Autologous CD30.CAR-T in Combination With Nivolumab in cHL Patients After Failure of Frontline Therapy (ACTION)
Primary Purpose
Classical Hodgkin Lymphoma, Hodgkin Disease Refractory, Hodgkin Disease Recurrent
Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Nivolumab
Autologous CD30.CAR-T
Fludarabine
Bendamustine
Sponsored by
About this trial
This is an interventional treatment trial for Classical Hodgkin Lymphoma focused on measuring cHL
Eligibility Criteria
Inclusion Criteria:
- Signed ICF
- Male or female patients who are 12 years of age and above
- Relapsed or refractory CD30+ cHL following failure of a standard frontline chemotherapy
- At least 1 lesion, which must be fluordeoxyglucose positron emission tomography (FDG-PET) avid and measurable by PET-CT scan
- Adequate laboratory parameters including hematologic, renal, hepatic, and coagulation function
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1, or equivalent either Karnofsky performance status (for patients ≥ 16 years of age) or Lansky performance status (for patients < 16 years of age)
- Anticipated life expectancy > 12 weeks
- No active infections including COVID 19 at Screening
Exclusion Criteria:
- Evidence of lymphomatous involvement of the central nervous system (CNS)
- Presence of clinically relevant or active seizure disorder, stroke, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or any autoimmune disease with central nervous system (CNS) involvement
- Symptomatic cardiovascular disease: Class III or IV according to the New York Heart Association (NYHA) Functional Classification
- Active uncontrolled bleeding or a known bleeding diathesis
- Inadequate pulmonary function defined as oxygen saturation by pulse oximetry < 90% on room air
- Echocardiogram (ECHO) or Multi-gated Acquisition (MUGA) scan with left ventricular ejection fraction (LVEF) < 45%
- Prior receipt of salvage therapy, for relapsed or refractory cHL, including allogeneic or ASCT
- Prior receipt of investigational CD30.CAR-T cells
- Receiving any investigational agents or any tumor vaccines
- Receiving any live/attenuated vaccines
- Ongoing treatment with immunosuppressive drugs or chronic systemic corticosteroids
- Unresolved > Grade 1 non-hematologic toxicity associated with any prior treatments
- Previous history of known or suspected autoimmune disease within the past 5 years
- Active interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected drug-related pulmonary toxicity
- Evidence of human immunodeficiency virus (HIV) infection
- Evidence of active viral infection with hepatitis B virus (HBV)
- Evidence of active viral infection with hepatitis C virus (HCV)
- Active second malignancy or history of another malignancy within the last 3 years
- History of hypersensitivity reactions to murine protein-containing products or other product excipients
- Any allergic or adverse reaction to nivolumab, fludarabine, or bendamustine that precludes treatment with these agents
- History of a significant irAE from prior immune checkpoint inhibitor therapy
Sites / Locations
- City of Hope National Medical Center
- University of Miami
- UNC Lineberger Comprehensive Cancer Center
- Baylor College of Medicine
- MD Anderson Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Nivolumab and CD30.CAR-T
Arm Description
Study treatment will include 4 cycles of nivolumab and a single CD30.CAR-T infusion (preceded by lymphodepletion chemotherapy of Fludarabine and Bendamustine).
Outcomes
Primary Outcome Measures
Safety of autologous CD30.CAR-T in combination with nivolumab
DLT
Secondary Outcome Measures
Anti-tumor activity using CR rate of autologous CD30.CAR-T in combination with nivolumab
CR rate
Overall response rate
ORR
Duration of response
DOR
Progression-free survival
PFS
Full Information
NCT ID
NCT05352828
First Posted
April 8, 2022
Last Updated
March 31, 2023
Sponsor
Tessa Therapeutics
Collaborators
Bristol-Myers Squibb
1. Study Identification
Unique Protocol Identification Number
NCT05352828
Brief Title
Autologous CD30.CAR-T in Combination With Nivolumab in cHL Patients After Failure of Frontline Therapy
Acronym
ACTION
Official Title
Phase 1b Study Evaluating the Safety and Efficacy of Autologous CD30.CAR-T in Combination With PD-1 Checkpoint Inhibitor (Nivolumab) in Relapsed or Refractory Classical Hodgkin Lymphoma Patients After Failure of Frontline Therapy (ACTION)
Study Type
Interventional
2. Study Status
Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 25, 2022 (Actual)
Primary Completion Date
December 15, 2025 (Anticipated)
Study Completion Date
December 15, 2037 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tessa Therapeutics
Collaborators
Bristol-Myers Squibb
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a Phase 1b, multicenter, open-label, single arm study to evaluate the safety and efficacy of the combination therapy, CD30.CAR-T and the programmed cell death protein-1 (PD-1) checkpoint inhibitor, nivolumab, in patients aged 12 years of age and above with relapsed or refractory classical Hodgkin lymphoma (cHL) following failure of standard frontline therapy.
Detailed Description
Upon successful leukapheresis to produce CD30.CAR-T cells, patients will enter the treatment phase of the study. Treatments will include 4 cycles of nivolumab and CD30.CAR-T infusion (preceded by lymphodepletion chemotherapy). Patients will then enter the post-treatment follow-up phase of the study, whereby patients will undergo either autologous stem cell transplant or continue to receive up to 6 additional treatment cycles of nivolumab. Patients will be followed for response assessments and safety monitoring until end of study (EOS); approximately 3 years after leukapheresis. Long-term follow-up will continue with additional safety monitoring and survival for up to 15 years after Leukapheresis.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Classical Hodgkin Lymphoma, Hodgkin Disease Refractory, Hodgkin Disease Recurrent
Keywords
cHL
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
Upon successful leukapheresis to produce CD30.CAR-T cells, patients will enter the treatment phase of the study. Treatments will include 4 cycles of nivolumab and CD30.CAR-T infusion (preceded by lymphodepletion chemotherapy). Patients will then enter the post-treatment follow-up phase of the study, whereby patients will undergo either autologous stem cell transplant or continue to receive up to 6 additional treatment cycles of nivolumab. Patients will be followed for response assessments and safety monitoring until end of study (EOS); approximately 3 years after leukapheresis. Long-term follow-up will continue with additional safety monitoring and survival for up to 15 years after Leukapheresis.
