A Phase Ib/II Exploratory Clinical Trial of Memory-Enhanced 7×19-THEMIS CAR-T Cell Therapy for Relapsed/Refractory Large B-Cell Lymphoma
A Phase Ib/II Exploratory Clinical Trial of Memory-Enhanced 7×19-THEMIS CAR-T Cell Therapy for Relapsed/Refractory Large B-Cell Lymphoma: A Single-Arm Design Using a Historical Control (7×19 CAR-T)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Wenbin Qian,Professor
- Phone Number: +86 13605801032
- Email: qianwb@zju.edu.cn
Study Contact Backup
- Name: Wen Lei,Doctor
- Phone Number: +86 18258448016
- Email: leiwen2017@zju.edu.cn
Study Locations
-
-
Zhejiang
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Hangzhou, Zhejiang, China, 310009
- Recruiting
- The Second Affiliated Hospital,School of Medicine,Zhejiang University, Hangzhou, Zhejiang 310009
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Contact:
- Wenbin Qian,Professor
- Phone Number: +86 13605801032
- Email: qianwb@zju.edu.cn
-
Contact:
- Wen Lei,Doctor
- Phone Number: +86 18258448016
- Email: leiwen2017@zju.edu.cn
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Voluntarily participate in this study and sign the informed consent form.
- Age range: 18 - 75 years old. Gender is not restricted.
- Histologically confirmed large B-cell lymphoma, including: diffuse large B-cell lymphoma (DLBCL), primary mediastinal large B-cell lymphoma (PMBCL), transformed follicular lymphoma (tFL), and mantle cell lymphoma (MCL).
- CD19-positive (as determined by immunohistochemistry or flow cytometry; based on the most recent tumor biopsy results).
- Definition of relapsed/refractory: Failure to achieve complete remission (CR) after at least two lines of therapy (which must include a CD20 monoclonal antibody and an anthracycline); or disease progression during any course of treatment; or relapse/progression within 12 months after autologous hematopoietic stem cell transplantation.
- At least one measurable lesion: any lymph node lesion with a longest dimension >1.5 cm, or any extranodal lesion with a longest dimension >1.0 cm, and the lesion shows uptake on PET-CT (SUV greater than the hepatic pool).
- Absolute neutrophil count in peripheral blood ≥ 1,000/μL; platelet count ≥ 45,000/μL.
- Cardiac, hepatic, and renal function: creatinine < 1.5 mg/dL; ALT/AST ≤ 2.5 times the upper limit of normal; total bilirubin < 1.5 mg/dL; ejection fraction ≥ 50%.
- Possess sufficient cognitive capacity to voluntarily sign the informed consent form.
- Participants of reproductive potential must be willing to use effective contraception (from the time of signing the informed consent form until 12 months after CAR-T infusion).
- The investigator estimates a life expectancy of at least 4 months.
- Willing to comply with the schedule of visits, dosing regimen, laboratory tests, and other trial procedures.
Exclusion Criteria:
- History of other malignant tumors (excluding cured basal cell carcinoma, cervical carcinoma in situ, papillary thyroid carcinoma, etc.).
- Autologous hematopoietic stem cell transplantation within the past 6 weeks.
- Any targeted CAR-T therapy within 3 months prior to this CAR-T treatment.
- Patients who have previously received PD-1 monoclonal antibodies must have a washout period of ≥3 months before enrollment.
- Received cytotoxic drugs, glucocorticoids (except for prednisone-equivalent doses of ≤10 mg/day), or other targeted therapies within 2 weeks prior to cell collection.
- Active autoimmune diseases (e.g., systemic lupus erythematosus, inflammatory bowel disease, etc.).
- Uncontrolled active bacterial, fungal, or viral infections.
- HIV infection, syphilis; active hepatitis B or C: Hepatitis B: HBsAg-positive and HBV-DNA ≥ 1,000 IU/mL; Hepatitis C: HCV RNA-positive and abnormal liver function.
- Known central nervous system lymphoma (confirmed by brain MRI or CT and cerebrospinal fluid examination).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: 7×19-THEMIS CAR-T
A single dose intravenous injection of 7X19-Themis at day 0
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IL7 and CCL19 Armed anti-CD19 CAR-T with coexpressing Themis
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Determination of the Recommended Phase II Dose (RP2D)
Time Frame: Up to 3 months
|
Based on the incidence of DLTs, CAR-T cell kinetics, preliminary efficacy, and safety data from the Phase Ib dose-escalation phase, the Safety Review Committee (SRC) determined the RP2D following a comprehensive evaluation.
|
Up to 3 months
|
|
Objective Response Rate (ORR)
Time Frame: Up to 3 months
|
At 3 months (±7 days) after infusion, the proportion of patients achieving complete remission (CR) or partial remission (PR) was assessed according to the Lugano 2014 criteria, and a descriptive comparison was made with the historical control cohort.
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Up to 3 months
|
|
Complete Remission Rate (CR Rate)
Time Frame: Up to 3 months
|
At 3 months (±7 days) after infusion, the proportion of patients who achieved complete remission (CR) was assessed according to the Lugano 2014 criteria, and a descriptive comparison was made with the historical control cohort.
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Up to 3 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence and severity of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) graded according to ASTCT 2019 criteria
Time Frame: up to 28 days
|
The incidence and severity of CRS and ICANS will be assessed according to the American Society for Transplantation and Cellular Therapy (ASTCT) 2019 consensus grading criteria.
