T-ALLPhase 2NCT06648889
Isatuximab in Adult Patients With Cytologic or Molecular Relapsed/Refractory CD38 Positive T-cell Acute Lymphoblastic Leukemia
A Phase 2 study testing Isatuximab in people with T-ALL, run by Goethe University at 15 sites in Germany.
Trial summary
The planned trial offers treatment cohorts for patients with full cytologic relapse (R/R ALL - Cohort 1), as well as for patients with molecular failure/relapse (MRD+ ALL - Cohort 2). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- T-ALL
- What is being tested?
- Isatuximab
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 28 participants
- Where
- 15 sitesGermany
- Study dates
- 22 Oct 2024to Jun 2030
- Phase
- Phase 2
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
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Cohort 1:
- Patients with CD38 positive T-ALL/T-LBL
- Either: In relapse or with primary refractory disease defined as ≥5% blasts in bone marrow cytology or ≥1% minimal residual disease (MRD)
- Or: Extramedullary relapse or primary refractory disease confirmed by standard imaging with measurable target leasions
- after at least three chemotherapy cycles (induction I-II, consolidation I) with the following additional specifications:
- early relapse within 12 months from first achievement of CR or
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- late relapse later than 12 months from first achievement of CR or
- primary refractory disease without any CR or
- any relapse after stem cell transplantation or
- any refractory relapse, defined as no response to at least one salvage therapy or
- any second or later relapse and
- Availability of patient material with blast cells (bone marrow or peripheral blood) for central MRD assessment or availability of respective predefined marker (not required in patients with extramedullary disease only).
- ECOG status: 0-2
- Age ≥ 18 years
- Evidence of a personally signed and dated informed consent indicating that the patient has been informed of all pertinent aspects of the study
- Patient must be willing and able to comply with scheduled visits, treatment plan, laboratory tests and other study procedures
- Regeneration from last chemotherapy defined as follows:
- Platelets ≥10.000/uL (platelet transfusion allowed)
- Hemoglobin ≥ 7.5 g/dl (red blood cell transfusion allowed)
- Adequate liver function defined as follows:
- Bilirubin ≤ 1.5 ULN (unless Gilbert Meulengracht disease or classified as result of liver infiltration by investigator)
- AST and ALT ≤ 2.5 x ULN (unless classified as result of liver infiltration by investigator)
- Adequate renal function defined as follows:
- Serum creatinine ≤ 2 x ULN
- Any serum creatinine level associated with a calculated creatinine clearance ≥ 40 mL/min
- Negative pregnancy test in women of childbearing potential (WOCBP)
- WOCBP must commit to either abstain continuously from heterosexual sexual intercourse or to use 2 methods of reliable birth control simultaneously.
- Men who are sexually active with a WOCBP must agree to use a barrier method of contraception
- Participation in the registry of the German Multicenter Study Group for Adult ALL (GMALL)
- Cohort 2:
- terminated with protocol version 3.2.
Who cannot join
- Cohort 1:
- Patients with CNS-only relapse
- Patients who have received prior antileukemic immunotherapy within 2 weeks prior to start of Isatuximab treatment
- Patients who have received treatment for leukemia with chemotherapy as follows:
- Patients who have received treatment for leukemia with chemotherapy within 2 weeks prior to start of Isatuximab treatment (exception: documented disease progression under chemotherapy and pre-phase therapy with 5-7 days of Dexamethasone, 3 days of Cyclophosphamide; intrathecal prophylaxis)
- Patients who are candidates for a treatment with Nelarabine (eligibility to be assessed particularly in patients with extramedullary involvement and/or early/mature T-ALL/T-LBL, due to limited efficacy)
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- Patients must have recovered from acute non-hematologic toxicity form previous therapies to ≤ grade I unless signs or symptoms are correlated to leukaemia involvement
- Prior SCT ≤ 3 months from start of study treatment
- Acute GvHD ≥ grade II or active chronic GvHD requiring systemic treatment
- Any systemic GvHD prophylaxis or treatment within 2 weeks from start of study treatment
- Known HIV positivity, known hepatitis B surface antigen positivity or known history of hepatitis C
- Unstable or severe uncontrolled medical condition e.g. unstable cardiac function or unstable pulmonary condition
- Treatment with an investigational agent within 4 weeks from start of study treatment (safety follow-up period of respective study)
- Concurrent active malignancy other than non-melanoma skin cancer, carcinoma in situ of the cervix, or localized prostate cancer that has been treated with radiation or surgery; patients with previous malignancies are eligible if they have been disease free for ≥ 2 years and do not require any antitumor therapy
- Evidence of uncontrolled current serious active infection or recent history (within 4 months) of deep tissue infections such as fasciitis or osteomyelitis
- Known allergies, hypersensitivity, or intolerance to Boron or Mannitol, corticosteroids, mAb (including Isatuximab) or human proteins, or their excipients (refer to respective Summary of Product Characteristics), or known sensitivity to mammalian-derived products
- Active infection, any other concurrent disease or medical condition that are deemed to interfere with the conduct of the study as judged by the investigator
- Pregnant or breastfeeding females
- Vaccination with live attenuated vaccines within 4 weeks of first study agent administration
- Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgement of the investigator, would make the patient inappropriate for entry into this study
- Cohort 2:
- terminated with protocol version 3.2.
