CD19-CD22-Bispecific Chimeric Antigen Receptor (CAR) T Cell Therapy for Pediatric Patients With Acute Lymphoblastic Leukemia (1922CAR)
试验速览
- 阶段
- 1 期
- 状态
- 招募中
- 入组人数
- 30
- 试验地点
- 2
- 主要终点
- Recommended phase 2 dose (RP2D) of CD19-CD22-CAR T cells
研究概览
简要总结
This study is a phase I study designed to evaluate the safety of CD19-CD22-CAR T cells.
Primary Objective:
To determine the safety profile and propose the recommended phase 2 dose (RP2D) of autologous CD19-CD22-CAR T cells in patients ≤ 21 years of age with recurrent/refractory CD19- and/or CD22-positive leukemia.
Secondary Objective:
To evaluate the anti-leukemic activity of CD19-CD22-CAR T cells.
详细描述
Treatment will include a single course of lymphodepleting chemotherapy (fludarabine/cyclophosphamide) followed by CAR T cell infusion. CAR T cell dose will be determined by the protocol-defined dose escalation scheme, based on the number of CAR+ T cells and participant weight.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- — 至 21 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age <21 years old
- •Relapsed/refractory CD19- and/or CD22-positive acute leukemia defined as:
- •*CD19 and/or CD22-positivity confirmed within 2 months and after receipt of any CD19 or CD22-directed therapy
- •Second or greater relapse
- •Any relapse after allogeneic HCT
- •Refractory disease (primary or in relapse) despite therapy designed to induce remission
- •Estimated life expectancy of > 12 weeks
- •Karnofsky or Lansky (age-dependent) performance score ≥50 (Appendix A)
- •For females of childbearing age:
- •Not lactating with intent to breastfeed
- •Not pregnant with negative serum or urine pregnancy test within 7 days prior to enrollment
排除标准
- •Known primary immunodeficiency
- •Known HIV positivity
- •Known contraindication to receiving protocol defined lymphodepleting
- •chemotherapy regimen
- •History of hypersensitivity reaction to murine protein-containing products
- •Treatment Eligibility
- •Inclusion Criteria:
- •Age < 21 years old
- •Detectable disease in the bone marrow
- •Estimated life expectancy of > 8 weeks
- •Karnofsky or Lansky (age-dependent) performance score > 50 (Appendix A)
- •Adequate cardiac function defined as left ventricular ejection fraction >40%, or shortening fraction > 25%
- •EKG without evidence of clinically significant arrhythmia
- •Adequate renal function defined as creatinine clearance or radioisotope GFR >50 mL/min/1.73m2 (GFR >40 mL/min/1.73m2 if <2 years of age)
- •Adequate pulmonary function defined as forced vital capacity (FVC) >50% of predicted value; or pulse oximetry >92% on room air
- •Total bilirubin < 3 times the upper limit of normal for age, except in subjects with Gilbert's syndrome
- •Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) < 5 times the upper limit of normal for age
- •Has recovered from all NCI CTAE grade III-IV, non-hematologic acute toxicities from prior therapy
- •Prior to planned CAR T cell infusion, patients with a history of prior allogeneicHCT must be at least 3 months from HCT, have no evidence of acute GVHD, and have not received a donor lymphocyte infusion (DLI) within the 28 daysprior to planned infusion
- •For females of childbearing age:
- •Not lactating with intent to breastfeed
- •Not pregnant with negative serum or urine pregnancy test within 7 days prior to enrollment
- •If sexually active, agreement to use birth control until 3 months after T cell infusion. Male partners should use a condom.
- •Exclusion Criteria:
- •Known primary immunodeficiency
- •Known HIV positivity
- •Known contraindication to receiving protocol defined lymphodepleting
- •chemotherapy regimen
- •History of hypersensitivity reactions to murine protein-containing products
- •Severe, uncontrolled bacterial, viral or fungal infection
- •Active CNS-3 disease
- •Evidence of active, uncontrolled neurologic disease
研究组 & 干预措施
CD19-CD22-CAR T cell therapy
This study has two parts:
Collection and Manufacturing Phase - Patients will have white blood cells collected in the St. Jude Blood Donor Center through a procedure called apheresis, or your doctors may use a previously collected frozen product. The collected cells will be engineered to improve their ability to recognize and kill cancer cells. The final cell product is referred to as the CD19-CD22 CAR T cells.
Treatment Phase - Eligible patients will receive chemotherapy before receiving the CAR T cells.
干预措施: CD19-CD22 CAR T cell infusion (Device)
CD19-CD22-CAR T cell therapy
This study has two parts:
Collection and Manufacturing Phase - Patients will have white blood cells collected in the St. Jude Blood Donor Center through a procedure called apheresis, or your doctors may use a previously collected frozen product. The collected cells will be engineered to improve their ability to recognize and kill cancer cells. The final cell product is referred to as the CD19-CD22 CAR T cells.
Treatment Phase - Eligible patients will receive chemotherapy before receiving the CAR T cells.
干预措施: Fludarabine (Drug)
CD19-CD22-CAR T cell therapy
This study has two parts:
Collection and Manufacturing Phase - Patients will have white blood cells collected in the St. Jude Blood Donor Center through a procedure called apheresis, or your doctors may use a previously collected frozen product. The collected cells will be engineered to improve their ability to recognize and kill cancer cells. The final cell product is referred to as the CD19-CD22 CAR T cells.
Treatment Phase - Eligible patients will receive chemotherapy before receiving the CAR T cells.
干预措施: Cyclophosphamide (Drug)
CD19-CD22-CAR T cell therapy
This study has two parts:
Collection and Manufacturing Phase - Patients will have white blood cells collected in the St. Jude Blood Donor Center through a procedure called apheresis, or your doctors may use a previously collected frozen product. The collected cells will be engineered to improve their ability to recognize and kill cancer cells. The final cell product is referred to as the CD19-CD22 CAR T cells.
Treatment Phase - Eligible patients will receive chemotherapy before receiving the CAR T cells.
干预措施: Mesna (Drug)
结局指标
主要结局
Recommended phase 2 dose (RP2D) of CD19-CD22-CAR T cells
时间窗: up to 4 weeks after CD19-CD22-CAR T-cell infusion
Phase I design to determine the RP2D of CD19-CD22-CAR T cells. Two (2) dose levels will be evaluated (1x106 and 3x106cells/kg).
Incidence of adverse events
时间窗: up to 4 weeks after CD19-CD22-CAR T-cell infusion
Will be assessed and graded using the CTCAE v5.0, with the exception of CRS and ICANS, which will be graded according to ASTCT Consensus Guidelines. Adverse events will be summarized descriptively and dose limiting toxicity (DLT) rate will be reported.
次要结局
未报告次要终点