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Pilot Study of Redirected Autologous T-cells Engineered to Contain Anti-CD19 Attached to TCR and 4-1BB Signaling Domains in Patient With Chemotherapy Resistant or Refractory CD19+ Leukemia and Lymphoma


N/A
18 Years
N/A
Open (Enrolling)
Both
Hematopoietic/Lymphoid Cancer, Adult Acute Lymphoblastic Leukemia in Remission, B-cell Adult Acute Lymphoblastic Leukemia, B-cell Chronic Lymphocytic Leukemia, Prolymphocytic Leukemia, Recurrent Adult Diffuse Large Cell Lymphoma, Recurrent Grade 1 Follicular Lymphoma, Recurrent Grade 2 Follicular Lymphoma, Recurrent Grade 3 Follicular Lymphoma, Recurrent Mantle Cell Lymphoma, Refractory Chronic Lymphocytic Leukemia, Stage III Adult Diffuse Large Cell Lymphoma, Stage III Chronic Lymphocytic Leukemia, Stage III Grade 1 Follicular Lymphoma, Stage III Grade 2 Follicular Lymphoma, Stage III Grade 3 Follicular Lymphoma, Stage III Mantle Cell Lymphoma, Stage IV Adult Diffuse Large Cell Lymphoma, Stage IV Chronic Lymphocytic Leukemia, Stage IV Grade 1 Follicular Lymphoma, Stage IV Grade 2 Follicular Lymphoma, Stage IV Grade 3 Follicular Lymphoma, Stage IV Mantle Cell Lymphoma

Thank you

Trial Information

Pilot Study of Redirected Autologous T-cells Engineered to Contain Anti-CD19 Attached to TCR and 4-1BB Signaling Domains in Patient With Chemotherapy Resistant or Refractory CD19+ Leukemia and Lymphoma


Primary objectives:

1. To evaluate the safety and feasibility of a single target dose of 5 times 10e9 total
cells, acceptable range of 1.5 times 10e7 to 5 times 10e9 total cells comprised of
autologous CART-19 cells that express the TCR zeta and 4-1 BB costimulatory domain.

Secondary objectives:

1. Proof of mechanism: determine if 2nd generation CAR expressing 4-1BB costimulation
domains have improved persistence in patients.

2. Proof of concept: determine the effects of CART-19 on CD19 expression in vivo.

3. Proof of bioactivity: Evaluate changes in systemic soluble immune factors in patients

4. Proof of bioactivity: Evaluate impact of CART19 treatment on tumor burden

5. Explore whether CART-19 cells retain anti-tumor activity in vivo.

6. Determine if host immunity develops against CART-19.

7. Characterize the relative subsets of CART-19 T cells (Tcm, Tem, and Treg).

8. Describe survival and response rates

Inclusion Criteria


Inclusion

- Male and female subjects with CD19+ B cell malignancies in patients with no available
curative treatment options (such as autologous or allogeneic SCT) who have limited
prognosis (several months to < 2 year survival) with currently available therapies
will be enrolled

- CD19+ leukemia or lymphoma

- ALL in CR2 or CR3 and not eligible for allogeneic SCT because of age, comorbid
disease, or lack of available family member or unrelated donor

- Follicular lymphoma, previously identified as CD19+:

- At least 2 prior combination chemotherapy regimens (not including single agent
monoclonal antibody (Rituxan) therapy

- Stage III-IV disease

- Less than 1 year between last chemotherapy and progression (i.e. most recent
progression free interval < 1 year)

- Disease responding or stable after most recent therapy (chemotherapy, MoAb, etc)

- CLL:

- At least 2 prior chemotherapy regimens (not including single agent monoclonal
antibody (Rituxan) therapy. Patients with high risk disease manifested by deletion
chromosome 17p will be eligible if they fail to achieve a CR to initial therapy or
progress within 2 years of 1 prior

- Less than 2 years between last chemotherapy and progression (i.e. most recent
progression free interval < 2 years)

- Not eligible or appropriate for conventional allogeneic SCT

- Patients who achieve only a partial response to FCR as initial therapy will be
eligible.

