Skip to main content
Clinical Trials/NCT04855253
NCT04855253SuspendedPhase 1

Phase I/II Trial Using E7777 to Enhance Regulatory T-Cell Depletion Prior to CAR-T Therapy for Relapsed/Refractory Large B-Cell Lymphomas

Masonic Cancer Center, University of Minnesota1 site in 1 country30 target enrollmentStarted: June 9, 2021Last updated:
Conditions
Interventions

Trial Snapshot

Phase
Phase 1
Status
Suspended
Enrollment
30
Locations
1
Primary Endpoint
Establish maximum tolerated dose (MTD)

Study Overview

Brief Summary

This is a multicenter Phase I study to determine the maximum tolerated dose (MTD) of E7777 when given prior to cyclophosphamide/fludarabine (CY/Flu) lymphodepletion (LD) chemotherapy and an FDAapproved CAR-T product Tisagenlecleucel/Kymriah, Axicabtagene Ciloleucel/Yescarta, or lisocabtagene maraleucel/Breyanzi) for the treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma grade 3 who are at a higher risk for failure of CAR-T therapy

Detailed Description

E7777 is a recombinant fusion toxin consisting of full-length human IL-2 fused to the catalytic domains of diphtheria toxin. This trial is designed to augment lymphodepletion prior to CAR-T cells by administration of a targeted immunotoxin against CD25-expressing T-cells. CD25 is expressed at high levels on Tregs but also on activated effector T cells. The use of the CAR-T cell product and associated apheresis and LD chemotherapy is considered standard of care (SOC).

Study Design

Study Type
Interventional
Allocation
Non Randomized
Intervention Model
Sequential
Primary Purpose
Treatment
Masking
None

Eligibility Criteria

Ages
18 Years to — (Adult, Older Adult)
Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Diagnosis of a relapse or refractory (r/r) B cell lymphoma, for which treatment with tisagenleucel (Kymriah), Axicabtagene (Yescarta) or Lisocabtagene Maraleucel (Breyanzi) is planned, including :
  • diffuse large B-cell lymphoma (DLBCL) not otherwise specified,
  • high grade B-cell lymphoma
  • DLBCL arising from follicular lymphoma
  • Primary mediastinal B cell lymphoma
  • Follicular lymphoma grade 3B
  • And considered at high risk for progression after CAR-T therapy by meeting one or more of the following factors:
  • refractory to last line of therapy/remission of less than 12 months
  • myc over expression >40% in any prior biopsy or bcl2/bcl6 and c-myc re-arrangement (double/triple hit)
  • 2 sites of extranodal disease
  • Elevated LDH at the time of relapse
  • Has secured coverage for Kymriah, Yescarta,Breyanzi administration
  • Age 18 years or older at the time of signing the consent
  • ECOG Performance status of 0, 1, or 2
  • Adequate bone marrow reserve (may be transfusion dependent)
  • Adequate organ function at enrollment and within 14 days of planned E7777 treatment as defined in Section 4.1.7
  • Hemodynamically stable and LVEF ≥ 50% confirmed by echocardiogram or MUGA
  • Grade 1 dyspnea (CTCAE v5) and SpO2 > 91% on room air
  • Sexually active females of child-bearing potential and males with partners of child bearing potential must agree to use effective contraception during therapy
  • Provides voluntary written consent prior to the performance of any research related activities.

Exclusion Criteria

  • Pregnant or breastfeeding - Females of childbearing potential must have a blood test or urine study within 14 days prior to study enrollment to rule out pregnancy. All females will be considered to be of childbearing potential unless they are postmenopausal (amenorrheic for at least 12 consecutive months, in the appropriate age group, and without other known or suspected cause) or have been sterilized surgically (i.e., bilateral tubal ligation, total hysterectomy, or bilateral oophorectomy, all with surgery at least 1 month before dosing)
  • Known bone marrow involvement, if history of bone marrow involvement must have a BM biopsy to rule-out current involvement
  • Prior allogeneic transplant
  • Ocular disease or complaints visual acuity impairment, color or shape distortion, or blurred vision - potential participants are required to have an ophthalmological examine as part of screening
  • Active CNS involvement by malignancy (history of CNS disease with negative CSF by flow cytometry and/or stable findings on brain MRI are acceptable)
  • Uncontrolled active hepatitis B or hepatitis C
  • Active or inactive HIV infection
  • Untreated active bacterial, viral or fungal infection (e.g. blood culture positive ≤ 72 hours prior to enrollment)
  • History of heart failure or pulmonary edema, evidence of pleural effusion or active lower extremity edema
  • Uncontrolled unstable angina and/or myocardial infarction within 3 months of enrollment
  • Investigational medicinal product within the last 7 days prior to apheresis or CAR-T infusion

