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Large B-cell LymphomaPhase 4NCT05108805

Chimeric Antigen Receptor (CAR) T Cell Therapy With YESCARTA in the Outpatient Setting

A Phase 4 study testing Telemedicine Visit, Vital sign measurements and Out-Patient Clinic Visit in people with Large B-cell Lymphoma and Diffuse Large B-cell Lymphoma, run by Vanderbilt-Ingram 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

We hope to demonstrate that YESCARTA can be safely administered in the outpatient setting if we closely monitor subjects with physical exams, wearable devices, and telemedicine visits and only admit those who meet specified criteria Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Telemedicine Visit, Vital sign measurements and Out-Patient Clinic Visit
Could I receive a placebo?
No, everyone receives an active treatment
How many people
25 participants
Where
1 siteUnited States
Study dates
2 Dec 2021to 8 Dec 2023
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age 18 years and above
  • Histologically proven large B cell lymphoma or transformed follicular lymphoma to DLBCL in relapse/refractory after two lines of therapies which included an anthracycline and CD20-targeted therapy.
  • Or
  • Chemotherapy refractory disease evidenced by lack of adequate response to first line therapy. This consists of either progressive disease as best response to first line therapy or stable disease as best response after 4 cycles of appropriate chemotherapy
  • Or
  • Refractory after autologous stem cell transplant (ASCT) at any time point
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  • And
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
  • Adequate hematologic, hepatic, renal and cardiac function evidenced by:
  • absolute neutrophil count (ANC) ≥1000/µL
  • Platelet ≥ 75,000/ µL
  • T-bilirubin ≤ 1.5 mg/dL
  • Normal serum creatinine or creatinine clearance ≥ 60 mL/min/1.73 m2
  • Cardiac ejection fraction ≥ 50%
  • Serum alanine aminotransferase/aspartate aminotransferase (ALT/AST) ≤ 5 times upper limit of normal (ULN).
  • At least 1 measurable lesion
  • Baseline oxygen saturation ≥92% on room air.
  • Ability to stay at a distance which allows for subjects to come in and for specific interventions like antibiotics and tocilizumab to be started in 1 hour or less. This is approximately 30 miles of Vanderbilt.
  • A caregiver who can be educated to operate equipment for vital signs monitoring.
  • Caregiver Eligibility:
  • Willingness to serve as a caregiver Ability to read, write and operate a phone Willingness to be taught to operate electronic device Willingness and ability to assist subject to wear electronic device such including patch, blood pressure machine, thermometer Pass caregiver assessment test
  • Subject and caregiver willing to be taught to operate an iPad or other electronic media for telemedicine, use wearable devices, and pass the caregiver competence test.

