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Efficacy and Safety of MB-CART2019.1 vs. SoC in Lymphoma Patients

Phase 2
Active, not recruiting
Conditions
Diffuse Large B-cell Lymphoma
Interventions
Genetic: MB-CART2019.1
Drug: R-GemOx or BR plus polatuzumab vedotin
Registration Number
NCT04844866
Lead Sponsor
Miltenyi Biomedicine GmbH
Brief Summary

This is a pivotal Phase II randomised, multi-centre, open-label study to evaluate the efficacy and safety of MB-CART2019.1 compared to standard of care therapy in participants with relapsed/refractory diffuse large B-cell lymphoma, who are not eligible for high-dose chemotherapy and autologous stem cell transplantation.

Detailed Description

This study should determine superiority of MB-CART2019.1 treatment compared to SoC therapy with R-GemOx (rituximab, gemcitabine and oxaliplatin) with respect to event-free survival in second-line therapy in participants with R-R DLBCL, who are non-eligible for high-dose chemotherapy and autologous stem cell transplantation.

MB-CART2019.1 is designed to effectively target malignant B cells in patients suffering from late stage haematological B-cell malignancies. MB-CART2019.1 consists of autologous cluster of differentiation CD20/CD19 chimeric antigen receptor (CAR) transduced CD4/CD8 enriched T cells, derived from a leukapheresis and processed by using the CliniMACS Prodigy®. Patients who are suitable for this study will be randomized 1:1 to either MB-CART2019.1 or SoC. Both treatment arms are unblinded.

MB-CART2019.1 arm: Single infusion of fresh formulation of 2.5 × 10\^6 CAR-transduced autologous T cells. IMP is only to be administered after a lymphodepleting chemotherapy with fludarabine and cyclophosphamide. For MB-CART2019.1 production, patients will undergo a leukapheresis.

SoC arm: R-GemOx (8 cycles of 14 days each) or (10% of SoC arm) BR (Bendamustine/Rituximab) + polatuzumab vedotin (6 cycles of 21 days each). Participants from the SoC arm are allowed to be treated with MB-CART2019.1 upon request by the investigator if at least one of the following criteria is confirmed by the IRC:

* Relapse or progression occurring at any time within 1 year after randomisation.

* Failure to achieve PR or CR at or beyond Week 8 after randomisation (after 4 cycles of R-GemOx or 3 cycles of BR plus polatuzumab vedotin) and the start of a new anti-lymphoma therapy is warranted.

The duration of the active part of the study for each individual participant from screening to the end of the 1-year follow-up after infusion of MB-CART2019.1 cells (experimental arm) or the start of SoC therapy (comparator arm) will be approximately 55 weeks. The LTFU in Year 2 after infusion of MB-CART2019.1 cells or the start of treatment in the comparator arm will not be part of the active part of the clinical study and will be reported separately.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
168
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CAR T-cell MB-CART2019.1MB-CART2019.1Single infusion of 2.5 × 10\^6 CAR-transduced autologous T cells per kg/body weight.
Standard of CareR-GemOx or BR plus polatuzumab vedotinImmunochemotherapy will be administered from the following 2 predefined regimens: R-GemOx (8 cycles of 14 days each) or BR plus polatuzumab vedotin (6 cycles of 21 days each). BR plus polatuzumab vedotin will be capped at a maximum of 10% of participants; i.e. a maximum of 8 participants will be randomised to the BR plus polatuzumab vedotin regimen. Participants from the SoC arm are allowed to be treated with CAR T-cell MB-CART2019.1 upon request by the investigator if at least one of the following criteria is confirmed by the IRC: * Relapse or progression occurring at any time within 1 year after randomisation. * Failure to achieve PR or CR at or beyond Week 8 after randomisation (after 4 cycles of R-GemOx or 3 cycles of BR plus polatuzumab vedotin) and the start of a new anti-lymphoma therapy is warranted.
Standard of CareMB-CART2019.1Immunochemotherapy will be administered from the following 2 predefined regimens: R-GemOx (8 cycles of 14 days each) or BR plus polatuzumab vedotin (6 cycles of 21 days each). BR plus polatuzumab vedotin will be capped at a maximum of 10% of participants; i.e. a maximum of 8 participants will be randomised to the BR plus polatuzumab vedotin regimen. Participants from the SoC arm are allowed to be treated with CAR T-cell MB-CART2019.1 upon request by the investigator if at least one of the following criteria is confirmed by the IRC: * Relapse or progression occurring at any time within 1 year after randomisation. * Failure to achieve PR or CR at or beyond Week 8 after randomisation (after 4 cycles of R-GemOx or 3 cycles of BR plus polatuzumab vedotin) and the start of a new anti-lymphoma therapy is warranted.
Primary Outcome Measures
NameTimeMethod
Event-free survivalup to 30 weeks after randomisation

Event-free survival (EFS), defined as the time between the date of randomisation and the date of objective disease progression, failure to achieve partial response (PR) or complete response (CR) at or beyond Week 8 after randomisation leading to a new anti-lymphoma therapy or death of any cause, whichever occurs first, based on independent review committee (IRC) assessment.

Secondary Outcome Measures
NameTimeMethod
Best complete response rateup to 99 weeks after randomisation

To evaluate the safety and toxicity of MB-CART2019.1 compared to SoC therapy.

Progression-free survival (PFS)up to 99 weeks after randomisation

defined as the time between the date of randomisation and the date of objective disease progression or death of any cause, whichever occurs first, based on IRC assessment.

