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A Study of LCAR-B38M CAR-T Cells, a Chimeric Antigen Receptor T-cell (CAR-T) Therapy Directed Against B-cell Maturation Antigen (BCMA) in Chinese Participants With Relapsed or Refractory Multiple Myeloma (CARTIFAN-1)

Primary Purpose

Multiple Myeloma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
LCAR-B38M CAR-T Cell
Sponsored by
Nanjing Legend Biotech Co.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma

Eligibility Criteria

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

Inclusion Criteria:

  • Documented initial diagnosis of multiple myeloma according to International Myeloma Working Group (IMWG) diagnostic criteria
  • Measurable disease at Screening
  • Received at least 3 prior lines of treatment for multiple myeloma

    a) Undergone at least 1 complete cycle of treatment for each line, unless progressive disease (PD) was documented by IMWG criteria as the best response to the regimen

  • Received a proteasome inhibitor (PI) and an immunomodulatory drug (IMiD)
  • Participant must have documented evidence of progressive disease based on investigator's determination of response consistent with IMWG criteria on or within 12 months of their last regimen. Non-responsive disease is defined as either failure to achieve minimal response or development of progressive disease (PD) while on therapy. Also, participants with documented evidence of PD disease (as above) within the previous 6 months and who are refractory or non-responsive to their most recent line of treatment afterwards are eligible
  • Eastern Cooperative Oncology Group (ECOG) Performance Status grade of 0 or 1

Exclusion Criteria:

  • Prior treatment with chimeric antigen receptor T (cells) CAR-T therapy directed at any target
  • Any therapy that is targeted to B-cell maturation antigen (BCMA)
  • The following cardiac conditions: a) New York Heart Association (NYHA) stage III or IV congestive heart failure b) Myocardial infarction or coronary artery bypass graft (CABG) 6 months prior to enrollment c) History of clinically significant ventricular arrhythmia or unexplained syncope, not believed to be vasovagal in nature or due to dehydration d) History of severe non-ischemic cardiomyopathy e) Impaired cardiac function (left ventricular ejection fraction [LVEF] less than [<]45%) as assessed by echocardiogram or multiple-gated acquisition (MUGA) scan (performed less than or equal to (<=) 8 weeks of apheresis)
  • Have received a cumulative dose of corticosteroids equivalent to greater than or equal to(>=)70 milligram (mg) of prednisone within 7 days prior to apheresis
  • Diagnosed or treated for invasive malignancy other than multiple myeloma, except:

    1. Malignancy treated with curative intent and with no known active disease present for greater than or equal to (>=) 2 years before enrollment; or
    2. Adequately treated non-melanoma skin cancer without evidence of disease
  • Prior antitumor therapy with insufficient washout period
  • Toxicity from previous anticancer therapy must resolve to baseline levels or to Grade 1 or less except for alopecia or peripheral neuropathy
  • Received either of the following:

    1. An allogeneic stem cell transplant for multiple myeloma
    2. An autologous stem cell transplant less than or equal to (<=) 12 weeks before apheresis
  • Known active, or prior history of, central nervous system (CNS) involvement or exhibits clinical signs of meningeal involvement of multiple myeloma

Sites / Locations

  • Peking University Third HospitalRecruiting
  • Fujian Medical University Union hospitalRecruiting
  • Sun Yat -Sen University Cancer CenterRecruiting
  • Nanjing Drum Tower Hospital
  • Jiangsu Province HospitalRecruiting
  • Shanghai Changzheng HospitalRecruiting
  • Ruijin Hospital, Shanghai Jiao Tong UniversityRecruiting
  • Shanghai Fourth People Hospital
  • The Second Affiliated Hospital of Xi'an Jiaotong UniversityRecruiting
  • West China Hospital, Sichuan UniversityRecruiting
  • The First Affiliated Hospital, Medical School of Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

LCAR-B38M Chimeric Antigen Receptor T Cell

Arm Description

Participants will receive LCAR-B38M CAR-T cells as a single infusion which consists of autologous T lymphocytes transduced with LCAR-B38M, a lentiviral vector to express a chimeric antigen receptor targeting the human B cell maturation antigen (anti-BCMA CAR). In addition, participants will enroll in additional cohort to further characterize the safety profile and accumulate efficacy data of LCAR-B38M CAR-T cells.

