Clinical Trial to Evaluate CT053 in Patients With Relapsed and/or Refractory Multiple Myeloma (LUMMICAR STUDY 1)

Multiple Myeloma Clinical Trial

Official title:

Open Label, Phase I/II Clinical Trial to Evaluate the Safety and Efficacy of Fully Human Anti-BCMA Chimeric Antibody Receptor Autologous T Cell （CAR T）in Patients With Relapsed and/or Refractory Multiple Myeloma (LUMMICAR STUDY 1)

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT03975907
• Other study ID #: CT053-MM-01
• Status: Active, not recruiting
• Phase: Phase 1/Phase 2
• Start date: June 10, 2019
• Est. completion date: December 31, 2025

Study information

• Verified date: March 2024
• Source: CARsgen Therapeutics Co., Ltd.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is an open-label, single arm study to evaluate the safety and tolerability of treatment with CT053 CAR-BCMA T in patients with relapsed and/or refractory multiple myeloma.

Description:

The study is composed of two stages, Phase I stage is for dose escalation and recommendation of phase 2 dose, and Phase II stage is to Detailed Description: verify the efficacy and safety of the dose proposed.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 121
• Est. completion date: December 31, 2025
• Est. primary completion date: December 31, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

1. Patients and legally acceptable representative must have voluntarily signed ICF and willing to complete the study procedure, after fully understanding of the study.

2. Age = 18 years and = 75 years, male or female

3. The patients have received at least 3 prior lines for MM, (Induction therapy followed by autologous transplantation[ASCT] and maintenance therapy represents one line of therapy, those who have not been treated with ASCT should have documented rationale); For each line of therapy, the patient should have received at least one standard treatment cycle (2016 IMWG) unless the best response to the treatment line is documented as progressive diseases (PD)

4. The patients should have received treatment with at least one proteasome inhibitor AND one immunomodulatory drug, and have ever been relapsed or deteriorated after treatment with at least one regimen consisting of above-mentioned medications (combination or single use);

5. Patient should be relapsed within 12 months after the last line of therapy, or disease progressed within 60 days after last line of therapy (IMWG criteria 2016), with documented evidence.

6. The patients should have measurable disease based on at least one of the following parameters:

• Serum M-protein = 10 g/L;

• Urine M-protein = 200 mg/24 hrs;

• For those whose Serum or Urine M- protein dose not meed the measurable criteria but the light chain type, serum free light chain (FLC): involved FLC level = 10 mg/dL (100 mg/L) provided serum FLC ratio is abnormal

7. Estimated life expectancy > 12 weeks

8. ECOG performance score 0-1;

9. Sufficient venous access for leukapheresis collection, and no other contraindications to leukapheresis

10. Patients should maintain adequate organ function

11. Women of childbearing age must undergo a serum pregnancy test with negative results before screening and lymphodepletion preconditioning with fludarabine and cyclophosphamide, and are willing to use effective and reliable method of contraception for at least 1 year after T cell infusion

12. Men who actively have intercourse with child-bearing potential women must be willing to use effective and reliable method of contraception for at least 1 year after T cell infusion

Exclusion Criteria:

1. Pregnant or lactating women;

2. Positive for any following tests: human immunodeficiency virus (HIV) antibody, Treponema Pallidum antibody, hepatitis C virus (HCV) antibody, hepatitis B virus (HBV) surface antigen (HBsAg), HBV e antigen (HBeAg), HBV e antibody, hepatitis B core antibody, HBV DNA;

3. Patients with any uncontrolled active infection including but not limited to active tuberculosis.

4. Patients with AEs from previous treatment that have not recovered to Common Terminology Criteria for Adverse Events (CTCAE) = 1, excluding hair loss, neuropathy and other events that the treating physician can determine to be tolerable.

