Axatilimab + CAR-T for High-Risk Lymphoma
An Open-label, Phase I Trial, With an Expansion Cohort: Macrophage Conditioning to Synergize With CAR-T in High-risk Lymphoma (MAC-SHIFT)
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 1
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Caitlin Guzowski, MBA, MHA, CCRC
- Numero di telefono: 404-851-8523
- Email: caitlin.guzowski@northside.com
Backup dei contatti dello studio
- Nome: Joseph Maakaron, MD
- Numero di telefono: 404-255-1930
- Email: jmaakaron@bmtga.com
Luoghi di studio
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Georgia
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Atlanta, Georgia, Stati Uniti, 30342
- Northside Hospital
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Contatto:
- Caitlin Guzowski, MBA, MHA, CCRC
- Numero di telefono: 404-851-8523
- Email: caitlin.guzowski@northside.com
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Bambino
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Age ≥ 18 years
- Histologically confirmed large B-cell lymphoma
- Presence of one or more high-risk features
- Eligible to receive CAR-T according to the FDA label
- Measurable disease by CT or PET
- Adequate organ function unless related to lymphoma involvement:
- Pulse oximetry ≥ 92% on room air
- Ejection Fraction ≥ 40%
- ALT/AST < 5x ULN
- Bilirubin < 3 x ULN
- Calculated or measured creatinine Clearance ≥ 30 mL/min
Exclusion Criteria:
- KPS <60
- Second malignancy with a high metastatic potential within 3 years
- Active CNS involvement. Treated CNS disease is allowed
- Active HBV or HCV infection.
- Active uncontrolled infections
- Known HIV positive status
- Allogeneic transplant within 100 days of enrollment
- Active acute or chronic graft versus host disease
- History of acute or chronic pancreatitis
- History of myositis
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: Axatilimab + Commercial CAR T cell therapy
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Dose Level -1: 0.1mg/kg Dose Level +1: 0.3mg/kg Dose Level +2: 1mg/kg Dose Level +3: 3mg/kg
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Determine the recommended Phase 2 dose (RP2D) of axatilimab
Lasso di tempo: 1 year
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Determine the recommended Phase 2 dose (RP2D) of axatilimab in combination with CAR T cell therapy by following a fast-track dose escalation design and assessing adverse events, using the CTCAE Version 6, related to axatilimab
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1 year
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Estimate 1 year progression-free survival
Lasso di tempo: 1 year
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Estimate 1 year progression-free survival by assessing disease status at 1 year following CAR T infusion
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1 year
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Estimate overall response rate
Lasso di tempo: 1 year
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Estimate overall response rate (a combination of complete and partial responders) by assessing disease status at 1 year following CAR T infusion
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1 year
|
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Estimate the overall survival of patients
Lasso di tempo: 1 year
|
Estimate the overall survival of patients by following survival status and cause of death for 1 year after CAR T infusion
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1 year
|
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Evaluate duration of response
Lasso di tempo: 1 year
|
Evaluate duration of response by assessing disease status at multiple timepoints (Days +30, 100, 180, and 365) within 1 year after CAR T infusion
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1 year
|
|
Characterize the safety of axatilimab in combination with CAR T therapy
Lasso di tempo: 1 year
|
Characterize the safety of axatilimab in combination with CAR T therapy by assessing the incidence of cytokine release syndrome and immune-effector cell associated neurotoxcity syndrome according to ASTCT consensus criteria
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1 year
|
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Characterize the safety of axatilimab in combination with CAR T therapy
Lasso di tempo: 1 year
|
Characterize the safety of axatilimab in combination with CAR T therapy by assessing the incidence of grade 3 and 4 adverse events using the CTCAE version 6 criteria
|
1 year
|
Collaboratori e investigatori
Sponsor
Sponsor
Pubblicazioni e link utili
Pubblicazioni generali
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- Carniti C, Caldarelli NM, Agnelli L, Torelli T, Ljevar S, Jonnalagadda S, Zanirato G, Fardella E, Stella F, Lorenzini D, Brich S, Arienti F, Dodero A, Chiappella A, Magni M, Corradini P. Monocytes in leukapheresis products affect the outcome of CD19-targeted CAR T-cell therapy in patients with lymphoma. Blood Adv. 2024 Apr 23;8(8):1968-1980. doi: 10.1182/bloodadvances.2024012563.
