Study to Evaluate the Feasibility and Safety of Autologous Cytokine-Induced Killer Cells (CIK_D332) in Combination With Tafasitamab and Lenalidomide in Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma (FOCUS)
A Multicenter, Phase I Study to Evaluate the Feasibility and Safety of Autologous Cytokine-Induced Killer Cells (CIK_D332) in Combination With Tafasitamab and Lenalidomide in Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma (DLBCL): The FOCUS Study
This is a multicentre, Phase I trial of Cytokine Induced Killer-cells (CIK_D332) in combination with Tafasitamab and Lenalidomide in patients with Diffuse Large B-cell Lymphoma (DLBCL) who have relapsed or are refractory after at least one prior line of therapy including an anti-CD20 drug and are not candidates for high-dose chemotherapy with hematopoietic stem cell auto transplantation or CAR-T therapy. The plasticity of CIK cells allows a simple and immediate modulation of the combined therapeutic strategy through the replacement of the antibody used, without having to resort to genetic modification of the effector cells. Furthermore, thanks to the simultaneous expression of CD3 and CD16 receptors, the choice of the antibody to be used in the combination can fall on both monoclonal antibodies (bound by CD16) and bispecific antibodies (capable of binding and stimulating CD3), significantly expanding the spectrum of therapeutic options and the possibilities of combining these effector cells in anticancer therapy. To demonstrate this potential, expanded CIK cells from healthy donors were combined with obinutuzumab (anti-CD20 mAb), tafasitamab (anti-CD19 mAb), and blinatumomab (anti-CD19 bsAb) in parallel and tested against a large panel of hematologic malignancies. The combination with each of the three antibodies led to a significant increase in the intrinsic cytotoxic activity of CIKs, inducing ADCC activity against all the lines analysed. The resulting activity was comparable to, and in some cases even superior to, cytotoxicity induced by CD19-specific CAR-T cells. CIKs are able to recognize tumour cells in a MHC-independent manner through receptors typical of NK cells, in particular NKG2D, and to induce cell death by means of perforins and granzymes. In addition, thanks to the expression of the CD16 receptor, it is possible to stimulate their antibody-dependent cell-mediated cytotoxicity (ADCC) activity, increasing their intrinsic antitumor activity [10]. The end result of this approach is a lytic activity that combines the intrinsic MHC-independent cytotoxicity of CIKs with antibody-induced ADCC, resulting in enhanced antitumor efficacy. The project aims to provide a "proof of concept" in the clinic of a complementary or alternative therapeutic strategy to other anti-tumour immunotherapies, treating patients with relapsed or refractory DLBCL with chemotherapy-free immunotherapy.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
A total of 14 patients with relapsed or refractory Diffuse Large B-Cell Lymphoma (DLBCL) will be enrolled. This sample size is intended to provide a sufficient cohort to evaluate the feasibility, safety, and preliminary efficacy of the combined therapy of CIK_D332, Tafasitamab, and Lenalidomide, while allowing for early assessment of the therapeutic approach in the specified patient population.
The treatment regimen consists of a combination of Tafasitamab, Lenalidomide, and CIK_D332, administered as follows:
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Tafasitamab: Administered at a dose of 12 mg/kg IV.
- Cycle 1 (28-day): Days 1, 4, 8, 15, and 22.
- Cycles 2-3: Days 1, 8, 15, and 22.
- Cycles 4-5: Days 1 and 15.
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Lenalidomide: Administered at 25 mg orally on days 1-21 of each cycle (up to 5 cycles). Dose adjustments are applied according to the label for renal clearance and toxicity.
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CIK_D332 Cells: Administered in cycles 2-5 (up to 8 doses total).
- Administration: Infused after Tafasitamab on days 1 and 15. In patient with previous infusion-related reactions requiring premedication with glucocorticosteroids also in cycles 2-5, CIK_D332 will be infused the following day
- Dosage: 3-5 x 106 cells/kg (total 225-300 x 106 cells).
- Note: The number of doses (2-8) depends on CIK_D332 cell amount produced. Patients receiving fewer than 2 doses will not be evaluable for secondary objectives.
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Maintenance: Following a clinical response, patients may continue treatment with Tafasitamab and Lenalidomide, without CIK_D332, until disease progression as per the label.
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Fase 1
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Alessandra Sperotto, MD
- Telefoonnummer: +39 0423 732336
- E-mail: alessandra.sperotto@iov.veneto.it
Studie Contact Back-up
- Naam: Gian Luca De Salvo, MD
- E-mail: clinical.trial@iov.veneto.it
Studie Locaties
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Verona, Italië
- Azienda Ospedaliera Universitaria integrata Verona
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Contact:
- Mauro Krampera, MD
- E-mail: mauro.krampera@univr.it
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Pd
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Padova, Pd, Italië, 35128
- Istituto Oncologico Veneto
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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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Signing of informed consent;
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Patients of both sexes, aged ≥18 years;
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Patients with relapsed/refractory DLBCL (including transformed indolent lymphoma with subsequent DLBCL recurrence) after at least one prior chemo-immonotherapy including anti-CD20 drug;
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Patients with documented CD19 expression (by immunohistochemistry [IHC] or flow cytometry [FCM]) in lymphoma cells;
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Patients not candidates for high-dose chemotherapy with hematopoietic stem cell auto transplantation or CAR-T therapy;.
