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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04002401
Other study ID # KT-US-471-0114
Secondary ID 2019-004803-11
Status Completed
Phase Phase 2
First received
Last updated
Start date November 5, 2019
Est. completion date January 30, 2023

Study information

Verified date February 2024
Source Gilead Sciences
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The primary objective of this study is to estimate the efficacy of axicabtagene ciloleucel in combination with rituximab, as measured by assessment of response rates in adult participants with relapsed/refractory large B-cell lymphoma.


Description:

Following at least 24 months of assessments after axicabtagene ciloleucel infusion, participants will be asked to rollover to a separate long-term follow-up study (Study KT-US-982-5968). Participants will complete the remainder of the 15-year follow-up assessments in the KT-US-982-5968 study.


Recruitment information / eligibility

Status Completed
Enrollment 27
Est. completion date January 30, 2023
Est. primary completion date January 30, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Key Inclusion Criteria: - Histologically confirmed large B-cell lymphoma - Chemotherapy-refractory disease, defined as one or more of the following: - No response to first-line therapy (primary refractory disease) - No response to second or greater lines of therapy OR - Refractory after autologous stem cell transplant (ASCT) - At least 1 measureable lesion according to the Lugano Classification (Cheson 2014). - Individuals must have received adequate prior therapy, including at a minimum: - Anti-CD20 monoclonal antibody - An anthracycline-containing chemotherapy regimen - Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 - Adequate renal, hepatic, pulmonary, and cardiac function Key Exclusion Criteria: - Known CD19 negative or CD20 negative tumor - History of Richter's transformation of Chronic Lymphocytic Leukemia (CLL) - Prior CAR therapy or other genetically modified T-cell therapy - Prior organ transplantation including prior allogeneic stem cell transplant (SCT) - Prior CD19 targeted therapy - Clinically significant infection or cardiopulmonary disease - Presence of any in-dwelling lines or drains (dedicated central venous access catheters allowed) - History or presence of central nervous system (CNS) lymphoma or nonmalignant CNS disorder or cerebrospinal fluid (CSF) malignant cells or brain metastases - History of autoimmune disease - History of deep vein thrombosis (DVT) or pulmonary embolism (PE) within the last 6 months Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Study Design


Intervention

Biological:
Axicabtagene Ciloleucel
A single infusion of CAR-transduced autologous T cells administered intravenously
Drug:
Rituximab
Administered intravenously
Fludarabine
Administered according to package insert
Cyclophosphamide
Administered according to package insert

Locations

Country Name City State
United States St. David's South Austin Medical Center Austin Texas
United States University of Chicago Medical Center Chicago Illinois
United States City of Hope National Medical Center Duarte California
United States Banner MD Anderson Cancer Center Gilbert Arizona
United States John Theurer Cancer Center at Hackensack University Medical Center Hackensack New Jersey
United States The University of Texas MD Anderson Cancer Center Houston Texas
United States Mayo Clinic Florida Jacksonville Florida
United States Loyola University Medical Center Maywood Illinois
United States Vanderbilt University Medical Center Nashville Tennessee
United States Columbia University Medical Center, New York Presbyterian Hospital New York New York
United States Stanford Cancer Institute Palo Alto California
United States Mayo Clinic Rochester Minnesota
United States UCLA Hematology/Oncology Santa Monica California
United States Swedish Cancer Institute Seattle Washington

Sponsors (1)

