wang
Organizational Affiliation
MD Anderson
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Matthew Wei
Organizational Affiliation
City of Hope Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
City of Hope National Medical Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
MD
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

A Clinical Study of ONCT-808 in Subjects With Relapsed or Refractory B-Cell Malignancies

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