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.
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Tipo de estudo
Inscrição (Estimado)
Inscrição
Estágio
Estágio
- Fase 1
Contactos e Locais
Contato de estudo
Contato de estudo
- Nome: Alessandra Sperotto, MD
- Número de telefone: +39 0423 732336
- E-mail: alessandra.sperotto@iov.veneto.it
Estude backup de contato
- Nome: Gian Luca De Salvo, MD
- E-mail: clinical.trial@iov.veneto.it
Locais de estudo
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Verona, Itália
- Azienda Ospedaliera Universitaria integrata Verona
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Contato:
- Mauro Krampera, MD
- E-mail: mauro.krampera@univr.it
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Pd
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Padova, Pd, Itália, 35128
- Istituto Oncologico Veneto
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Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Outro
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Número de braços
Armas e Intervenções
Grupo de Participantes / BraçoGrupo de Participantes / Braço |
Intervenção / TratamentoIntervenção / Tratamento |
|---|---|
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Experimental: 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:
|
O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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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.
Prazo: Through study completion, an average of 3 years
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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.
Prazo: 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
|
Medidas de resultados secundários
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Feasibility of performing therapy on an outpatient basis
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Colaboradores
Colaboradores
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Início do estudo
Conclusão Primária (Estimado)
Conclusão Primária
Conclusão do estudo (Estimado)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Neoplasias
- Doenças do sistema imunológico
- Neoplasias por Tipo Histológico
- Doenças Linfáticas
- Distúrbios Linfoproliferativos
- Distúrbios imunoproliferativos
- Linfoma Não-Hodgkin
- Linfoma de Células B
- Linfoma
- Doenças hemic e linfáticas
- Linfoma de Células B Grandes Difuso
- Produtos químicos orgânicos
- Compostos heterocíclicos, 1 anel
- Compostos heterocíclicos
- Compostos heterocíclicos, 2 anel
- Compostos heterocíclicos, anel fundido
- Ácidos carboxílicos
- Piperidinas
- Ftalimidas
- Ácidos ftaléticos
- Ácidos, carbocíclicos
- Piperidones
- Isoindoles
- Lenalidomida
Outros números de identificação do estudo
Outros números de identificação do estudo
- IOV-DLBCL-01-2026-FOCUS
- 2026-525494-39-00 (Ctis)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
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