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Washout period following treatment with cytotoxic T-cell drugs before peripheral blood collection for CIK_D332 cell manufacturing:
- minimum 2 weeks from systemic chemotherapy and targeted agents
- minimum 12 weeks from lymphotoxic therapy (Bendamustine, Fludarabine, Cladribine, Pentostatin, loncastuximab, CAR-T)
- minimum 7 days stop from corticosteroids
- 2-4 weeks stop from immunosuppressants (e.g., for GVHD).
Exclusion Criteria:
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● Patients with known active malignancy;
- Patients with a positive test for human immunodeficiency virus (HIV) or active hepatitis B or C;
- Patients with active autoimmune disease requiring systemic treatment
- Woman who is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study;
- Patients suffering from Burkitt's lymphoma, aggressive lymphoma with rearrangement of MYC, BCL2 or BCL6;
- Patients with > 4 lines of therapy for lymphoma;
- Patients with known hypersensitivity to study antibodies, Human Serum Albumin (HSA), Dimethyl Sulfoxide (DMSO) or any formulation excipients of CIK_D332;
- Patients with medical or psychological conditions that prevent participation;
- Active, uncontrolled systemic bacterial, viral, fungal, or parasitic infections;.
- Severe baseline organ failure (NYHA Class III/IV cardiac dysfunction, hepatic impairment with total bilirubin > 2.0× ULN, or renal failure with CrCl < 30 mL/min);.
- Administration of live attenuated vaccines within 6 months prior to or following CIK_D332 cell infusion.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ander
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
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Experimenteel: Experimental
Cytokine Induced Killer-cells (CIK_D332) in combination with Tafasitamab and Lenalidomide |
The treatment regimen consists of a combination of Tafasitamab, Lenalidomide, and CIK_D332, administered as follows:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Feasibility of CIK (CIK_D332) cell therapy added to tafasitamab/lenalidomide in patients with relapsed/refractory DLBCL after at least one line of immuno-chemotherapy.
Tijdsspanne: Through study completion, an average of 3 years
|
The ability to expand CIK cells for therapy from peripheral blood of individual patient will be evaluated as CIK_D332 cell expansion rate > 6 x 108 cells at first production |
Through study completion, an average of 3 years
|
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Safety of CIK (CIK_D332) cell therapy added to tafasitamab/lenalidomide in patients with relapsed/refractory DLBCL after at least one line of immuno-chemotherapy.
Tijdsspanne: Through study completion, an average of 3 years
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The safety of CIK_D332 cell therapy added to tafasitamab/lenalidomide will be evaluated as rate of CRS (total and grade III-IV), ICANS (total and grade III-IV) and rate and severity of treatment-emergent adverse events (TEAE). |
Through study completion, an average of 3 years
|
Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Feasibility of performing therapy on an outpatient basis
Tijdsspanne: Through study completion, an average of 3 years
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Rate of outpatient infusions/total infusion starting from the second CIK_D332 dose |
Through study completion, an average of 3 years
|
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Overall Response Rate (ORR) according to 2007 International Working Group response criteria for malignant lymphoma at the End of Treatment
Tijdsspanne: Through study completion, an average of 3 years
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Overall Response Rate (ORR) will be defined as the proportion of patients who achieve a confirmed Complete Response (CR) or Partial Response (PR) after the end of treatment or death from any cause, whichever occurs first |
Through study completion, an average of 3 years
|
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Complete Response Rate (CRR) according to 2007 International Working Group response criteria for malignant lymphoma at End of Treatment
Tijdsspanne: Through study completion, an average of 3 years
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Complete Response Rate (CRR) will be defined as the percentage of patients who achieve a Complete Response (CR) at the end of treatment |
Through study completion, an average of 3 years
|
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Progression Free survival (PFS) according to 2007 International Working Group response criteria for malignant lymphoma at End of Treatment
Tijdsspanne: Through study completion, an average of 3 years
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Progression Free Survival (PFS) will be defined as the time from the date of the first tafasitamab infusion (Day 0) to the date of the first documentation of Progressive Disease (PD), or death from any cause, whichever occurs first |
Through study completion, an average of 3 years
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Medewerkers
Medewerkers
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
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
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
- Heterocyclische verbindingen, 1-ring
- Heterocyclische verbindingen
- Heterocyclische verbindingen, 2-ring
- Heterocyclische verbindingen, gefuseerd ring
- Carbonzuren
- Piperidines
- Phtalimiden
- Phtaliczuren
- Zuren, carbocyclisch
- Piperidones
- Isoindoles
- Lenalidomide
Andere studie-ID-nummers
Andere studie-ID-nummers
- IOV-DLBCL-01-2026-FOCUS
- 2026-525494-39-00 (Ctis)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
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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