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P-CD19CD20-ALLO1 Allogeneic CAR-T Cells in the Treatment of Subjects With B Cell Malignancies

Phase 1
Recruiting
Conditions
Diffuse Large B-Cell Lymphoma, Not Otherwise Specified
High-grade B-cell Lymphoma
Primary Mediastinal Large B-cell Lymphoma (PMBCL)
Transformed Follicular Lymphoma (tFL)
Follicular Lymphoma Grade 3B
Registration Number
NCT06014762
Lead Sponsor
Poseida Therapeutics, Inc.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Recruiting
Sex
All
Target Recruitment
Not specified
Inclusion Criteria

Inclusion Criteria<br><br> 1. Must have signed written, informed consent.<br><br> 2. Males or females = 18 years of age.<br><br> 3. Must have prior biopsy proven confirmed diagnosis of DLBCL NOS (including DLBCL<br> arising from indolent lymphomas), HGBL, PMBCL,and tFL or follicular lymphoma Grade<br> 3B.<br><br> 4. Diagnosis of the disease based on WHO 2016 (Swerdlow, 2016) criteria.<br><br> 5. Subjects must have measurable disease as defined by Lugano 2016 criteria (Cheson,<br> 2016).<br><br> 6. Must have relapsed/refractory disease and have received adequate prior anti-cancer<br> therapy, as defined below:<br><br> a. Prior systemic chemotherapy must include a line of chemoimmunotherapy that<br> includes an anti-CD20 antibody, an anthracycline, and 1 or more of the following: i.<br> No response to first-line therapy (primary refractory disease). Refractory disease<br> (defined as SD, PD, PR or CR with relapse before 3 months).<br><br> ii. Progressive disease following two or more lines of therapy. However, SD as the<br> best response after at least 2 cycles of the last line of therapy with SD duration<br> no longer than 6 months from the last dose of therapy is also acceptable.<br><br> iii. Refractory post-autologous stem cell transplant (ASCT). Disease progression or<br> relapse occurring at less than or equal to 12 months of undergoing ASCT (must have<br> biopsy proven recurrence in relapsed patients). If salvage therapy is given<br> post-ASCT, the patient must have had no response to or relapsed after the last line<br> of therapy.<br><br> iv. Refractory disease (SD, PD, PR or CR with relapse before 3 months) or relapsed<br> disease (defined as CR/PR with relapse on, or after lasting at least 3 months but no<br> more than 12 months), to CD20 antibody and anthracycline containing first-line<br> therapy.<br><br> 7. Must be willing to practice birth control from the time of Screening and throughout<br> the first year of the study after P-CD19CD20-ALLO1 administration (both males and<br> females of childbearing potential).<br><br> 8. Must have a negative serum pregnancy test at Screening and a negative urine<br> pregnancy test within 3 days prior to initiating the lymphodepletion chemotherapy<br> regimen (females of childbearing potential).<br><br> 9. Must be at least 90 days since ASCT, if performed.<br><br> 10. Treatment with prior CD19 targeted therapy is allowed, provided the last dose was<br> administered at least 90 days before the start of P-CD19CD20-ALLO1 treatment in this<br> study. Must be at least 3 months since autologous CAR-T therapy if such therapy was<br> administered (medical monitor must approve prior CAR-T therapy or other prior T cell<br> targeted therapy).<br><br> 11. Must have adequate vital organ function, defined as follows (or medical monitor<br> approval):<br><br> 1. Serum creatinine = 1.5 mg/dL or estimated creatinine clearance = 30 mL/min as<br> calculated using the Cockcroft-Gault formula and not dialysis-dependent.<br><br> 2. Adequate hematologic function, including:<br><br> i. Absolute neutrophil count (ANC) = 1000/µL in the absence of growth factor support<br> (granulocyte colony stimulating factor [G-CSF] within 7 days or peg-G-CSF within 14<br> days) ii. Platelet count = 50,000/µL in the absence of transfusion support (platelet<br> transfusion within 7 days) iii. Hemoglobin = 8 g/dL in the absence of transfusion<br> support (red blood cell count or whole blood within 7 days) c. Aspartate<br> transaminase (AST) and alanine aminotransferase (ALT) = 3 × the upper limit of<br> normal (ULN), and total bilirubin = 2.0 mg/dL (unless there is a history of<br> Gilbert's Syndrome in which case bilirubin levels = 3 mg/dL).<br><br> d. Left ventricular ejection fraction (LVEF) = 45%. LVEF assessment must have been<br> performed within 4 weeks of enrollment.