Outcomes

Primary Outcome Measures

Overall Response Rate (ORR)
The ORR is defined as the percentage of participants who achieve at least a partial response (PR) or better according to international myeloma working group (IMWG) criteria.

Secondary Outcome Measures

Number of Participants With Adverse Events
An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.
Chimeric Antigen Receptor T (CAR-T) Positive Cell Concentration
Venous blood samples will be collected for measurement of CAR-T positive cellular concentration.
Transgene Levels of LCAR-B38M CAR-T Cells
Transgene Levels of LCAR-B38M CAR-T Cells using sensitive assay methods will be assessed.
Systemic Cytokine Concentrations
Serum cytokine concentrations such as Interleukin [IL]-6, IL-15, IL-10 will be measured for biomarker assessment.
Number of Participants With Anti- LCAR-B38M CAR-T Cell Antibodies
Number of participants with anti- LCAR-B38M CAR-T cell antibodies will be evaluated.
Percentage of Participants with Very Good Partial Response (VGPR) or Better Rate
The VGPR or better rate, defined as the percentage of participants achieving VGPR and complete response (CR) (including stringent complete response [sCR]) according to IMWG criteria during or after the study treatment. IMWG criteria for VGPR: Serum and urine M-component detectable by immunofixation but not on electrophoresis, or greater than or equal to (>=) 90 percent (%) reduction in serum Mprotein plus urine M-protein less than (<) 100 milligram (mg)/24 hours, CR: Negative immunofixation on the serum and urine, disappearance of any soft tissue plasmacytomas and <5% plasma cells (PCs) in bone marrow. sCR: CR plus normal free light chain (FLC) ratio, and absence of clonal PCs by immunohistochemistry (IHC), immunofluorescence for 2 to 4 color flow cytometry.
Percentage of Participants with Complete Response (CR)
Complete response is based on serum M-Protein and bone marrow assessments as per IMWG criteria.
Percentage of Participants with Negative Minimal Residual Disease (MRD)
Minimal residual disease negative rate is defined as the percentage of participants who achieve MRD negative status by the respective time point. MRD will be assessed by bone marrow 8-colored flow cytometry.
Percentage of Participants who Achieve Clinical Benefit
Clinical Benefit Rate is defined as the percentage of participants who achieve ORR (sCR + CR + VGPR + PR) and minimal response (MR) as per IMWG criteria.
Duration of Response (DOR)
Duration of response (DOR) will be calculated among responders (with a PR or better response) from the date of initial documentation of a response (PR or better) to the date of first documented evidence of progressive disease, as defined in the IMWG criteria or death due to any cause, whichever occurs first.
Time to Response (TTR)
Time to response (TTR) is defined as the time between date of the initial infusion of LCAR-B38M CAR-T cells and the first efficacy evaluation that the participant has met all criteria for PR or better.
Progression-Free Survival (PFS)
PFS defined as time from date of initial infusion of LCAR-B38M CAR-T cells to date of first documented disease progression, defined in the IMWG criteria, or death due to any cause, whichever occurs first.
Overall survival (OS)
Overall survival (OS) is measured from the date of infusion of the LCAR-B38M CAR-T cells to the date of the participant's death.
Levels of CAR-T cell Activation Markers
Levels of CAR-T cell Activation Markers like CD4+, CD8+, and CD25+ will be assessed. An evaluation of cell populations may be performed by flow cytometry.
Levels of LCAR-B38M CAR-T cell Expansion (proliferation)
Levels of LCAR-B38M CAR-T cell expansion (proliferation) will be reported.
Levels of LCAR-B38M CAR-T Persistence
Levels of LCAR-B38M CAR-T persistence will be evaluated via monitoring CAR-T positive cell counts and CART transgene levels.
Percentage of Participants with Stringent Complete Response (sCR)
Stringent Complete Response (sCR) is based on serum M-Protein and bone marrow assessments as per IMWG criteria for complete response(CR) plus normal free light chain (FLC) ratio, and absence of clonal PCs by immunohistochemistry(IHC), or 2 to 4 color flow cytometry.
Circulating Soluble B-Cell Maturation Antigen (sBCMA) Levels
Blood samples will be collected for measurement of sBCMA level.
Percent Reduction in BCMA Expression Cells
Percent reduction in BCMA Expression Cells will be measured.

