A Study of CD19/22 CART Cells Combined With PD-1 Inhibitor in Relapsed/Refractory B-cell Lymphoma

Phase 2

• Conditions: Relapsed Non Hodgkin Lymphoma; Refractory Non-Hodgkin Lymphoma
• Interventions: Biological: CD19/22 CART; Drug: Tislelizumab

• Registration Number: NCT04539444
• Lead Sponsor: The First Affiliated Hospital of Soochow University

Brief Summary

This is a single center, non-randomized, open-label, phase 2 study to evaluate the efficacy and safety of CD19/22 CART cells combined with PD-1 Inhibitor in relapsed/refractory B Cell Lymphoma.

Detailed Description

Though response rates have greatly improved with the development of Chimeric antigen receptor T cells (CART) therapy in refractory/relapsed B cell non-Hodgkin's lymphoma (R/R B-NHL), the response can't usually last long and relapse occurs in a large proportion of patients who receive CART cells infusion. The main reasons of relapse might be tumor antigen loss and a lack of CART cell persistence. Currently, preclinical studies have shown that there is a synergistic effect between CAR-T cell therapy and anti-PD1 pathway, and it did have efficacy in clinic. In parallel, the combined use of CART-19 and CART-22 cells has a better potential to reduce antigen escape and increase anti-tumor activity. Therefore, the combination of CD19/22 CART and PD-1 inhibitor is one of the ways to improve the therapeutic effect of CART cells. This study was conducted to explore the efficacy and safety of CD19/22 CART cells in R/R B-NHL.

Study Timeline

• Status Verified: 2020-08
• Study Start: 2020-08-01
• Study First Submitted: 2020-08-31
• Study First Submitted QC: 2020-08-31
• Study First Posted: 2020-09-07
• Last Update Submitted: 2021-07-30
• Last Update Posted: 2021-08-02
• Primary Completion: 2022-02-01
• Study Completion: 2023-02-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 10

Inclusion Criteria

1. R/R B-NHL with measurable (≧1.5cm) lesions confirmed by pathological immunohistochemistry or flow cytometry ( meeting any of the following conditions):

   A.The lesion shrinkage <50% or disease progression after 4 courses of standard first-line treatment or 2 courses of two-line treatment (primary refractory disease) B. Progress disease as the best response after hematopoietic stem cell transplantation C.Progress disease or stable disease as the best response to most recent therapy regimen

2. Age ≥ 18 years

3. The Eastern Cooperative Oncoloy Group (ECOG) physical condition score ≤ 2 points

4. The main organ functions need to meet the following conditions:

   A.Left ventricular ejection fraction ≥50% B.Creatinine ≤132umol/l or creatinine clearance ≥60 ml/min C.ALT and AST≤2 upper limitation of normal D.SpO2 > 90%

5. Results of pregnant test should be negative, and agree to conception control during treatment and 1 year after CAR-T infusion

6. Expected survival exceeds 3 months

7. Written informed consent could be acquired

Exclusion Criteria

1. Immunosuppressant medications or steroids was used within 2 weeks before cell collection, or need to use steroids or immunosuppressant medications more than two years
2. Uncontrolled bacteria, fungi, viruses, mycoplasma or other types of infection
3. Active hepatitis B or hepatitis C infection
4. HIV infection
5. Severe acute or chronic graft-versus-host disease (GVHD)
6. Participated in any other drug research clinical trials within 30 days before enrollment
7. Prior CART cells therapy within 3 months before enrollment
8. Prior allogeneic hematopoietic stem cell transplantation within 6 months before enrollment
9. Have contraindications to the PD-1 inhibitors
10. Uncontrolled other tumor
11. Women in pregnancy,lactation or planning to become pregnant
12. The researcher considers inappropriate to participate in this research

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
CD19/22 CART cells combined with PD-1 inhibitors	Tislelizumab	Patients will receive PD-1 inhibitor on the first day after CART cell infusion
CD19/22 CART cells combined with PD-1 inhibitors	CD19/22 CART	Patients will receive PD-1 inhibitor on the first day after CART cell infusion

Primary Outcome Measures

Name	Time	Method
Overall response rate (ORR)	1 year	Number of patients who achieved response (complete response and partial response ) after treatment of CD19/22 CART combined with PD-1 inhibitor. Response will be assessed using the Lugano criteria.
Progression-free survival(PFS)	1 year	PFS will be assessed from the first CART cell infusion to progression,death or last follow-up.

Secondary Outcome Measures

Name	Time	Method
Duration of overall response (DOR)	1 year	Duration of overall response will be assessed from the first CAR-T cell infusion to progression,death or last follow-up.
Overall survival(OS)	1 year	OS will be assessed from the first CART cell infusion to death or last follow-up.
Incidence of treatment-related adverse events	1 year	The incidence rate of adverse events from the first day of preconditioning chemotherapy to 1 year after CART cells infusion
Complete relapse rate(CR)	1 year	Number of patients who achieved complete response after treatment by CD19/22 CART combined with PD-1 inhibitor.

Trial Locations

Locations (1)

The First Affiliated Hospital of Soochow University; 🇨🇳 Suzhou, Jiangsu, China