<br><br> 12. Must have recovered from toxicities due to prior therapies to Grade = 2 according to<br> the NCI CTCAE v5.0 criteria or to the subject's prior baseline.<br><br> 13. Must have an ECOG performance status of 0 to 1.<br><br>Exclusion Criteria<br><br> 1. Is pregnant or lactating.<br><br> 2. Has inadequate venous access.<br><br> 3. Has active hemolytic anemia, POEMS syndrome (polyneuropathy, organomegaly,<br> endocrinopathy, monoclonal protein, and skin changes), disseminated intravascular<br> coagulation, leukostasis, or amyloidosis.<br><br> 4. Concurrent or previous other malignancy within 2 years of study entry, except<br> curatively treated malignancies including basal or squamous cell skin cancer,<br> prostate intraepithelial neoplasm, carcinoma in situ of the cervix, breast, or<br> Bowen's disease. Patients with other curatively treated malignancies with low risk<br> of recurrence not listed may also be considered eligible after review and approval<br> by the Sponsor medical monitor.<br><br> 5. Has active autoimmune disease, such as psoriasis, multiple sclerosis, lupus,<br> rheumatoid arthritis, etc. (the medical monitor will determine if a disease is<br> active and autoimmune).<br><br> 6. Has a history of significant central nervous system (CNS) disease, such as stroke,<br> epilepsy, primary CNS lymphoma, etc. (the medical monitor will determine if<br> significant).<br><br> 7. Has an active systemic infection (e.g., causing fevers or requiring antimicrobial<br> treatment).<br><br> 8. Has a history of hepatitis B virus (HBV), hepatitis C virus (HCV), human<br> immunodeficiency virus (HIV), or human T-lymphotropic virus (HTLV) infection, or any<br> immunodeficiency syndrome. Subjects with a history of treated hepatitis C can be<br> enrolled if negative by hepatitis C polymerase chain reaction (PCR) on multiple<br> occasions and with medical monitor approval.<br><br> 9. Is positive for human herpes virus (HHV)-6 or HHV-7 infection by PCR at the<br> Screening Visit (subjects may be included in the study if they are HHV-6 or HHV-7<br> IgG antibody-positive but PCR-negative).<br><br> 10. Has New York Heart Association (NYHA) Class III or IV heart failure, unstable<br> angina, or a history of myocardial infarction or significant arrhythmia (e.g.,<br> atrial fibrillation, sustained [> 30 seconds] ventricular tachyarrhythmias, etc.).<br><br> 11. Has any psychiatric or medical disorder (e.g., cardiovascular, endocrine, renal,<br> gastrointestinal, genitourinary, immunodeficiency or pulmonary disorder not<br> otherwise specified) that would, in the opinion of the Investigator or medical<br> monitor, preclude safe participation in and/or adherence to the protocol (including<br> medical conditions or laboratory findings that indicate a significant probability of<br> not qualifying for or being unable to undergo, LD chemotherapy and/or CAR-T cell<br> administration).<br><br> 12. Has received non-mAb anti-cancer medications within 2 weeks of the time of<br> initiating LD chemotherapy.<br><br> 13. Has received mAb therapy within 4 weeks of initiating LD chemotherapy.<br><br> 14. Has received immunosuppressive medications within 2 weeks of the time of<br> administration of P-CD19CD20-ALLO1, and/or expected to require them while on study<br> (the medical monitor will determine if a medication is considered<br> immunosuppressive.)<br><br> 15. Has received systemic corticosteroid therapy > 5 mg/day of prednisone or equivalent<br> dose of another corticosteroid within 1 week or 5 half-lives (whichever is shorter)<br> of the administration of P-CD19CD20-ALLO1 or is expected to require it during the<br> course of the stu

Exclusion Criteria

Not provided

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Assess the safety and MTD or RDE of P-CD19CD20-ALLO1 based on dose limiting toxicities (DLT)
Secondary Outcome Measures
NameTimeMethod
The safety of P-CD19CD20-ALLO1 (AEs);The anti-B cell malignancy effect of P-CD19CD20-ALLO1 (ORR);The anti-B cell malignancy effect of P-CD19CD20-ALLO1 (DOR);The anti-B cell malignancy effect of P-CD19CD20-ALLO1 (PFS);The anti-B cell malignancy effect of P-CD19CD20-ALLO1 (OS);The effect of cell dose and LD regimen to guide selection of specific cell dose and LD regimen for further assessment in Phase 2/3 studies
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