5. Patients who have ever had any CAR T cell therapy;

6. Patients who have ever had anti-BCMA therapy;

7. Patients have received allogeneic stem cell transplantation for treating multiple myeloma;

8. Patients have received autologous stem cell transplantation less than 12 weeks before leukapheresis;

9. Patients have received any anti-cancer treatment within 14 days before leukapheresis including but not limited to cytotoxic therapy, proteasome inhibitors, immunomodulatory agents, targeted therapies, epigenetic therapy or experimental drug therapy. If the field of radiation covers = 5% of the bone marrow, the subjects are eligible to participate in the study regardless of the radiotherapy end date;

10. Patients have received = 5 mg prednisone daily or other equivalent dose of steroids within 14 days before leukapheresis or lymphodepletion;

11. Patients have plasma cell leukemia, Waldenström macroglobulinemia, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome or AL amyloidosis;

12. Patients have been administered live attenuated vaccine 4 weeks before leukapheresis or lymphodepletion

13. Patients allergic to component of study treatment.

14. Patients have any of the condition as following within 6 months of ICF sign-off: New York Heart Association (NYHA) stage III or IV congestive heart failure, angina pectoris, myocardial infarction, coronary artery bypass graft, stroke (excluding lacunar stroke), history of clinically significant arrhythmia including but not limited to ventricular arrhythmia, significant QT interval prolongation, uncontrolled blood pressure as defined as systolic > 160 mmHg, diastolic > 100 mmHg, uncontrolled diabetes mellitus, pulmonary thrombolism, other conditions that investigators believe that participating in this clinical trial may endanger the health of the patients

15. Patients are known to have active autoimmune diseases including but not limited to psoriasis, rheumatoid arthritis and other needs of long-term immunosuppressive therapy

16. patients are oxygen dependent as defined by the blood oxygen saturation (finger oxygen detection method) can be maintained > 95% only by oxygen inhalation before leukapheresis

17. Patients with second malignancies in addition to MM are not eligible if the second malignancy has required treatment within the past 5 years or is not in complete remission. There are two exceptions to this criterion: successfully treated cervical carcinoma in situ and non-metastatic basal cell skin carcinoma

18. Patients have central nervous system (CNS) metastases or CNS involvement (including cranial neuropathies or mass lesions and leptomeningeal disease). Patients with history of spinal cord compression from MM are eligible provided spinal cord compression has been treated with surgery or radiation at least 28 days prior to study entry

19. Patients are unable or unwilling to comply with the requirements of clinical trial

20. Patients have received major surgery 2 weeks prior to leukapheresis or 4 weeks prior to lymphodepletion and after the study treatment (excluding cataract and other local anesthesia)

21. Patients are relatives to investigator or his/her staff, or those who may have an interest in the investigator and/or his/her staff.

Related Conditions & MeSH terms

• Multiple Myeloma
• Neoplasms, Plasma Cell

Intervention

Biological:
• CAR-BCMA T Cells
The CAR-BCMA T cells (study drug) used in this study are chimeric antigen receptor specifically expressing T cells targeting BCMA.

Locations

Country	Name	City	State
China	Beijing Boren Hospital	Beijing
China	Beijing Chaoyang hospital	Beijing	Beijing
China	Beijing Hospital	Beijing
China	Peking University People's Hospital	Beijing
China	Peking University Third Hospital	Beijing
China	The first affiliated hospital of bengbu medical college	Bengbu	Anhui
China	The Third Xiangya Hospital of Central South University	Changsha	Hunan
China	Xiangya Hospital Central South University	Changsha	Hunan
China	Guangdong Provincial People's Hospital	Guangzhou	Guangdong
China	Sun Yat-sen University Cancer Centre	Guangzhou	Guangdong
China	The first Affiliated Hospital, College of medicine, Zhejiang University	Hanzhou	Zhejiang
China	Qilu Hospital of Shandong University	Jinan	Shandong
China	Affiliated Hospital of Nantong University	Nantong	Jiangsu
China	Tongji Hospital of Tongji University	Shanghai
China	Xinhua Hospital Affiliated To Shanghai Jiaotong University School of Medicine	Shanghai
China	Shengjing Hospital of China Medical University	Shenyang	Liaoning
China	The 2nd People's Hospital of Shenzhen	Shenzhen	Guangdong
China	The First Affiliated Hospital Of Soochow University	Suzhou	Jiangsu
China	Tianjin Medical University General Hospital	Tianjin
China	The first Affiliated Hospital of Wenzhou Medical University	Wenzhou	Zhejiang
China	Union Hospital Tongji Medical College Huazhong University of Science and Technology	Wuhan	Hubei
China	Henan Cancer Hospital	Zhengzhou	Henan
China	Henan Provincial People's Hospital	Zhengzhou

Sponsors (14)

Lead Sponsor

Collaborator

CARsgen Therapeutics Co., Ltd.

