A Phase 1b Dose Escalation Study of Metabolically Fit CD19 Chimeric Antigen Receptor (CAR) T Cells With CD34 Selection Markers in Adult Patients With Relapsed or Refractory CD19 B-Cell Non-Hodgkin Lymphoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Status: Recruiting
Location: See location...
Intervention Type: Drug, Biological
Study Type: Interventional
Study Phase: Phase 1/Phase 2
SUMMARY

This is a single-center, nonrandomized, open-label dose-escalation study followed by dose-expansion of CD19- CD34t metabolically programmed CAR T-cell therapy in adult patients with relapsed or refractory CD19 B-cell non-Hodgkin lymphoma (NHL) or chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL).

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

∙ Patients eligible for study participation must meet all of the following criteria:

• Disease Related Criteria

• Participants must have histologic confirmation of one of the following:

⁃ CD19+ aggressive non-Hodgkin lymphoma including any of the following subtypes

• Diffuse Large B-cell Lymphoma, not otherwise specified

∙ DLBCL, germinal-center B-cell type (GCB)

∙ DLBCL, activated B-cell type (ABC)

∙ T-cell histiocyte-rich B-cell lymphomas (THRBCL)

∙ Primary cutaneous DLBCL, leg type

∙ Intravascular large B cell lymphoma

∙ EBV+ DLBCL, NOS

∙ DLBCL associated with chronic inflammation

∙ HHV8+ DLBCL, NOS

∙ High grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangement(double hit lymphoma)

∙ High grade B-cell lymphoma, NOS

∙ Primary mediastinal B-cell lymphoma

∙ B-cell Lymphoma, unclassifiable with features intermediate between DLBCL and Hodgkin lymphoma, as well as with features intermediate between DLBCL and Burkitt lymphoma

∙ Follicular lymphoma grade 3B

∙ Transformation of indolent lymphoma (i.e. CLL, MZL, FL, Waldenstrom's lymphoma,etc) to -diffuse large B-cell lymphoma

∙ Burkitt Lymphoma

∙ Lymphomatoid granulomatosis

⁃ CD19+ indolent non-Hodgkin lymphoma including any of the following subtypes:

• Follicular lymphoma (grade 1-3A)

∙ Marginal zone lymphoma: Including splenic marginal zone lymphoma, nodal marginal zone lymphoma, and mucosa associated lymphoid tissue (MALT) lymphoma

∙ Waldenstrom's Macrogloublinemia

∙ Nodular lymphocyte predominant hodgkin lymphoma (with documented CD19 expression)

⁃ Mantle cell Lymphoma

⁃ Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Leukemia (SLL)

• Prior Therapy Criteria Prior/Concurrent Therapy Related Criteria (dependent upon subtype - see below)

‣ Aggressive lymphoma: patients will qualify if any of the following scenarios are met below (radiation does not count as a line of therapy)

• Relapse or persistent disease after ≥ 2 lines of systemic therapy OR

∙ Refractory disease or relapse within 12 months of completion of 1st line systemic therapy OR

∙ Refractory disease or relapse ≥ 1 line of therapy but not a candidate for autologous stem cell transplant

∙ Patients with Burkitt lymphoma will qualify after ≥ 1 line of therapy regardless of the timing of relapse

⁃ Indolent lymphoma:

• Relapse or persistent disease after ≥ 2 lines of systemic therapy. (Neither single agent rituximab or radiation qualify as a line of therapy.)

⁃ Mantle cell lymphoma:

• Relapse or persistent disease after ≥ 1 line of systemic therapy. Neither single agent rituximab or radiation qualify as a line of therapy.

⁃ Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

• Evidence of progression or intolerance after ≥ 2 lines of therapy. The following will qualify as a line of therapy for CLL/SLL:

‣ systemic chemoimmunotherapy (e.g. BR, FCR, etc),

⁃ BTK inhibitor, BCL-2 inhibitor,

⁃ or PI3 Kinase inhibitor.

⁃ Neither single agent rituximab/obinutuzumab or radiation qualify as a line of therapy.

• Clinical/Laboratory Criteria

‣ Participants must be at least 18 years old

⁃ Participants must have a performance status of 0-2 on the ECOG scale

⁃ Participants must have adequate caregiving support for CAR T-cell therapy as determined by the PI/Co-I.

⁃ Participants must have measurable disease on cross section imaging by PET-CT and/or CT scans alone that is at least 1.5 cm in the longest diameter and measurable in two perpendicular dimensions as defined by IWG criteria. If participants with CLL do not have measurable disease on imaging, a bone marrow biopsy showing \> 5% CLL involvement in the bone marrow will qualify for enrollment

⁃ Participants that have received prior CD19 targeted therapy in the past they must have a tissue biopsy after completion of CD19 targeted therapy noting CD19 expression by either flowcytometry or immunohistochemistry (IHC). CD19 expression must be sufficient per PI/Co-I

⁃ Adequate organ function

• Bone marrow function as evidenced by the following (unless directly attributable to disease within the bone marrow) within 14 days prior to registration.

‣ Platelet count ≥ 50,000 cells/mm3

⁃ ANC ≥ 750 cells/mm3

⁃ Absolute lymphocyte count ≥ 150 cells/ mm3

∙ Hepatic function as evidenced by the following within 14 days prior to registration.

‣ Serum bilirubin ≤ 1.5 X ULN unless attributed to Gilbert's syndrome or hemolysis or lymphoma involvement

∙ Cardiac

‣ No clinically significant ECG findings per PI/Co-I

∙ Pulmonary

‣ Oxygen saturation \> 90% on room air

∙ Renal function as evidenced by the following within 14 days prior to registration.

‣ Serum creatinine ≤ 2 mg/dL or creatinine clearance (as estimated by Cockcroft Gault Equation) ≥ 60 mL/min

⁃ Participants with hepatitis B virus infection must have undetectable viral load and on suppressive therapy within 14 days prior to registration and no evidence of HBV related hepatic damage.

⁃ Participants with Hepatitis C infection must have complete eradication therapy completed, have no evidence of HCV related damage and have undetectable viral load within 14 days of registration.

⁃ Participants with known human immunodeficiency virus (HIV)-infection must be receiving anti- retroviral therapy and have an undetectable viral load test within 14 days prior to registration.

‣ WOCBP should be advised to avoid becoming pregnant and men should be advised to not father a child while receiving treatment. All men and women of childbearing potential must use acceptable methods of birth control throughout the study as described below. FCBP must have negative serum or urine pregnancy within 7 days prior to registration.

‣ Men with female partners who are of childbearing potential: Recommendations for male and partner to use at least two effective contraceptive methods, as described above, during the study.

‣ Participants are able to understand and voluntarily sign consent prior to any study related assessments or procedures are performed.

Locations
United States
South Carolina
Hollings Cancer Center at Medical University of South Carolina
RECRUITING
Charleston
Contact Information
Primary
Alan Brisendine
brisend@musc.edu
(843) 792-9007
Backup
Jasmin Brooks
brooksjm@musc.edu
Time Frame
Start Date: 2023-11-06
Estimated Completion Date: 2026-12-30
Participants
Target number of participants: 27
Treatments
Experimental: Dose Level 1
1 x 10\^6 transduced T cells/kg (± 20%)
Experimental: Dose Level 2
1.5 x 10\^6 transduced T cells/kg (± 20%)
Experimental: Dose Level 3
2 x 10\^6 transduced T cells/kg (± 20%)
Sponsors
Leads: Medical University of South Carolina

This content was sourced from clinicaltrials.gov

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