- Jain MD, Zhao H, Wang X, Atkins R, Menges M, Reid K, Spitler K, Faramand R, Bachmeier C, Dean EA, Cao B, Chavez JC, Shah B, Lazaryan A, Nishihori T, Hussaini M, Gonzalez RJ, Mullinax JE, Rodriguez PC, Conejo-Garcia JR, Anasetti C, Davila ML, Locke FL. Tumor interferon signaling and suppressive myeloid cells are associated with CAR T-cell failure in large B-cell lymphoma. Blood. 2021 May 13;137(19):2621-2633. doi: 10.1182/blood.2020007445.
- Wang J, Gao K, Lei W, Dong L, Xuan Q, Feng M, Wang J, Ye X, Jin T, Zhang Z, Zhang Q. Lymphocyte-to-monocyte ratio is associated with prognosis of diffuse large B-cell lymphoma: correlation with CD163 positive M2 type tumor-associated macrophages, not PD-1 positive tumor-infiltrating lymphocytes. Oncotarget. 2017 Jan 17;8(3):5414-5425. doi: 10.18632/oncotarget.14289.
- Marchesi F, Cirillo M, Bianchi A, Gately M, Olimpieri OM, Cerchiara E, Renzi D, Micera A, Balzamino BO, Bonini S, Onetti Muda A, Avvisati G. High density of CD68+/CD163+ tumour-associated macrophages (M2-TAM) at diagnosis is significantly correlated to unfavorable prognostic factors and to poor clinical outcomes in patients with diffuse large B-cell lymphoma. Hematol Oncol. 2015 Jun;33(2):110-2. doi: 10.1002/hon.2142. Epub 2014 Apr 8. No abstract available.
- Li YL, Shi ZH, Wang X, Gu KS, Zhai ZM. Tumor-associated macrophages predict prognosis in diffuse large B-cell lymphoma and correlation with peripheral absolute monocyte count. BMC Cancer. 2019 Nov 6;19(1):1049. doi: 10.1186/s12885-019-6208-x.
- Cencini E, Fabbri A, Schiattone L, Sicuranza A, Mecacci B, Granai M, Mancini V, Lazzi S, Bocchia M, Leoncini L. Prognostic impact of tumor-associated macrophages, lymphocyte-to-monocyte and neutrophil-to-lymphocyte ratio in diffuse large B-cell lymphoma. Am J Blood Res. 2020 Aug 25;10(4):97-108. eCollection 2020.
- Wang Z, Jiang R, Li Q, Wang H, Tao Q, Zhai Z. Elevated M-MDSCs in Circulation Are Indicative of Poor Prognosis in Diffuse Large B-Cell Lymphoma Patients. J Clin Med. 2021 Apr 19;10(8):1768. doi: 10.3390/jcm10081768.
- Shen L, Li H, Shi Y, Wang D, Gong J, Xun J, Zhou S, Xiang R, Tan X. M2 tumour-associated macrophages contribute to tumour progression via legumain remodelling the extracellular matrix in diffuse large B cell lymphoma. Sci Rep. 2016 Jul 28;6:30347. doi: 10.1038/srep30347.
- Benner B, Scarberry L, Suarez-Kelly LP, Duggan MC, Campbell AR, Smith E, Lapurga G, Jiang K, Butchar JP, Tridandapani S, Howard JH, Baiocchi RA, Mace TA, Carson WE 3rd. Generation of monocyte-derived tumor-associated macrophages using tumor-conditioned media provides a novel method to study tumor-associated macrophages in vitro. J Immunother Cancer. 2019 May 28;7(1):140. doi: 10.1186/s40425-019-0622-0.
- Ugel S, De Sanctis F, Mandruzzato S, Bronte V. Tumor-induced myeloid deviation: when myeloid-derived suppressor cells meet tumor-associated macrophages. J Clin Invest. 2015 Sep;125(9):3365-76. doi: 10.1172/JCI80006. Epub 2015 Sep 1.
