Phase 1/1b, Open-label, Dose-escalation, Dose-expansion, Parallel Assignment Study to Evaluate Safety and Clinical Activity of PBCAR0191 (Azercabtagene Zapreleucel or Azer-cel) in Subjects With Relapsed/Refractory (r/r) Non-Hodgkin Lymphoma (NHL) and r/r B-cell Acute Lymphoblastic Leukemia (B-ALL)

Who is this study for? Adult patients with B Cell CD19-Positive Acute Lymphoblastic Leukemia
What treatments are being studied? CD19-Positive CAR-T Cells
Status: Recruiting
Location: See all (22) locations...
Intervention Type: Drug, Biological
Study Type: Interventional
Study Phase: Phase 1
SUMMARY

This is a Phase 1/1b, nonrandomized, open-label, parallel assignment, dose-escalation, and dose-expansion study to evaluate the safety and clinical activity of azer-cel, an allogeneic anti-CD19 CAR T, in adults with r/r B ALL and r/r B-cell NHL.

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

• Criteria for B-ALL:

• Participant has unequivocal r/r CD19+ B-ALL that has been confirmed by morphology, flow cytometry, or a validated minimal residual disease (MRD) assay.

• Participants with Philadelphia chromosome positive disease can be eligible if they are intolerant to tyrosine kinase inhibitor therapy or if they have r/r disease.

• Criteria for NHL:

• Participant has unequivocal aggressive CD19+ r/r B-cell NHL that is confirmed by archived tumor biopsy tissue from last relapse after CD19-directed therapy and corresponding pathology report. Alternatively, if at least 1 tumor involved site is accessible at time of Screening, the participant's diagnosis is confirmed by pretreatment biopsy (excisional when possible) or by flow cytometry of fine needle aspirate (FNA). If a participant never had a CR, a sample from the most recent biopsy is acceptable. NHL subtypes included but are not limited to:

• For Phase 1 Dose Escalation:

‣ Diffuse large B-cell lymphoma (DLBCL) including Richter's transformation

⁃ FL including Grade 3 or transformed FL

⁃ High-grade B-cell lymphoma

⁃ Primary mediastinal lymphoma

• For Phase 1b Dose Expansion:

‣ DLBCL not otherwise specified (NOS)

⁃ High grade B-Cell Lymphoma

⁃ DLBCL transformed from the following indolent lymphoma subtypes (Follicular lymphoma, Marginal Zone lymphoma and Waldenstrom's Macroglobulinemia)

• Participant has measurable or detectable (for example positron emission tomography-positive) disease according to the Lugano Classification.

• Participant must have received at least 2 lines of prior anti-cancer therapy for the disease under study, including at least 1 chemoimmunotherapy regimen (e.g., anti-CD20 monoclonal antibody plus chemotherapy), consistent with standard of care treatment guidance (e.g., National Comprehensive Cancer Network \[NCCN\]), unless no second line therapy of known benefit exists for a given subject. For Richter's transformation, only 1 prior line of therapy is required for the DLBCL component.

• Participant has received no more than 7 systemic lines of anti-cancer therapy for the disease under study.

• Participants previously treated with CD19-directed autologous CAR T therapies have received no more than 2 lines of therapy after administration of their previous CAR T product.

• Expansion cohort only: Participants must have received autologous CD19-directed CAR T therapy and demonstrated clinical response to the treatment at Day 28 or later, followed by relapse or progression.

• Criteria for both B-ALL and NHL:

• Eastern Cooperative Oncology Group performance status score of 0 or 1.

• An estimated life expectancy of at least 12 weeks according to the investigator's judgment.

• Seronegative for human immunodeficiency virus antibody (i.e., intact immune function).

• Participant has adequate bone marrow, renal, hepatic, pulmonary, and cardiac function defined as:

∙ Estimated glomerular filtration rate (eGFR) \>30 mL/min/1.73 m2 (calculated using the CKD-EPI equation \[Levey et al, 2009\]). For participants receiving an LD regimen that contains 4 days of Fludarabine, an eGFR \>=60 mL/min/1.73 m2 (calculated using the CKD-EPI equation) is required. If there is a concern that eGFR calculation is not an accurate reflection of renal function, a 24-hour urine collection for creatinine clearance may be used at the investigator's discretion.

‣ Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels both ≤3 times of upper limit of normal (ULN), unless there is suspected disease in the liver.

