Human CD19 Targeted T Cells Injection(CD19 CAR-T) Therapy for Relapsed and Refractory CD19-positive Lymphoma.
Primary Purpose
CD19-positive, Diffuse Large B-cell Lymphoma, Follicular Lymphoma
Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Human CD19 targeted T Cells Injection
Sponsored by
About this trial
This is an interventional treatment trial for CD19-positive focused on measuring CD19, CAR-T, Diffuse Large B-cell Lymphoma, Follicular Lymphoma, Relapsed /Refractory
Eligibility Criteria
Inclusion Criteria:
Male or female subjects with CD19+ B cell lymphomas who have a limited prognosis (several months to <2 year survival) with currently available therapies will be enrolled.
- 18 to 70 Years Old, Male and female;
- Expected survival > 12 weeks;
- Clinical performance status of ECOG score 0-1;
Pathology demonstrated that CD19-positive B-cell non-Hodgkin's lymphoma and who meet one of the following conditions:
- Relapsed and refractory CD19-positive Diffuse large B-cell lymphoma and Follicular lymphoma: patients previously received at least first-line and second- line treatment and fail to achieve CR;
- Disease recurrence after stem cell transplantation, and at least 1 years after stem cell transplantation.
- It can establish the venous access required for collection, satisfying hemoglobin ≥ 70 g / L, neutrophils ≥ 1.0 × 10 ^ 9 / L, platelets ≥ 50 × 10 ^ 9 / L. Mononuclear cell collection can be determined by the investigators;
- At least 1 measurable tumor foci according to the 2014 Lugano treatment response criteria;
Liver, kidney and cardiopulmonary functions meet the following requirements:
- Serum creatinine ≤ 1.5 × ULN;
- Left ventricular ejection fraction >50%, no pericardial effusion and no pleural effusion (ECHO examination);
- Baseline oxygen saturation > 92%;
- Total bilirubin ≤ 1.5 × ULN;
- ALT and AST ≤ 3 × ULN.
- Able to understand and sign the Informed Consent Document.
Exclusion Criteria:
- In the first 5 years before screening, there are malignant tumors other than diffuse large B-cell lymphoma and follicular lymphoma, except for fully treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after radical surgery,and catheter carcinoma in situ after radical surgery;
- Hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood HBV DNA titer higher than the upper limit of detection; hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; human immunodeficiency Viral (HIV) antibody positive; Positive syphilis test;
- Any unstable systemic disease including, but not limited to, active infection (except for local infection), unstable angina pectoris, cerebrovascular accident or transient cerebral ischemia (within 6 months prior to screening), myocardial infarction (within 6 months prior to screening), congestive heart failure (New York Heart Association [NYHA] classification ≥ III), severe arrhythmia , liver, kidney or metabolic disease requiring medication;
- Any other diseases could affect the outcome of this trial;
- Any affairs could affect the safety of the subjects or outcome of this trial;
- Pregnant or lactating women, or planned pregnancy during treatment or within 1 year after treatment, or a male subject whose partner plans pregnancy within 1 year of their cell transfusion;
- Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment;
- 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;
- Received CAR-T treatment or other gene therapies before enrollment;
- Patients with symptoms of central nervous system or brain metastasis or have received treatment for central nervous system or brain metastasis (radiotherapy, surgery or other treatment) within 3 months before enrollment;
- Subject suffering disease affects the understanding of informed consent or comply with study protocol;
- The investigators consider other conditions unsuitable for enrollment.
Sites / Locations
- The Second Affiliated Hospital of Nanchang UniversityRecruiting
- Fudan University Zhongshan HospitalRecruiting
- The First Affilicated Hospital of Wenzhou Medical UniversityRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Human CD19 targeted T Cells Injection
Arm Description
Outcomes
Primary Outcome Measures
Safety measured by occurrence of study related adverse effects defined by NCI CTCAE 5.0
Secondary Outcome Measures
Duration of CAR-positive T cells in circulation
Total number of CAR-positive T cells infiltrated into lymphoma tissue
Overall remission rate including complete response and Partial response defined by the standard response criteria for malignant lymphoma.
Duration of Response after administration
Progress Free Survival after administration
Overall Survival after administration
The immunogenicity of Human CD19 targeted T Cells Injection. (HAMA detection of human anti-mouse antibody)
Full Information
NCT ID
NCT03720457
First Posted
October 24, 2018
Last Updated
August 29, 2021
Sponsor
Hrain Biotechnology Co., Ltd.
Collaborators
Shanghai Zhongshan Hospital
1. Study Identification
Unique Protocol Identification Number
NCT03720457
Brief Title
Human CD19 Targeted T Cells Injection(CD19 CAR-T) Therapy for Relapsed and Refractory CD19-positive Lymphoma.
Official Title
A Phase I Clinical Trial of Human CD19 Targeted T Cells Injection for Subjects With Relapsed and Refractory CD19-positive Diffuse Large B-cell Lymphoma and Follicular Lymphoma
Study Type
Interventional
2. Study Status
Record Verification Date
August 2021
Overall Recruitment Status
Unknown status
Study Start Date
November 13, 2018 (Actual)
Primary Completion Date
October 2021 (Anticipated)
Study Completion Date
October 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hrain Biotechnology Co., Ltd.
Collaborators
Shanghai Zhongshan Hospital
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 tolerance of human CD19 targeted T Cells injection for the treatment of relapsed and refractory CD19-positive diffuse large B-cell lymphoma and follicular lymphoma. Patients will be given a conditioning chemotherapy regimen of fludarabine and cyclophosphamide followed by a single infusion of CD19 CAR+ T cells.