Full Information

First Posted
November 27, 2018
Last Updated
December 27, 2022
Sponsor
Nanjing Legend Biotech Co.
Collaborators
Janssen Research & Development, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03758417
Brief Title
A Study of LCAR-B38M CAR-T Cells, a Chimeric Antigen Receptor T-cell (CAR-T) Therapy Directed Against B-cell Maturation Antigen (BCMA) in Chinese Participants With Relapsed or Refractory Multiple Myeloma
Acronym
CARTIFAN-1
Official Title
A Phase 2, Open-Label Study of LCAR-B38M CAR-T Cells, a Chimeric Antigen Receptor T-cell (CAR-T) Therapy Directed Against BCMA in Chinese Subjects With Relapsed or Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
January 23, 2019 (Actual)
Primary Completion Date
February 16, 2026 (Anticipated)
Study Completion Date
February 16, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nanjing Legend Biotech Co.
Collaborators
Janssen Research & Development, LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the efficacy and safety of LCAR-B38M chimeric antigen receptor T (CAR-T) cells.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
130 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
LCAR-B38M Chimeric Antigen Receptor T Cell
Arm Type
Experimental
Arm Description
Participants will receive LCAR-B38M CAR-T cells as a single infusion which consists of autologous T lymphocytes transduced with LCAR-B38M, a lentiviral vector to express a chimeric antigen receptor targeting the human B cell maturation antigen (anti-BCMA CAR). In addition, participants will enroll in additional cohort to further characterize the safety profile and accumulate efficacy data of LCAR-B38M CAR-T cells.
Intervention Type
Biological
Intervention Name(s)
LCAR-B38M CAR-T Cell
Other Intervention Name(s)
Ciltacabtagene autoleucel
Intervention Description
Participants will receive LCAR-B38M CAR-T cells as a single infusion which consists of autologous T lymphocytes transduced with LCAR-B38M, a lentiviral vector to express a chimeric antigen receptor targeting the human B cell maturation antigen (anti-BCMA CAR).
Primary Outcome Measure Information:
Title
Overall Response Rate (ORR)
Description
The ORR is defined as the percentage of participants who achieve at least a partial response (PR) or better according to international myeloma working group (IMWG) criteria.
Time Frame
Minimum 2 years after LCAR-B38M chimeric antigen receptor T (CAR-T) infusion (Day 1)
Secondary Outcome Measure Information:
Title
Number of Participants With Adverse Events
Description
An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Chimeric Antigen Receptor T (CAR-T) Positive Cell Concentration
Description
Venous blood samples will be collected for measurement of CAR-T positive cellular concentration.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Transgene Levels of LCAR-B38M CAR-T Cells
Description
Transgene Levels of LCAR-B38M CAR-T Cells using sensitive assay methods will be assessed.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Systemic Cytokine Concentrations
Description
Serum cytokine concentrations such as Interleukin [IL]-6, IL-15, IL-10 will be measured for biomarker assessment.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Number of Participants With Anti- LCAR-B38M CAR-T Cell Antibodies
Description
Number of participants with anti- LCAR-B38M CAR-T cell antibodies will be evaluated.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Percentage of Participants with Very Good Partial Response (VGPR) or Better Rate
Description
The VGPR or better rate, defined as the percentage of participants achieving VGPR and complete response (CR) (including stringent complete response [sCR]) according to IMWG criteria during or after the study treatment. IMWG criteria for VGPR: Serum and urine M-component detectable by immunofixation but not on electrophoresis, or greater than or equal to (>=) 90 percent (%) reduction in serum Mprotein plus urine M-protein less than (<) 100 milligram (mg)/24 hours, CR: Negative immunofixation on the serum and urine, disappearance of any soft tissue plasmacytomas and <5% plasma cells (PCs) in bone marrow. sCR: CR plus normal free light chain (FLC) ratio, and absence of clonal PCs by immunohistochemistry (IHC), immunofluorescence for 2 to 4 color flow cytometry.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Percentage of Participants with Complete Response (CR)
Description
Complete response is based on serum M-Protein and bone marrow assessments as per IMWG criteria.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Percentage of Participants with Negative Minimal Residual Disease (MRD)
