A Phase Ib, Open Label Study to Evaluate Safety of Axicabtagene Ciloleucel Reinfusion (Axi-Cel-2) in Patients With Relapsed and/or Refractory Second Line High-Risk Non-Hodgkin Lymphoma After Standard of Care Axi-Cel

Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1
SUMMARY

This is a phase Ib study to establish safety of Axi-Cel-2 in patients with Large B Cell Lymphoma (LBCL) who are at high risk of relapse.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Diagnosis: Histologically confirmed aggressive B cell NHL including the following types defined by WHO 2008:

‣ Diffuse large B cell lymphoma (DLBCL); OR

⁃ primary mediastinal (thymic) large B cell lymphoma; OR

⁃ transformation of follicular lymphoma (TFL), marginal zone lymphoma to DLBCL; OR

⁃ high grade B-cell Lymphoma NOS will also be included

• Patients must be considered high-risk lymphoma (defined as LDH greater than upper limit of normal per institutional cut-off) at or within two weeks of leukapheresis.

• Subjects must have received at least and a maximum one prior line of therapy for LBCL indication (i.e subjects receiving second line standard of care Axi-Cel will be enrolled in this study).

• At least 1 measurable lesion on PET-CT or CT scan. If the only measurable disease is lymph-node disease, at least 1 lymph node should be ≥ 1.5 cm.

• Age 18 years or older

• Eastern cooperative oncology group (ECOG) performance status of 0 or 1. ECOG 2 permitted if performance status is solely attributed to lymphoma.

• Normal Organ and Marrow Function

‣ ANC ≥ 1,000/uL

⁃ Platelet count ≥ 75,000/uL

⁃ Adequate renal, hepatic, pulmonary and cardiac function defined as:

• Creatinine clearance (as estimated by Cockcroft Gault Equation) ≥ 60 mL/min

∙ Serum ALT or AST ≤ 2.5 x ULN (except in subjects with liver involvement by lymphoma)

∙ Total bilirubin ≤ 1.5 mg/dl, except in subjects with Gilbert's syndrome.

∙ Cardiac ejection fraction ≥ 40%, no evidence of pericardial effusion as determined by an Echocardiogram.

⁃ No clinically significant pleural effusion or ascites

⁃ Baseline oxygen saturation \> 92% on room air

• Ability to understand and the willingness to sign the written IRB-approved informed consent document. Subjects unable to give informed consent will not be eligible for this study.

• Females of childbearing potential must have a negative serum or urine pregnancy test (females who have undergone surgical sterilization or who have been postmenopausal for at least 2 years are not considered to be of childbearing potential)

⁃ Contraception: Subjects of child-bearing or child-fathering potential must be willing to practice birth control from the time of enrollment on this study and for twelve (12) months after receiving the preparative lymphodepletion regimen.

⁃ If prior CD19 directed therapy, demonstrates CD19 positivity by biopsy (Flow cytometry or immunohistochemistry per the institutional criteria)

⁃ Prior therapy washout of at least 2 weeks or 5 half-lives, whichever is shorter, must have elapsed since any prior systemic therapy at the time the subject is planned for leukapheresis

Locations
United States
California
Stanford University
RECRUITING
Palo Alto
Contact Information
Primary
Kelly Chyan, MPH
kchyan@stanford.edu
(650) 725-8130
Time Frame
Start Date: 2023-05-23
Estimated Completion Date: 2038-04-01
Participants
Target number of participants: 20
Treatments
Active_comparator: Safety Run-in phase
First three patients (maximum of 6) will receive 0.5 x 106/kg CART cells (25% standard dose) as reinfusion product between days 7 through 14 if CRS/ICANS has resolved to a grade 1 or less.
Experimental: Phase 1b
Up to 20 evaluable subjects will receive the target dose of AxiCel infusion to evaluate efficacy of Axi-Cel-2 in adults with high risk relapsed/refractory LBCL
Sponsors
Leads: Stanford University
Collaborators: Kite Pharma

This content was sourced from clinicaltrials.gov