Trial locations and contacts
15 sites in 1 country. Contact the study team or a site near you to ask about taking part.
15 sites in 1 country
Germany15 sites, 15 recruiting
- Recruiting
University Hospital Augsburg, II. Medizinischen Klinik, Hämatologie, internistische Onkologie und Hämostaseologie
Augsburg, 86156
Andreas Rank, MD
Andreas Rank, MD
- Recruiting
Charité Berlin, Campus Benjamin Franklin, Department of Hematology, Oncology and Tumorimmunologyt Hämatologie
Berlin, 12203
Stefan Schwartz, MD
Stefan Schwartz, MD
- Recruiting
Gesundheit Nord Klinikverbund Bremen gGmbH, Klinikum Bremen-Mitte, Med. Klinik I
Bremen, 28205
Maher Hanoun, Prof. M.D.
Maher Hanoun, Prof. M.D.
- Recruiting
Klinikum Carl Gustav Carus Dresden, Medizinische Klinik und Poliklinik I
Dresden, 01307
Lisa Heberling, MD
Lisa Heberling, MD
- Recruiting
University Hospital Düsseldorf, Department of Hematology, Oncology and Clinical Immunology
Düsseldorf, 40225
Kathrin Nachtkamp, MD
Kathrin Nachtkamp, MD
- Recruiting
University Hospital Erlangen AöR, Department of Medicine 5
Erlangen, 91054
Bernd Spriewald, MD
Bernd Spriewald, MD
- Recruiting
Goethe University Hospital Frankfurt, Department of Medicine, Hematology and Oncology
Frankfurt am Main, 60580
Nicola Goekbuget, MD, 0049-6963016365, goekbuget@em.uni-frankfurt.de
Anjali Cremer, MD
- Recruiting
University Hospital Hamburg-Eppendorf, Department of Medicine II
Hamburg, 20251
Franziska Westendorf, MD
Franziska Westendorf, MD
- Recruiting
University Hospital Heidelberg, Department V, Hematology, Oncology and Rheumatology
Heidelberg, 69120
Simon Raffel, MD
Simon Raffel, MD
- Recruiting
University Hospital Schleswig-Holstein, Campus Kiel, Medical Department II
Kiel, 24105
Lars Fransecky, MD
Lars Fransecky, MD
- Recruiting
University Hospital Leipzig; Klinik für Hämatologie, Zelltherapie, Hämostaseologie und Infektiologie, Bereich Hämatologie und Zelltherapie
Leipzig, 04103
Georg-Nikolaus Franke, MD
Georg-Nikolaus Franke, MD
- Recruiting
University Hospital München-Großhadern, Medizinische Klinik und Poliklinik III
München, 81377
Veit Bücklein, MD
Veit Bücklein, MD
- Recruiting
University Hospital Münster, Medizinische Klinik A / KMT-Zentrum
Münster, 48149
Matthias Stelljes, MD
Matthias Stelljes, MD
- Recruiting
Klinikum Oldenburg AöR, Universitätsklinik für Innere Medizin - Onkologie und Hämatologie
Oldenburg, 26135
Andreas Voß, MD
Andreas Voß, MD
- Recruiting
Robert-Bosch-Krankenhaus; Abteilung für Hämatologie, Onkologie und Palliativmedizin
Stuttgart, 70376
Sonja Martin, MD
Sonja Martin, MD
About this study
Official title: A Multicenter, Single-arm Phase II Study to Assess the Safety, Tolerability, and Efficacy of Isatuximab in Adult Patients With Cytologic or Molecular Relapsed/Refractory CD38 Positive T-cell Acute Lymphoblastic Leukemia (GMALL-Isatuximab)
The planned trial offers treatment cohorts for patients with full cytologic relapse (R/R ALL - Cohort 1), as well as for patients with molecular failure/relapse (MRD+ ALL - Cohort 2). Basically, the study aims to develop data for optimization of first-line therapy of T-ALL, either by modification of standard induction with Isatuximab or by establishing a post-induction therapy for eradication of MRD and thereby evaluates in parallel two different strategies.
