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Natural Killer (NK) Cell Therapy for B-Cell Malignancies

Phase 1
Recruiting
Conditions
B-cell Lymphoma
B-cell Acute Lymphoblastic Leukemia
Interventions
Registration Number
NCT05379647
Lead Sponsor
Zhejiang University
Brief Summary

This is an open-label, Phase I study of QN-019a (allogeneic CAR-NK cells targeting CD19) as monotherapy in relapsed/refractory B-cell Acute Lymphoblastic Leukemia (B-ALL) and in combination with Rituximab in relapsed/refractory B-cell Lymphoma.

This clinical study is to evaluate the safety, tolerability and preliminary efficacy of QN-019a in patients with relapsed/refractory B-cell lymphoma or B-ALL. Up to 22-36 patients will be enrolled.

Detailed Description

This is an open-label, Phase I study of QN-019a (allogeneic CAR-NK cells targeting CD19) as monotherapy in relapsed/refractory B-cell Acute Lymphoblastic Leukemia (B-ALL) and in combination with Rituximab in relapsed/refractory B-cell Lymphoma.

This clinical study is to evaluate the safety, tolerability and preliminary efficacy of QN-019a in patients with relapsed/refractory B-cell lymphoma or B-ALL, where a "3+3" enrollment schema will be utilized at dose escalation stage. Up to 24-36 patients will be enrolled.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
24
Inclusion Criteria
  • Diagnosis of B-cell lymphoma or B-ALL as described below:

B-cell Lymphoma:

  • Histologically documented lymphomas expected to express CD19 and CD20
  • Relapsed/refractory disease following at least two prior systemic treatment regimens, or relapsed after the autologous hematopoietic stem cell transplantation (HSCT)

B-ALL:

  • Diagnosis of B-ALL that expected to express CD19
  • Relapsed/refractory disease following prior systemic treatment regimens

ALL SUBJECTS:

  • Provision of signed and dated informed consent form (ICF)
  • Age ≥ 18 years old
  • Stated willingness to comply with study procedures and duration
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤1
  • Adequate organ function as defined in the protocol
  • Donor specific antibody (DSA) to QN-019a: MFI <= 2000
  • At least 3 weeks after the last systemic immunochemotherapy treatment
  • The estimated survival days are expected to be over 3 months

Key

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Exclusion Criteria

ALL SUBJECTS:

  • Females who are pregnant or lactating
  • Evidence of insufficient organ function as defined in the protocol
  • ECOG Performance Status ≥2
  • Prior allogeneic hematopoietic stem cell transplant (HSCT) or allogeneic CAR-T/CAR-NK within 6 months of Day 1, or ongoing requirement for systemic GvHD therapy
  • Currently receiving or likely to require systemic immunosuppressive therapy
  • Known active central nervous system (CNS) involvement by malignancy. Non-malignant CNS disease such as stroke, epilepsy, or neurodegenerative disease
  • Clinically significant cardiovascular disease as defined in the protocol
  • Known HIV infection, active Hepatitis B (HBV) or Hepatitis C (HCV) infection
  • Donor specific antibody (DSA) to QN-019a: MFI > 2000
  • Other comorbid conditions and concomitant medications prohibited as per study protocol
  • Investigator-assessed presence of any medical or social issues that are likely to interfere with study conduct or may cause increased risk to subject
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
QN-019a MonotherapyQN-019aQN-019a Monotherapy in adult subjects with r/r B-ALL
QN-019a in Combination with Monoclonal AntibodiesQN-019aQN-019a in Combination with Rituximab in adult subjects with r/r B-cell lymphoma.
QN-019a in Combination with Monoclonal AntibodiesCyclophosphamidQN-019a in Combination with Rituximab in adult subjects with r/r B-cell lymphoma.
QN-019a MonotherapyCyclophosphamidQN-019a Monotherapy in adult subjects with r/r B-ALL
QN-019a MonotherapyFludarabineQN-019a Monotherapy in adult subjects with r/r B-ALL
QN-019a MonotherapyVP-16QN-019a Monotherapy in adult subjects with r/r B-ALL
QN-019a in Combination with Monoclonal AntibodiesRituximabQN-019a in Combination with Rituximab in adult subjects with r/r B-cell lymphoma.
QN-019a in Combination with Monoclonal AntibodiesFludarabineQN-019a in Combination with Rituximab in adult subjects with r/r B-cell lymphoma.
QN-019a in Combination with Monoclonal AntibodiesVP-16QN-019a in Combination with Rituximab in adult subjects with r/r B-cell lymphoma.
Primary Outcome Measures
NameTimeMethod
The incidence of subjects with Dose Limiting Toxicities within each dose level cohortDay 28
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]Day 28

Incidence, nature, and severity of treatment related adverse events will be evaluated.

Secondary Outcome Measures
NameTimeMethod
Objective response rate (ORR) of QN-019a as monotherapy in r/r B-ALL and in combination with Rituximab in r/r B-cell LymphomaFrom baseline tumor assessment up to approximately 2 years after last dose of QN-019a
Duration of response (DOR) of QN-019a as monotherapy in r/r B-ALL and in combination with Rituximab in r/r B-cell LymphomaUp to approximately 2 years after last dose of QN-019a
Progression-free survival (PFS) of QN-019a in combination with Rituximab in r/r B-cell LymphomaUp to approximately 2 years after last dose of QN-019a
Overall survival (OS) of QN-019a as monotherapy in r/r B-ALL and in combination with Rituximab in r/r B-cell LymphomaUp to approximately 2 years after last dose of QN-019a
Determination of the pharmacokinetics (PK) of QN-019a cells in peripheral bloodUp to approximately 2 years after last dose of QN-019a

The PK of QN-019a in peripheral blood will be reported as the relative percentage of product (QN-019a) DNA versus patient DNA (% chimerism) measured from blood samples at the specified time points

Event-free survival (EFS) of QN-019a as monotherapy in r/r B-ALLUp to approximately 2 years after last dose of QN-019a

Trial Locations

Locations (1)

The First Affiliated Hospital of Medical College of Zhejiang University

🇨🇳

Hangzhou, Zhejiang, China

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