Studie van E7777 voorafgaand aan Kymriah voor R/R DLBCL
Fase I/II-onderzoek waarbij E7777 wordt gebruikt om regulatoire T-celdepletie te verbeteren voorafgaand aan Tisagenlecleucel (Kymriah)-therapie voor recidiverend/refractair diffuus grootcellig B-cellymfoom (DLBCL)
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
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
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).
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Fase 2
- Fase 1
Contacten en locaties
Studie Locaties
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Minnesota
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Minneapolis, Minnesota, Verenigde Staten, 55455
- University of Minnesota, Masonic Cancer Center
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Niet-gerandomiseerd
- Interventioneel model: Sequentiële toewijzing
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
|
Experimenteel: 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
Andere namen:
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
Andere namen:
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
Andere namen:
|
|
Experimenteel: 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
Andere namen:
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
Andere namen:
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
Andere namen:
|
|
Experimenteel: 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
Andere namen:
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
Andere namen:
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
Andere namen:
|
|
Experimenteel: 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
Andere namen:
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
Andere namen:
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
Andere namen:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Establish maximum tolerated dose (MTD)
Tijdsspanne: 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
|
Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Number of participants experiencing adverse events
Tijdsspanne: 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)
Tijdsspanne: 1 year Post E7777 infusion
|
Number of participants experiencing disease free survival (DFS) at 1 year |
1 year Post E7777 infusion
|
|
Number of participants experiencing overall survival (OS)
Tijdsspanne: 1 year Post E7777 infusion
|
Number of participants experiencing overall survival (DFS) at 1 year |
1 year Post E7777 infusion
|
|
Number of non-relapse mortality incidents at day 100
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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:
|
28 Days Post E7777 infusion
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Veronika Bachanova, MD, Masonic Cancer Center, University of Minnesota
Publicaties en nuttige links
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata
- Ziekten van het immuunsysteem
- Neoplasmata per histologisch type
- Lymfatische ziekten
- Lymfoproliferatieve aandoeningen
- Immunoproliferatieve aandoeningen
- Lymfoom, non-Hodgkin
- Lymfoom, B-cel
- Lymfoom
- Hemische en lymfatische ziekten
- Lymfoom, grote B-cel, diffuus
- Organische chemicaliën
- Koolwaterstoffen
- Fosforamide mosterd
- Stikstofmosterdverbindingen
- Mosterdverbindingen
- Koolwaterstoffen, gehalogeneerd
- Fosforamides
- Organofosforverbindingen
- Cyclofosfamide
- fludarabine
- axicabtagene ciloleucel
- TisagenleCleucel
- E7777 fusie-eiwit
Andere studie-ID-nummers
Andere studie-ID-nummers
- 2020LS100
- MT2020-27 (Andere identificatie: University of Minnesota Masonic Cancer Center)
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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