CD19-directed CAR-T Cell Therapy for Refractory or Relapsed Acute Lymphoblastic Leukemia or Non-Hodgkin Lymphoma: a Multicenter Phase I/II Trial.

Status: Recruiting
Location: See all (5) locations...
Intervention Type: Biological
Study Type: Interventional
Study Phase: Phase 1/Phase 2
SUMMARY

The goal of this prospective, multicentric, single-arm, phase I/II clinical trial is to evaluate the safety and efficacy of a novel CD19-directed CAR-T cell locally produced in an academic institution in Brazil in patients with refractory or relapsed acute lymphoblastic leukemia or non-Hodgkin lymphoma. Participants will receive a single intravenous infusion of an autologous academic anti-CD19 CAR-T cell and will be followed for 5 years.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 3
Maximum Age: 70
Healthy Volunteers: f
View:

∙ For non-Hodgkin Lymphomas (B-NHL):

• Provision of signed Informed Consent form;

• Age between 18 and 70 years;

• Performance status according to the Eastern Cooperative Oncology Group \< 2;

• Relapsed or refractory B-NHL of the following types (confirmed by biopsy):

‣ Diffuse large B-cell lymphoma (DLBCL, NOS);

⁃ High-grade B-cell lymphoma (HGBCL);

⁃ Diffuse large B-cell lymphoma/high-grade B-cell lymphoma with MYC and BCL-2 rearrangement;

⁃ Follicular lymphoma (FL) grade 3B; or

⁃ Transformed follicular lymphoma (tFL)

• Refractory or relapsed to two or more lines of systemic therapy, with at least one scheme containing an anti-CD20 monoclonal antibody and anthracycline, as defined below:

‣ Refractoriness: partial response (PR), stable disease (SD), or progressive disease (PD) as the best response to the last treatment, assessed by PET-CT, according to the Lugano criteria and confirmed by a new biopsy.

⁃ Relapsed disease: disease reappearance after obtaining a complete response to the last treatment, assessed by PET-CT, according to the Lugano criteria and confirmed by a new biopsy.

• Have performed, or be ineligible for, autologous hematopoietic progenitor cell transplantation (ASCT). Ineligibility is defined by:

‣ Lack of at least partial response after salvage chemotherapy; or

⁃ Failure to mobilize and/or collect hematopoietic progenitor cells (HPC), as defined by the investigator.

• Measurable disease, defined as:

‣ Nodal lesions \>15 mm in the long axis, regardless of the length of the short axis, and/or

⁃ Extranodal lesions (outside lymph node or nodal mass, but including liver and spleen) \>10 mm in long axis, regardless of the length of the short axis.

• Adequate organ function:

∙ Renal function defined as:

• estimated glomerular filtration rate (eGFR) ≥ 40 mL/min/1.73 m2

∙ Hepatic function defined as:

• Alanine Transaminase (ALT) and Aspartate Transaminase (AST) ≤ 2.5 × ULN; and

• Total bilirubin ≤ 1.5 × ULN, except for patients with Gilbert syndrome.

∙ Hematologic Function (regardless of transfusions for 14 days) defined as:

• Absolute neutrophil count (ANC) \>500/uL

• Platelets ≥ 50,000/uL

• Hemoglobin \>7.0 g/dl

‣ In women of childbearing potential, willingness to use effective means of birth control for 1 year after CAR-T cell infusion.

⁃ In male participants, willingness to use a barrier birth control method for 1 year after CAR-T cell infusion

⁃ Able to comply with inpatient treatment, outpatient treatment, laboratory monitoring, and required clinic visits for the duration of study participation.

∙ For Acute Lymphoblastic Leukemia (B-ALL):

• Provision of signed Informed Consent form;

• Age ≥ 3 and \< 25 years;

• Performance status \< 2, according to the Eastern Cooperative Oncology Group for patients ≥ 16 years old, or ≥ 50%, according to the Lansky performance status for patients younger than 16 years old;

• Relapsed or refractory CD19 positive B-ALL, with documentation of CD19 disease expression within 3 months of screening visit.

• Relapsed or refractory disease as defined below;

‣ Failure to obtain hematologic complete remission (bone marrow with \< 5% lymphoblasts by morphologic assessment) after 2 distinct chemotherapy lines; or

⁃ Relapsed or refractoriness after at least 1 previous chemotherapy regimen and ineligibility for allogeneic hematopoietic progenitor cell transplantation (HSCT) due to lack of available donor (including alternative donors), comorbidity, have previously undergone or refused HSCT; or

⁃ Relapsed disease ≥ 6 months after HSCT; or

⁃ Relapsed or refractoriness after ≥ TKi for Philadelphia-positive B-ALL.

• Bone marrow with ≥ 5% lymphoblasts by morphologic assessment within 30 days from screening

• Adequate organ function:

∙ Renal function defined as:

• Estimated glomerular filtration rate (eGFR) ≥ 40 mL/min/1.73 m2

∙ Hepatic function defined as:

• Alanine Transaminase (ALT) and Aspartate Transaminase (AST) ≤ 5 × ULN; and

• Total bilirubin ≤ 2 × ULN, except for patients with Gilbert syndrome.

‣ In women of childbearing potential, willingness to use effective means of birth control for 1 year after CAR-T cell infusion.

⁃ In male participants, willingness to use a barrier birth control method for 1 year after CAR-T cell infusion

⁃ Able to comply with outpatient treatment, laboratory monitoring, and required clinic visits for the duration of study participation. duration of the parent study and the long-term follow-up observational study

Locations
Other Locations
Brazil
Hospital de Clínicas da UNICAMP
RECRUITING
Campinas
Ribeirao Preto School of Medicine, University of Sao Paulo
RECRUITING
Ribeirão Preto
A Beneficência Portuguesa de São Paulo
RECRUITING
São Paulo
Hospital das Clinicas de São Paulo
RECRUITING
São Paulo
Hospital Sírio-Libanês
RECRUITING
São Paulo
Contact Information
Primary
Diego V Cle, MD, PhD, MBA
terapia@hemocentro.fmrp.usp.br
+551621019300
Time Frame
Start Date: 2024-03-21
Estimated Completion Date: 2028-12
Participants
Target number of participants: 81
Treatments
Experimental: CD19-directed CAR-T cell
After lymphodepletion, a single intravenous infusion of an academic, locally produced, autologous CD19-directed CAR-T cells will be administered.
Sponsors
Leads: University of Sao Paulo
Collaborators: Hospital das Clínicas de Ribeirão Preto, Blood Center of Ribeirao Preto

This content was sourced from clinicaltrials.gov

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