RecruitingPhase 1Phase 2NCT04544592

UCD19 CarT in Treatment of Pediatric B-ALL and B-NHL

Phase I/II Dose Escalation and Preliminary Efficacy of CD19 Directed CAR-T Cells Generated Using the Miltenyi CliniMACs Prodigy System (UCD19 CAR-T) in Pediatric Patients With Relapsed and/or Refractory B-Cell Acute Lymphoblastic Leukemia (B-ALL) and B-Cell Non-Hodgkin Lymphoma (B-NHL)


Sponsor

University of Colorado, Denver

Enrollment

45 participants

Start Date

Mar 10, 2021

Study Type

INTERVENTIONAL

Conditions

Summary

This phase I/II trial will investigate a new CD19 directed CAR-T therapy manufactured locally with the goals to expedite infusion to wider patient inclusion that includes those who were previously excluded, such as pediatric patients with B-cell NHL and patients in primary relapse.


Eligibility

Min Age: 31 DaysMax Age: 30 Years

Inclusion Criteria34

  • Meets clinical criteria for leukapheresis or has a leukapheresis product previously collected and stored per recommended guidelines.
  • Provision of signed and dated consent form from parent or guardian (patients \<18), the patient themselves (\>18), or legally authorized representative (patient \>18 who lack decision-making capacity); Pediatric patients will be included in age-appropriate discussions and assent will be obtained for those \> 7 years of age, when appropriate, according to institutional standards.
  • Willingness to participate in long term follow up study.
  • Stated willingness to comply with all study procedures and be available for the duration of the study.
  • Males OR non-pregnant, non-breastfeeding females.
  • o Patients of child-bearing potential or capable of fathering a child must agree to use highly effective contraception from the time of initial CAR T cell administration though 12 months following the final administration of investigational product.
  • Aged 31 days to 30 years (inclusive) at time of consent and enrollment.
  • Acute Lymphoblastic Leukemia (ALL) OR Non-Hodgkin Lymphoma (NHL) of B-cell origin that:
  • o Has confirmed expression of CD19 by flow cytometry, immunohistochemistry (IHC), or both.
  • Cohort One Criteria:
  • Meets any one of the following conditions:
  • Relapsed two or more times
  • Relapsed at any time after allogeneic BMT
  • Refractory to standard therapy as determined by the treating physician
  • Meets criteria for BMT but is ineligible as determined by the treating physician
  • Patient and/or parents declining BMT options and would prefer CAR-T Therapy.
  • Non-Hodgkin Lymphoma includes all of the following:
  • Diffuse large B-cell lymphoma (DLBCL)
  • Burkitt Lymphoma
  • Intermediate lymphoma between Burkitt and DLBCL
  • Primary Mediastinal B-cell Lymphoma (PMBL)
  • Follicular lymphoma
  • High grade B cell lymphoma
  • Transformed lymphoma
  • Cohort Two Criteria:
  • B-ALL in first relapse with any one of the following conditions:
  • High-risk genomic alterations at initial diagnosis such as KMT2A gene rearrangement, t(17;19), hypodiploidy, Ph-like mutations, BCR-ABL1 fusion (Ph+ ALL), iAMP21, and TP53 inactivating mutation/deletion.
  • Isolated CNS relapse such that cranial radiation would be indicated as a component of standard salvage therapy.
  • Down syndrome.
  • Minimal residual disease (MRD) positivity of \> 0.01% by FACS or \> 0 clonal sequences by NGS in bone marrow post re-induction chemotherapy.
  • Age 18 years or older. OR
  • Newly diagnosed with persistent MRD ≥ 0.01% by flow cytometry in bone marrow at end of consolidation.
  • Performance score (Lansky or Karnofsky) of 50% or better;
  • Unable to or declined to receive commercially available CD19 CAR-T Therapy.

Exclusion Criteria11

  • Evidence of rapidly progressive disease without adequate salvage/bridging regimens as determined by the investigator.
  • Active Graft-versus-Host Disease (GvHD).
  • Active, uncontrolled, life-threatening infection that at the determination of the treating physician would preclude safe leukapheresis or tolerance of LD chemotherapy, cell infusion, or cytokine release syndrome.
  • Evidence of severe organ dysfunction as defined by:
  • Myocardial dysfunction: Ejection fraction ≤ 40% or shortening fraction ≤ 28%, evidence of physiologically significant pericardial effusion as determined by an echocardiogram (ECHO), and clinically significant electrocardiogram (ECG) findings.
  • Baseline oxygen saturation of ≤ 90% on room air
  • Transaminases \> 10x upper limit of normal (ULN) or bilirubin \>2x the ULN, unless thought to be related to primary disease
  • Estimated Cr clearance \<60 mL/min/1.73 m2 (if nuclear medicine GFR or other more specific testing exceeds this level than it can supersede the estimated clearance)
  • Post-pubertal females that are pregnant, planning to become pregnant, or unwilling to use birth control (includes abstinence) for the study duration.
  • Known HIV infection, or active Hepatitis B or active Hepatitis C infection.
  • Prior gene therapy, including prior CAR-T cell.

Interventions

DRUGCD19CAR-CD3Zeta-4-1BB-Expressing Autologous T-Lymphocyte Cells

The CD19 CAR used in this study consists of three main components: the variable regions of the anti-CD19 monoclonal antibody FMC63 71, linked to the TNFRSF-19-derived transmembrane domain, the 4-1BB costimulatory molecule, and the signaling domain of the CD3-zeta molecule. The DNA encoding this receptor was cloned into a lentiviral vector (LV) backbone.


Locations(1)

Children's Hospital Colorado

Aurora, Colorado, United States

View Full Details on ClinicalTrials.gov

For the most up-to-date information, visit the official listing.

Visit

NCT04544592


Related Trials