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MB-CART20.1 Lymphoma

Phase 1
Completed
Conditions
B-cell Lymphoma Recurrent
Non-Hodgkin's Lymphoma
Relapsed or Refractory B-cell Non-Hodgkin's Lymphoma
B-cell Lymphoma Refractory
Interventions
Registration Number
NCT03664635
Lead Sponsor
Miltenyi Biomedicine GmbH
Brief Summary

This trial is a phase I/II trial to assess safety, dose finding and feasibility of ex vivo generated MB-CART20.1 cells in patients with relapsed or refractory CD20 positive B-NHL.

Detailed Description

MB-CART20.1 consists of autologous Anti-CD20 Chimeric Antigen Receptor (CAR) transduced CD4 /CD8 enriched T cells targeting CD20-positive tumor cells in Non-Hodgkin-Lymphoma (NHL)

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  • Refractory/relapsed CD20+ B-NHL (including malignant transformation like Richter's transformation) with no curative treatment option.
  • At least 18 years of age
  • Estimated life expectancy of more than 3 months
  • ECOG performance status (Eastern cooperative oncology group) of 0-2
  • Negative serological HBV (Hepatitis B virus) test, negative testing of HCVAb (Hepatitis C virus Antibody), negative HIV1/2 (Human immunodeficiency virus 1/2 ) test within 6 weeks prior to enrollment
  • No childbearing potential or negative pregnancy test at screening and before chemotherapy in women with childbearing potential.
  • Signed and dated informed consent before conduct of any trial-specific procedure
Exclusion Criteria
  • Participation in another interventional trial that could interact with this trial
  • Any evidence 0f CNS (Central nervous system) involvement
  • Known history or presence of clinically relevant CNS pathology
  • Patients with history of primary immunodeficiency,
  • Patients with any history of auto-immune induced condition such as those caused by checkpoint inhibitors, MEK inhibitors or BRAF inhibitors, for example pituitary hypophysitis must be excluded
  • Patients with Chronic Lymphocytic Leukemia unless suffering from malignant transformation
  • Active systemic fungal, viral or bacterial infection
  • Serious cardiac functional incapacity (class III or IV as defined by the New York Heart Association Classification)
  • Severe pulmonary disease (DLCO (Transfer factor of the lung for carbon monoxide) and/or FEV1 (Forced expiratory volume in 1 second) < 65%, dyspnea at rest)
  • Liver dysfunction as indicated by a total bilirubin, AST (Aspartate Aminotransferase), and ALT (Alanine aminotransferase) ≥ 2 the institutional ULN (Upper limit of normal) value, unless directly attributable to the patient's tumor
  • Creatinine clearance <50 ml/min calculated according to the modified formula of Cockcroft and Gault
  • Pregnant or lactating women
  • Active secondary malignancy requiring treatment (except basal cell carcinoma or malignant tumor curatively treated by surgery) within the last 5 years before enrollment.
  • Medical condition requiring prolonged use of systemic corticosteroids (> 1 month)
  • Prior therapy with genetically modified substances
  • Use of anti-CD20 antibodies within 4 weeks before leukapheresis
  • Chemotherapy within 4 weeks prior to leukapheresis
  • Other treatment within 4 weeks or two half-lives, whichever is longer before MB-CART20.1 infusion. This pertains to immunomodulatory therapies such as checkpoint inhibitors because of the influence on the immune system
  • Concurrent systemic radiotherapy
  • Hypersensitivity against any drug or its ingredients/impurities that is scheduled or likely to be given during trial participation e.g. as part of the mandatory lymphodepletion protocol, pre-medication for infusion, rescue medication/salvage therapies for treatment of related toxicities
  • Patients in which such medication is contraindicated for other reasons than hypersensitivity (e.g. live vaccines and fludarabine)
  • Patients in which trial related procedures are contraindicated as judged by the investigator, e.g. lumbar punctures for CSF (Cerebrospinal fluid) sampling
  • Patient's lack of accountability, inability to appreciate the nature, meaning and consequence of the trial and to formulate his/her own wishes correspondingly
  • Patients who have a relationship of dependence or employer employee relationship to the sponsor or the investigator
  • Committal to an institution on judicial or official order
  • Cerebral dysfunction, legal incapacity
  • Other investigational treatment within 4 weeks before IMP (Investigational Medicinal Product) infusion
  • Clinically relevant autoimmune diseases or history of autoimmune disease