The incidence of each grade (Grades 1-4) will be summarized, with particular attention to the incidence of Grade ≥3 CRS and Grade ≥3 ICANS.
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up to 28 days
|
|
Incidence and duration of Grade ≥3 hematologic toxicities assessed according to CTCAE version 5.0
Time Frame: up to 28 days
|
The incidence and duration of Grade ≥3 neutropenia, anemia, and thrombocytopenia will be assessed and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
|
up to 28 days
|
|
Incidence of clinically significant infections requiring anti-infective treatment or hospitalization
Time Frame: up to 28 days
|
The incidence of bacterial, fungal, and viral infections requiring anti-infective treatment or hospitalization will be recorded and summarized.
|
up to 28 days
|
|
Progression-Free Survival (PFS)
Time Frame: up to 2-5 years
|
Progression-free survival is defined as the time from CAR-T cell infusion to the first documented disease progression (PD) or death from any cause, whichever occurs first.
Median PFS and PFS rates at 12 and 24 months will be estimated using the Kaplan-Meier method.
|
up to 2-5 years
|
|
Overall Survival (OS)
Time Frame: up to 2-5 years
|
Overall survival is defined as the time from CAR-T cell infusion to death from any cause.
Median OS and OS rates at 12 and 24 months will be estimated using the Kaplan-Meier method.
|
up to 2-5 years
|
|
Duration of Response (DOR)
Time Frame: up to 2-5 years
|
Among participants who achieve complete response (CR) or partial response (PR), duration of response is defined as the time from the first documented response to disease progression or death from any cause, whichever occurs first.
Median DOR will be estimated using the Kaplan-Meier method.
|
up to 2-5 years
|
|
In Vivo Kinetics of CAR-T Cells
Time Frame: up to 2-5 years
|
Measurement of CAR-T Cell Counts in Peripheral Blood and Comparison of Kinetic Parameters
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up to 2-5 years
|
|
Serum Cytokine Dynamics
Time Frame: day-5,day4,day7,day11,day14,day18,day21,day28,month 3
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Measure the concentrations of cytokines such as IL-6, IFN-γ, IL-7, and CCL19 in serum at various time points following infusion.
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day-5,day4,day7,day11,day14,day18,day21,day28,month 3
|
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B-Cell Recovery
Time Frame: month1, month3, month6, month9, months12, month24, year3 and year5
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Determine the absolute count of CD19+CD20+ cells in peripheral blood to assess the dynamics of B-cell recovery following infusion.
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month1, month3, month6, month9, months12, month24, year3 and year5
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Single-Cell Functional Characterization of CAR-T Products
Time Frame: day-5, day4, day7, day11, day14, day18, day21, day28, month2
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Detection of various cytokines secreted by CAR-T infusion products at the single-cell level upon stimulation with the CD19 antigen.
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day-5, day4, day7, day11, day14, day18, day21, day28, month2
|
|
Spearman correlation between memory T-cell subset proportions in the CAR-T infusion product and 3-month complete response
Time Frame: day-5, day4, day7, day11, day14, day18, day21, day28, month3
|
The proportions of stem cell memory T cells (TSCM), central memory T cells (TCM), effector memory T cells (TEM), and terminal effector T cells (TTE) in the CAR-T infusion product will be measured by multicolor flow cytometry.
T-cell subsets will be defined as TSCM (CD45RA+CCR7+CD95+), TCM (CD45RA-CCR7+), TEM (CD45RA-CCR7-), and TTE (CD45RA+CCR7-).
The proportion of each subset will be expressed as the percentage of CAR-T cells.
The correlation between memory T-cell subset proportions and complete response at 3 months will be assessed using Spearman rank correlation and exploratory group comparisons using the Mann-Whitney U test.
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day-5, day4, day7, day11, day14, day18, day21, day28, month3
|
|
Trends in Anti-CAR Antibodies (ADA)
Time Frame: day-5, day4, day7, day11, day14, day18, day21, day28, month3,month6,month12, year2 and year5
|
Determination of the Prevalence and Titer of Anti-FMC63 Antibodies (ADA) in Serum
|
day-5, day4, day7, day11, day14, day18, day21, day28, month3,month6,month12, year2 and year5
|
|
Area under the receiver operating characteristic curve (AUC) of peak serum cytokine and chemokine levels within 28 days after CAR-T infusion for discrimination of objective response
Time Frame: month6, month12, year2, year5
|
Peak serum concentrations of IL-7, CCL19, MIP-1α, MIP-1β, and SDF-1α during the first 28 days after CAR-T cell infusion will be measured using the protocol-specified serum cytokine/chemokine assay.
Receiver operating characteristic (ROC) curve analysis will be performed to evaluate the ability of each biomarker to discriminate objective response, defined as complete response or partial response according to protocol-defined disease response criteria.
The AUC and the optimal biomarker cutoff value will be determined for each biomarker.
|
month6, month12, year2, year5
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Wenbin Qian,Professor, Second Affiliated Hospital, Zhejiang University, School of Medicine
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms
- Disease Attributes
- Immune System Diseases
- Neoplasms by Histologic Type
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Lymphoma, B-Cell
- Lymphoma
- Pathological Conditions, Signs and Symptoms
- Hemic and Lymphatic Diseases
- Recurrence
- Lymphoma, Large B-Cell, Diffuse
- Lymphoma, Mantle-Cell
Other Study ID Numbers
Other Study ID Numbers
- 2026-0675
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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