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Anti-CD19/CD22 Bispecific CAR-T Cell Therapy for MRD Positive ALL

Primary Purpose

MRD-positive, Acute Lymphoblastic Leukemia

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
anti-CD19/CD22 CAR-T cells
Fludarabine
Cyclophosphamide
Sponsored by
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for MRD-positive focused on measuring CD19/CD22, Bispecific CAR-T, leukemia, MRD-positive, B-ALL

Eligibility Criteria

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

Inclusion Criteria:

  • (1) CD19 positive/CD22 positive, or CD19-CD22 positive B-cell acute lymphoblastic leukemia;
  • (2)18 to 70 Years Old, Male and female;
  • (3) Expected survival > 12 weeks;
  • (4) ECOG score 0-2;
  • (5) Bone marrow examination clearly diagnosed as B-cell acute lymphoblastic leukemia and who met one of the following conditions:

    1. Recurrent patients who achieves MRD-positive CR or CRi after standard therapy;
    2. Those who achieves CR, but failed to achieve MRD-negative after at least 2 courses of consolidation therapy;
    3. For Ph-positive ALL patients, a history of at least one TKI application is required in addition to two standard chemotherapy treatments
  • (6) The venous access required for collection can be established and mononuclear cell collection can be determined by the investigators;
  • (7) Liver, kidney and cardiopulmonary functions meet the following requirements:

    1. Creatinine is in the normal range;
    2. Left ventricular ejection fraction >50%;
    3. Baseline oxygen saturation>92%;
    4. Total bilirubin ≤ 2×ULN;
    5. ALT and AST ≤ 2.5×ULN;
  • (8) Able to understand and sign the Informed Consent Document.

Exclusion Criteria:

  • (1) Malignant tumors other than acute lymphoblastic leukemia within 5 years prior to screening, in addition to adequately treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, localized prostate cancer after radical resection, and ductal carcinoma in situ after radical resection;
  • (2) Subjects with positive HBsAg or HBcAb and peripheral blood HBV DNA titer detection ≥ 1 × 102 copy number / L; HCV antibody positive and peripheral blood HCV RNA positive; HIV antibody positive; CMV DNA positive; syphilis positive;
  • (3) Any instability of systemic disease, including but not limited to unstable angina, cerebrovascular accident, or transient cerebral ischemic (within 6 months prior to screening), myocardial infarction (within 6 months prior to screening), congestive heart failure (New York heart association (NYHA) classification ≥ III), need drug therapy of severe arrhythmia, liver, kidney, or metabolic disease;
  • (4) Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment;
  • (5) Pregnant or lactating woman, and female subject who plans to have a pregnancy within 1 year after cell transfusion, or male subject whose partner plans to have a pregnancy within 1 year after cell transfusion;
  • (6) Received CAR-T treatment or other gene therapies before enrollment;
  • (7) Patients with symptoms of central nervous system;
  • (8) Subjects who are receiving systemic steroid treatment and requiring long-term systemic steroid treatment during the treatment as determined by the investigator before screening (except inhalation or topical use); And subjects treated with systemic steroids (except inhalation or topical use) within 72h prior to cell transfusion;
  • (9) The investigators consider other conditions unsuitable for enrollment.

Sites / Locations

  • Shanghai General HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

anti-CD19/CD22 CAR-T cells

Arm Description

Administration with anti-CD19/ CD22 CAR-T cells in the MRD-positive ALL patients.

Outcomes

Primary Outcome Measures

Safety measured by occurence of study related adverse effects defined by NCI CTCAE5.0
Safety measured by occurence of study related adverse effects defined by NCI CTCAE5.0

Secondary Outcome Measures

MRD clearance
MRD clearance
Content of CD19 positive B-cells in peripheral blood
Content of CD19 positive B-cells in peripheral blood
Content of CAR-T related cytokines positive T cells in circulation
Content of CAR-T related cytokines positive T cells in circulation
Total response rate (ORR) after administration
Total response rate (ORR) after administration
Duration of remission (DOR) after administration
Duration of remission (DOR) after administration
Overall Survival (OS)after administration
Overall Survival (OS)after administration

Full Information

First Posted
April 7, 2019
Last Updated
July 15, 2022
Sponsor
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT03919526
Brief Title
Anti-CD19/CD22 Bispecific CAR-T Cell Therapy for MRD Positive ALL
Official Title
The Safety and Clinical Efficacy of Human CD19/CD22 Bispecific CAR-T Cell Therapy for Subjects With MRD-positive B Cell Acute Lymphoblastic Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 11, 2019 (Actual)
Primary Completion Date
August 1, 2022 (Anticipated)
Study Completion Date
August 1, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine

4. Oversight

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

5. Study Description

Brief Summary
To evaluate the safety and efficacy of CD19/CD22 Bispecific CAR-T for the treatment of MRD-positive B cell acute lymphoblastic leukemia. Patients will be given a conditioning chemotherapy regimen of fludarabine and cyclophosphamide followed by a single infusion of CD19/CD22 CAR+ T cells.
Detailed Description
Participants with MRD-positive B cell acute lymphoblastic leukemia can participate if all eligibility criteria are met. Tests required to determine eligibility include disease assessments, a physical exam, Electrocardiograph, CT/MRI , and blood draws. Participants receive chemotherapy prior to the infusion of CD19/CD22 CAR+ T cells. After the infusion, participants will be followed for side effects and effect of CD19/CD22 CAR+ T cells. Study procedures may be performed while hospitalized.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
MRD-positive, Acute Lymphoblastic Leukemia
Keywords
CD19/CD22, Bispecific CAR-T, leukemia, MRD-positive, B-ALL

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
anti-CD19/CD22 CAR-T cells
Arm Type
Experimental
Arm Description
Administration with anti-CD19/ CD22 CAR-T cells in the MRD-positive ALL patients.
Intervention Type
Biological
Intervention Name(s)
anti-CD19/CD22 CAR-T cells
Intervention Description
Retroviral vector-transduced autologous T cells to express anti-CD19 and anti-CD22 CARs
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Intervention Description
30mg/m2/d
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
300mg/m2/d
Primary Outcome Measure Information:
Title
Safety measured by occurence of study related adverse effects defined by NCI CTCAE5.0
Description
Safety measured by occurence of study related adverse effects defined by NCI CTCAE5.0
Time Frame
28 days post infusion
Secondary Outcome Measure Information:
Title
MRD clearance
Description
MRD clearance
Time Frame
3 months post infusion
Title
Content of CD19 positive B-cells in peripheral blood
Description
Content of CD19 positive B-cells in peripheral blood
Time Frame
3 months post infusion
Title
Content of CAR-T related cytokines positive T cells in circulation
Description
Content of CAR-T related cytokines positive T cells in circulation
Time Frame
3 months post infusion
Title
Total response rate (ORR) after administration
Description
Total response rate (ORR) after administration
Time Frame
3 months post infusion
Title
Duration of remission (DOR) after administration
Description
Duration of remission (DOR) after administration
Time Frame
2 years post infusion
Title
Overall Survival (OS)after administration
Description
Overall Survival (OS)after administration
Time Frame
2 years post infusion

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: (1) CD19 positive/CD22 positive, or CD19-CD22 positive B-cell acute lymphoblastic leukemia; (2)18 to 70 Years Old, Male and female; (3) Expected survival > 12 weeks; (4) ECOG score 0-2; (5) Bone marrow examination clearly diagnosed as B-cell acute lymphoblastic leukemia and who met one of the following conditions: Recurrent patients who achieves MRD-positive CR or CRi after standard therapy; Those who achieves CR, but failed to achieve MRD-negative after at least 2 courses of consolidation therapy; For Ph-positive ALL patients, a history of at least one TKI application is required in addition to two standard chemotherapy treatments (6) The venous access required for collection can be established and mononuclear cell collection can be determined by the investigators; (7) Liver, kidney and cardiopulmonary functions meet the following requirements: Creatinine is in the normal range; Left ventricular ejection fraction >50%; Baseline oxygen saturation>92%; Total bilirubin ≤ 2×ULN; ALT and AST ≤ 2.5×ULN; (8) Able to understand and sign the Informed Consent Document. Exclusion Criteria: (1) Malignant tumors other than acute lymphoblastic leukemia within 5 years prior to screening, in addition to adequately treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, localized prostate cancer after radical resection, and ductal carcinoma in situ after radical resection; (2) Subjects with positive HBsAg or HBcAb and peripheral blood HBV DNA titer detection ≥ 1 × 102 copy number / L; HCV antibody positive and peripheral blood HCV RNA positive; HIV antibody positive; CMV DNA positive; syphilis positive; (3) Any instability of systemic disease, including but not limited to unstable angina, cerebrovascular accident, or transient cerebral ischemic (within 6 months prior to screening), myocardial infarction (within 6 months prior to screening), congestive heart failure (New York heart association (NYHA) classification ≥ III), need drug therapy of severe arrhythmia, liver, kidney, or metabolic disease; (4) Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment; (5) Pregnant or lactating woman, and female subject who plans to have a pregnancy within 1 year after cell transfusion, or male subject whose partner plans to have a pregnancy within 1 year after cell transfusion; (6) Received CAR-T treatment or other gene therapies before enrollment; (7) Patients with symptoms of central nervous system; (8) Subjects who are receiving systemic steroid treatment and requiring long-term systemic steroid treatment during the treatment as determined by the investigator before screening (except inhalation or topical use); And subjects treated with systemic steroids (except inhalation or topical use) within 72h prior to cell transfusion; (9) The investigators consider other conditions unsuitable for enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xianmin Song, M.D.
Phone
021-63240090
Email
shongxm@139.com
First Name & Middle Initial & Last Name or Official Title & Degree
Hongliang Fang, doctor
Phone
021-58552006
Email
fanghongliang@dashengbio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xianmin Song, M.D.
Organizational Affiliation
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shanghai General Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200080
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xianmin Song, M.D.
Phone
86-21-63240090
Ext
3172
Email
shongxm@sjtu.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Anti-CD19/CD22 Bispecific CAR-T Cell Therapy for MRD Positive ALL

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