Who cannot join

  • History of malignancy other than nonmelanoma skin cancer or carcinoma in situ (e.g. cervix, bladder, breast) or follicular lymphoma unless disease free for at least 3 years.
  • Known CD19 negative tumor.
  • History of Richter's transformation of chronic lymphocytic leukemia (CLL).
  • Autologous stem cell transplant with therapeutic intent within 6 weeks of planned YESCARTA infusion.
  • History of allogeneic stem cell transplantation.
  • Prior CAR therapy or other genetically modified T-cell therapy.
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  • History of severe, immediate hypersensitivity reaction attributed to aminoglycosides.
  • Presence or suspicion of fungal, bacterial, viral, or other infection that is uncontrolled or requiring IV antimicrobials for management. Simple urinary tract infection (UTI) and uncomplicated bacterial pharyngitis are permitted if responding to active treatment and after consultation with the sponsor's medical monitor.
  • History of human immunodeficiency virus (HIV) infection or acute or chronic hepatitis B or hepatitis C infection. Subjects with history of hepatitis infection must have cleared their infection as determined by standard serological and genetic testing per current Infectious Diseases Society of America (IDSA) guidelines or applicable country guidelines.
  • Presence of any in-dwelling line or drain (e.g., percutaneous nephrostomy tube, in-dwelling Foley catheter, biliary drain, or pleural/peritoneal/pericardial catheter). Dedicated central venous access catheters, such as a Port-a-Cath or Hickman catheter, are permitted.
  • Subjects with detectable cerebrospinal fluid malignant cells, or brain metastases, or with a history of central nervous system (CNS) lymphoma or primary CNS lymphoma, cerebrospinal fluid malignant cells or brain metastases. Patients with treated secondary CNS involvement of lymphoma are allowed.
  • History or presence of CNS disorder, such as seizure disorder, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, progressive multifocal leukoencephalopathy, or any autoimmune disease with CNS involvement if it impairs ability to complete an effective and reliable neurological assessment.
  • Subjects with cardiac atrial or cardiac ventricular lymphoma involvement.
  • History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other clinically significant cardiac disease within 12 months of enrolment.
  • Requirement for urgent therapy due to tumor mass effects (e.g., blood vessel compression, bowel obstruction, or transmural gastric involvement).
  • Primary immunodeficiency.
  • Any medical condition likely to interfere with assessment of safety or efficacy of study treatment.
  • Live vaccine ≤ 6 weeks prior to planned start of conditioning regimen.
  • History of severe immediate hypersensitivity reaction to any of the agents used in this study.
  • Women of child-bearing potential who are pregnant or breastfeeding because of the potentially dangerous effects of the preparative chemotherapy on the fetus or infant. Females who have undergone surgical sterilization or who have been postmenopausal for at least 2 years are not considered to be of childbearing potential.
  • Subjects of both genders who are not willing to practice birth control from the time of consent through 6 months after the completion of conditioning chemotherapy.
  • In the investigator's judgment, the subject is unlikely to complete all protocol-required study visits or procedures, including follow-up visits, or comply with the study requirements for participation.
  • History of autoimmune disease (e.g. Crohn's, rheumatoid arthritis, systemic lupus) resulting in end organ injury or requiring systemic immunosuppression/systemic disease modifying agents within the last 2 years.
  • Must not have received immunomodulating agents including checkpoint inhibitors, Bruton tyrosine kinase (BTK) inhibitors, and Revlimid within 2 months or 5 half-lives whichever is shorter.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Vanderbilt-Ingram Cancer Center

    Nashville, Tennessee, 37232

Other trials in United States

About this study

Official title: Safety and Feasibility Study of Chimeric Antigen Receptor (CAR) T Cell Therapy With YESCARTA in the Outpatient Setting

We hope to demonstrate that YESCARTA can be safely administered in the outpatient setting if we closely monitor subjects with physical exams, wearable devices, and telemedicine visits and only admit those who meet specified criteria

Read the detailed description

Primary Objectives

  • To explore the feasibility of treating subjects with YESCARTA in the outpatient setting and guide the development of a subsequent, larger study that will determine the tolerability and safety profile of YESCARTA in the outpatient setting.
  • To determine the time to specific interventions post infusion and the number of subjects who remain outpatient through 72 hours, 7, 14, and 30 days.

Secondary Objectives:

  • Identify risk factors that preclude outpatient administration, and to obtain clinical data that will guide the development of guidelines by which YESCARTA treatment in the outpatient setting can be done safely.
  • Assess the impact of close monitoring with telemedicine and twice-daily physical exam on specific outcomes including CRS and ICANS in subjects treated with YESCARTA in the outpatient setting.
  • Cumulative steroid exposure within 28 days post YESCARTA infusion.
  • To calculate the estimated cost of YESCARTA administered in the outpatient setting.

Exploratory Objectives:

  • Time from YESCARTA infusion to the following: fever, fever with neutropenia, fever without neutropenia.
  • Time from fever to Tocilizumab, fever to ICU admission, fever to low BP, fever to IV Fluid, fever to vasopressor, fever to onset to arrhythmias and fever to hospitalization.
  • Calculate modified Neutropenic Fever Symptom Burden (NFSB) score for days 1-3 for each subject. Appendix D
  • Obtain subject reported outcomes measured by Subject-Reported Outcomes Measurement Information System (PROMIS; Appendix F) [16, 17]
  • Feasibility of using wearable devices to monitor vital signs in the outpatient setting. Data collected are for research only
Being tested
Telemedicine Visit, Vital sign measurements, Out-Patient Clinic Visit, Blood pressure and pulse oximeter, Axicabtagene Ciloleucel
Medical subject headings
Lymphoma, Large B-Cell, Diffuse

What participants receive

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

  • Telemedicine VisitProcedure or surgery

    A remote telemedicine visit with audio and video, using the internet with a nurse practitioner (NP) located elsewhere. The participant and NP will activate the telemedicine App in their electronic device. Family will obtain vital signs (BP, heart rate (HR), respiration rate (RR), SPO2) and provide NP with the information. NP will also review the previous vital signs. Review of system questions are asked, and the answers given by subject recorded. Neurological assessment done, and ICE score calculated.

