RecruitingPhase 1Phase 2NCT05826535

Study of LYL314 in Aggressive Large B-Cell Lymphoma

A Phase 1/2 Multi-Center Study Evaluating the Safety and Efficacy of LYL314, a CD19/CD20 Dual-Targeting Chimeric Antigen Receptor T-Cell Therapy in Participants With Aggressive B-Cell Non-Hodgkin Lymphoma


Sponsor

Lyell Immunopharma, Inc.

Enrollment

270 participants

Start Date

May 9, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of LYL314, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma.


Eligibility

Min Age: 18 Years

Inclusion Criteria23

  • Age 18 years or older at time of informed consent
  • Willing and able to provide written informed consent
  • Histologically confirmed aggressive NHL, including the following types defined by the World Health Organization (WHO 2017):
  • DLBCL
  • DLBCL arising from follicular lymphoma (transformed FL, tFL)
  • Primary mediastinal (thymic) large B-cell lymphoma (PMBCL)
  • High-grade large B-cell lymphoma with or without MYC and BCL2 and/or BCL6 rearrangement (HGBL)
  • Grade 3B follicular lymphoma/Large cell follicular lymphoma (FL3B)
  • Received at least two prior lines of therapy for Cohorts 1, 2, and 4 and one prior line of therapy for Cohort 3. Prior therapy must have included:
  • Anti-CD20 monoclonal antibody, and
  • An anthracycline containing chemotherapy regimen
  • Participants with tFL must have received at least one of their prior lines of therapy after transformation to DLBCL
  • b. Cohort 5 (High-risk first-line) participants must have high-risk large B-cell lymphoma
  • Relapsed or refractory disease, defined by the following:
  • Disease progression after last regimen (including salvage therapy after autologous stem cell transplantation \[ASCT\]). In participants who have only received front-line therapy, progression should be ≤ 12 months of first-line therapy (applicable for Cohort 3)
  • In patients who received one line of therapy, refractory disease is defined as failure to achieve at least a PR after at least 4 cycles of therapy (applicable for Cohort 3)
  • In patients who received two or more lines of therapy (Cohorts 1, 2, and 4), refractory disease is defined as failure to achieve a CR to last line of therapy (including CAR T and/or salvage therapy).
  • At least 1 measurable lesion (per Lugano classification). Lesions that have been previously irradiated will be considered measurable only if progression has been documented following completion of radiation therapy
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 or ECOG 0 to 2 (Cohort 5)
  • Absolute neutrophil count (ANC) ≥ 1000/uL
  • Platelet count ≥ 50,000/uL
  • Absolute lymphocyte count (ALC) ≥ 200/uL
  • Other protocol-defined criteria apply.

