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CD19 hsCAR-T for Refractory/Relapsed CD19+ B-ALL Patients

Primary Purpose

Acute Lymphoblastic Leukemia

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
CD19 hsCAR-T
Sponsored by
Xuanwu Hospital, Beijing
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Lymphoblastic Leukemia focused on measuring CD19 hsCAR-T, B-ALL, Humanized selective CAR

Eligibility Criteria

1 Year - 75 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects with refractory/relapse B-cell ALL with no available curative treatment options (such as autologous or allogeneic SCT);
  2. Subjects previously treated with B cell-directed engineered cell therapy are eligible if they meet the following criteria:

    1. relapsed and/or MRD-positive after prior cell therapy;
    2. partial response to prior cell therapy;
    3. Clinical and laboratory data are available;
  3. Documented CD19 expression after previous B cell-directed therapies;
  4. Aged 1 to 75 years;
  5. KPS>40;
  6. At least 2 weeks or 5 drug half-lives, whichever is shorter must have elapsed since any prior systemic therapy at the time the subject is planned for leukapheresis, except for systemic inhibitory/stimulatory immune checkpoint therapy;
  7. Women of childbearing potential must have a urine pregnancy test taken and proven negative prior to the treatment. All patients agree to use reliable methods of contraception during the trial period and throughout the last follow-up visit;
  8. Subjects with relapsed disease after prior allogeneic SCT (myeloablative or non-myeloablative) will be eligible if the patients do not present with active GVHD and are not undergoing immunosuppressive regimes;
  9. Patients with CNS3 (WCB ≥5/mL in CSF with presence of lymphoblasts) disease will be eligible if the CNS disease is responsive to therapy;
  10. Participation in the clinical trials should be voluntary with signed informed consent.

Exclusion Criteria:

  1. Patients with hypervolemia (white blood cell count> 50 x 10^9 / L) or rapidly progressive disease that in the estimation of the investigators and sponsors would compromise the patient's ability to complete the study;
  2. History of melanoma skin cancer or other primary tumors (eg, cervical cancer, bladder cancer, breast cancer) (except for those with 3 years or longer of cure);
  3. Patients with fungal, bacterial, viral, or other uncontrollable infections or infections requiring Level 4 isolation (UTI or inoculation assays may be performed if necessary);
  4. Patients with positive results for HIV, HBV, HCV tests;
  5. With CNS disorders such as cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or autoimmune disease with CNS involvement;
  6. History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other clinically significant cardiac diseases within 12 months of enrollment, or with cardiac atrial or cardiac ventricular lymphoma;
  7. Patients that are receiving anticoagulant therapy or have ever coagulation disorders;
  8. Any medical condition that in the judgment of the sponsors/investigators is likely to interfere with assessment of safety or efficacy of study;
  9. History of severe immediate hypersensitivity reaction to any of the agents used in this study;
  10. Female patients who are pregnant or breastfeeding;
  11. Feasibility assessment during screening demonstrates <30% transduction of target lymphocytes, or insufficient expansion (< 5-fold) in response to CD3/CD28 co-stimulation;
  12. Patients with any uncontrolled diseases that are unsuitable for enrollment;
  13. CNS3 disease that is progressive on therapy, or with CNS parenchymal lesions that might increase the risk of CNS toxicity;
  14. Any situation that is considered to potentially increase the risk of the subject or interfere with the outcome of the study;
  15. Patients who have been enrolled in other clinical studies.

Sites / Locations

  • Beijing Children's Hospital Capital Meidcal UniversityRecruiting
  • Beijing Children's Hospital, Capital Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CD19 hsCAR-T

Arm Description

This cohort will be administrated by T cells transduced with lentivirus vectors expressing CD19 hsCAR

Outcomes

Primary Outcome Measures

Overall response rate (ORR) within 3 months
Overall response rate (ORR) within 3 months after infusion of CD19 hsCAR-T

Secondary Outcome Measures

Best overall response (BOR)
Best overall response (BOR) of complete remission (CR) or CR with incomplete blood count recovery (CRi) within 3 months after CD19 hsCAR-T infusion
Duration of remission (DoR)
Duration of remission (DoR) within 1 year after CD19 hsCAR-T infusion (Duration of remission (DOR) is defined as the duration from the date when the response criteria of CR or CRi is first met to the date of relapse or death due to ALL)
Event free survival within 1 year
Event free survival within 1 year (Event free survival is defined as the time from start of the first infusion to the earliest of death from any cause or relapse)
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability])
Safety and tolerability of CD19 hsCAR-T: frequency and severity of adverse events, including, but not limited to, cytokine release syndrome (CRS) and macrophage activation syndrome (MAS)

Full Information

First Posted
April 1, 2019
Last Updated
April 4, 2019
Sponsor
Xuanwu Hospital, Beijing
Collaborators
Beijing Children's Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03902197
Brief Title
CD19 hsCAR-T for Refractory/Relapsed CD19+ B-ALL Patients
Official Title
A Phase II Study of CD19 hsCAR-T for Refractory/Relapsed CD19+ B-ALL Patients Previously Treated With Cell Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Recruiting
Study Start Date
April 22, 2019 (Anticipated)
Primary Completion Date
December 31, 2021 (Anticipated)
Study Completion Date
December 21, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Xuanwu Hospital, Beijing
Collaborators
Beijing Children's Hospital