Duration of complete responseup to 91 weeks

To evaluate the safety and toxicity of MB-CART2019.1 compared to SoC therapy.

Overall survivalup to 99 weeks after randomisation

To evaluate the safety and toxicity of MB-CART2019.1 compared to SoC therapy.

Trial Locations

Locations (53)

Hospital Clinic de Barcelona (Hospital Clinic i Provincial)

🇪🇸

Barcelona, Spain

Medizinische Universitaetsklinik Graz

🇦🇹

Graz, Austria

Universitatsklinikum Innsbruck Universitatsklinik fur Innere Medizin V

🇦🇹

Innsbruck, Austria

Ordensklinikum Linz GmbH Elisabethinen

🇦🇹

Linz, Austria

Medizinische Universitaet Wien - Allgemeines Krankenhaus der Stadt Wien (AKH)

🇦🇹

Wien, Austria

Jules Bordet lnstitute

🇧🇪

Anderlecht, Belgium

Universitaire Ziekenhuizen Leuven - Campus Gasthuisberg

🇧🇪

Leuven, Belgium

Universite Catholique de Louvain Namur, Centre Hospitalier Universitaire Dinant Godinne Site Godinne

🇧🇪

Yvoir, Belgium

University Hospital Hradec Kralove

🇨🇿

Hradec Králové, Czechia

FNsP Ostrava

🇨🇿

Ostrava, Czechia

Centre Hospitalier Universitaire (CHU) - Hopital Henri Mondor

🇫🇷

Créteil, France

CHRU de Lille - Hopital Claude Huriez

🇫🇷

Lille, France

Centre Hospitalier Lyon Sud, Hospices Civils de Lyon Groupement Hospitalier Sud

🇫🇷

Lyon, France

Centre Paoli Calmettes

🇫🇷

Marseille, France

Centre Hospitalier Universitaire de Montpellier - Hopital Saint-Eloi

🇫🇷

Montpellier, France

Centre Hospitalier Universitaire de Nantes (CHU de Nantes) - Hopital Hotel Dieu

🇫🇷

Nantes, France

Hospital Saint-Louis - APHP

🇫🇷

Paris, France

Centre Hospitalier Universitaire de Bordeaux - Hopital Haut-Leveque

🇫🇷

Pessac, France

Centre Hospitalier Universitaire de Poitiers

🇫🇷

Poitiers, France

CHU de Rennes - Hopital de Pontchaillou

🇫🇷

Rennes, France

Institut Universitaire du Cancer Service d´hématologie

🇫🇷

Toulouse, France

CHU de Nancy Hopitaux de Brabois

🇫🇷

Vandœuvre-lès-Nancy, France

Universitatsklinikum Augsburg

🇩🇪

Augsburg, Germany

Helios Klinikum Berlin - Buch

🇩🇪

Berlin, Germany

Universitaetsklinikum Knappschaftskrankenhaus Bochum der Ruhr-Universitat Bochum

🇩🇪

Bochum, Germany

Universitaetsklinikum Koeln

🇩🇪

Cologne, Germany

Klinikum Erlangen der Friedrich-Alexander-Universitaet Erlangen-Nuernberg

🇩🇪

Erlangen, Germany

Universitaetsklinikum Essen

🇩🇪

Essen, Germany

Asklepios Klinik St. Georg

🇩🇪

Hamburg, Germany

University Medical Center Hamburg-Eppendorf

🇩🇪

Hamburg, Germany

Universitaetsklinikum Heidelberg

🇩🇪

Heidelberg, Germany

Universitätsklinikum Leipzig

🇩🇪

Leipzig, Germany

Klinikum der Universitat München, Studienzentrale fur Hematologie der Medizinischen Klinik II

🇩🇪

München, Germany

Universitaetsklinikum Muenster

🇩🇪

Münster, Germany

University Hospital Regensburg

🇩🇪

Regensburg, Germany

University Hospital of Tuebingen

🇩🇪

Tuebingen, Germany

Del-Pesti Centrumkorhaz - Orszagos Hematologiai es Infektologiai Intezet

🇭🇺

Budapest, Hungary

Debreceni Egyetem - Orvos es Egeszsegtudomanyi Centrum (DEOEC) (University of Debrecen Medical and Health Science Center)

🇭🇺

Debrecen, Hungary

Azienda Ospedaliera San Giovanni Battista Di Torino

🇮🇹

Torino, Italy

VUH Santaros Klinikos

🇱🇹

Vilnius, Lithuania

Amsterdam Universitaire Medische Centra (UMC) - locatie Amsterdam Medisch Centrum (AMC)

🇳🇱

Amsterdam, Netherlands

University Medical Center Groningen

🇳🇱

Groningen, Netherlands

Leiden University Medical Center (LUMC)

🇳🇱

Leiden, Netherlands

Erasmus University Medical Center

🇳🇱

Rotterdam, Netherlands

Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego we Wroclawiu. Klinika Hematologii, Nowotworow Krwi i Transplantacji Szpiku

🇵🇱

Wrocław, Poland

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Catalan Institute of Oncology (ICO) Hospitalet

🇪🇸

Barcelona, Spain

Hospital Universitario Fundacion Jimenez Diaz

🇪🇸

Madrid, Spain

Hospital Universitario Virgen De La Arrixaca (Huva)

🇪🇸

Murcia, Spain

Clinica Universidad de Navarra

🇪🇸

Pamplona, Spain

Hospital Clinico Universitario de Salamanca

🇪🇸

Salamanca, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Onkologikliniken

🇸🇪

Uppsala, Sweden

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