Anti-CD19:TCRζ Chimeric Antigen Receptor-T Cells in the Treatment for CD19+ B Cell Lymphoma

Anti-CD19:TCRζ Chimeric Antigen Receptor-T Cells in the Treatment for Chemotherapy-resistant or Refractory CD19+B Cell Lymphoma:a Double-arm, Single Center, Open-label Clinical Trial

This study aims to evaluate the safety, efficacy and duration of response of CD19 Chimeric Antigen Receptor (CAR) redirected allogeneic T-cells in patients with chemotherapy-resistant or refractory CD19+ B cell lymphoma.

Study Overview

• Status: Unknown
• Conditions: Lymphoma, B Cell
• Intervention / Treatment: Biological: IL-2 pre-treated CD19 cells; Biological: IL-7/IL-15 pre-treated CD19 cells

Detailed Description

This is a single-centre, randomised, open label Phase I clinical trial of CD19 Chimeric Antigen Receptor (CAR) T-cells (CD19 CAR T-cells) in patients with chemotherapy-resistant or refractory CD19+ B cell lymphoma. Following informed consent and registration to the trial, Patients will receive the allogeneic CD19 CAR T-cells following lymphodepleting chemotherapy. The study will evaluate the safety, efficacy and duration of response of the CD19 CAR T-cells in patients with chemotherapy-resistant or refractory CD19+ B cell lymphoma.

• Study Type: Interventional
• Enrollment (Anticipated): 10
• Phase: Phase 4

Contacts and Locations

• Study Contact: Name: Jingting Jiang, Professor; Email: jjtnew@163.com

Study Locations

• China
  • Jiangsu
    • Changzhou, Jiangsu, China, 213003
      • First People's Hospital of Changzhou
      • Contact: Qi Zhou, Doctor; Email: dr_qzhou@163.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Enrollment for enough male or female patients with CD19+ hematological malignancies, without regimens for cure (autologous or allogeneic stem cell transplantation), and having a poor prognosis (several months to 2 years) under current optional regimens

1. Age ranges from 18 to 70 years old
2. Expected survival time longer than 12 weeks
3. Performance status score 0-2

4. Pathologically confirmed CD19+ lymphoma (CD19+ follicular lymphoma, Mantle cell lymphoma, diffuse large B cell lymphoma) and meets at least one of follows:

   1. having received at least 2-4 cycles of combined chemotherapy (excluding monoclonal antibody monotherapy, such as rituximab) but do not reach a complete response; recurrent disease; not applicable for conventional stem cell transplantation; being partial responsible or stable but not complete responsible after the latest therapy
   2. recurrence develops after stem cell transplantation
   3. diagnosis confirmed but refusing to receive conventional therapy
5. Creatinine<2.5 mg/dl；
6. alanine aminotransferase/aspartate aminotransferase lower than 3 folds of normal range
7. Bilirubin<2.0 mg/dl；
8. Venous channel available and no contraindications for leukocyte collection
9. Reliable contraception from the beginning to 30 days after discontinuation of therapy
10. Informed consent signed

Exclusion Criteria:

1. Central nerve system invasion with symptoms
2. Other concurrent uncontrolled malignancies
3. Hepatitis B infection or active period of hepatitis C, HIV infection
4. Other uncontrolled diseases hampering the intervention in the study
5. Coronary heart disease, angina, myocardial infarction, arrhythmia, cerebral thrombosis, cerebral hemorrhage and other serious cardiovascular or cerebrovascular diseases.
6. Grade 2-3 or uncontrolled hypertension
7. History of uncontrolled mental disease
8. Not suitable for participation judged by researchers
9. Immunosuppressive agents administered due to organ transplantation, not including recent or current inhaled corticosteroid
10. Medical history of mental diseases or abnormities of lab tests might increase the risks of participation in study or drug administration, or interfering the results
11. Screening suggesting transfection efficiency of targeting cells lower than 30% or cell expansion deficiency under CD3/CD28 (cluster of differentiation 3,CD3)stimulation (less than 5 folds)
12. Unstable pulmonary embolism, deep venous thromboembolism or other major arterial/venous thromboembolism events develop in 30 days before the randomization. If anti-coagulation therapy is received, the treatment dose should reach stability before the randomization.
13. Pregnancy or lactation, or pregnancy planned during the study or in 2 months after the study
14. Reliable contraception not accepted during the study or in 2 months after the study. Female subjects are required to provide negative results from serum or urine pregnancy test 48 hours before therapy
15. Systematic active or uncontrolled infection (excluding infection of urinary tract or upper respiratory tract infection) in 14 days before the randomization
16. Informed consent not signed or study rules violated