Description
Minimal residual disease negative rate is defined as the percentage of participants who achieve MRD negative status by the respective time point. MRD will be assessed by bone marrow 8-colored flow cytometry.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Percentage of Participants who Achieve Clinical Benefit
Description
Clinical Benefit Rate is defined as the percentage of participants who achieve ORR (sCR + CR + VGPR + PR) and minimal response (MR) as per IMWG criteria.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Duration of Response (DOR)
Description
Duration of response (DOR) will be calculated among responders (with a PR or better response) from the date of initial documentation of a response (PR or better) to the date of first documented evidence of progressive disease, as defined in the IMWG criteria or death due to any cause, whichever occurs first.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Time to Response (TTR)
Description
Time to response (TTR) is defined as the time between date of the initial infusion of LCAR-B38M CAR-T cells and the first efficacy evaluation that the participant has met all criteria for PR or better.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Progression-Free Survival (PFS)
Description
PFS defined as time from date of initial infusion of LCAR-B38M CAR-T cells to date of first documented disease progression, defined in the IMWG criteria, or death due to any cause, whichever occurs first.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Overall survival (OS)
Description
Overall survival (OS) is measured from the date of infusion of the LCAR-B38M CAR-T cells to the date of the participant's death.
Time Frame
Mnimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Levels of CAR-T cell Activation Markers
Description
Levels of CAR-T cell Activation Markers like CD4+, CD8+, and CD25+ will be assessed. An evaluation of cell populations may be performed by flow cytometry.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Levels of LCAR-B38M CAR-T cell Expansion (proliferation)
Description
Levels of LCAR-B38M CAR-T cell expansion (proliferation) will be reported.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Levels of LCAR-B38M CAR-T Persistence
Description
Levels of LCAR-B38M CAR-T persistence will be evaluated via monitoring CAR-T positive cell counts and CART transgene levels.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Percentage of Participants with Stringent Complete Response (sCR)
Description
Stringent Complete Response (sCR) is based on serum M-Protein and bone marrow assessments as per IMWG criteria for complete response(CR) plus normal free light chain (FLC) ratio, and absence of clonal PCs by immunohistochemistry(IHC), or 2 to 4 color flow cytometry.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Circulating Soluble B-Cell Maturation Antigen (sBCMA) Levels
Description
Blood samples will be collected for measurement of sBCMA level.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)
Title
Percent Reduction in BCMA Expression Cells
Description
Percent reduction in BCMA Expression Cells will be measured.
Time Frame
Minimum 2 years after LCAR-B38M CART infusion (Day 1)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Documented initial diagnosis of multiple myeloma according to International Myeloma Working Group (IMWG) diagnostic criteria Measurable disease at Screening Received at least 3 prior lines of treatment for multiple myeloma a) Undergone at least 1 complete cycle of treatment for each line, unless progressive disease (PD) was documented by IMWG criteria as the best response to the regimen Received a proteasome inhibitor (PI) and an immunomodulatory drug (IMiD) Participant must have documented evidence of progressive disease based on investigator's determination of response consistent with IMWG criteria on or within 12 months of their last regimen. Non-responsive disease is defined as either failure to achieve minimal response or development of progressive disease (PD) while on therapy. Also, participants with documented evidence of PD disease (as above) within the previous 6 months and who are refractory or non-responsive to their most recent line of treatment afterwards are eligible Eastern Cooperative Oncology Group (ECOG) Performance Status grade of 0 or 1 Exclusion Criteria: Prior treatment with chimeric antigen receptor T (cells) CAR-T therapy directed at any target Any therapy that is targeted to B-cell maturation antigen (BCMA) The following