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A Study of GC019F CAR-T Cell Immunotherapy for Relapsed or Refractory B- ALL

Primary Purpose

B-cell Acute Lymphoblastic Leukemia

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
GC019F
Sponsored by
Peking University Third Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-cell Acute Lymphoblastic Leukemia

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Aged 18-70 years;
  2. Eastern cooperative oncology group (ECOG) performance status of 0 to 2;
  3. Life expectancy≥12 weeks;
  4. CD19 tumor expression demonstrated in bone marrow or peripheral blood by flow cytometry;
  5. Relapsed or refractory B- ALL: a) Refractory B- ALL: Fail to achieve a CR after 2 cycles of a standard induction chemotherapy regimen or one-line/multi-line salvage chemotherapy; b) Relapsed B- ALL: Relapse after remission for the first time in 12 months or relapse after one-line/multi-line salvage chemotherapy; Relapse is defined as recurrence of primitive cell in peripheral blood or bone marrow(>5%) after remission; c)Relapse after autologous stem cell transplantation or allogeneic hematopoietic stem cell transplantation; d)Patients with Philadelphia chromosome positive(Ph+) ALL were eligible if they were intolerant to or had failed two lines of tyrosine kinase inhibitor (TKI) therapy, or had t315i mutation.
  6. Did not receive hematopoietic stem cell transplantation≤6 months prior to enrollment;
  7. Adequate organ function defined as: a) Creatinine clearance (as estimated by Cockcroft Gault method) >60 mL/min; b) Serum ALT/AST <2.5 ULN; c) Total bilirubin <1.5 ULN (subjects with Gilbert's syndrome≤3 ULN); d) Cardiac ejection fraction≥50%, no evidence of clinically significant pericardial effusion as determined by an ECHO; e) No clinically significant pleural effusion; f) Baseline oxygen saturation >92% on room air;
  8. Females of reproductive age must be in non-lactation period. Females of childbearing potential must have a negative serum or urine pregnancy test. All subjects must use medical-approved-contraception (such as intrauterine device and contraceptive drugs) during the treatment and in 2 years after cell transfusion treatment; Males should avoid sperm donation;
  9. Venous access can be established, peripheral blood mononuclear cells (PBMC) can be collected in researcher's judgement;
  10. The subject agrees to and sign informed consent form;
  11. The subject can communicate well with the researcher, is willing and able to comply with the research plans, and finish the research according to the research rule.

Exclusion Criteria:

  1. Isolated extramedullary leukemia or isolated extramedullary disease relapse;
  2. Central nervous system leukemia involved CNS3;
  3. Concomitant malignancy other than cured non-melanoma skin cancer or cervical carcinoma in situ or localized prostate cancer or superficial bladder cancer or ductal carcinoma in situ or diagnosis of other malignancy exceeds 5 years without relapse or treatment during the 5 years;
  4. Any result of the following infectious disease tests is positive: HIV; HCV; HBsAg; or HBcAb positive with HBV DNA copies positive; TPPA;
  5. Live vaccine ≤4 weeks prior to enrollment;
  6. For Ph+ ALL, TKI therapy ≤1 week prior to enrollment;
  7. History of anti-CD19 therapy or CAR-T or other gene-editing T cell therapy;
  8. Presence of ≥ grade 2 acute graft-versus-host disease (GVHD, Glucksberg criteria) or extensive chronic GVHD (Seattle criteria) that require treatment ≤4 weeks prior to enrollment, or during the study period the subject is required to receive anti-GCHD therapy in researcher's judgement;
  9. Presence of concomitant disease that require systemic steroids or other immune suppressive therapy during the study period in researcher's judgement; Allogeneic cell therapy (such as donor lymphocyte infusion, DLI) ≤4 weeks prior to enrollment;
  10. CNS stereotactic radiotherapy ≤4 weeks prior to enrollment;
  11. Toxicities related to previous therapy did not relieved to ≤1 grade, except hematological toxicity and alopecia;
  12. Known life-threatening hypersensitivity to cyclophosphamide or fludarabine, or presence of other intolerant conditions, or severe allergic constitution;
  13. Patients with active autoimmune disease (e.g., systemic lupus erythematosus, sjogren syndrome, rheumatoid arthritis, psoriasis, multiple sclerosis, inflammatory bowel disease, Hashimoto's thyroiditis, hypothyroidism which can be controlled by thyroid hormone replacement therapy is an exception);
  14. For patients that underwent or plan to undergo major surgical operation before CAR-T treatment, major surgery which required general anesthesia happened ≤4 weeks prior to enrollment, or did not be fully recovered and clinically stable prior to enrollment, or be anticipated to undergo major surgical operation which requires general anesthesia during the study;
  15. Took drug from other research≤28 days prior to enrollment;
  16. Any unstable cardiovascular diseases happened ≤6 months prior to enrollment, including but not limited to, unstable angina, myocardial infarction, heart failure (NYHA grade≥ III grade), severe arrhythmia that require drug interference, cardiac angioplasty/coronary stent implantation/ cardiac bypass surgery ≤6 months prior to enrollment;
  17. Presence of central nervous system (CNS) disease or disease history, including epilepsy, cerebral ischemia/bleeding, dementia, cerebellar disease, or any autoimmune diseases that involve CNS;
  18. Any other condition that researcher think it is inappropriate for the subject to anticipate the trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    CAR-T treatment group

    Arm Description

    The patients will receive one dose of GC019F.