Detailed Description
Participants with relapsed/refractory CD19-positive Diffuse Large B-cell Lymphoma and Follicular Lymphoma 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 CAR+ T cells. After the infusion, participants will be followed for side effects and effect of CD19 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
CD19-positive, Diffuse Large B-cell Lymphoma, Follicular Lymphoma
Keywords
CD19, CAR-T, Diffuse Large B-cell Lymphoma, Follicular Lymphoma, Relapsed /Refractory
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
Human CD19 targeted T Cells Injection
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Human CD19 targeted T Cells Injection
Intervention Description
Autologous genetically modified anti-CD19 CAR transduced T cells
Primary Outcome Measure Information:
Title
Safety measured by occurrence of study related adverse effects defined by NCI CTCAE 5.0
Time Frame
2 years post infusion
Secondary Outcome Measure Information:
Title
Duration of CAR-positive T cells in circulation
Time Frame
2 years post infusion
Title
Total number of CAR-positive T cells infiltrated into lymphoma tissue
Time Frame
2 years post infusion
Title
Overall remission rate including complete response and Partial response defined by the standard response criteria for malignant lymphoma.
Time Frame
90 days post infusion
Title
Duration of Response after administration
Time Frame
90 days post infusion
Title
Progress Free Survival after administration
Time Frame
90 days post infusion
Title
Overall Survival after administration
Time Frame
90 days post infusion
Title
The immunogenicity of Human CD19 targeted T Cells Injection. (HAMA detection of human anti-mouse antibody)
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:
Male or female subjects with CD19+ B cell lymphomas who have a limited prognosis (several months to <2 year survival) with currently available therapies will be enrolled.
18 to 70 Years Old, Male and female;
Expected survival > 12 weeks;
Clinical performance status of ECOG score 0-1;
Pathology demonstrated that CD19-positive B-cell non-Hodgkin's lymphoma and who meet one of the following conditions:
Relapsed and refractory CD19-positive Diffuse large B-cell lymphoma and Follicular lymphoma: patients previously received at least first-line and second- line treatment and fail to achieve CR;
Disease recurrence after stem cell transplantation, and at least 1 years after stem cell transplantation.
It can establish the venous access required for collection, satisfying hemoglobin ≥ 70 g / L, neutrophils ≥ 1.0 × 10 ^ 9 / L, platelets ≥ 50 × 10 ^ 9 / L. Mononuclear cell collection can be determined by the investigators;
At least 1 measurable tumor foci according to the 2014 Lugano treatment response criteria;
Liver, kidney and cardiopulmonary functions meet the following requirements:
Serum creatinine ≤ 1.5 × ULN;
Left ventricular ejection fraction >50%, no pericardial effusion and no pleural effusion (ECHO examination);
Baseline oxygen saturation > 92%;
Total bilirubin ≤ 1.5 × ULN;
ALT and AST ≤ 3 × ULN.
Able to understand and sign the Informed Consent Document.
Exclusion Criteria:
In the first 5 years before screening, there are malignant tumors other than diffuse large B-cell lymphoma and follicular lymphoma, except for fully treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after radical surgery,and catheter carcinoma in situ after radical surgery;
Hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood HBV DNA titer higher than the upper limit of detection; hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; human immunodeficiency Viral (HIV) antibody positive; Positive syphilis test;
Any unstable systemic disease including, but not limited to, active infection (except for local infection), unstable angina pectoris, cerebrovascular accident or transient cerebral ischemia (within 6 months prior to screening), myocardial infarction (within 6 months prior to screening), congestive heart failure (New York Heart Association [NYHA] classification ≥ III), severe arrhythmia , liver, kidney or metabolic disease requiring medication;
Any other diseases could affect the outcome of this trial;
Any affairs could affect the safety of the subjects or outcome of this trial;
Pregnant or lactating women, or planned pregnancy during treatment or within 1 year after treatment, or a male subject whose partner plans pregnancy within 1 year of their cell transfusion;
Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment;
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;
Received CAR-T treatment or other gene therapies before enrollment;
Patients with symptoms of central nervous system or brain metastasis or have received treatment for central nervous system or brain metastasis (radiotherapy, surgery or other treatment) within 3 months before enrollment;
Subject suffering disease affects the understanding of informed consent or comply with study protocol;
The investigators consider other conditions unsuitable for enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hongliang Fang, Dr.
Phone
021-58552006
Email
fanghongliang@dashengbio.com
Facility Information:
Facility Name
The Second Affiliated Hospital of Nanchang University
City
Nanchang
State/Province
Jiangxi
ZIP/Postal Code
330006
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qingming Wang, M.D.
Phone
0791-86300483
Email
wqming222@163.com
Facility Name
Fudan University Zhongshan Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Peng Liu, Professor
Phone
021-60267405
Email
Liu.peng@zs-hospital.sh.cn
Facility Name
The First Affilicated Hospital of Wenzhou Medical University
City
Wenzhou
State/Province
Zhejiang
ZIP/Postal Code
325003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Songfu Jiang
Phone
0577-55578023
Email
jiangsongfu@189.cn
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
34515338
Citation
Ernst M, Oeser A, Besiroglu B, Caro-Valenzuela J, Abd El Aziz M, Monsef I, Borchmann P, Estcourt LJ, Skoetz N, Goldkuhle M. Chimeric antigen receptor (CAR) T-cell therapy for people with relapsed or refractory diffuse large B-cell lymphoma. Cochrane Database Syst Rev. 2021 Sep 13;9(9):CD013365. doi: 10.1002/14651858.CD013365.pub2.
Results Reference
derived
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Human CD19 Targeted T Cells Injection(CD19 CAR-T) Therapy for Relapsed and Refractory CD19-positive Lymphoma.
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