cardiac conditions: a) New York Heart Association (NYHA) stage III or IV congestive heart failure b) Myocardial infarction or coronary artery bypass graft (CABG) 6 months prior to enrollment c) History of clinically significant ventricular arrhythmia or unexplained syncope, not believed to be vasovagal in nature or due to dehydration d) History of severe non-ischemic cardiomyopathy e) Impaired cardiac function (left ventricular ejection fraction [LVEF] less than [<]45%) as assessed by echocardiogram or multiple-gated acquisition (MUGA) scan (performed less than or equal to (<=) 8 weeks of apheresis) Have received a cumulative dose of corticosteroids equivalent to greater than or equal to(>=)70 milligram (mg) of prednisone within 7 days prior to apheresis Diagnosed or treated for invasive malignancy other than multiple myeloma, except: Malignancy treated with curative intent and with no known active disease present for greater than or equal to (>=) 2 years before enrollment; or Adequately treated non-melanoma skin cancer without evidence of disease Prior antitumor therapy with insufficient washout period Toxicity from previous anticancer therapy must resolve to baseline levels or to Grade 1 or less except for alopecia or peripheral neuropathy Received either of the following: An allogeneic stem cell transplant for multiple myeloma An autologous stem cell transplant less than or equal to (<=) 12 weeks before apheresis Known active, or prior history of, central nervous system (CNS) involvement or exhibits clinical signs of meningeal involvement of multiple myeloma
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xiaohu Fan
Phone
13851733397
Email
frank.fan@legendbiotech.com
First Name & Middle Initial & Last Name or Official Title & Degree
Qiong Wang
Phone
18051978283
Email
wangqiong@legendbiotech.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Research&Development,LLC Clinical Trail
Organizational Affiliation
Janssen Research & Development, LLC
Official's Role
Study Director
Facility Information:
Facility Name
Peking University Third Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100191
Country
China
Individual Site Status
Recruiting
Facility Name
Fujian Medical University Union hospital
City
Fuzhou
State/Province
Fujian
ZIP/Postal Code
350001
Country
China
Individual Site Status
Recruiting
Facility Name
Sun Yat -Sen University Cancer Center
City
Guandong
State/Province
Guangzhou
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Name
Nanjing Drum Tower Hospital
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210008
Country
China
Individual Site Status
Not yet recruiting
Facility Name
Jiangsu Province Hospital
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210029
Country
China
Individual Site Status
Recruiting
Facility Name
Shanghai Changzheng Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200003
Country
China
Individual Site Status
Recruiting
Facility Name
Ruijin Hospital, Shanghai Jiao Tong University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200025
Country
China
Individual Site Status
Recruiting
Facility Name
Shanghai Fourth People Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200434
Country
China
Individual Site Status
Not yet recruiting
Facility Name
The Second Affiliated Hospital of Xi'an Jiaotong University
City
Xi'an
State/Province
Shanxi
ZIP/Postal Code
710004
Country
China
Individual Site Status
Recruiting
Facility Name
West China Hospital, Sichuan University
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610041
Country
China
Individual Site Status
Recruiting
Facility Name
The First Affiliated Hospital, Medical School of Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310003
Country
China
Individual Site Status
Recruiting

12. IPD Sharing Statement

Citations:
PubMed Identifier
36269898
Citation
Mi JQ, Zhao W, Jing H, Fu W, Hu J, Chen L, Zhang Y, Yao D, Chen D, Schecter JM, Yang F, Tian X, Sun H, Zhuang SH, Ren J, Fan X, Jin J, Niu T, Chen SJ. Phase II, Open-Label Study of Ciltacabtagene Autoleucel, an Anti-B-Cell Maturation Antigen Chimeric Antigen Receptor-T-Cell Therapy, in Chinese Patients With Relapsed/Refractory Multiple Myeloma (CARTIFAN-1). J Clin Oncol. 2023 Feb 20;41(6):1275-1284. doi: 10.1200/JCO.22.00690. Epub 2022 Oct 21.
Results Reference
derived

Learn more about this trial

A Study of LCAR-B38M CAR-T Cells, a Chimeric Antigen Receptor T-cell (CAR-T) Therapy Directed Against B-cell Maturation Antigen (BCMA) in Chinese Participants With Relapsed or Refractory Multiple Myeloma

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