A Phase I Trial of Donor- Derived 19-28z CAR T Cells Following Allogeneic Transplant for the Treatment of CD19 Malignancies
- Conditions
- LymphomaLeukemiaLymphoma, B-Cell
- Interventions
- Biological: CAR T-Cell Infusion
- Registration Number
- NCT04556266
- Lead Sponsor
- Memorial Sloan Kettering Cancer Center
- Brief Summary
The purposed of this study is to determine whether an infusion with specialized 'modified T cells' (or CD19 chimeric antigen T cells, also called CD19 CAR T cells) that target the B cell marker will reduce the risk of relapse after transplant.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- WITHDRAWN
- Sex
- All
- Target Recruitment
- Not specified
The following criteria must be met prior to the allogenic transplantation:
-
ALL in second remission or greater (≥ CR2)
- Please refer to section 3.0 for more discussion of ALL in CR1 versus CR2
-
CLL
- High risk in any remission status as defined by 17p deletion or Richter's transformation, or
- All other patients eligible after at least 2 lines of standard or investigational chemotherapy
-
B-NHL
- Refractory or stable disease to last line of therapy per ICML 2014. Patients should have at least 2 lines of prior therapy.
- Relapsed disease in patients who are not candidates for autologous transplant
-
Patient's age is ≥ 18 and ≤ 60.
-
KPS ≥ 70%
-
Patients must have CD19 expression (by any detection method) demonstrated on their malignant cells at the time of enrollment on the protocol.
-
Patients relapsed after prior CD19 CAR T cell or blinatumomab are eligible for enrollment as long as CD19 expression is still prese on the malignant cells.
-
Patients who have a matched related donor willing to donate HSC for allograft and PBMC for CAR T cell generation
-
Patients must have adequate organ function measured by:
- Cardiac: asymptomatic or if symptomatic then LVEF at rest must be > 50%
- Hepatic: < 3x ULN ALT and < 1.5 total serum bilirubin, unless there is congenital benign hyperbilirubinemia.
- Renal: serum creatinine <1.3 mg/dl or if serum creatinine is outside the normal range, then CrCl > 60 ml/min (measured or calculated/estimated)
- Pulmonary: asymptomatic or if symptomatic, DLCO > 50% of predicted (corrected for hemoglobin)
- Negative serum pregnancy test for women of child-bearing potential is required
- Active and uncontrolled infection at time of transplantation. Please note that patients being actively treated for a viral reactivation may be enrolled on the protocol at the discretion of the investigators.
- Patients who have undergone a prior allogeneic or autologous stem cell transplant within the previous six months.
- Pregnant or breast feeding
- HIV infection
- Progressive disease at time of transplant
- Patients with known autoimmune disease.
- Patients with active or clinically significant neurological disorders, such as seizure disorders.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SEQUENTIAL
- Arm && Interventions
Group Intervention Description Cohort -1 CAR T-Cell Infusion Cohorts of 3-6 patients each will be treated with escalating doses of consolidative modified T cells at Day 30 (+/- 5 days) post allo-HSCT Total T-Cell Dose: 1 x 10\^4 cells/kg Cohort 1 CAR T-Cell Infusion Cohorts of 3-6 patients each will be treated with escalating doses of consolidative modified T cells at Day 30 (+/- 5 days) post allo-HSCT Total T-Cell Dose: 1 x 10\^5 cells/kg Cohort II CAR T-Cell Infusion Cohorts of 3-6 patients each will be treated with escalating doses of consolidative modified T cells at Day 30 (+/- 5 days) post allo-HSCT Total T-Cell Dose: 2 x 10\^5 cells/kg Cohort III CAR T-Cell Infusion Cohorts of 3-6 patients each will be treated with escalating doses of consolidative modified T cells at Day 30 (+/- 5 days) post allo-HSCT Total T-Cell Dose: 4 x 10\^5 cells/kg
- Primary Outcome Measures
Name Time Method Maximum tolerated dose (MTD) 24 month To determine maximum tolerated dose (MTD) of intravenously administered allogeneic, donor-derived 19-28z CAR T cells administered following TCD allo-HSCT for patients with high-risk CD19+ malignancies
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Memorial Sloan Kettering Cancer Center
🇺🇸New York, New York, United States