    Outcomes

    Primary Outcome Measures

    Incidence and severity of adverse events(AE)
    AEs will be collected and graded according to ASTCT consensus(for Cytokine Release Syndrome, CRS and Immune Effector Cell-Associated Neurotoxicity Syndrome, ICANS) and CTCAE v5.0(for AE except for CRS/ICANS )

    Secondary Outcome Measures

    CAR copies and concentration of GC007F in peripheral blood, bone marrow and CSF
    GC007F CAR copies and cells in peripheral blood, bone marrow and CSF will be measured by qPCR and FCM in 2 years
    Overall response rate (ORR) and minimal residual disease negative (MRD-) rate of patients who received GC007F infusion
    ORR will be estimated as the percentage of patients who achieved CR or CRi. MRD- rate will be estimated as the percentage of patients who achieved MRD-(blast cells in bone marrow<10^-4 as determined by FCM).
    Duration of response (DOR), progression-free survival (PFS), overall survival (OS) of patients who received GC007F infusion
    DOR refers to the time interval from the date when the patient was evaluated as CR/CRi for the first time to the date when the patient was evaluated as disease relapse or death due to any reason. PFS refers to the time interval from the date of GC007F infusion to the date when the patient was evaluated as disease relapse or death due to any reason. OS refers to the time interval from the date of GC007F infusion to the date when the patient died due to any reason.
    Concentration of anti-GC007F antibody after infusion
    After GC007F infusion, GC007F antibody in peripheral blood will be measured in 2 years

    Full Information

    First Posted
    October 14, 2020
    Last Updated
    October 14, 2020
    Sponsor
    Peking University Third Hospital
    Collaborators
    Gracell Biotechnology Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04595162
    Brief Title
    A Study of GC019F CAR-T Cell Immunotherapy for Relapsed or Refractory B- ALL
    Official Title
    A Study of GC019F CAR-T Cell Immunotherapy for Relapsed or Refractory B-cell Acute Lymphoblastic Leukemia
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2019
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    March 15, 2021 (Anticipated)
    Primary Completion Date
    December 15, 2023 (Anticipated)
    Study Completion Date
    December 15, 2035 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Peking University Third Hospital
    Collaborators
    Gracell Biotechnology Ltd.