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
ACTIVE_COMPARATOR: IL-2 pre-treated CD19 cells; Initial therapy: IL-2 (interleukin,IL)stimulated, CD28-ζ-vector (cluster of differentiation 28,CD28)transfected T cells(TCRζ chimeric antigen receptor-T cell)， were administered at 1×106/kg by single infusion	Biological: IL-2 pre-treated CD19 cells; IL-2 stimulated, CD28-ζ-vector transfected T cells(TCRζ chimeric antigen receptor-T cell)， were administered at 1×106/kg by single infusion
ACTIVE_COMPARATOR: IL-7/IL-15 pre-treated CD19 cells; Initial therapy: IL-7/IL-15 stimulated, CD28-ζ-vector transfected T cells(TCRζ chimeric antigen receptor-T cell)， were administered at 1×106/kg by single infusion	Biological: IL-7/IL-15 pre-treated CD19 cells; IL-7/IL-15 stimulated, CD28-ζ-vector transfected T cells(TCRζ chimeric antigen receptor-T cell)， were administered at 1×106/kg by single infusion

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
overall survival	5 year

Secondary Outcome Measures

Outcome Measure	Time Frame
progression-free survival	56 day
Objective Response Rate	56 day

Collaborators and Investigators

• Sponsor: jiangjingting
• Investigators: Principal Investigator: Jingting Jiang, Professor, The First People's Hospital Of Changzhou

Publications and helpful links

General Publications

• Rafiq S, Purdon TJ, Daniyan AF, Koneru M, Dao T, Liu C, Scheinberg DA, Brentjens RJ. Optimized T-cell receptor-mimic chimeric antigen receptor T cells directed toward the intracellular Wilms Tumor 1 antigen. Leukemia. 2017 Aug;31(8):1788-1797. doi: 10.1038/leu.2016.373. Epub 2016 Dec 7.
• Minagawa K, Jamil MO, Al-Obaidi M, Pereboeva L, Salzman D, Erba HP, Lamb LS, Bhatia R, Mineishi S, Di Stasi A. In Vitro Pre-Clinical Validation of Suicide Gene Modified Anti-CD33 Redirected Chimeric Antigen Receptor T-Cells for Acute Myeloid Leukemia. PLoS One. 2016 Dec 1;11(12):e0166891. doi: 10.1371/journal.pone.0166891. eCollection 2016. Erratum In: PLoS One. 2017 Feb 15;12 (2):e0172640.

Study record dates

Study Major Dates

• Study Start: December 1, 2016
• Primary Completion (ANTICIPATED): August 1, 2020
• Study Completion (ANTICIPATED): January 1, 2022

Study Registration Dates

• First Submitted: December 12, 2016
• First Submitted That Met QC Criteria: December 12, 2016
• First Posted (ESTIMATE): December 14, 2016

Study Record Updates

• Last Update Posted (ESTIMATE): December 14, 2016
• Last Update Submitted That Met QC Criteria: December 12, 2016
• Last Verified: December 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Immune System Diseases; Neoplasms by Histologic Type; Neoplasms; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Lymphoma, Non-Hodgkin; Lymphoma; Lymphoma, B-Cell
• Other Study ID Numbers: CAAA

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO