Étude du E7777 avant Kymriah pour le DLBCL R/R
Essai de phase I/II utilisant E7777 pour améliorer la déplétion des lymphocytes T régulateurs avant le traitement par Tisagenlecleucel (Kymriah) pour le lymphome diffus à grandes cellules B (DLBCL) récidivant/réfractaire
This is a multicenter Phase I study to determine the maximum tolerated dose (MTD) of E7777 when given prior to cyclophosphamide/fludarabine (CY/Flu) lymphodepletion (LD) chemotherapy and an FDAapproved CAR-T product Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma grade 3 who are at a higher risk for failure of CAR-T therapy
Aperçu de l'étude
Statut
Les conditions
Description détaillée
E7777 is a recombinant fusion toxin consisting of full-length human IL-2 fused to the catalytic domains of diphtheria toxin. This trial is designed to augment lymphodepletion prior to CAR-T cells by administration of a targeted immunotoxin against CD25-expressing T-cells. CD25 is expressed at high levels on Tregs but also on activated effector T cells. The use of the CAR-T cell product and associated apheresis and LD chemotherapy is considered standard of care (SOC).
Type d'étude
Inscription (Estimé)
Phase
- Phase 2
- La phase 1
Contacts et emplacements
Lieux d'étude
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Minnesota
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Minneapolis, Minnesota, États-Unis, 55455
- University of Minnesota, Masonic Cancer Center
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
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Diagnosis of a relapse or refractory (r/r) B cell lymphoma, for which treatment with tisagenleucel (Kymriah), Axicabtagene (Yescarta) or Lisocabtagene Maraleucel (Breyanzi) is planned, including :
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diffuse large B-cell lymphoma (DLBCL) not otherwise specified,
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high grade B-cell lymphoma
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DLBCL arising from follicular lymphoma
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Primary mediastinal B cell lymphoma
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Follicular lymphoma grade 3B
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And considered at high risk for progression after CAR-T therapy by meeting one or more of the following factors:
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refractory to last line of therapy/remission of less than 12 months
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myc over expression >40% in any prior biopsy or bcl2/bcl6 and c-myc re-arrangement (double/triple hit)
- 2 sites of extranodal disease
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IPI ≥ 3
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Elevated LDH at the time of relapse
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Has secured coverage for Kymriah, Yescarta,Breyanzi administration
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Age 18 years or older at the time of signing the consent
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ECOG Performance status of 0, 1, or 2
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Adequate bone marrow reserve (may be transfusion dependent)
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Adequate organ function at enrollment and within 14 days of planned E7777 treatment as defined in Section 4.1.7
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Hemodynamically stable and LVEF ≥ 50% confirmed by echocardiogram or MUGA
- Grade 1 dyspnea (CTCAE v5) and SpO2 > 91% on room air
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Sexually active females of child-bearing potential and males with partners of child bearing potential must agree to use effective contraception during therapy
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Provides voluntary written consent prior to the performance of any research related activities.
Exclusion Criteria:
- Pregnant or breastfeeding - Females of childbearing potential must have a blood test or urine study within 14 days prior to study enrollment to rule out pregnancy. All females will be considered to be of childbearing potential unless they are postmenopausal (amenorrheic for at least 12 consecutive months, in the appropriate age group, and without other known or suspected cause) or have been sterilized surgically (i.e., bilateral tubal ligation, total hysterectomy, or bilateral oophorectomy, all with surgery at least 1 month before dosing)
- Known bone marrow involvement, if history of bone marrow involvement must have a BM biopsy to rule-out current involvement
- Prior allogeneic transplant
- Ocular disease or complaints visual acuity impairment, color or shape distortion, or blurred vision - potential participants are required to have an ophthalmological examine as part of screening
- Active CNS involvement by malignancy (history of CNS disease with negative CSF by flow cytometry and/or stable findings on brain MRI are acceptable)
- Uncontrolled active hepatitis B or hepatitis C
- Active or inactive HIV infection
- Untreated active bacterial, viral or fungal infection (e.g. blood culture positive ≤ 72 hours prior to enrollment)
- History of heart failure or pulmonary edema, evidence of pleural effusion or active lower extremity edema
- Uncontrolled unstable angina and/or myocardial infarction within 3 months of enrollment
- Investigational medicinal product within the last 7 days prior to apheresis or CAR-T infusion
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Non randomisé
- Modèle interventionnel: Affectation séquentielle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Dose level 1 : E7777 at 5 mcg/kg
Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy |
E7777 is a recombinant fusion toxin consisting of full-length human IL-2 fused to the catalytic domains of diphtheria toxin. E7777 is preferentially bound to and internalized by cells expressing the high affinity form (CD25+) of the IL-2 receptor. Fludarabine 25 mg/m2 IV daily for 3 days. Days -5, -4 and -3. Taken in combination with Cyclophosphamide Cyclophosphamide 250 mg/m2 IV daily for 3 days starting with the first dose of fludarabine. Days -5, -4 and -3. Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
|
|
Expérimental: Dose level 1 : E7777 at 7 mcg/kg
Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy |
E7777 is a recombinant fusion toxin consisting of full-length human IL-2 fused to the catalytic domains of diphtheria toxin. E7777 is preferentially bound to and internalized by cells expressing the high affinity form (CD25+) of the IL-2 receptor. Fludarabine 25 mg/m2 IV daily for 3 days. Days -5, -4 and -3. Taken in combination with Cyclophosphamide Cyclophosphamide 250 mg/m2 IV daily for 3 days starting with the first dose of fludarabine. Days -5, -4 and -3. Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
|
|
Expérimental: Dose level 1 : E7777 at 9 mcg/kg
Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy |
E7777 is a recombinant fusion toxin consisting of full-length human IL-2 fused to the catalytic domains of diphtheria toxin. E7777 is preferentially bound to and internalized by cells expressing the high affinity form (CD25+) of the IL-2 receptor. Fludarabine 25 mg/m2 IV daily for 3 days. Days -5, -4 and -3. Taken in combination with Cyclophosphamide Cyclophosphamide 250 mg/m2 IV daily for 3 days starting with the first dose of fludarabine. Days -5, -4 and -3. Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
|
|
Expérimental: MTD from phase 1
Single dose of E7777 (Maximum tolerated dose level identified in phase 1) given on Day -7 two days prior to the start of lymphodepleting chemotherapy |
E7777 is a recombinant fusion toxin consisting of full-length human IL-2 fused to the catalytic domains of diphtheria toxin. E7777 is preferentially bound to and internalized by cells expressing the high affinity form (CD25+) of the IL-2 receptor. Fludarabine 25 mg/m2 IV daily for 3 days. Days -5, -4 and -3. Taken in combination with Cyclophosphamide Cyclophosphamide 250 mg/m2 IV daily for 3 days starting with the first dose of fludarabine. Days -5, -4 and -3. Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
Patient will receive one FDA approved CAR-T product - Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma
Autres noms:
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Establish maximum tolerated dose (MTD)
Délai: 1 month
|
The primary objective of this Phase I study is to establish a maximum tolerated dose (MTD) of E7777 when given prior to standard of care CAR-T therapy product for the treatment of relapsed/refractory B-cell lymphoma who are at a higher risk for failure of CAR-T therapy. |
1 month
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Number of participants experiencing adverse events
Délai: 100 days Post E7777 infusion
|
Number of participants experiencing adverse events related to E7777 to determine safety of the E7777 |
100 days Post E7777 infusion
|
|
Number of participants experiencing disease free survival (DFS)
Délai: 1 year Post E7777 infusion
|
Number of participants experiencing disease free survival (DFS) at 1 year |
1 year Post E7777 infusion
|
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Number of participants experiencing overall survival (OS)
Délai: 1 year Post E7777 infusion
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Number of participants experiencing overall survival (DFS) at 1 year |
1 year Post E7777 infusion
|
|
Number of non-relapse mortality incidents at day 100
Délai: 100 days Post E7777 infusion
|
Number of participants experiencing non-relapse mortality at day 100 post E7777 infusion |
100 days Post E7777 infusion
|
|
Number of Grade 3 or 4 cytokine release syndrome (CRS) incidents
Délai: 28 Days Post E7777 infusion
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Number of participants experiencing Grade 3 or 4 cytokine release syndrome (CRS) after CAR-T cell therapy. |
28 Days Post E7777 infusion
|
|
Number of Grade 3 or 4 immune effector cell associated neurotoxicity (ICAN) syndrome incidents
Délai: 28 Days Post E7777 infusion
|
Number of participants experiencing Grade 3 or 4 immune effector cell associated neurotoxicity (ICAN) syndrome after CAR-T cell therapy. |
28 Days Post E7777 infusion
|
|
Number of participants experiencing dose limiting toxicity events
Délai: 28 Days Post E7777 infusion
|
Dose Limiting Toxicity (DLT) is defined as any of the following events based on CTCAE v5 from the 1st infusion of E7777 through 21 days after the administration of CAR-T:
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28 Days Post E7777 infusion
|
Collaborateurs et enquêteurs
Les enquêteurs
- Chercheur principal: Veronika Bachanova, MD, Masonic Cancer Center, University of Minnesota
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Tumeurs
- Maladies du système immunitaire
- Tumeurs par type histologique
- Maladies lymphatiques
- Troubles lymphoprolifératifs
- Troubles immunoprolifératifs
- Lymphome non hodgkinien
- Lymphome à cellules B
- Lymphome
- Maladies hémiques et lymphatiques
- Lymphome diffus à grandes cellules B
- Produits chimiques organiques
- Hydrocarbures
- Moutards phosphoramides
- Composés de moutarde d'azote
- Composés moutarde
- Hydrocarbures, halogénés
- Phosphoramides
- Composés organophosphores
- Cyclophosphamide
- fludarabine
- axicabtagene ciloleucel
- tisagenlecleucel
- Protéine de fusion E7777
Autres numéros d'identification d'étude
- 2020LS100
- MT2020-27 (Autre identifiant: University of Minnesota Masonic Cancer Center)
Informations sur les médicaments et les dispositifs, documents d'étude
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