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Phase I - Dose Level 1MB-CART20.1In phase I six (6) + 3 patients will be treated with 1x10\^6 MB-CART20.1 cells per kg body weight administered intravenously as single dose in the dose level 1
Phase I - Dose Level 2MB-CART20.1In phase I six (6) + 3 patients will be treated with 3x10\^6 MB-CART20.1 cells per kg body weight administered intravenously as single dose in the dose level 2
Phase I - Safety Dose LevelMB-CART20.1In phase I three (3) + 3 patients will be treated with 1x10\^5 MB-CART20.1 cells per kg body weight administered intravenously as single dose in the preceding safety dose level
Phase IIMB-CART20.1The number of additional patients who will be treated with MB-CART20.1 cells in Phase II is depending on the number of evaluable patients treated with the maximum tolerated dose (MTD) level and the results in Part I
Primary Outcome Measures
NameTimeMethod
Phase I - Determination of the maximum tolerated dose (MTD)until day 28 after infusion of MB-CART20.1

MTD is defined as the highest dose level at which \< 33% of patients experience Dose Limiting Toxicity (DLT). Safety and toxicity assessment of MB-CART20.1 per adverse events (AE) reporting classified according to CTCAE version 5.0.

Phase II - Best overall response rate3 months after infusion of MB-CART20.1

Response (Complete response (CR), Partial response (PR), Stable disease (SD), Progressive disease (PD)) is defined according to Cheson criteria.

Secondary Outcome Measures
NameTimeMethod
Phase I - Best overall response rate over 4 weeks and 3 months4 weeks and 3 months after infusion of MB-CART20.1

Response (CR, PR, SD and PD) is defined according to Cheson criteria.

Phase I - Occurrence of B-cell aplasia1 year after infusion of MB-CART20.1

Circulating B cell numbers in the peripheral blood will be assessed by Flow cytometry.

Phase I - Phenotype and Persistence of MB-CART20.11 year after infusion of MB-CART20.1

Blood samples for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed.

Phase II - Best overall response rate over 1 year1 year after infusion of MB-CART20.1

Response (CR, PR, SD and PD) is defined according to Cheson criteria.

Phase II - Overall response rate over 4 weeks and 3 months4 weeks and 3 months after infusion of MB-CART20.1

Response (CR, PR, SD and PD) is defined according to Cheson criteria.

Phase II - Occurrence of B-cell aplasia1 year after infusion of MB-CART20.1

Circulating B cell numbers in the peripheral blood will be assessed by Flow cytometry.

Phase I - Related safety and toxicity of MB-CART20.1months 3, 6, 9 and 12 after infusion of MB-CART20.1

Per adverse events (AE) reporting classified according to CTCAE version 5.0.

Phase I - Best overall response rate over 1 year1 year after infusion of MB-CART20.1

Response (CR, PR, SD and PD) is defined according to Cheson criteria.

Phase II - Overall response rate over 1 year1 year after infusion of MB-CART20.1

Response (CR, PR, SD and PD) is defined according to Cheson criteria.

Phase II - Number of patients with CR, PR, SD and PD1 year after infusion of MB-CART20.1

Response (CR, PR, SD and PD) is defined according to Cheson criteria.

Phase II -Percentage of patients with CR, PR, SD and PD1 year after infusion of MB-CART20.1

Response (CR, PR, SD and PD) is defined according to Cheson criteria.

Phase II - Safety and toxicity assessment of MB-CART20.11 year after infusion of MB-CART20.1

Per adverse events (AE) reporting classified according to CTCAE version 5.0.

Phase II - Phenotype and Persistence of MB-CART20.11 year after infusion of MB-CART20.1

Blood samples for determination of persistence/phenotyping of infused MB-CART20.1 will be analysed.

Trial Locations

Locations (2)

Universitätsklikum Leipzig, AöR

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Leipzig, Germany

University Hospital of Cologne - Clinic for Internal Medicine I

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Cologne, Germany

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