  • Vital sign measurementsProcedure or surgery

    Participant and their family will record and measure vital signs using a wearable device and will place a call to the covering nurse practitioner to report the vital signs prior to reporting to the out patient visit.

  • Out-Patient Clinic VisitProcedure or surgery

    Physical exam and review of all available data

  • Blood pressure and pulse oximeterProcedure or surgery

    Participant and their family take their blood pressure and pulse oximeter

  • Axicabtagene CiloleucelBiological

    Axicabtagene Ciloleuce given by IV

  • CyclophosphamideDrug

    Also called Cyclophosphamide 500 mg/m^2/day, Cytoxan®

    Given IV

  • FludarabineDrug

    Also called Fludarabine 30 mg/m^2/day, Fludara®

    Given IV

Study groups in NCT05108805
Study groupRoleWhat they receive
YESCARTA (Axicabtagene Ciloleucel) in the Outpatient SettingExperimentalPatients receive cyclophosphamide IV and fludarabine IV on days -5 to -3. Patients then receive YESCARTA IV for over 30 minutes on day 0 in the absence of disease progression of unacceptable toxicity.
Receives: Procedure: Telemedicine Visit; Procedure: Vital sign measurements; Procedure: Out-Patient Clinic Visit; Procedure: Blood pressure and pulse oximeter; Biological: Axicabtagene Ciloleucel; Drug: Cyclophosphamide; Drug: Fludarabine

What is being measured

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

  1. Number of Participants That Received YESCARTA

    The number of participants that received YESCARTA as outpatient therapy

    Measured: Approximately 6 weeks

  2. Participants That Required Hospitalization at 72 Hours Post Infusion

    Number of subjects that were admitted to hospital at 72 hours post infusion

    Measured: at 72 hours

  3. Participants That Required Hospitalization at 7 Days Post Infusion

    Number of subjects that were admitted to the hospital at 7 days post infusion

    Measured: at 7 days

  4. Participants That Required Hospitalization at 14 Days Post Infusion

    Number of subjects that were admitted to the hospital at 14 days post infusion

    Measured: at 14 days

  5. Participants That Required Hospitalization at 30 Days Post Infusion

    Number of subjects that were admitted to hospital at 30 days post infusion

    Measured: at 30 days

Secondary outcomes (5)
  1. Count of Risk Factors That Preclude Out-patient Administration of YESCARTA

    Reasons as to why a participant did not receive YESCARTA in the out-patient setting

    Measured: Approximately 30 days

  2. Participants That Experienced Cytokine Release Syndrome Events

    Count of participants that had cytokine release syndrome events

    Measured: Approximately 30 days

  3. Participants That Experienced Immune Effector Cell-associated Neurotoxicity Syndrome Events

    Count of participants that had an immune effector cell-associated neurotoxicity syndrome event

    Measured: Approximately 30 days

  4. Incidence of Steroid Administration During YESCARTA

    Count of participants that were administered steroids during treatment

    Measured: Approximately 30 days

  5. Cost Per Patient of Administering YESCARTA in the Out-patient Setting

    Cost includes hospital clinic charges and CAR-T acquisition. It was pre-specified to report a single dollar amount that every participant was changed. The amount entered was the amount that each patient was charged. It was not planned to assess this amount separately for each participant.

    Measured: Approximately 30 days

Timeline

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

  1. First posted5 Nov 2021
  2. Study start2 Dec 2021
  3. Primary completion8 Dec 2023
  4. Study completion8 Dec 2023

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 4
Primary purpose
Supportive care
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
25 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05108805
Sponsor's protocol ID
VICC CTT 2109
Status last verified
Mar 2025
First submitted
29 Oct 2021
Last updated
27 Mar 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Telemedicine Visit, Vital sign measurements and Out-Patient Clinic Visit in people with Large B-cell Lymphoma and Diffuse Large B-cell Lymphoma, run by Vanderbilt-Ingram 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 22 inclusion and 24 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 27 Mar 2025. 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 phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

Yes. Results are posted in the registry (first posted 27 Mar 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Number of Participants That Received YESCARTA (time frame: Approximately 6 weeks). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 27 Mar 2025; AzTrials last refreshed its copy on 26 Oct 2026.

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