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Nivolumab and CD30.CAR-T
Arm Type
Experimental
Arm Description
Study treatment will include 4 cycles of nivolumab and a single CD30.CAR-T infusion (preceded by lymphodepletion chemotherapy of Fludarabine and Bendamustine).
Intervention Type
Drug
Intervention Name(s)
Nivolumab
Other Intervention Name(s)
Opdivo
Intervention Description
Dose: 480 mg or 6 mg/kg Q4W
Intervention Type
Drug
Intervention Name(s)
Autologous CD30.CAR-T
Other Intervention Name(s)
CD30-directed CAR-T cells
Intervention Description
Dose: 2 x 10e8 cells/m2
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Other Intervention Name(s)
Fludara
Intervention Description
Dose: 30 mg/m2/day x 3 days
Intervention Type
Drug
Intervention Name(s)
Bendamustine
Other Intervention Name(s)
Bendeka, Treanda
Intervention Description
Dose: 70 mg/m2/day x 3 days
Primary Outcome Measure Information:
Title
Safety of autologous CD30.CAR-T in combination with nivolumab
Description
DLT
Time Frame
From first dose of nivolumab (Cycle 1) to end of nivolumab Cycle 4 (each cycle is 28 days)
Secondary Outcome Measure Information:
Title
Anti-tumor activity using CR rate of autologous CD30.CAR-T in combination with nivolumab
Description
CR rate
Time Frame
Up to end of 10 weeks post-CD30.CAR-T treatment
Title
Overall response rate
Description
ORR
Time Frame
Through study completion, an average of 3 years from Leukapheresis
Title
Duration of response
Description
DOR
Time Frame
Through study completion, an average of 3 years from Leukapheresis
Title
Progression-free survival
Description
PFS
Time Frame
Through study completion, an average of 3 years from Leukapheresis
Other Pre-specified Outcome Measures:
Title
Overall survival
Description
OS
Time Frame
Through study completion, an average of 3 years from Leukapheresis
Title
Pharmacokinetics - Maximum concentration (Cmax)
Description
Maximum concentration of CD30.CAR-T
Time Frame
Through study completion, an average of 3 years from Leukapheresis
Title
Pharmacokinetics - Time of maximum concentration (Tmax)
Description
Time to peak concentration of CD30.CAR-T in the blood
Time Frame
Through study completion, an average of 3 years from Leukapheresis
Title
Pharmacokinetics - Area under the curve
Description
Area under the curve of CD30.CAR-T in the blood
Time Frame
Through study completion, an average of 3 years from Leukapheresis
10. Eligibility
Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed ICF
Male or female patients who are 12 years of age and above
Relapsed or refractory CD30+ cHL following failure of a standard frontline chemotherapy
At least 1 lesion, which must be fluordeoxyglucose positron emission tomography (FDG-PET) avid and measurable by PET-CT scan
Adequate laboratory parameters including hematologic, renal, hepatic, and coagulation function
Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1, or equivalent either Karnofsky performance status (for patients ≥ 16 years of age) or Lansky performance status (for patients < 16 years of age)
Anticipated life expectancy > 12 weeks
No active infections including COVID 19 at Screening
Exclusion Criteria:
Evidence of lymphomatous involvement of the central nervous system (CNS)
Presence of clinically relevant or active seizure disorder, stroke, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or any autoimmune disease with central nervous system (CNS) involvement
Symptomatic cardiovascular disease: Class III or IV according to the New York Heart Association (NYHA) Functional Classification
Active uncontrolled bleeding or a known bleeding diathesis
Inadequate pulmonary function defined as oxygen saturation by pulse oximetry < 90% on room air
Echocardiogram (ECHO) or Multi-gated Acquisition (MUGA) scan with left ventricular ejection fraction (LVEF) < 45%
Prior receipt of salvage therapy, for relapsed or refractory cHL, including allogeneic or ASCT
Prior receipt of investigational CD30.CAR-T cells
Receiving any investigational agents or any tumor vaccines
Receiving any live/attenuated vaccines
Ongoing treatment with immunosuppressive drugs or chronic systemic corticosteroids
Unresolved > Grade 1 non-hematologic toxicity associated with any prior treatments
Previous history of known or suspected autoimmune disease within the past 5 years
Active interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected drug-related pulmonary toxicity
Evidence of human immunodeficiency virus (HIV) infection
Evidence of active viral infection with hepatitis B virus (HBV)
Evidence of active viral infection with hepatitis C virus (HCV)
Active second malignancy or history of another malignancy within the last 3 years
History of hypersensitivity reactions to murine protein-containing products or other product excipients
Any allergic or adverse reaction to nivolumab, fludarabine, or bendamustine that precludes treatment with these agents
History of a significant irAE from prior immune checkpoint inhibitor therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Helen Heslop, MD
Organizational Affiliation
Baylor College of Medicine
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sairah Ahmed, MD
Organizational Affiliation
M.D. Anderson Cancer 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
Facility Name
University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
UNC Lineberger Comprehensive Cancer Center
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Autologous CD30.CAR-T in Combination With Nivolumab in cHL Patients After Failure of Frontline Therapy
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