Dose-escalation and Dose-expansion Study of Safety of Azer-cel (PBCAR0191) in Participants With Relapsed/Refractory (r/r) Non-Hodgkin Lymphoma (NHL) and r/r B-cell Acute Lymphoblastic Leukemia (B-ALL)
A Phase 1/1b, Open-label, Dose-escalation, Dose-expansion, Parallel Assignment Study to Evaluate Safety and Clinical Activity of PBCAR0191 (Azercabtagene Zapreleucel or "Azer-cel") in Subjects With Relapsed/Refractory (r/r) Non-Hodgkin Lymphoma (NHL) and r/r B-cell Acute Lymphoblastic Leukemia (B-ALL)
Imugene Limited
135 participants
Mar 11, 2019
INTERVENTIONAL
Conditions
Summary
This is a Phase 1/1b, nonrandomized, open-label, parallel assignment, dose-escalation, and dose-expansion study to evaluate the safety and clinical activity of azer-cel, an allogeneic anti-CD19 CAR T, in adults with r/r B ALL, r/r B-cell NHL and CLL/SLL.
Eligibility
Inclusion Criteria32
- Criteria for B-ALL:
- • Participant has confirmed unequivocal r/r CD19+ B-ALL.
- Criteria for NHL and CLL/SLL:
- • Participant has unequivocal aggressive CD19+ r/r B-cell NHL that is confirmed by tumor biopsy tissue from last relapse after CD19-directed therapy.
- For Phase 1 Dose Escalation:
- Diffuse large B-cell lymphoma (DLBCL) including Richter's transformation
- Follicular lymphoma (FL) including Grade 3 or transformed FL
- High-grade B-cell lymphoma (HGBCL)
- Primary mediastinal lymphoma
- For Phase 1b Dose Expansion (CAR T-relapsed cohort):
- DLBCL not otherwise specified (NOS)
- HGBCL
- DLBCL transformed from the following indolent lymphoma subtypes (FL, Marginal Zone lymphoma \[MZL\], and Waldenstrom's Macroglobulinemia \[WM\])
- Other large B-cell lymphoma (LBCL) subtypes may be enrolled with approval from the Medical Monitor.
- Participants previously treated with CD19-directed autologous CAR T therapies have received no more than 2 lines of therapy after administration of their previous CAR T product.
- For the expansion CAR T-relapsed cohort only: Participants must have received autologous CD19-directed CAR T therapy and demonstrated clinical response to the treatment at Day 28 or later, followed by relapse or progression.
- For Phase 1b dose expansion (CAR T-naive cohort):
- DLBCL NOS
- DLBCL transformed from the following indolent lymphoma subtypes (FL, MZL, and WM)
- HGBCL
- FL (Grade 1-3a)
- MZL that is fluorodeoxyglucose (FDG)-avid on positron emission tomography (PET) scan
- WM
- CLL/SLL
- Primary central nervous system (CNS) lymphoma (PCNSL)
- Other LBCL subtypes may be enrolled with approval from the Medical Monitor.
- Participant must have received at least 1-2 prior lines of therapy, depending on histological subtype but no more than 7 systemic lines of anti-cancer therapy.
- Criteria for both B-ALL, NHL, and CLL/SLL:
- Eastern Cooperative Oncology Group performance status score of 0 or 1.
- An estimated life expectancy of at least 12 weeks according to the investigator's judgment.
- Seronegative for human immunodeficiency virus antibody.
- Participant has adequate bone marrow, renal, hepatic, pulmonary, and cardiac function.
Exclusion Criteria24
- Criteria for B-ALL:
- • Burkitt cell (L3 ALL) or mixed-lineage acute leukemia.
- Criteria for NHL:
- Requirement for urgent therapy due to tumor mass effects such as bowel obstruction or blood vessel compression.
- Active hemolytic anemia.
- Criteria for B-ALL and NHL:
- No active CNS disease, excluding PCNSL
- History of another primary malignancy
- Any form of primary immunodeficiency (for example, severe combined immunodeficiency disease).
- History of hepatitis B or hepatitis C currently receiving ongoing antiviral therapy.
- Any known uncontrolled cardiovascular disease at the time of Screening that, in the investigator's opinion, renders the participant ineligible
- History of hypertension crisis or hypertensive encephalopathy within 3 months prior to Screening.
- History of severe immediate hypersensitivity reaction to any of the agents used in this study.
- Presence of a CNS disorder that, in the opinion of the investigator, renders the participant ineligible for treatment.
- History of concomitant genetic syndrome such as Fanconi anemia, Kostmann syndrome, Shwachman-Diamond syndrome, or any other known bone marrow failure syndrome.
- Active uncontrolled autoimmune disease requiring active immunosuppression at the time of Screening (excluding participants needing steroids for physiologic replacement).
- Participant has received stem cell transplant within 90 days before Screening.
- Participant has active graft-versus-host disease (GvHD) symptoms.
- Participant has received a systemic biologic agent for treatment of the disease under study within 28 days of LD, other systemic anti-cancer therapy within 10 days or 5 half-lives (whichever is shorter) of LD, and no pulse steroid for disease control within 3 days of LD.
- Radiotherapy within 4 weeks before Screening.
- Presence of pleural/peritoneal/pericardial catheter, as well as permeant biliary and ureteral stents (does not apply to intravenous lines).
- Participant has received live vaccine within 4 weeks before Screening. Note: Non-live virus vaccines are not excluded.
- Participant has received CD19-directed therapy other than autologous CD19-directed CAR T therapy within 90 days of the anticipated start date of LD.
- Additional criteria apply.
Interventions
Infusion of Allogeneic Anti-CD19 CAR T cells
Specified dose on specified days
Specified dose on specified days
Specified dose on specified days
Locations(23)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT03666000