Phase II Clinical Trial of CNCT19 Cell Injection in the Treatment of Relapsed or Refractory Non-Hodgkin's Lymphoma
The study is a Phase II, single-arm, open-label, single-dose clinical trial, and its primary objective is to evaluate the efficacy and safety of CNCT19 Cell Injection in the treatment of relapsed or refractory NHL.
• Patients who are willing to sign the informed consent form;
• Aged 18-75 years, male or female;
• At screening, subjects complying with the following diagnostic and treatment requirements:
∙ Complying with CD19-positive NHL according to the WHO classification 2017, which are provided specifically as follows:
⁃ Diffuse large B cell lymphoma (DLBCL), not otherwise specified (NOS);
• Primary mediastinal large B cell lymphoma (PMBCL);
• Transformed follicular lymphoma
• High grade B cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements, and high grade B cell lymphoma - not otherwise specified.
‣ Previously received≥2nd-line adequate therapy or autologous hematopoietic stem cell transplantation (ASCT), including:
⁃ Received at least Rituximab or other CD20 targeted drugs containing (except CD20 negative tumors) chemotherapy and
• Received at least one chemotherapy regimen containing anthracycline;
• Definition of line: Stable disease (SD) after receiving a first-line adequate therapy or progressive disease (PD), and SD after a second-line therapy for at least 2 cycles or PD .
‣ In relapsed or refractory status at screening:
⁃ Definition of relapse: Remission (including partial remission (PR) or complete remission (CR)) after treatment with at least the standard therapy regimen (it must contain Ribuximab), and then PD;
• Definition of refractoriness:
• Non-responsiveness to the last therapy: The best response by the last therapy is SD or PD; Relapse or progression after ASCT, including: Relapse (it must be proved by biopsy) or PD within 12 months after ASCT; if a rescue therapy is received, the patient is non-responsive (SD or PD) to the last therapy;
• For transformed follicular lymphoma (TFL), patients must be treated adequately against FL, and after transformation, must have received at least once the therapy against TFL, and become relapsed or refractory after the last therapy.
• Measurable imaging lesion at screening: Intranodal lesion must have a long diameter of more than 1.5 cm, and extranodal lesion must have a long diameter of more than 1.0 cm (per revised IWG Response Criteria 2014 in Lymphomas);
• Eastern Cooperative Oncology Group (ECOG) performance status of 0-1;
• Adequate bone marrow reserve, defined as:
‣ Absolute neutrophil count (ANC) \> 1.0×109/L;
⁃ Absolute lymphocyte count (ALC) ≥ 0.3×109/L;
⁃ Platelet (PLT) ≥50×109/L;
• Proper organ function, complying with the following criteria (except hepatic dysfunction due to tumor cell infiltration): Aspartate aminotransferase (AST) ≤ 3 Upper Limit of Normal (ULN); Alanine aminotransferase (ALT) ≤ 3 ULN; Total serum bilirubin ≤ 2 ULN, unless there exists concurrent Gilbert syndrome; patients with Gilbert syndrome, with total serum bilirubin ≤ 3 ULN and direct bilirubin ≤ 1.5 ULN, may be included; Renal function: serum creatinine ≤ 1.5 ULN or creatinine clearance ≥ 60 mL/min (Cockcroft-Gault formula); Minimum pulmonary reserve, defined as Grade ≤ 1 dyspnea, and blood oxygen saturation \> 91% at non-oxygen inhalation status; International normalized ratio (INR) ≤ 1.5 ULN and activated partial thromboplastin time (aPTT) ≤ 1.5 ULN.
• Vascular conditions for apheresis;
• Women with child-bearing potential are negative in blood/urine pregnancy tests within 3 d prior to apheresis, and prior to infusion of CNCT19 cell injection infusion; any male or female patient with child-bearing potential must agree to adopt effective contraceptive measures throughout the study, and at least a year after administration of the investigational therapy. As judged by the investigator, a patient with child-bearing potential means that: He/she has normal sexual life and is biologically fertile to have children. Non-fertile female patients (i.e., complying one of the following criteria):Previously received hysterectomy, bilateral ovariectomy, or bilateral tubal ligation, or Medically confirmed ovarian failure, or Medically confirmed postmenopause (amenorrhea of at least 12 consecutive months).