LMP1 CAR-T for Patients With LMP1 Positive Infectious Diseases and Hematological Malignancies

Hematological Malignancies Clinical Trial

Official title:

Clinical Trial for the Safety and Efficacy of Sequential of LMP1 CAR-T for Patients With LMP1 Positive Infectious Diseases and Hematological Malignancies

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT04657965
• Other study ID #: LMP1-001
• Status: Not yet recruiting
• Phase: Early Phase 1
• Start date: January 15, 2021
• Est. completion date: January 15, 2027

Study information

• Verified date: December 2020
• Source: Zhejiang University
• Contact: He Huang, PhD
• Phone: 86-13605714822
• Email: hehuangyu[@]126.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

A study of LMP1 CAR-T for patients with LMP1 positive infectious diseases and hematological malignancies

Description:

This is a single arm, open-label, single-center study. This study is indicated for LMP1 positive infectious diseases and hematological malignancies. The selections of dose levels and the number of subjects are based on clinical trials of similar foreign products. 144 patients will be enrolled. Primary objective is to explore the safety, main consideration is dose-related safety.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 144
• Est. completion date: January 15, 2027
• Est. primary completion date: January 15, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

Only applicable to the inclusion criteria of CAEBV

1. Subjects who are diagnosed with CAEBV according to the Okano revised standard proposed by the Japanese Ministry of Health, Labour and Welfare Research Group for the Prevention of Refractory Diseases;

2. All CAEBV patients who have not achieved complete remission, including:

1. Active phase: EBV-DNA level in PBMC is higher than 1×10^2.5 copies/µg DNA, with symptoms and signs of active diseases such as fever, hepatomegaly, splenomegaly, abnormal liver function, decrease of blood three lines, lymphadenopathy, and progressive skin lesions with increased EBV titer in peripheral blood;

2. inactive phase: EBV-DNA level in PBMC is higher than 1×10^2.5 copies/µg DNA, without symptoms and signs of active diseases;

3. The disease has not yet progressed to hematopoietic lymphohistiocytosis (HLH);

Only applicable to the inclusion criteria of LMP1-positive ENKTL:

1. According to the 2016 WHO classification criteria for lymphocytic tumors: Subjects diagnosed by histopathology as extranodal NK/T cell lymphoma, nasal type (ENKTL) with LMP1 positive in tumor tissue;

2. R/R ENKTL (meets one of the following prerequisites)

1. Without remission or with progression after receiving second-line or higher-line chemotherapy/chemotherapy + radiotherapy;

2. Primary drug resistance;

3. With recurrence after receiving autologous/allogeneic hematopoietic stem cell transplantation;

3. According to 2014 Lugano standard, there should be at least one evaluable tumor lesion.

Only applicable to the inclusion criteria for LMP1-positive HL:

1. According to the 2016 WHO classification criteria for lymphocytic tumors, subjects with Hodgkin lymphoma diagnosed by histopathology (HD) and LMP1 positive in tumor tissue;

2. R/R HD (meets one of the following prerequisites):

1. Without remission or with progression after receiving second-line or higher-line chemotherapy;

2. Primary resistance Drugs;

3. With recurrence after receiving autologous hematopoietic stem cell transplantation;

3. According to the Lugano 2014 standard, there should be at least one evaluable tumor lesion;

Only applicable to the inclusion criteria for LMP1-positive PTLD:

1. Only PTLD after hematopoietic stem cell transplantation;

2. According to the 2016 WHO classification criteria for lymphocytic tumors, subjects with PTLD diagnosed by histopathology and LMP1 positive in tumor tissue;

3. Excluding PTLD of early-stage

4. R/R PTLD (meets one of the following prerequisites):

1. Without remission or with progression after receiving rituximab-based standard treatment;

2. Primary drug resistance;

5. According to the Lugano 2014 standard, there should be at least one evaluable tumor lesion

Exclusion Criteria:

Subjects with any of the following exclusion criteria were not eligible for this trial:

1. History of craniocerebral trauma, conscious disturbance,epilepsy,cerebrovascular ischemia, and cerebrovascular, hemorrhagic diseases;

2. Electrocardiogram shows prolonged QT interval, severe heart diseases such as severe arrhythmia in the past;

3. Pregnant (or lactating) women;

4. Patients with severe active infections (excluding simple urinary tract infection and bacterial pharyngitis);

5. Active infection of hepatitis B virus or hepatitis C virus;

6. Concurrent therapy with systemic steroids within 2 weeks prior to screening, except for the patients recently or currently receiving in haled steroids;

7. Previously treated with any CAR-T cell product or other genetically modified T cell therapies;

8. Creatinine>2.5mg/dl, or ALT / AST > 3 times of normal amounts, or bilirubin>2.0 mg/dl;

9. Other uncontrolled diseases that were not suitable for this trial;

10. Patients with HIV infection;

11. Any situations that the investigator believes may increase the risk ofpatients or interfere with the results of study

Related Conditions & MeSH terms

• Communicable Diseases
• Hematologic Neoplasms
• Hematological Malignancies
• Infection
• Infectious Diseases
• Neoplasms

Intervention

Drug:
• LMP1 CAR T-cells
Each subject receive LMP1 CAR T-cells by intravenous infusion

Locations

Country	Name	City	State
China	The First Affiliated Hospital,College of Medicine, Zhejiang University	Hangzhou	Zhejiang

Sponsors (2)

Lead Sponsor	Collaborator
Zhejiang University	Yake Biotechnology Ltd.

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Dose-limiting toxicity (DLT)	Adverse events assessed according to NCI-CTCAE v5.0 criteria	Baseline up to 28 days after LMP1 targeted CAR T-cells infusion
Primary	Incidence of treatment-emergent adverse events (TEAEs)	Incidence of treatment-emergent adverse events [Safety and Tolerability]	Up to 2 years after LMP1 targeted CAR T-cells infusion
Secondary	Chronic active EB virus infection (CAEBV), Overall response rate (ORR)	Assessment of ORR (ORR = CR + PR) at Month 1, 3, 6, 12, 18 and 24	At Month 1, 3, 6, 12, 18 and 24
Secondary	CAEBV,Duration of remission(DOR)	From the first remission after LMP1 CAR-T cells to relapse, death or the last visit	Up to 2 years after LMP1 CAR-T cells infusion
Secondary	CAEBV, Overall survival (OS)	From the first infusion of LMP1 CAR-T cells to death or the last visit	Up to 2 years after LMP1 CAR-T cells infusion
Secondary	CAEBV, Relapse rate(RR)	From the first remission after LMP1 CAR-T cells to relapse or the last visit	At Month 6, 12, 18 and 24
Secondary	CAEBV, Event-free survival (EFS)	From the first infusion of LMP1 CAR-T cells to the occurrence of any event, including death, relapse or gene relapse, disease progression (any one occurs first), and the last visit	Up to 2 years after LMP1 CAR-T cells infusion
Secondary	Hodgkin's lymphoma(HL), Extranodal NK/T cell lymphoma(ENKTL),Nasal type, Lymphoproliferative disease after hematopoietic stem cell transplantation, (post-HSCT PTLD),Overall response rate (ORR)	Assessment of ORR (ORR = CR + PR) at Month 1, 3, 6, 12, 18 and 24	At Month 1, 3, 6, 12, 18 and 24
Secondary	HL, ENKTL, PTLD, OS	From the first infusion of LMP1 CAR-T cells to death or the last visit	Up to 2 years after LMP1 CAR-T cells infusion
Secondary	HL, ENKTL, PTLD, EFS	From the first infusion of LMP1 CAR-T cells to the occurrence of any event, including death, relapse or gene relapse, disease progression (any one occurs first), and the last visit	Up to 2 years after LMP3 CAR-T cells infusion
Secondary	Quality of life	Assessment using European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scale [For item1-28: max score: 112, min score: 28, higher scores mean a better outcome; for item 28-29: max score: 14, min score: 2, higher scores mean a worse outcome] to measure Quality of life at Baseline, Month 1, 3, 6, 9 and 12	At Baseline, Month 1, 3, 6, 9 and 12
Secondary	Activities of Daily Living (ADL) score	Assessment using Activities of Daily Living (ADL) scale (Barthel Index) [max score: 100, min score: 0, higher scores mean a better outcome] at Baseline, Month 1, 3, 6, 9 and 12	At Baseline, Month 1, 3, 6, 9 and 12
Secondary	Instrumental Activities of Daily Living (IADL) score	Assessment of Instrumental Activities of Daily Living (IADL) scale [max score: 56, min score: 14, higher scores mean a worse outcome] at Baseline, Month 1, 3, 6, 9 and 12	At Baseline, Month 1, 3, 6, 9 and 12
Secondary	Hospital Anxiety and Depression Scale (HADS) score	Assessment using Hospital Anxiety and Depression Scale (HADS) [max score: 42, min score: 0, higher scores mean a worse outcome] at Baseline, Month 1, 3, 6, 9 and 12	At Baseline, Month 1, 3, 6, 9 and 12