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Philadelphia Chromosome Negative Adult Precursor Acute Lymphoblastic LeukemiaPhase 1/2NCT01475058

CD19 CAR T Cells for B Cell Malignancies After Allogeneic Transplant

A Phase 1/2 study testing allogeneic cytomegalovirus-specific cytotoxic T lymphocytes in people with Philadelphia Chromosome Negative Adult Precursor Acute Lymphoblastic Leukemia and Philadelphia Chromosome Positive Adult Precursor Acute Lymphoblastic Leukemia, run by Fred Hutchinson Cancer Center at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This phase I/II trial studies the safety and toxicity of post-transplant treatment with donor T cells engineered to express a chimeric antigen receptor (CAR) targeting CD19 in patients who have had a matched related allogeneic hematopoietic stem cell transplant for a CD19+ B cell malignancy. Read more about this study

Who is it for?
Ages 18 to 75 years
What is being tested?
allogeneic cytomegalovirus-specific cytotoxic T lymphocytes
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1 participants
Where
1 siteUnited States
Study dates
Apr 2012to Jul 2014
Phase
Phase 1/2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with CD19+ B cell malignancy who have persistent, relapsed or progressive disease after hematopoietic stem cell transplant from an human leukocyte antigen (HLA)-matched related donor OR patients with CD19+ B cell malignancy who are planned for or have had a hematopoietic stem cell transplant from an HLA-matched related donor and are at risk of relapse after HCT defined by any one of the disease-specific criteria listed below:
  • Philadelphia chromosome negative acute lymphoblastic leukemia:
  • Beyond first complete remission (CR) at the time of pre-transplant evaluation
  • Required > 1 cycle of induction chemotherapy to achieve CR
  • First morphologic CR but with evidence of minimal residual disease by flow cytometry, conventional cytogenetics, fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR)
  • First CR with poor risk cytogenetics (t(4:11), t(8;14), hypodiploidy, near triploidy or > 5 cytogenetic abnormalities) at diagnosis
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  • Planned for or have had a reduced intensity conditioned or non-myeloablative transplant
  • Philadelphia positive acute lymphoblastic leukemia
  • Not in CR at the time of pre-transplant evaluation
  • In CR with the following features:
  • Intolerant or unwilling to use a TKI after HCT
  • Current or previous detection of cytogenetic abnormalities in addition to t(9;22) by conventional karyotyping, FISH or molecular methods
  • Chronic lymphocytic leukemia, or low grade B cell lymphomas:
  • Failed or ineligible for prior immunochemotherapy that included a purine analog and anti-CD20 monoclonal antibody AND a lymph node >= 5 cm at the time of pre-transplant evaluation
  • Mantle cell lymphoma:
  • Failed or ineligible for autologous transplant AND a lymph node >= 2 cm at the time of pre-transplant evaluation
  • Diffuse large B cell lymphomas, large B cell transformation of an indolent lymphoma or other aggressive B cell lymphomas
  • Failed or ineligible for autologous transplant AND not in CR at the time of pre-transplant evaluation
  • Confirmation of tumor diagnosis and expression of CD19 after review by University of Washington Medical Center (UWMC) or Seattle Cancer Care Alliance (SCCA) pathology services
  • The patient has signed the informed consent form for this study
  • DONOR: Genotypic or phenotypic HLA-identical family members
  • DONOR: Express one or more of the following combinations of viral serostatus and HLA allele:
  • CMV seropositive and HLA-A*0101 positive
  • CMV seropositive and HLA-A*0201 positive
  • CMV seropositive and HLA-B*0702 positive
  • CMV seropositive and HLA-B*0801 positive
  • EBV seropositive and HLA-A*0201 positive
  • EBV seropositive and HLA-B*0801 positive
  • DONOR: Hematocrit >= 35% at enrollment
  • DONOR: Age >= 18 years
  • DONOR: The donor has signed the informed consent form for the study

Who cannot join

  • Known central nervous system (CNS) tumor (CNS2 or CNS3) that is refractory to intrathecal chemotherapy and/or cranio-spinal radiation; patients with a history of CNS disease that has been effectively treated to CNS1 or lower evidence of disease will be eligible
  • Human immunodeficiency virus (HIV) seropositive
  • Significant medical or psychological conditions that would make them unsuitable candidates for T cell therapy
  • Fertile patients unwilling to use contraception during and for 12 months after protocol enrollment
  • Pregnant or breast-feeding
  • DONOR: G-CSF administered within one month prior to the blood draw for T cell collection
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  • DONOR: Unable for any reason to provide a 400 ml blood draw
  • DONOR: Inadequate peripheral veins for blood collection
  • DONOR: HIV-1, HIV-2, human T-lymphotropic virus (HTLV)-1 or HTLV-2 seropositive
  • DONOR: Active hepatitis B or hepatitis C virus infection
  • DONOR: Positive serologic test for syphilis
  • DONOR: Aberrant CD45RA isoform expression on all T cells
  • DONOR: Systolic blood pressure (BP) < 80 or > 200
  • DONOR: Heart rate < 50 or > 120, if considered due to cardiac disease
  • DONOR: Oxygen (O2) saturation < 88% on room air
  • DONOR: Serum creatinine (Cr) > 3.0
  • DONOR: Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 4 x the upper limit of normal
  • DONOR: Unable to provide informed consent to participate
  • DONOR: Significant medical conditions (e.g. immunosuppressive therapy) that would make them unsuitable T cell donors
  • DONOR: Pregnant or nursing

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium

    Seattle, Washington, 98109

Other trials in United States

About this study

Official title: A Phase I/II Study of Cellular Immunotherapy With Donor Central Memory-derived Virus-specific CD8+ T-cells Engineered to Target CD19 for CD19+ Malignancies After Allogeneic Hematopoietic Stem Cell Transplant

This phase I/II trial studies the safety and toxicity of post-transplant treatment with donor T cells engineered to express a chimeric antigen receptor (CAR) targeting CD19 in patients who have had a matched related allogeneic hematopoietic stem cell transplant for a CD19+ B cell malignancy.