Lead Sponsor Collaborator
Kite, A Gilead Company

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Complete Response (CR) Rate Per the International Working Group (IWG) Lugano Classification as Determined by Study Investigators CR rate is defined as the incidence of a CR per the IWG Lugano Classification as determined by study investigators. CR rate: percentage of participants with CR [complete metabolic response (CMR); complete radiological response (CRR)]. CMR: positron emission tomography (PET) 5-point scale (5-PS) scores of 1 (no uptake above background), 2 (uptake = mediastinum), 3 (uptake > mediastinum but = liver) with/without a residual mass); no new lesions; and no evidence of fluorodeoxyglucose (FDG)-avid disease in bone marrow (BM). CRR: target nodes/nodal masses regressed to = 1.5 cm in longest transverse diameter of lesion (LDi); no extralymphatic sites of disease; absent non-measured lesion (NMLs); organ enlargement regress to normal; no new sites; and bone marrow normal by morphology. 95% confidence interval (CI) was calculated by Clopper-Pearson method. First infusion date up to maximum duration of 32.7 months
Secondary Percentage of Participants Who Experienced Treatment Emergent Adverse Events (TEAEs) An AE is defined as any untoward medical occurrence in a clinical trial participant that does not necessarily have a relationship with study treatment or worsening of a pre-existing medical condition. TEAEs are any AEs with onset on or after axicabtagene ciloleucel infusion or worsening of a pre-existing medical condition that occurs on or after axicabtagene ciloleucel infusion. First infusion date up to maximum duration of 27 months
Secondary Percentage of Participants Who Experienced Laboratory Toxicity Grade Shifts to Grade 3 or Higher Resulting From Increased Parameter Value Grading categories were determined by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Laboratory parameters with only non-zero values are presented. First infusion date up to maximum duration of 27 months
Secondary Objective Response Rate (ORR) Per the IWG Lugano Classification as Determined by Study Investigators ORR: percentage of participants with CR [CMR;CRR] or PR [partial metabolic response (PMR); partial radiologic response (PRR)].CMR: PET 5PS scores of 1 (no uptake above background, 2 (uptake = mediastinum), 3 (uptake > mediastinum but = liver) with/without a residual mass; no new lesions; no evidence of FDG-avid disease in BM. CRR: target nodes/nodal masses regressed to = 1.5 cm in LDi;no extralymphatic sites of disease;absent NMLs;organ enlargement regress to normal;no new sites;bone marrow morphology normal. PMR: scores 4 (uptake moderately > liver), 5 (uptake markedly > liver, new lesions) with reduced uptake compared with baseline and residual mass; no new lesions; responding disease at interim/residual disease at end of treatment (EOT). PRR: = 50% decrease in sum of the product of perpendicular diameters (SPD) of up to 6 target measurable nodes and extra-nodal sites; absent/normal, regressed, but no increase of NMLs; spleen regressed by > 50% in length beyond normal; no new sites. First infusion date up to maximum duration of 32.7 months
Secondary Duration of Response (DOR) Per the IWG Lugano Classification as Determined by Study Investigators DOR is defined only for participants who experience an objective response and is the time from the first objective response to disease progression [progressive metabolic disease (PMD); progressive radiologic disease (PRD)] or death from any cause. Objective response is defined in outcome measure (OM) 4. PMD: scores 4 (uptake moderately > liver), 5 (uptake markedly > liver, new lesions) with increased uptake compared with baseline; new fluorodeoxyglucose (FDG)-avid foci consistent with lymphoma rather than another etiology; new or recurrent FDG-avid foci in bone marrow. PRD: LDi >1.5 cm; = 50% increase from cross product of LDi and perpendicular diameter (PPD); increase in LDi or shortest axis perpendicular to the LDi (SDi) of 0.5 cm for lesions =1.5 cm and 1 cm for lesions >2 cm; spleen increased by >50% in length beyond normal; new or recurrent splenomegaly, bone marrow involvement; new lesions; progression of pre-existing lesions. Kaplan-Meier (KM) estimate of median was reported. From the date of first confirmed objective response (CR or PR) to disease progression or death regardless of cause (up to approximately 32.7 months)
Secondary Progression-Free Survival (PFS) Per the IWG Lugano Classification as Determined by Study Investigators PFS is defined as the time from the axicabtagene ciloleucel infusion date to the date of disease progression (PMD; PRD) or death from any cause. PMD: scores 4 (uptake moderately > liver), 5 (uptake markedly > liver, new lesions) with increased uptake compared with baseline; new FDG-avid foci consistent with lymphoma rather than another etiology; new or recurrent FDG-avid foci in bone marrow. PRD: LDi >1.5 cm; = 50% increase from cross product of LDi and PPD; increase in LDi or SDi of 0.5 cm for lesions =1.5 cm and 1 cm for lesions >2 cm; spleen increased by >50% in length beyond normal; new or recurrent splenomegaly, bone marrow involvement; new lesions; progression of pre-existing lesions. KM estimate of median was reported. First infusion date up to disease progression or death regardless of cause (up to approximately 32.7 months)
Secondary Overall Survival (OS) OS is defined as the time from axicabtagene ciloleucel infusion to the date of death from any cause. KM estimate of median was reported. First infusion date up to death regardless of cause (up to approximately 32.7 months)
Secondary Peak Level of Anti-CD19 CAR T Cells in Blood Peak was defined as the maximum number of CAR T cells in blood measured after infusion. Baseline (Day 0), post-infusion on Days 7, 14, 21, 28, 49, 105, 180, Months 9, 12, 15, 18, and 24
Secondary Level of Anti-CD19 CAR T Cells in Blood by Visit Baseline (Day 0), post-infusion on Days 7, 14, 21, 28, 49, 105, 180, Months 9, 12, 15, 18, and 24
Secondary Area Under the Curve of CAR T Cells From Day 0 to Day 28 (AUC0-28) AUC0-28 is defined as the area under curve in a plot of number of CAR T cells against scheduled visit from Day 0 to Day 28. Baseline (Day 0), post-infusion on Days 7, 14, 21, and 28
Secondary Time to Peak Level of Anti-CD19 CAR T Cells in Blood Time to peak was defined as the number of days from the date of the axicabtagene ciloleucel infusion to the date of peak level defined as the maximum number of CAR T cells in blood measured after infusion. Baseline (Day 0), post-infusion on Days 7, 14, 21, 28, 49, 105, 180, Months 9, 12, 15, 18, and 24
See also
  Status Clinical Trial Phase
Recruiting NCT04836507 - Study of Efficacy and Safety of CRC01 in Adult Large B-cell Lymphoma Patients Phase 1/Phase 2

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