A Clinical Study of ONCT-808 in Subjects With Relapsed or Refractory B-Cell Malignancies
Relapsed/Refractory Aggressive B-Cell Malignancies
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
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
Experimental
Experimental
Phase 1: Dose Escalation
Phase 2: Dose Expansion
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.