Beijing Chao Yang Hospital, Beijing Hospital, First Affiliated Hospital of Wenzhou Medical University, First Affiliated Hospital of Zhejiang University, First Affiliated Hospital, Sun Yat-Sen University, Peking University People's Hospital, Qilu Hospital of Shandong University, Shanghai Tongji Hospital, Tongji University School of Medicine, Sun Yat-sen University, The First Affiliated Hospital of Soochow University, Tianjin Medical University General Hospital, Xiangya Hospital of Central South University, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Phase 1, Safety and tolerability: dose limiting toxicity	dose limiting toxicity	28days post administration of CAR-T-cells
Primary	Phase 2, efficacy of CT053 CAR-BCMA T cells: overall response rate	overall response rate (ORR)=(sCR+CR+VGPR+PR)	3 months post administration of CAR-T-cells
Secondary	Additional efficacy evaluation after 12 weeks of CT053 CAR-BCMA T cells infusion	Minimal residual disease (MRD) negativity	3 months post administration of CAR-T-cells
Secondary	Additional efficacy evaluation after 12 weeks of CT053 CAR-BCMA T cells infusion	TTR TIme to Response	3 months post administration of CAR-T-cells
Secondary	Additional efficacy evaluation after 12 weeks of CT053 CAR-BCMA T cells infusion	Complete Response (CR) /stringent Complete Response (sCR)	3 months post administration of CAR-T-cells
Secondary	Additional efficacy evaluation after 12 weeks of CT053 CAR-BCMA T cells infusion	=Very Good Partial Response (VGPR), including VGPR, CR, sCR	3 months post administration of CAR-T-cells
Secondary	Additional efficacy evaluation after 12 weeks of CT053 CAR-BCMA T cells infusion	ORR at Wk12	3 months post administration of CAR-T-cells
Secondary	Additional efficacy evaluation after 12 weeks of CT053 CAR-BCMA T cells infusion	CBR, clinical benefit rate	3 months post administration of CAR-T-cells
Secondary	Safety and tolerability of CAR-BCMA T cell therapy	AE&SAE	through 24 months post administration of CAR-T-cells
Secondary	Pharmacokinetics (the cell persistence duration in peripheral blood)	Copy numbers of CAR-BCMA gene in peripheral blood	through 24 months post administration of CAR-T-cells
Secondary	Pharmacokinetics (the cell persistence duration in peripheral blood)	Number of CAR positive cells in peripheral blood	through 24 months post administration of CAR-T-cells
Secondary	Safety and tolerability of CAR-BCMA T cell therapy	positivity of ADA (Anti-CAR-T antibody)	through 24 months post administration of CAR-T-cells
Secondary	Efficacy endpoint of CAR-BCMA T cells after infusion	Overal response rate (ORR)	through 24 months post administration of CAR-T-cells
Secondary	Efficacy endpoint of CAR-BCMA T cells after infusion	Complete Response (CR) /stringent Complete Response (sCR)	through 24 months post administration of CAR-T-cells
Secondary	Efficacy endpoint of CAR-BCMA T cells after infusion	=Very Good Partial Response (VGPR), including VGPR, CR, sCR	through 24 months post administration of CAR-T-cells
Secondary	Efficacy endpoint of CAR-BCMA T cells after infusion	Duration of Response (DOR)	through 24 months post administration of CAR-T-cells
Secondary	Efficacy endpoint of CAR-BCMA T cells after infusion	Clinical Benefit Rate (CBR)	through 24 months post administration of CAR-T-cells
Secondary	Efficacy endpoint of CAR-BCMA T cells after infusion	Time to Response (TTR)	through 24 months post administration of CAR-T-cells
Secondary	Efficacy endpoint of CAR-BCMA T cells after infusion	Minimal residual disease (MRD) negativity	through 24 months post administration of CAR-T-cells
Secondary	Efficacy endpoint of CAR-BCMA T cells after infusion	Progression Free Survival (PFS)	through 24 months post administration of CAR-T-cells
Secondary	Efficacy endpoint of CAR-BCMA T cells after infusion	Overall Survival (OS)	through 24 months post administration of CAR-T-cells