- Noy R, Pollard JW. Tumor-associated macrophages: from mechanisms to therapy. Immunity. 2014 Jul 17;41(1):49-61. doi: 10.1016/j.immuni.2014.06.010.
- Iacoboni G, Navarro V, Martin-Lopez AA, Rejeski K, Kwon M, Jalowiec KA, Amat P, Reguera-Ortega JL, Gallur L, Blumenberg V, Gutierrez-Herrero S, Roddie C, Benzaquen A, Delgado-Serrano J, Sanchez-Salinas MA, Bailen R, Carpio C, Lopez-Corral L, Hernani R, Bastos M, O'Reilly M, Martin-Martin L, Subklewe M, Barba P. Recent Bendamustine Treatment Before Apheresis Has a Negative Impact on Outcomes in Patients With Large B-Cell Lymphoma Receiving Chimeric Antigen Receptor T-Cell Therapy. J Clin Oncol. 2024 Jan 10;42(2):205-217. doi: 10.1200/JCO.23.01097. Epub 2023 Oct 24.
- Vercellino L, Di Blasi R, Kanoun S, Tessoulin B, Rossi C, D'Aveni-Piney M, Oberic L, Bodet-Milin C, Bories P, Olivier P, Lafon I, Berriolo-Riedinger A, Galli E, Bernard S, Rubio MT, Bossard C, Meignin V, Merlet P, Feugier P, Le Gouill S, Ysebaert L, Casasnovas O, Meignan M, Chevret S, Thieblemont C. Predictive factors of early progression after CAR T-cell therapy in relapsed/refractory diffuse large B-cell lymphoma. Blood Adv. 2020 Nov 24;4(22):5607-5615. doi: 10.1182/bloodadvances.2020003001.
- Shah NN, Fry TJ. Mechanisms of resistance to CAR T cell therapy. Nat Rev Clin Oncol. 2019 Jun;16(6):372-385. doi: 10.1038/s41571-019-0184-6.
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- Dean EA, Mhaskar RS, Lu H, Mousa MS, Krivenko GS, Lazaryan A, Bachmeier CA, Chavez JC, Nishihori T, Davila ML, Khimani F, Liu HD, Pinilla-Ibarz J, Shah BD, Jain MD, Balagurunathan Y, Locke FL. High metabolic tumor volume is associated with decreased efficacy of axicabtagene ciloleucel in large B-cell lymphoma. Blood Adv. 2020 Jul 28;4(14):3268-3276. doi: 10.1182/bloodadvances.2020001900.
- Beyar Katz O, Perry C, Grisariu-Greenzaid S, Yehudai-Ofir D, Luttwak E, Avni B, Zuckerman T, Sdayoor I, Stepensky P, Ringelstein-Harlev S, Bar-On Y, Libster D, Sharvit L, Amit O, Greenbaum U, Gold R, Herishanu Y, Benyamini N, Avivi I, Ram R. Response rates of extra-nodal diffuse large B cell lymphoma to anti-CD19-CAR T cells: A real word retrospective multicenter study. Eur J Haematol. 2023 Jul;111(1):63-71. doi: 10.1111/ejh.13968. Epub 2023 Apr 10.
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Primo inviato
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Primo inviato che soddisfa i criteri di controllo qualità
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Aggiornamenti dei record di studio
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Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Neoplasie
- Malattie del sistema immunitario
- Neoplasie per tipo istologico
- Malattie dell'apparato digerente
- Malattie gastrointestinali
- Malattie dello stomaco
- Malattie linfatiche
- Malattie linfoproliferative
- Disturbi immunoproliferativi
- Linfoma non Hodgkin
- Linfoma, cellule B
- Linfoma
- Malattie emiche e linfatiche
- Stenosi pilorica
- Ostruzione dello sbocco gastrico
- Linfoma, a grandi cellule B, diffuso
- Linfoma, follicolare
- Stenosi pilorica, ipertrofica
- axatilimab
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- NSH 1445
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Informazioni su farmaci e dispositivi, documenti di studio
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