CD30.CAR EBVSTS allogénique en banque modifié par IL7R constitutif (C7R) pour les lymphomes CD30-positifs (CABAL2)
Lymphocytes T spécifiques au virus d'Epstein-Barr (CD30.CAR-EBVST) du récepteur d'antigène chimérique CD30 allogénique en banque modifié constitutif par IL7R (C7R) chez les patients atteints de lymphomes CD30 positifs en rechute ou réfractaires
This study involves patients with diffuse large B cell lymphoma (DLBCL), natural killer/T-cell lymphoma (NKTL), or classical Hodgkin lymphoma (cHL) (referred to collectively as lymphoma) whose disease has returned or not responded to treatment.
Previous research combined antibodies and T cells to treat cancer. Antibodies bind to foreign substances, and T cells are infection-fighting white blood cells that can kill tumor cells. Both approaches have shown promise but have not been sufficient to cure most patients. In prior studies, an antibody targeting CD30, a protein found on some T cells and cancer cells, was joined to T cells through gene transfer to create CD30.CAR T cells.
Another study showed encouraging responses using CD30.CAR T cells made from a patient's own blood and returned to the same patient (autologous cells). In an ongoing study, patients have been treated with CD30.CAR T cells derived from healthy donors (allogeneic cells), allowing use of banked cells without individualized manufacturing. This approach has shown promising clinical activity with no safety concerns to date.
In this study, investigators are evaluating CD30.CAR-EBVST cells modified with an additional molecule called C7R, which has been shown in laboratory studies to enhance anti-cancer effects. The study aims to assess the safety and effectiveness of these allogeneic, banked C7R-modified CD30.CAR-EBVST cells and determine whether they may help treat lymphoma.
As an added safety measure, the modified T cells include a marker called iC9. If significant side effects occur, patients may receive rimiducid, which can eliminate the infused T cells. Rimiducid is not yet FDA approved but has been tested in patients without significant side effects.
Aperçu de l'étude
Statut
Les conditions
- Lymphome de Hodgkin
- Lymphome non hodgkinien
- Lymphome T périphérique
- Lymphome anaplasique à grandes cellules, ALK-positif
- Lymphome anaplasique à grandes cellules, ALK-négatif
- CD30-Lymphome diffus à grandes cellules B positif
- Lymphome anaplasique à grandes cellules, type à cellules T et à cellules nulles
Intervention / Traitement
Description détaillée
This is a Phase 1 dose-escalation study evaluating allogeneic C7R.CD30.CAR-EBVST cells in patients with relapsed or refractory CD30-positive lymphoma.
Participants are treated in sequential cohorts at one of four dose levels of C7R.CD30.CAR-EBVST cells. Treatment begins at the lowest dose level, and subsequent cohorts are treated at higher dose levels if the preceding dose is determined to be safe. If significant toxicity is observed, dose escalation may be halted, reduced, or discontinued. The relationship between dose level and both safety and potential clinical benefit is evaluated.
Prior to treatment, participants undergo screening evaluations including laboratory testing, imaging studies, and confirmation of CD30 expression. Human leukocyte antigen (HLA) testing is performed to identify the most appropriate partially matched cell line from a bank of allogeneic C7R.CD30.CAR-EBVST products.
Participants may receive lymphodepleting chemotherapy with cyclophosphamide and fludarabine prior to infusion, as clinically appropriate, to reduce endogenous lymphocytes and support expansion of the infused cells.
C7R.CD30.CAR-EBVST cells are administered as a single intravenous infusion at the assigned dose level. Premedication may be given to reduce the risk of infusion-related reactions. Participants are monitored in the clinical setting following infusion and are required to remain within close proximity to the treatment center for a defined period to allow for monitoring of potential adverse events.
Following treatment, participants undergo scheduled follow-up evaluations including physical examinations, laboratory testing, and imaging studies to assess safety and disease status. Blood samples are collected at multiple time points after infusion to evaluate persistence of the infused cells. Tumor assessments are performed using imaging and, when clinically indicated, biopsy.
Participants demonstrating an objective clinical response following initial dosing may be considered for up to three (3) additional infusions of C7R.CD30.CAR-EBVST cells, at the discretion of the treating clinical team.
Participants are followed longitudinally after treatment, with more frequent assessments early after infusion and less frequent long-term follow-up, for up to 15 years after the most recent infusion.
Type d'étude
Inscription (Estimé)
Phase
- La phase 1
Contacts et emplacements
Coordonnées de l'étude
- Nom: Premal Lulla, MD
- Numéro de téléphone: 713-441-1450
- E-mail: pdlulla@houstonmethodist.org
Sauvegarde des contacts de l'étude
- Nom: Vicky Torrano, RN
- Numéro de téléphone: (832) 824-7821
- E-mail: vxtorran@texaschildrens.org
Lieux d'étude
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Texas
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Houston, Texas, États-Unis, 77030
- Recrutement
- Houston Methodist Hospital
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Contact:
- Vicky Torrano, RN
- Numéro de téléphone: 832-824-7821
- E-mail: vxtorran@texaschildrens.org
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Contact:
- Premal Lulla, MD
- Numéro de téléphone: 713-441-1450
- E-mail: pdlulla@houstonmethodist.org
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Houston, Texas, États-Unis, 77030
- Pas encore de recrutement
- Texas Children's Hospital
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Contact:
- Vicky Torrano, RN
- Numéro de téléphone: 832-824-7821
- E-mail: vxtorran@texaschildrens.org
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Contact:
- Helen Heslop, MD
- E-mail: hheslop@bcm.edu
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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 and clinical course falling into one of the following categories:
- Hodgkin lymphoma
- CD30+ aggressive B-cell lymphoma
- ALK-negative anaplastic T cell lymphoma or other peripheral T- cell lymphoma
- ALK-positive anaplastic T cell lymphoma
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CD30-positive tumor as assayed in a CLIA certified Pathology Laboratory.