Read the detailed description

PRIMARY OBJECTIVES:

  1. To assess the safety and feasibility of pre-emptive adoptive T cell therapy using ex vivo expanded cytomegalovirus (CMV)- or Epstein-Barr virus (EBV)-specific T cells derived from donor CD62L+ central memory (TCM) cells and genetically modified to express a CD19-specific chimeric antigen receptor (CAR) in patients in complete remission after human leukocyte antigen (HLA)-matched related donor hematopoietic stem cell transplantation (HCT) for CD19+ B cell malignancies at high risk of post-HCT relapse. (Cohort A)

II. To assess the safety and feasibility of adoptive T cell therapy using ex vivo expanded CMV- or EBV-specific T cells derived from donor CD62L+ TCM cells and genetically modified to express a CD19-specific CAR in patients with persistent, progressive or relapsed disease after HLA-matched related donor HCT for CD19+ B cell malignancies. (Cohort B)

SECONDARY OBJECTIVES:

  1. To determine the duration of in vivo persistence of adoptively transferred bi-specific CD8+ T cells, and the phenotype of persisting T cells.

II. To determine if adoptively transferred bi-specific CD8+ T cells traffic to the bone marrow and function in vivo.

III. To determine if adoptively transferred bi-specific CD8+ T cells proliferate in allogeneic HCT recipients that reactivate CMV or EBV.

IV. To determine if the adoptive transfer of bi-specific CD8+ T cells eliminates CD19+ tumor cells in the subset of patients with a measurable tumor burden prior to T cell transfer.

OUTLINE:

At least 30 days after HCT, patients will receive one intravenous (IV) infusion of CMV/CD19 or EBV/CD19 bi-specific CD8+ T cells.

After completion of study treatment, patients are followed up periodically for 15 years.

Being tested
allogeneic cytomegalovirus-specific cytotoxic T lymphocytes
Medical subject headings
Precursor Cell Lymphoblastic Leukemia-Lymphoma, Lymphoma, Large B-Cell, Diffuse, Lymphoma, Large-Cell, Immunoblastic, Lymphoma, Mantle-Cell, Leukemia, Lymphocytic, Chronic, B-Cell

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • allogeneic cytomegalovirus-specific cytotoxic T lymphocytesBiological

    Also called allogeneic CMV-specific CTLs

    Allogeneic CD19-specific chimeric antigen receptor-modified CD8+ central memory derived virus-specific T cells. Allogeneic CD19CAR-TCM cells given IV

Study groups in NCT01475058
Study groupRoleWhat they receive
Treatment (T cell therapy)ExperimentalPatients undergo one IV infusion of donor-derived CD8+ central memory-derived CMV/CD19 or EBV/CD19 bi-specific T cells, at least 30 days after HCT.
Receives: Biological: allogeneic cytomegalovirus-specific cytotoxic T lymphocytes

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety and toxicity assessment of study treatment

    Incidence of grade >= 3 toxicity, as defined by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 occurring from the T cell infusion through day 42 after the T cell infusion. Analysis will be performed separately in patients in complete remission (cohort A) or with detectable disease (cohort B) at day 28 post-transplant (prior to the T cell infusion). Incidence of acute GVHD occurring from the T cell infusion through day 42 after the T cell infusion will be assessed.

    Measured: Up to day 42 after the T cell infusion

  2. Feasibility assessment of study treatment

    If the prescribed T cell dose is delivered in more than 50% of the patients, this approach will be considered feasible for further study to reduce relapse after allogeneic HCT.

    Measured: Up to 5 years

Secondary outcomes (1)
  1. Anti-tumor efficacy and duration of persistence, migration, and function of adoptively transferred bi-specific effector cells

    Measured: Up to 15 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Nov 2011 (estimated)
  2. Study startApr 2012
  3. Primary completionApr 2014
  4. Study completionJul 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
1 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01475058
Sponsor's protocol ID
2494.00
Other IDs
NCI-2011-01819, 2494.00, P30CA015704, R01CA136551
Status last verified
Feb 2017
First submitted
10 Nov 2011
Last updated
15 Feb 2017
Results posted
No
Data monitoring committee
Yes

Publications

  • Ernst M, Oeser A, Besiroglu B, Caro-Valenzuela J, Abd El Aziz M, Monsef I, Borchmann P, Estcourt LJ, Skoetz N, Goldkuhle M. Chimeric antigen receptor (CAR) T-cell therapy for people with relapsed or refractory diffuse large B-cell lymphoma. Cochrane Database Syst Rev. 2021 Sep 13;9(9):CD013365. doi: 10.1002/14651858.CD013365.pub2.

    PubMed 34515338

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing allogeneic cytomegalovirus-specific cytotoxic T lymphocytes in people with Philadelphia Chromosome Negative Adult Precursor Acute Lymphoblastic Leukemia and Philadelphia Chromosome Positive Adult Precursor Acute Lymphoblastic Leukemia, run by Fred Hutchinson Cancer Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 31 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Feb 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety and toxicity assessment of study treatment (time frame: Up to day 42 after the T cell infusion). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01475058, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Feb 2017.

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