‣ Total bilirubin \<2.0 mg/dL, except in participants with Gilbert's syndrome.

‣ Platelet count ≥50,000/μL and absolute neutrophil count of ≥1000/ μL. Platelet transfusions within 14 days of screening are not allowed except for participants in B-ALL disease cohort with extensive bone marrow disease burden, in which case adequate bone marrow recovery after prior treatment is required to be documented. NHL participants with a platelet count \<50,000/μL and absolute neutrophil count (ANC) of \<1000/ μL may be enrolled with Medical Monitor approval if there is documentation of significant bone marrow involvement by disease and in the Investigator's assessment, no other reasonable etiology for the low counts.

‣ Left ventricular ejection fraction \>45% as assessed by echocardiogram (ECHO) or multiple gated acquisition scan performed within 1 month before starting lymphodepleting chemotherapy. ECHO results performed within 6 months before Screening and at least 28 days after the last cancer treatment may be acceptable if the participant has not received any treatment with cardiotoxicity risks.

‣ No clinically significant evidence of pericardial effusion or pleural effusion causing clinical symptoms and needing immediate intervention, based on the investigator's opinion. Any known effusion must be stable without need for drainage within 2 weeks of enrollment.

‣ No clinically significant renal/pulmonary comorbidities.

‣ Baseline oxygen saturation \>92% on room air.

Locations
United States
Arizona
Banner MD Anderson Cancer Center
RECRUITING
Gilbert
California
City of Hope
RECRUITING
Duarte
Florida
H. Lee Moffitt Cancer Center
RECRUITING
Tampa
Georgia
Northside Hospital Cancer Institute
RECRUITING
Atlanta
Winship Cancer Institute Emory University
RECRUITING
Atlanta
Massachusetts
Dana-Farber Cancer Institute
COMPLETED
Boston
Tufts Medical Center
RECRUITING
Boston
Maryland
University of Maryland
RECRUITING
Baltimore
Michigan
Barbara Ann Karmanos Cancer Institute (Wayne State University)
RECRUITING
Detroit
Minnesota
University of Minnesota
RECRUITING
Minneapolis
North Carolina
Duke University
COMPLETED
Durham
New York
Columbia University Irving Medical Center/New York Presbyterian Hospital
RECRUITING
New York
Weill Cornell Medical College - NY Presbyterian Hospital
ACTIVE_NOT_RECRUITING
New York
Ohio
Ohio State University
RECRUITING
Columbus
Rhode Island
Lifespan Cancer Institute at Rhode Island Hospital
RECRUITING
Providence
Texas
Baylor University Medical Center
RECRUITING
Dallas
MD Anderson
COMPLETED
Houston
Wisconsin
Medical College of Wisconsin
RECRUITING
Milwaukee
Other Locations
Australia
Royal Adelaide Hospital
RECRUITING
Adelaide
Royal Prince Alfred Hospital
RECRUITING
Camperdown
St Vincent's Hospital Melbourne
RECRUITING
Fitzroy
Liverpool Hospital
NOT_YET_RECRUITING
Liverpool
Contact Information
Primary
Imugene Clinical Team
info@imugene.com
984-245-0082
Time Frame
Start Date: 2019-03-11
Estimated Completion Date: 2027-06
Participants
Target number of participants: 129
Treatments
Experimental: Dose Level 1
Azer-cel 3 x 10\^5 CAR T cells per kilogram (kg) body weight.~Route of Administration: Intravenous infusion.
Experimental: Dose Level 2
Azer-cel, 1 x 10\^6 CAR T cells per kg body weight
Experimental: Dose Level 3a
Azer-cel, 3 x 10\^6 CAR T cells per kg body weight.
Experimental: Dose Level 4
Azer-cel, 6 x 10\^6 CAR T cells per kg body weight as 2 administrations of 3 x 10\^6 CAR T cells per kg body weight administered after a single lymphodepletion.
Experimental: Dose Level 4b
Azer-cel, 500 x 10\^6 CAR T cells (flat dose)
Experimental: Dose level 4c
Azer-cel, 1000 x 10\^6 CAR T cells (flat dose) given as 2 administrations of 500 × 106 cells/per dose on Day 0 and Day 5.
Authors
Koen Van Besien, Luke P Akard, Fiona He
Sponsors
Leads: Imugene Limited

This content was sourced from clinicaltrials.gov

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