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
This Phase II study is to evaluate the efficacy and safety of a CD19-targeting humanized selective CAR-T (CD19 hsCAR-T) in refractory/relapsed CD19+ B-ALL leukemia patients who have no available curative treatment options, have a limited prognosis with currently available treatments, and were previously treated with a B cell directed cell therapy.
Detailed Description
CD19+ B-ALL patients who have relapsed after murine-based CD19 CAR-T (CD19mCAR-T) treatment and/or have limited clinical response to CD19mCAR-T will be enrolled to receive CD19 hsCAR-T treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Lymphoblastic Leukemia
Keywords
CD19 hsCAR-T, B-ALL, Humanized selective CAR

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CD19 hsCAR-T
Arm Type
Experimental
Arm Description
This cohort will be administrated by T cells transduced with lentivirus vectors expressing CD19 hsCAR
Intervention Type
Biological
Intervention Name(s)
CD19 hsCAR-T
Intervention Description
CD19 hsCAR-T will be administered by I.V. infusion
Primary Outcome Measure Information:
Title
Overall response rate (ORR) within 3 months
Description
Overall response rate (ORR) within 3 months after infusion of CD19 hsCAR-T
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Best overall response (BOR)
Description
Best overall response (BOR) of complete remission (CR) or CR with incomplete blood count recovery (CRi) within 3 months after CD19 hsCAR-T infusion
Time Frame
3 months
Title
Duration of remission (DoR)
Description
Duration of remission (DoR) within 1 year after CD19 hsCAR-T infusion (Duration of remission (DOR) is defined as the duration from the date when the response criteria of CR or CRi is first met to the date of relapse or death due to ALL)
Time Frame
1 year
Title
Event free survival within 1 year
Description
Event free survival within 1 year (Event free survival is defined as the time from start of the first infusion to the earliest of death from any cause or relapse)
Time Frame
1 year
Title
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability])
Description
Safety and tolerability of CD19 hsCAR-T: frequency and severity of adverse events, including, but not limited to, cytokine release syndrome (CRS) and macrophage activation syndrome (MAS)
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects with refractory/relapse B-cell ALL with no available curative treatment options (such as autologous or allogeneic SCT); Subjects previously treated with B cell-directed engineered cell therapy are eligible if they meet the following criteria: relapsed and/or MRD-positive after prior cell therapy; partial response to prior cell therapy; Clinical and laboratory data are available; Documented CD19 expression after previous B cell-directed therapies; Aged 1 to 75 years; KPS>40; At least 2 weeks or 5 drug half-lives, whichever is shorter must have elapsed since any prior systemic therapy at the time the subject is planned for leukapheresis, except for systemic inhibitory/stimulatory immune checkpoint therapy; Women of childbearing potential must have a urine pregnancy test taken and proven negative prior to the treatment. All patients agree to use reliable methods of contraception during the trial period and throughout the last follow-up visit; Subjects with relapsed disease after prior allogeneic SCT (myeloablative or non-myeloablative) will be eligible if the patients do not present with active GVHD and are not undergoing immunosuppressive regimes; Patients with CNS3 (WCB ≥5/mL in CSF with presence of lymphoblasts) disease will be eligible if the CNS disease is responsive to therapy; Participation in the clinical trials should be voluntary with signed informed consent. Exclusion Criteria: Patients with hypervolemia (white blood cell count> 50 x 10^9 / L) or rapidly progressive disease that in the estimation of the investigators and sponsors would compromise the patient's ability to complete the study; History of melanoma skin cancer or other primary tumors (eg, cervical cancer, bladder cancer, breast cancer) (except for those with 3 years or longer of cure); Patients with fungal, bacterial, viral, or other uncontrollable infections or infections requiring Level 4 isolation (UTI or inoculation assays may be performed if necessary); Patients with positive results for HIV, HBV, HCV tests; With CNS disorders such as cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or autoimmune disease with CNS involvement; History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other clinically significant cardiac diseases within 12 months of enrollment, or with cardiac atrial or cardiac ventricular lymphoma; Patients that are receiving anticoagulant therapy or have ever coagulation disorders; Any medical condition that in the judgment of the sponsors/investigators is likely to interfere with assessment of safety or efficacy of study; History of severe immediate hypersensitivity reaction to any of the agents used in this study; Female patients who are pregnant or breastfeeding; Feasibility assessment during screening demonstrates <30% transduction of target lymphocytes, or insufficient expansion (< 5-fold) in response to CD3/CD28 co-stimulation; Patients with any uncontrolled diseases that are unsuitable for enrollment; CNS3 disease that is progressive on therapy, or with CNS parenchymal lesions that might increase the risk of CNS toxicity; Any situation that is considered to potentially increase the risk of the subject or interfere with the outcome of the study; Patients who have been enrolled in other clinical studies.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zhiguo Chen, PhD
Phone
86-10-83198889
Email
chenzhiguo@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yu Zhao, PhD
Phone
86-10-83198274
Email
zhaoyu198387@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhiguo Chen, PhD
Organizational Affiliation
Xuanwu Hospital, Beijing
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Huyong Zheng, MD, PhD
Organizational Affiliation
Beijing Children's Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Children's Hospital Capital Meidcal University
City
Beijing
State/Province
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Huyong Zheng, MD, PhD
Facility Name
Beijing Children's Hospital, Capital Medical University
City
Beijing
State/Province
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Huyong Zheng, MD, PhD
First Name & Middle Initial & Last Name & Degree
Zhiguo Chen, PhD
First Name & Middle Initial & Last Name & Degree
Huyong Zheng, MD, PhD
First Name & Middle Initial & Last Name & Degree
Yu Zhao, PhD

12. IPD Sharing Statement

Learn more about this trial

CD19 hsCAR-T for Refractory/Relapsed CD19+ B-ALL Patients

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