Relapsed or Refractory B-cell Non-Hodgkin Lymphoma Clinical Trial
Official title:
Prospective, Single-center, Single-arm, Open-label Study of Obinutuzumab, Zanubrutinib and Lenalidomide Sequential CD19/CD22 CAR-T in Patients With Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma
Verified date | February 2023 |
Source | The First Affiliated Hospital of Soochow University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study intends to use Obinutuzumab, Zanubrutinib, and Lenalidomide sequential CD19/CD22 CAR-T in the treatment of Relapsed or Refractory B-cell Non-Hodgkin Lymphoma patients. The main purpose of this study is to explore a new treatment mode for R/R B-NHL patients and observe the efficacy and safety of this treatment regimen.
Status | Enrolling by invitation |
Enrollment | 20 |
Est. completion date | June 30, 2024 |
Est. primary completion date | June 30, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: 1. Histologically confirmed CD22 + and/or CD19 + aggressive B-cell non-Hodgkin lymphoma (NHL), including the following types as defined by World Health Organization (WHO) 2016: Diffuse large B-cell lymphoma (DLBCL); High grade B-cell lymphoma (HGBL); Primary mediastinal large B-cell lymphoma(PMBCL); T cell/histiocyte-rich large B-cell lymphoma (THRBCL); High grade follicular cell lymphoma Grade 3b (3bFL); Mantle cell lymphoma (MCL) except indolent; Other aggressive B-cell lymphomas. 2. Disease refractory to first-line therapy or early relapse within 12 months of last treatment. 3. Relapse or progressive disease (PD) = 3 months after targeted CD19 therapy including CD19 CAR T cells or anti-CD19/anti-CD3. 4. Successful leukapheresis assessment and T-cell preculture. 5. Life expectancy > 3 months. 6. Appropriate organ function: Creatinine < 1.6 mg/dL (140 µmol/L) or creatinine clearance = 60ml/min; Alanine aminotransferase (ALT)/aspartate aminotransferase (AST) < 3 × upper limit of normal; Bilirubin < 2.0 mg/dL unless subject has Gilbert 's syndrome (< 3.0 mg/dL); Pulmonary reserve = Grade 1 dyspnea and SPO2 > 91%; Cardiac ejection fraction = 50% in the absence of oxygen, no evidence of pericardial effusion as determined by echocardiogram (ECHO), and no clinically significant electrocardiogram (ECG) findings. 7. Adequate bone marrow reserve was defined as: Absolute neutrophil count (ANC) > 1000/mm3; Absolute lymphocyte count (ALC) = 300/mm3; Platelet count = 50,000/mm3. Hemoglobin > 7.0 mg/dL. 8. Measurable or evaluable lesions according to "IWG response criteria for malignant lymphoma" (Cheson 2014). 9. Patients have the ability to understand and are willing to provide written informed consent. Exclusion Criteria: 1. severe liver and kidney dysfunction (alanine aminotransferase, bilirubin, creatinine > 3 times the upper limit of normal); 2. the presence of structural heart disease, and lead to clinical symptoms or abnormal heart function (NYHA = 2); 3. uncontrolled active infection; 4. the presence of other tumors requiring treatment or intervention; 5. the current or expected need for systemic corticosteroid therapy; 6. pregnant or lactating women. 7. Other psychological conditions that prevent patients from participating in the study or signing informed consent; 8. According to the investigator 's judgment, the subject is unlikely to complete all protocol-required study visits or procedures, including follow-up visits, or fail to meet the requirements for participation in the study. |
Country | Name | City | State |
---|---|---|---|
China | the First Affiliated Hospital of Soochow University | Suzhou | Jiangsu |
Lead Sponsor | Collaborator |
---|---|
The First Affiliated Hospital of Soochow University |
China,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Overall response rate (ORR) after GZL therapy | the rate of patients who achieved CR or PR after GZL therapy | At the end of GZL therapy (2-4 cycles, each cycle is 21days) | |
Primary | Complete response rate (CRR) after CAR-T | the best rate of patients who achieved CR after CAR-T therapy | Within 3 months after CAR-T therapy | |
Primary | Progression-free survival (PFS) after CAR-T | PFS will be assessed from the GZL combination therapy given to date of progression, relapse, death or end of follow-up. | up to 24 months after the end of last patient's treatment | |
Secondary | Incidence of treatment-emergent adverse events, treatment-related adverse events and serious adverse events | The safety and tolerability of the therapeutic regimen measured by the incidence of Treatment-Emergent Adverse Event. | Initiation of GZL therapy until 30 days after CAR-T therapy | |
Secondary | Overall response rate (ORR) after CAR-T | The best rate of patients who achieved CR or PR after CAR-T therapy | Within 3 months after CAR-T therapy | |
Secondary | Overall survival (OS) after CAR-T | OS will be assessed from the GZL combination therapy given to date of death or end of follow-up. | up to 24 months after the end of last patient's treatment | |
Secondary | Duration of Response(DOR) after CAR-T | DOR will be assessed from the date of CAR-T infusion to the date of progression, relapse, death or end of follow-up | up to 24 months after the end of last patient's treatment |
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