Exclusion Criteria19

  • History of malignancy other than non-melanoma skin cancer or carcinoma in situ (e.g., cervix, bladder, breast) unless disease-free for at least 3 years. Participants who have received therapy for a prior malignancy within the prior 3 years, e.g., in the adjuvant setting, are not excluded
  • Active central nervous system (CNS) involvement by malignancy on magnetic resonance imaging (MRI) or by lumbar puncture. Participants with prior evidence of brain metastasis treated at least 8 weeks prior to enrollment will not be excluded for participation if CNS disease is deemed stable at the time of study enrollment
  • History of cardiac lymphoma involvement or Epstein-Barr virus (EBV)+ lymphoma
  • Ongoing or impending oncologic emergency (e.g., tumor mass effect, tumor lysis syndrome, known vascular invasion)
  • Received the following therapies in the specified time frame prior to enrollment/leukapheresis
  • Any systemic therapy within 2 weeks
  • Any systemic inhibitory/stimulatory immune checkpoint molecule therapy within 3 half-lives prior to enrollment (e.g., ipilimumab, nivolumab, pembrolizumab, atezolizumab, OX40 agonists, 4-1BB agonists)
  • Fludarabine within 12 weeks
  • Alemtuzumab, bendamustine or antithymocyte globuline (ATG) within 6 months
  • Any T cell engager/bispecific antibody therapy such as CD20/CD3 or CD19/CD3 bispecific antibodies within 4 weeks
  • Any experimental therapy within 4 weeks or 5 half-lives (whichever is shorter)
  • Received radiation therapy within 3 weeks prior to enrollment/leukapheresis
  • Experiencing non-hematologic toxicities due to prior therapy. Exceptions include: stable and recovered to grade ≤ 1 or non-clinically significant toxicities such as (1) alopecia, (2) toxicities where Grade 2 is solely defined by participant receiving hormone replacement therapy for endocrinopathies resulting from previous checkpoint inhibitor therapy, (3) Grade 2 lymphopenia, and (4) hearing loss or Grade 2 neuropathy associated with prior treatment with taxanes or platinating agents
  • History of allogeneic stem cell or solid organ transplantation
  • Receipt of autologous stem cell transplantation within 6 weeks prior to enrollment/leukapheresis
  • History of prior genetically modified cell therapy other than a product targeting CD19 with an FMC63-based CAR (e.g., axicabtagene ciloleucel (axi-cel), tisagenlecleucel (tisa-cel), or lisocabtagene maraleucel (liso-cel). For all other CAR T cell therapy treatments, discussion with the Sponsor's Medical Monitor is required
  • Primary immunodeficiency
  • History of autoimmune disease (e.g., Crohn's disease, rheumatoid arthritis, systemic lupus) resulting in end organ injury or requiring systemic immunosuppression/systemic disease modifying agents within the last 2 years. Participants who have other autoimmune condition(s) considered to be associated with underlying malignancy may be enrolled in the study after discussion with and approval of the Medical Monitor.
  • Other protocol-defined criteria apply.

Interventions

DRUGLYL314

CAR T-cell therapy

DRUGFludarabine

Conditioning chemotherapy

DRUGCyclophosphamide

Conditioning chemotherapy


Locations(27)

University of California-Irvine Medical Center

Irvine, California, United States

Cedars-Sinai Medical Center

Los Angeles, California, United States

University of California, Los Angeles (UCLA) Medical Center

Los Angeles, California, United States

Scripps Clinic

San Diego, California, United States

Colorado Blood Cancer Institute

Denver, Colorado, United States

Augusta University Medical Center

Augusta, Georgia, United States

Indiana Blood and Marrow Transplantation

Indianapolis, Indiana, United States

University of Iowa

Iowa City, Iowa, United States

University of Louisville Brown Cancer Center

Louisville, Kentucky, United States

Louisiana State University Health Sciences Center

Shreveport, Louisiana, United States

Corewell Health

Grand Rapids, Michigan, United States

University of Nebraska Medical Center

Omaha, Nebraska, United States

University of New Mexico Comprehensive Cancer Center

Albuquerque, New Mexico, United States

Roswell Park Comprehensive Cancer Center

Buffalo, New York, United States

Montefiore Medical Center

The Bronx, New York, United States

University of Cincinnati (UC) Physicians Company, LLC

Cincinnati, Ohio, United States

Cleveland Clinic

Cleveland, Ohio, United States

Lehigh Valley Topper Cancer Center Institute

Allentown, Pennsylvania, United States

Thomas Jefferson University

Philadelphia, Pennsylvania, United States

West Penn Hospital

Pittsburgh, Pennsylvania, United States

Baylor University Medical Center

Dallas, Texas, United States

Texas Transplant Institute

San Antonio, Texas, United States

Huntsman Cancer Institute

Salt Lake City, Utah, United States

Intermountain Healthcare

Salt Lake City, Utah, United States

Virginia Oncology Associates

Norfolk, Virginia, United States

Virginia Commonwealth University-Massey Cancer Center

Richmond, Virginia, United States

Medical College of Wisconsin

Milwaukee, Wisconsin, United States

View Full Details on ClinicalTrials.gov

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

Visit

NCT05826535


Related Trials