Arms & Interventions

Dose level 1 : E7777 at 5 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: E7777 (Drug)

Dose level 1 : E7777 at 5 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Fludarabine (Drug)

Dose level 1 : E7777 at 5 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Cyclophosphamide (Drug)

Dose level 1 : E7777 at 5 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Tisagenlecleucel (Drug)

Dose level 1 : E7777 at 5 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Axicabtagene Ciloleucel (Drug)

Dose level 1 : E7777 at 5 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Lisocabtagene Maraleucel Intravenous Suspension (Drug)

Dose level 1 : E7777 at 7 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: E7777 (Drug)

Dose level 1 : E7777 at 7 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Fludarabine (Drug)

Dose level 1 : E7777 at 7 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Cyclophosphamide (Drug)

Dose level 1 : E7777 at 7 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Tisagenlecleucel (Drug)

Dose level 1 : E7777 at 7 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Axicabtagene Ciloleucel (Drug)

Dose level 1 : E7777 at 7 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Lisocabtagene Maraleucel Intravenous Suspension (Drug)

Dose level 1 : E7777 at 9 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: E7777 (Drug)

Dose level 1 : E7777 at 9 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Fludarabine (Drug)

Dose level 1 : E7777 at 9 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Cyclophosphamide (Drug)

Dose level 1 : E7777 at 9 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Tisagenlecleucel (Drug)

Dose level 1 : E7777 at 9 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Axicabtagene Ciloleucel (Drug)

Dose level 1 : E7777 at 9 mcg/kg

Experimental

Single dose of E7777 given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Lisocabtagene Maraleucel Intravenous Suspension (Drug)

MTD from phase 1

Experimental

Single dose of E7777 (Maximum tolerated dose level identified in phase 1) given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: E7777 (Drug)

MTD from phase 1

Experimental

Single dose of E7777 (Maximum tolerated dose level identified in phase 1) given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Fludarabine (Drug)

MTD from phase 1

Experimental

Single dose of E7777 (Maximum tolerated dose level identified in phase 1) given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Cyclophosphamide (Drug)

MTD from phase 1

Experimental

Single dose of E7777 (Maximum tolerated dose level identified in phase 1) given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Tisagenlecleucel (Drug)

MTD from phase 1

Experimental

Single dose of E7777 (Maximum tolerated dose level identified in phase 1) given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Axicabtagene Ciloleucel (Drug)

MTD from phase 1

Experimental

Single dose of E7777 (Maximum tolerated dose level identified in phase 1) given on Day -7 two days prior to the start of lymphodepleting chemotherapy

Intervention: Lisocabtagene Maraleucel Intravenous Suspension (Drug)

Outcomes

Primary Outcomes

Establish maximum tolerated dose (MTD)

Time Frame: 1 month

The primary objective of this Phase I study is to establish a maximum tolerated dose (MTD) of E7777 when given prior to standard of care CAR-T therapy product for the treatment of relapsed/refractory B-cell lymphoma who are at a higher risk for failure of CAR-T therapy.

Secondary Outcomes

  • Number of participants experiencing adverse events(100 days Post E7777 infusion)
  • Number of Grade 3 or 4 cytokine release syndrome (CRS) incidents(28 Days Post E7777 infusion)
  • Number of participants experiencing overall survival (OS)(1 year Post E7777 infusion)
  • Number of participants experiencing dose limiting toxicity events(28 Days Post E7777 infusion)
  • Number of participants experiencing disease free survival (DFS)(1 year Post E7777 infusion)
  • Number of non-relapse mortality incidents at day 100(100 days Post E7777 infusion)
  • Number of Grade 3 or 4 immune effector cell associated neurotoxicity (ICAN) syndrome incidents(28 Days Post E7777 infusion)

Investigators

Sponsor Class
Other
Responsible Party
Sponsor

Study Sites (1)

Loading locations...

Similar Trials