Clinical Study of Cord Blood-derived CAR-NK Cells Targeting CD19 in the Treatment of Refractory/Relapsed B-cell NHL

B-cell Non Hodgkin Lymphoma Clinical Trial

Official title:

Clinical Study of Cord Blood-derived CAR-NK Cells Targeting CD19 in the Treatment of Refractory/Relapsed B-cell NHL

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05472558
• Other study ID #: 2022-0496
• Status: Recruiting
• Phase: Phase 1
• Start date: September 10, 2022
• Est. completion date: September 10, 2025

Study information

• Verified date: July 2022
• Source: Second Affiliated Hospital, School of Medicine, Zhejiang University
• Contact: Wenbin Qian
• Phone: +8613605801032
• Email: qianwb[@]zju.edu.cn
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

To study the safety and effectiveness of cord blood-derived CAR-NK cells targeting CD19 in patients with B-cell non-Hodgkin's lymphoma

Description:

This is an open, single-arm, single-dose, dose-escalation clinical trial designed to evaluate the safety and the preliminary efficacy of CB CAR-NK019 cells. 9-18 patients are planned to be enrolled in the dose-escalation trial (2×10^6 cells/kg ,3×10^6 cells/kg, 4×10^6 cells/kg) . The primary endpoints are DLT, MTD, and the second endpionts are the overall response rates (CR and PR), overall survival, and progression-free survival. Based on the results in the dose-escalation trial, the recommended dose will be determined. Another 30 patients will be enrolled to estimate the safety and efficacy of CB CAR-NK019 under the best dose.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 48
• Est. completion date: September 10, 2025
• Est. primary completion date: September 10, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

• Inclusion Criteria:

Volunteer to participate in this study and sign an informed consent form; Age 18-75 years old, no gender limit;

Histologically diagnosed as diffuse large B-cell lymphoma (DLBCL), transforming follicular lymphoma (TFL), primary mediastinal B-cell lymphoma (PMBCL), mantle cell lymphoma (MCL) and other inert B-cells NHL conversion type:

Refractory or relapsed DLBCL refers to the failure to achieve complete remission after 2-line treatment; disease progression during any treatment, or disease stable time equal to or less than 6 months; or disease progression or recurrence within 12 months after autologous hematopoietic stem cell transplantation ; Refractory or relapsed MCL must be resistant to or intolerable to BTK inhibitors; Refractory or relapsed indolent B-cell NHL is the failure or recurrence of third-line treatment; Previous treatment must include CD20 monoclonal antibody treatment (unless the subject is CD20 negative) and anthracyclines; At least one measurable lesion with the longest diameter = 1.5 cm exists; The expected survival period is =12 weeks; The puncture section of the tumor tissue was positive for CD19 expression; ECOG score 0-2 points;

Sufficient organ function reserve:

Alanine aminotransferase, aspartate aminotransferase = 2.5× UNL (upper limit of normal value); Creatinine clearance rate (Cockcroft-Gault method) =60 mL/min; Serum total bilirubin and alkaline phosphatase =1.5× UNL; Glomerular filtration rate>50Ml/min Cardiac ejection fraction (EF) =50%; Under natural indoor air environment, basic oxygen saturation>92% Allow a previous stem cell transplantation The approved anti-B-cell lymphoma treatments, such as systemic chemotherapy, systemic radiotherapy, and immunotherapy, have been completed for at least 3 weeks before the study medication; Allow patients who have previously received CAR-T cell therapy and have failed or relapsed after 3 months of evaluation; Female subjects of childbearing age must have a negative pregnancy test and agree to take effective contraceptive measures during the trial Two tests for the new coronavirus were negative.

Exclusion Criteria:

• Those who have a history of allergies to any of the ingredients in cell products; History of other tumors Previously presented with II-IV degree (Glucksberg criteria) acute GvHD or extensive chronic GvHD; or are receiving anti-GvHD treatment; Have received gene therapy in the past 3 months; Active infections that require treatment (except for simple urinary tract infections and bacterial pharyngitis), but preventive antibiotics, antiviral and antifungal infection treatments are allowed; Hepatitis B (HBsAg positive, but HBV-DNA <103 is not an exclusion criterion) or hepatitis C virus infection (including virus carriers), syphilis and other subjects with acquired and congenital immunodeficiency diseases, including But not limited to people living with HIV; According to the New York Heart Association's Heart Function Classification Standard, it is classified as Grade III or Grade IV.

Impaired subjects;

Those who have received anti-tumor therapy in the early stage but the toxic reaction has not recovered (the CTCAE 5.0 toxic reaction has not recovered to =1, except for fatigue, anorexia, and hair loss); Subjects with a history of epilepsy or other central nervous system diseases; Enhanced CT or MRI of the head showed evidence of central nervous system lymphoma; Have received any other drugs that target CD19; Women who are breastfeeding and unwilling to stop breastfeeding; Any other situation that the investigator believes may increase the risk of the subject or interfere with the results of the test.

Related Conditions & MeSH terms

• B-cell Non Hodgkin Lymphoma
• Lymphoma, B-Cell

Intervention

Biological:
• anti-CD19 CAR-NK
lentiviral vector-transducted cord blood-derived NK cells to express anti-CD19 CAR

Locations

Country	Name	City	State
China	2nd Affiliated Hospital, School of Medicine, Zhejiang University	Hanzhou	Zhejiang

Sponsors (1)

Lead Sponsor	Collaborator
Second Affiliated Hospital, School of Medicine, Zhejiang University

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence of dose limiting toxicity (DLTs)	To evaluate the safety, tolerability, and determine the recommended dosage of cord blood-derived Anti-CD19 CAR-NK Cell Therapy for B-cell Non-Hodgkin Lymphoma	Up to 28 days
Secondary	Complete response rate (CR)	To determine the anti-tumor effectivity of CB CAR-NK019	Up to 2 years
Secondary	Progression free survival (PFS)	To determine the anti-tumor effectivity of CB CAR-NK019	Up to 2 years
Secondary	Duration of response (DOR)	To determine the anti-tumor effectivity of CB CAR-NK019	Up to 2 years
Secondary	Overall survival (OS)	To determine the anti-tumor effectivity of CB CAR-NK019	Up to 2 years
Secondary	Partial response rate (PR)	To determine the anti-tumor effectivity of CB CAR-NK019	Up to 2 years
Secondary	Overall response rate (ORR)	To determine the anti-tumor effectivity of CB CAR-NK019	Up to 2 years
Secondary	Immunogenicity after the infusion of CB CAR-NK019	To evaluate the immunogenicity of CB CAR-NK019	Up to 2 years