    4. Oversight

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

    5. Study Description

    Brief Summary
    The study is an early, open, single-centered trial. The aim of this study is to evaluate the safety and tolerance of GC019F CAR-T cell immunotherapy in relapsed or refractory B-ALL. The study will include 6-12 subjects to receive GC019F therapy.
    Detailed Description
    This study is an early, open, single-centered trial. The major aim of this study is to evaluate the safety and tolerance of GC019F CAR-T cell immunotherapy in relapsed or refractory B-ALL. The study will include 6-12 subjects to receive GC019F single infusion.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    B-cell Acute Lymphoblastic 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
    12 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    CAR-T treatment group
    Arm Type
    Experimental
    Arm Description
    The patients will receive one dose of GC019F.
    Intervention Type
    Biological
    Intervention Name(s)
    GC019F
    Intervention Description
    GC019F is the CAR-T cell immunotherapy targeted CD19. The subjects will receive one single infusion of GC019F.
    Primary Outcome Measure Information:
    Title
    Incidence and severity of adverse events(AE)
    Description
    AEs will be collected and graded according to ASTCT consensus(for Cytokine Release Syndrome, CRS and Immune Effector Cell-Associated Neurotoxicity Syndrome, ICANS) and CTCAE v5.0(for AE except for CRS/ICANS )
    Time Frame
    15 years
    Secondary Outcome Measure Information:
    Title
    CAR copies and concentration of GC007F in peripheral blood, bone marrow and CSF
    Description
    GC007F CAR copies and cells in peripheral blood, bone marrow and CSF will be measured by qPCR and FCM in 2 years
    Time Frame
    2 years
    Title
    Overall response rate (ORR) and minimal residual disease negative (MRD-) rate of patients who received GC007F infusion
    Description
    ORR will be estimated as the percentage of patients who achieved CR or CRi. MRD- rate will be estimated as the percentage of patients who achieved MRD-(blast cells in bone marrow<10^-4 as determined by FCM).
    Time Frame
    2 years
    Title
    Duration of response (DOR), progression-free survival (PFS), overall survival (OS) of patients who received GC007F infusion
    Description
    DOR refers to the time interval from the date when the patient was evaluated as CR/CRi for the first time to the date when the patient was evaluated as disease relapse or death due to any reason. PFS refers to the time interval from the date of GC007F infusion to the date when the patient was evaluated as disease relapse or death due to any reason. OS refers to the time interval from the date of GC007F infusion to the date when the patient died due to any reason.
    Time Frame
    15 years
    Title
    Concentration of anti-GC007F antibody after infusion
    Description
    After GC007F infusion, GC007F antibody in peripheral blood will be measured in 2 years
    Time Frame
    2 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Aged 18-70 years; Eastern cooperative oncology group (ECOG) performance status of 0 to 2; Life expectancy≥12 weeks; CD19 tumor expression demonstrated in bone marrow or peripheral blood by flow cytometry; Relapsed or refractory B- ALL: a) Refractory B- ALL: Fail to achieve a CR after 2 cycles of a standard induction chemotherapy regimen or one-line/multi-line salvage chemotherapy; b) Relapsed B- ALL: Relapse after remission for the first time in 12 months or relapse after one-line/multi-line salvage chemotherapy; Relapse is defined as recurrence of primitive cell in peripheral blood or bone marrow(>5%) after remission; c)Relapse after autologous stem cell transplantation or allogeneic hematopoietic stem cell transplantation; d)Patients with Philadelphia chromosome positive(Ph+) ALL were eligible if they were intolerant to or had failed two lines of tyrosine kinase inhibitor (TKI) therapy, or had t315i mutation. Did not receive hematopoietic stem cell transplantation≤6 months prior to enrollment; Adequate organ function defined as: a) Creatinine clearance (as estimated by Cockcroft Gault method) >60 mL/min; b) Serum ALT/AST <2.5 ULN; c) Total bilirubin <1.5 ULN (subjects with Gilbert's syndrome≤3 ULN); d) Cardiac ejection fraction≥50%, no evidence of clinically significant pericardial effusion as determined by an ECHO; e) No clinically significant pleural effusion; f) Baseline oxygen saturation >92% on room air; Females of reproductive age must be in non-lactation period. Females of childbearing potential must have a negative serum or urine pregnancy test. All subjects must use medical-approved-contraception (such as intrauterine device and contraceptive drugs) during the treatment and in 2 years after cell transfusion treatment; Males should avoid sperm donation; Venous access can be established, peripheral blood mononuclear cells (PBMC) can be collected in researcher's judgement; The subject agrees to and sign informed consent form; The subject can communicate well with the researcher, is willing and able to comply with the research plans, and finish the research according to the research rule. Exclusion Criteria: Isolated extramedullary leukemia or isolated extramedullary disease relapse; Central nervous system leukemia involved CNS3; Concomitant malignancy other than cured non-melanoma skin cancer or cervical carcinoma in situ or localized prostate cancer or superficial bladder cancer or ductal carcinoma in situ or diagnosis of other malignancy exceeds 5 years without relapse or treatment during the 5 years; Any result of the following infectious disease tests is positive: HIV; HCV; HBsAg; or HBcAb positive with HBV DNA copies positive; TPPA; Live vaccine ≤4 weeks prior to enrollment; For Ph+ ALL, TKI therapy ≤1 week prior to enrollment; History of anti-CD19 therapy or CAR-T or other gene-editing T cell therapy; Presence of ≥ grade 2 acute graft-versus-host disease (GVHD, Glucksberg criteria) or extensive chronic GVHD (Seattle criteria) that require treatment ≤4 weeks prior to enrollment, or during the study period the subject is required to receive anti-GCHD therapy in researcher's judgement; Presence of concomitant disease that require systemic steroids or other immune suppressive therapy during the study period in researcher's judgement; Allogeneic cell therapy (such as donor lymphocyte infusion, DLI) ≤4 weeks prior to enrollment; CNS stereotactic radiotherapy ≤4 weeks prior to enrollment; Toxicities related to previous therapy did not relieved to ≤1 grade, except hematological toxicity and alopecia; Known life-threatening hypersensitivity to cyclophosphamide or fludarabine, or presence of other intolerant conditions, or severe allergic constitution; Patients with active autoimmune disease (e.g., systemic lupus erythematosus, sjogren syndrome, rheumatoid arthritis, psoriasis, multiple sclerosis, inflammatory bowel disease, Hashimoto's thyroiditis, hypothyroidism which can be controlled by thyroid hormone replacement therapy is an exception); For patients that underwent or plan to undergo major surgical operation before CAR-T treatment, major surgery which required general anesthesia happened ≤4 weeks prior to enrollment, or did not be fully recovered and clinically stable prior to enrollment, or be anticipated to undergo major surgical operation which requires general anesthesia during the study; Took drug from other research≤28 days prior to enrollment; Any unstable cardiovascular diseases happened ≤6 months prior to enrollment, including but not limited to, unstable angina, myocardial infarction, heart failure (NYHA grade≥ III grade), severe arrhythmia that require drug interference, cardiac angioplasty/coronary stent implantation/ cardiac bypass surgery ≤6 months prior to enrollment; Presence of central nervous system (CNS) disease or disease history, including epilepsy, cerebral ischemia/bleeding, dementia, cerebellar disease, or any autoimmune diseases that involve CNS; Any other condition that researcher think it is inappropriate for the subject to anticipate the trial.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Hongmei Jing, Doctor
    Phone
    15611908428
    Email
    hongmei_jing@163.com

    12. IPD Sharing Statement

    Learn more about this trial

    A Study of GC019F CAR-T Cell Immunotherapy for Relapsed or Refractory B- ALL

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