A Study of CD20/CD22 Targeted CAR T-cell Therapy for Relapsed or Refractory Lymphoid Malignancies

Launched by HE HUANG · Feb 21, 2020

Keywords

ClinConnect Summary

This clinical trial is exploring a new treatment called CAR T-cell therapy, specifically targeting proteins known as CD20 and CD22, for patients with certain types of blood cancers that have not responded to previous treatments. The study is open to both children and adults aged 3 to 70 years who have been diagnosed with relapsed or refractory lymphoid malignancies, such as B-cell acute lymphoblastic leukemia (B-ALL) or specific types of lymphoma. To participate, patients need to meet certain criteria, including having a confirmed diagnosis and evidence of disease that hasn't improved after standard treatments.

Participants in this study will receive the CAR T-cell therapy and will be closely monitored for safety and effectiveness. This means they will have regular check-ups and tests to see how well the treatment is working and to watch for any side effects. It’s important for potential participants and their families to know that this trial is still in the early phase, meaning researchers are gathering initial information about how well the therapy works and how safe it is. If you or a loved one is considering participation, you'll need to discuss this option with your healthcare provider to see if this trial is a suitable choice.

Gender

ALL

Eligibility criteria

• Criteria:
• Inclusion Criteria:
• Inclusion criteria applicable to ALL only:
• • 1. Male or female aged ≥ 3 and \<70 years old;
• • 2. Histologically confirmed diagnosis of CD19+ B-ALL per the US National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Acute Lymphoblastic Leukemia (2016.v1);
• 3. Relapsed or refractory CD19+ B-ALL (meeting one of the following conditions):
• • 1. CR not achieved after standardized chemotherapy;
• • 2. CR achieved following the first induction, but CR duration is ≤ 12 months;
• • 3. Ineffective after first or multiple remedial treatments;
• • 4. 2 or more recurrences;
• • 4. The number of primordial cells (lymphoblast and prolymphocyte) in bone marrow is \>5% (morphology) and/or \>1% (Flow cytometry);
• • 5. Philadelphia-chromosome-negative (Ph-) patients; or Philadelphia-chromosome- positive (Ph+) patients who cannot tolerate TKI treatments or do not respond to 2 TKI treatments;
• Inclusion criteria applicable to NHL only:
• • 1. Male or female aged ≥ 18 and \<70 years old;
• • 2. Histologically confirmed diagnosis per WHO Classification Criteria for Lymphocytic Tumors 2016, including DLBCL(NOS), follicular lymphoma, Chronic lymphoblastic leukemia/small lymphoblastic lymphoma transforms DLBCL, PMBCL and high grade B cell lymphoma;
• 3. Relapsed or refractory DLBCL (meeting one of the following conditions):
• • 1. No remission or recurrence after receiving second-line or above second-line chemotherapy;
• • 2. Primary drug resistance;
• • 3. Recurrence after autologous hematopoietic stem cell transplantation;
• • 4. According to Lugano 2014, there should be at least one evaluable tumor lesion.
• Applicable standards for ALL and NHL:
• • 1. HLA antibody(-) or HLA antibody(+) and HLA donor specific antibody(DSA)(-);
• • 2. total bilirubin ≤ 51umol/L, ALT and AST ≤ 3 times of upper limit of normal, creatinine ≤ 176.8umol/L;
• • 3. Echocardiogram shows left ventricular ejection fraction (LVEF) ≥ 50%;
• • 4. No active infection in the lungs, blood oxygen saturation by sucking air is ≥ 92%;
• • 5. Estimated survival time ≥ 3 months;
• • 6. ECOG performance status 0 to 2;
• • 7. Patients or their legal guardians volunteer to participate in the study and sign the informed consent.
• Exclusion Criteria:
• • 1. patients with extramedullary lesions, except those with CNSL (CNS-1) under effective control (for ALL patients only);
• • 2. Confirmed diagnosis of lymphoblastic crisis of chronic myeloid leukemia, Burkitt's leukemia/lymphoma per WHO Classification Criteria (for ALL patients only);
• • 3. Patients with hereditary syndrome such as Fanconi anemia, Kostmann syndrome, Shwachman syndrome or any other known bone marrow failure syndrome (for ALL patients only);
• • 4. Patients with intracranial extralateral lesions (cerebrospinal fluid tumor cells and/or intracranial lymphoma invasion shown by MRI) (for NHL patients only) ;
• • 5. Extensive involvement of gastrointestinal lymphoma (for NHL patients only);
• • 6. Radiotherapy, chemotherapy and monoclonal antibody within 1 week before screening;
• • 7. Have a history of allergy to any of the components in the cell products;
• • 8. Prior treatment with any CAR T cell product or other genetically-modified T cell therapies;
• • 9. According to the New York heart association (NYHA) cardiac function classification criteria, Subjects with grade III or IV cardiac insufficiency;
• • 10. Myocardial infarction, cardioangioplasty or stenting, unstable angina pectoris, or other severe cardiac diseases within 12 months of enrollment;
• • 11. Severe primary or secondary hypertension of grade 3 or above (WHO Hypertension Guidelines, 1999);
• • 12. Electrocardiogram shows prolonged QT interval, severe heart diseases such as severe arrhythmia in the past;
• • 13. History of craniocerebral trauma, conscious disturbance, epilepsy, cerebrovascular ischemia, and cerebrovascular hemorrhagic diseases;
• • 14. Patients with severe active infections (excluding simple urinary tract infection and bacterial pharyngitis).
• • 15. Indwelling catheters in vivo (e.g. percutaneous nephrostomy, Foley catheter, bile duct catheter, or pleural/peritoneal/pericardial catheter). Ommaya storage, dedicated central venous access catheters such as Port-a-Cath or Hickman catheters are allowed;
• 16. History of other primary cancer, except for the following conditions:
• • 1. Cured non-melanoma after resection, such as basal cell carcinoma of the skin;
• • 2. Cervical cancer in situ, localized prostate cancer, ductal cancer in situ with disease-free survival ≥ 2 years after adequate treatment;
• • 17. Patients with autoimmune diseases requiring treatment, patients with immunodeficiency or requiring immunosuppressive therapy;
• • 18. Patients with graft-versus-host disease (GVHD);
• • 19. Prior immunizations with live vaccine 4 weeks prior to screening;
• • 20. History of alcoholism, drug abuse or mental illness;
• • 21. If HBsAg positive at screening, HBV DNA copy number detected by PCR in patients with active hepatitis B \> 1000 (if HBV DNA copy number≤1000, routine antiviral therapy is required after enrollment), as well as CMV, hepatitis C, syphilis infection;
• • 22. Concurrent therapy with systemic steroids within 1 week prior to screening, except for the patients recently or currently receiving inhaled steroids;
• • 23. Patients who have participated in any other clinical studies within 2 weeks prior to screening;
• • 24. Pregnant and breast-feeding women and the subjects who are fertile and unable to take effective contraceptive measures (regardless of the gender);
• • 25. Any situations that the investigator believes may increase the risk of patients or interfere with the results of study.