Axatilimab + CAR-T for High-Risk Lymphoma
5 juni 2026 uppdaterad av: Northside Hospital, Inc.
An Open-label, Phase I Trial, With an Expansion Cohort: Macrophage Conditioning to Synergize With CAR-T in High-risk Lymphoma (MAC-SHIFT)
Axatilimab + CAR-T in High-Risk Lymphoma
Studieöversikt
Status
Har inte rekryterat ännu
Betingelser
Intervention / Behandling
Studietyp
Interventionell
Inskrivning (Beräknad)
29
Fas
- Fas 1
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studiekontakt
- Namn: Caitlin Guzowski, MBA, MHA, CCRC
- Telefonnummer: 404-851-8523
- E-post: caitlin.guzowski@northside.com
Studera Kontakt Backup
- Namn: Joseph Maakaron, MD
- Telefonnummer: 404-255-1930
- E-post: jmaakaron@bmtga.com
Studieorter
-
-
Georgia
-
Atlanta, Georgia, Förenta staterna, 30342
- Northside Hospital
-
Kontakt:
- Caitlin Guzowski, MBA, MHA, CCRC
- Telefonnummer: 404-851-8523
- E-post: caitlin.guzowski@northside.com
-
-
Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
- Barn
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Nej
Beskrivning
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
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: N/A
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Axatilimab + Commercial CAR T cell therapy
|
Dose Level -1: 0.1mg/kg Dose Level +1: 0.3mg/kg Dose Level +2: 1mg/kg Dose Level +3: 3mg/kg
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Determine the recommended Phase 2 dose (RP2D) of axatilimab
Tidsram: 1 year
|
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
|
1 year
|
|
Estimate 1 year progression-free survival
Tidsram: 1 year
|
Estimate 1 year progression-free survival by assessing disease status at 1 year following CAR T infusion
|
1 year
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Estimate overall response rate
Tidsram: 1 year
|
Estimate overall response rate (a combination of complete and partial responders) by assessing disease status at 1 year following CAR T infusion
|
1 year
|
|
Estimate the overall survival of patients
Tidsram: 1 year
|
Estimate the overall survival of patients by following survival status and cause of death for 1 year after CAR T infusion
|
1 year
|
|
Evaluate duration of response
Tidsram: 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
|
1 year
|
|
Characterize the safety of axatilimab in combination with CAR T therapy
Tidsram: 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
|
1 year
|
|
Characterize the safety of axatilimab in combination with CAR T therapy
Tidsram: 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
|
Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Sponsor
Publikationer och användbara länkar
Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.
Allmänna publikationer
- Lee DW, Santomasso BD, Locke FL, Ghobadi A, Turtle CJ, Brudno JN, Maus MV, Park JH, Mead E, Pavletic S, Go WY, Eldjerou L, Gardner RA, Frey N, Curran KJ, Peggs K, Pasquini M, DiPersio JF, van den Brink MRM, Komanduri KV, Grupp SA, Neelapu SS. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. Biol Blood Marrow Transplant. 2019 Apr;25(4):625-638. doi: 10.1016/j.bbmt.2018.12.758. Epub 2018 Dec 25.
- Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008 Jul 24;454(7203):436-44. doi: 10.1038/nature07205.
- Haranaka M, Kinami K, Yang YO, Li H, Pratta M, Suzukawa K. Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Axatilimab in Healthy Japanese Male Participants: Results from a Phase 1, Randomized, Double-Blind, Dose-Escalation Study. Clin Drug Investig. 2025 Jun;45(6):327-334. doi: 10.1007/s40261-025-01438-7. Epub 2025 May 17.
- Kitko CL, Arora M, DeFilipp Z, Zaid MA, Di Stasi A, Radojcic V, Betts CB, Coussens LM, Meyers ML, Qamoos H, Ordentlich P, Kumar V, Quaranto C, Schmitt A, Gu Y, Blazar BR, Wang TP, Salhotra A, Pusic I, Jagasia M, Lee SJ. Axatilimab for Chronic Graft-Versus-Host Disease After Failure of at Least Two Prior Systemic Therapies: Results of a Phase I/II Study. J Clin Oncol. 2023 Apr 1;41(10):1864-1875. doi: 10.1200/JCO.22.00958. Epub 2022 Dec 2.
- Yan ZX, Li L, Wang W, OuYang BS, Cheng S, Wang L, Wu W, Xu PP, Muftuoglu M, Hao M, Yang S, Zhang MC, Zheng Z, Li J, Zhao WL. Clinical Efficacy and Tumor Microenvironment Influence in a Dose-Escalation Study of Anti-CD19 Chimeric Antigen Receptor T Cells in Refractory B-Cell Non-Hodgkin's Lymphoma. Clin Cancer Res. 2019 Dec 1;25(23):6995-7003. doi: 10.1158/1078-0432.CCR-19-0101. Epub 2019 Aug 23.
- 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.
- Galli E, Guarneri A, Sora F, Viscovo M, Pansini I, Maiolo E, Alma E, Annunziata S, Sica S, Leccisotti L, Hohaus S. Baseline Tumor Burden Assessed With AI-Guided PET/CT Total Metabolic Tumor Volume (TMTV) and LDH Levels Predict Efficacy of CAR-T in Aggressive B-Cell Lymphoma. Hematol Oncol. 2025 Jan;43(1):e70029. doi: 10.1002/hon.70029.
- 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.
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart (Beräknad)
31 oktober 2026
Primärt slutförande (Beräknad)
31 december 2028
Avslutad studie (Beräknad)
31 december 2029
Studieregistreringsdatum
Först inskickad
5 juni 2026
Först inskickad som uppfyllde QC-kriterierna
5 juni 2026
Första postat (Faktisk)
10 juni 2026
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
10 juni 2026
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
5 juni 2026
Senast verifierad
1 juni 2026
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
- Neoplasmer
- Immunsystemets sjukdomar
- Neoplasmer efter histologisk typ
- Matsmältningssystemets sjukdomar
- Gastrointestinala sjukdomar
- Magsjukdomar
- Lymfatiska sjukdomar
- Lymfoproliferativa störningar
- Immunproliferativa störningar
- Lymfom, icke-Hodgkin
- Lymfom, B-cell
- Lymfom
- Hemiska och lymfsjukdomar
- Pylorisk stenos
- Obstruktion av magutloppet
- Lymfom, stor B-cell, diffus
- Lymfom, follikulärt
- Pylorisk stenos, hypertrofisk
- axatilimab
Andra studie-ID-nummer
- NSH 1445
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
NEJ
Läkemedels- och apparatinformation, studiedokument
Studerar en amerikansk FDA-reglerad läkemedelsprodukt
Ja
Studerar en amerikansk FDA-reglerad produktprodukt
Nej
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