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Age 12 to 75.
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Bilirubin less than or equal to 2 times the upper limit of normal (except for Gilbert syndrome, where the criteria will be Bilirubin less than or equal to 3 times the upper limit of normal).
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AST less than 3 times the upper limit of normal.
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Estimated GFR > 70 mL/min.
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Pulse oximetry of > 90% on room air
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Karnofsky or Lansky score of > 60%.
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Recovered from all acute non-hematologic toxic effects of all prior chemotherapy.
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Sexually active patients must be willing to utilize one of the more effective birth control methods during the study and for 6 months after the study is concluded. The male partner should use a condom.
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Informed consent explained to, understood by and signed by patient or guardian. Patient or guardian given a copy of the informed consent form.
Exclusion Criteria:
- Received an investigational cell therapy or vaccine within the past 6 weeks.
- Received an investigational small molecule drug within the past 2 weeks.
- Received anti-CD30 antibody-based therapy within the previous 4 weeks.
- History of hypersensitivity reactions to murine protein-containing products.
- Pregnant or lactating.
- Tumor in a location where enlargement could cause airway obstruction (determined at the investigators' discretion).
- Current use of systemic corticosteroids at a dose equivalent to or higher than 10 mg/day of prednisone.
- Active significant, uncontrolled bacterial, viral or fungal infection.
- Symptomatic cardiac disease (NYHA Class III or IV disease).
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Treatment Phase
Four dose levels will be evaluated based on safety data from our current study of CD30 CAR T cells. Cohorts of three patients will be enrolled at each dose level The dose is based on the number of CD.30 CAR-EBVT-expressing cells administered. The total number of dose levels evaluated will depend upon toxicities experienced. Dose level cohorts will be numbered sequentially.
|
The dose is based on the number of CD30.CAR- expressing cells. In our previous study the highest dose was 4 × 10^8 cells/m2 and we did not reach an MTD. On Day 0, patients will receive their planned dose of investigational T cell product by IV infusion over approximately 1 to 10 minutes in an expected volume of 1 to 50 mL.
Autres noms:
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Dose Limiting Toxicity (DLT)
Délai: 28 days
|
Dose-limiting toxicity (DLT) is defined as any of the following considered possibly, probably, or definitely related to study cellular products: (1) Grade 5 event without disease progression; (2) CRS: Grade 4, or Grade 3 not improving to ≤Grade 2 within 72 hours despite therapy; (3) ICANS: Grade 4, or Grade 3 not improving within 72 hours despite therapy; (4) Grade ≥3 IEC-HS; (5) Grade ≥3 acute GvHD requiring corticosteroids and not resolving within 7 days, or steroid-refractory Grade 2 GvHD; (6) Grade 4 neutropenia or thrombocytopenia not resolving to ≤Grade 2 within 42 days, or Grade 3 thrombocytopenia with major bleeding; (7) Grade ≥3 vital organ toxicity (except transient hepatic/renal abnormalities resolving within 7 days); (8) other Grade 3 toxicities not resolving within 72 hours; (9) Grade ≥2 allergic reaction. |
28 days
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Rate of Anti-Tumor effect Objective Response (OR)
Délai: 6 to 8 weeks post CTL infusion
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Objective response rate is defined as complete response and partial response |
6 to 8 weeks post CTL infusion
|
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Duration of response
Délai: Up to 5 years
|
Response duration will be measured from the time of initial response until documented tumor progression. |
Up to 5 years
|
|
Stable disease (SD) rate
Délai: 6 to 8 weeks post CTL infusion
|
SD will be defined as the proportion of patients that have stable disease |
6 to 8 weeks post CTL infusion
|
|
Duration of SD
Délai: Up to 5 years
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Stable disease is measured from the start of the treatment until the criteria for progression are met. |
Up to 5 years
|
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Progression free survival (PFS)
Délai: Up to 5 years
|
PFS is defined as the time from treatment until objective tumor progression or death, whichever occurs first. |
Up to 5 years
|
Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Helen Heslop, MD, Baylor College of Medicine
- Chercheur principal: Premal Lulla, MD, The Methodist Hospital Research Institute
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
Termes MeSH pertinents supplémentaires
- Tumeurs
- Maladies du système immunitaire
- Tumeurs par type histologique
- Maladies lymphatiques
- Troubles lymphoprolifératifs
- Troubles immunoprolifératifs
- Lymphome
- Lymphome à cellules T
- Maladies hémiques et lymphatiques
- Lymphome non hodgkinien
- Maladie de Hodgkin
- Lymphome, lymphocyte T, périphérique
- Lymphome anaplasique à grandes cellules
Autres numéros d'identification d'étude
- H-56523, CABAL2
Informations sur les médicaments et les dispositifs, documents d'étude
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