- Mantle cell lymphoma:

- Beyond 1st CR with relapsed or persistent disease and not eligible or appropriate for
conventional allogeneic or autologous SCT

- Disease responding or stable after most recent therapy (chemotherapy, MoAb, etc...)

- Relapsed after prior autologous SCT

- B-cell prolymphocytic leukemia (PLL) with relapsed or residual disease after at least
1 prior therapy and not eligible for allogeneic SCT

- Diffuse large cell lymphoma, previously identified as CD19+:

- Residual disease after primary therapy and not eligible for autologous SCT

- Relapsed after prior autologous SCT

- Beyond 1st CR with relapsed or persistent disease and not eligible or appropriate of
conventional allogeneic or autologous SCT

- Expected survival > 12 weeks

- Creatinine < 2.5 mg/dl

- ALT/AST < 3x normal

- Bilirubin < 2.0 mg/dl

- Any relapse after prior autologous SCT will make patient eligible regardless of other
prior therapy

- Adequate venous access for apheresis, and no other contraindications for
leukapheresis

- Voluntary informed consent is given

Exclusion

- Pregnant or lactating women

- The safety of this therapy on unborn children is not known

- Female study participants of reproductive potential must have a negative serum or
urine pregnancy test performed within 48 hours before infusion

- Uncontrolled active infection

- Active hepatitis B or hepatitis C infection

- Concurrent use of systemic steroids. Recent or current use of inhaled steroids is not
exclusionary

- Previously treatment with any gene therapy products

- Feasibility assessment during screening demonstrates < 30% transduction of target
lymphocytes, or insufficient expansion (< 5-fold) in response to CD3/CD28
costimulation

- Any uncontrolled active medical disorder that would preclude participation as
outlined

- HIV infection

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Number of Adverse Events

Safety Issue:

Yes

Principal Investigator

Noelle Frey, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Abramson Cancer Center of the University of Pennsylvania

Authority:

United States: Food and Drug Administration

Study ID:

UPCC 04409

NCT ID:

NCT01029366

Start Date:

July 2009

Completion Date:

Related Keywords:

  • Hematopoietic/Lymphoid Cancer
  • Adult Acute Lymphoblastic Leukemia in Remission
  • B-cell Adult Acute Lymphoblastic Leukemia
  • B-cell Chronic Lymphocytic Leukemia
  • Prolymphocytic Leukemia
  • Recurrent Adult Diffuse Large Cell Lymphoma
  • Recurrent Grade 1 Follicular Lymphoma
  • Recurrent Grade 2 Follicular Lymphoma
  • Recurrent Grade 3 Follicular Lymphoma
  • Recurrent Mantle Cell Lymphoma
  • Refractory Chronic Lymphocytic Leukemia
  • Stage III Adult Diffuse Large Cell Lymphoma
  • Stage III Chronic Lymphocytic Leukemia
  • Stage III Grade 1 Follicular Lymphoma
  • Stage III Grade 2 Follicular Lymphoma
  • Stage III Grade 3 Follicular Lymphoma
  • Stage III Mantle Cell Lymphoma
  • Stage IV Adult Diffuse Large Cell Lymphoma
  • Stage IV Chronic Lymphocytic Leukemia
  • Stage IV Grade 1 Follicular Lymphoma
  • Stage IV Grade 2 Follicular Lymphoma
  • Stage IV Grade 3 Follicular Lymphoma
  • Stage IV Mantle Cell Lymphoma
  • Leukemia
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Leukemia, Lymphoid
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Leukemia, Prolymphocytic
  • Lymphoma
  • Lymphoma, Follicular
  • Lymphoma, Large B-Cell, Diffuse
  • Lymphoma, Non-Hodgkin
  • Lymphoma, Mantle-Cell

Name

Location

Abramson Cancer Center of the University of Pennsylvania Philadelphia, Pennsylvania  19104-4283