- Conditions
- T-ALL
- Being tested
- Isatuximab
- Keywords
- R/R or MRD CD38-positive T-ALL
- Medical subject headings
- Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
IsatuximabDrug
Also called Bortezomib
Cohort 1: All patients will receive two cycles of induction therapy with standard chemotherapy, Bortezomib and Isatuximab. Isatuximab maintenance may be administered in patients with CR until SCT, progression/relapse, unacceptable toxicity, physicians' decision to change treatment or withdrawal of consent.
IsatuximabDrug
Cohort 2: All patients will receive at least one cycle with Isatuximab. Each cycle will be 4 weeks in duration. Isatuximab will be administered until SCT, hematologic relapse including extramedullary, unacceptable toxicity, physicians' decision, or withdrawal of consent - terminated with protocol version 3.2.
| Study group | Role | What they receive |
|---|---|---|
| GMALL-Isatuximab | Experimental | Cohort 1: In this Cohort, Isatuximab shall be implemented as part of a combination therapy for patients with R/R T-ALL/T-LBL, defined as bone marrow infiltration of ≥5% (R/R T-ALL) or ≥1% minimal residual disease (MRD).
Cohort 2: In this Cohort, Isatuximab shall be implemented as single drug treatment for patients with molecular failure/relapse. Cohort 2 will include patients with hematologic remission (bone marrow blast count <5%) of T-cell ALL, but with molecular failure or molecular relapse (MRD+ T-ALL) - terminated with protocol version 3.2. Receives: Drug: Isatuximab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of patients with complete hematologic response (ORR= CR and CRi)
Cohort 1: Proportion of patients with complete hematologic response (ORR= CR and CRi) after 2 cycles of induction therapy including Isatuximab.
Measured: Day 22, Week 9, per SoC
Overall incidence and severity of adverse events
Cohort 1: Overall incidence and severity of adverse events (CTCAE 5.0).
Measured: Day 22, Week 9, month 3, month 6 (depends on duration of therapy which is variable)
Proportion of patients with molecular response (MolCR)
Cohort 2:
Proportion of patients with molecular response (MolCR) after one cycle of Isatuximab.
Measured: Day 22, Week 9, per SoC
Secondary outcomes (14)
Proportion of patients with CR and CRi, MolCR and cMolCR in R/R
Cohort 1: Proportion of patients with CR and CRi, MolCR and cMolCR in R/R (cohort 1) after 1 or 2 cycles of induction (best response)
Measured: Day 22, Week 9, per SoC
Probability of continuous complete remission
Probability of continuous complete remission (remission duration) at 18 months
Measured: at 18 months
Probability of overall survival
Probability of overall survival at 18 months
Measured: at 18 Months
Probability of relapse-free survival
Probability of relapse-free survival at 18 months
Measured: at 18 months
Probability of event-free survival
Probability of event-free survival at 18 months
Measured: at 18 months
Incidence of relapses and proportion of relapse localisations
Incidence of relapses and proportion of relapse localisations
Measured: Day 22, Week 9, per SoC
Incidence of GvHD in patients with prior SCT
Incidence of GvHD in patients with prior SCT
Measured: until end of trial
Duration of molecular remission (mimimal residual disease by PCR)
Measured: Day 22, Week 9, per SoC
Treatment realization for Isatuximab
Dosing of Isatuximab as scheduled per protocol
Measured: d22, week 9, per maintenance cycle, end of treatment at month 6
Probability of continuous MolCR and cMolCR and duration of MolCR and cMolCR
Probability of continuous MolCR and cMolCR and duration of MolCR and cMolCR
Measured: Day 22, Week 9, per SoC
Time to MolCR and cMolCR
Time to MolCR and cMolCR measured by time-point of first achievement.
Measured: Day 22, Week 9, per SoC
Conduct of SCT in patients with CR (ORR), MolCR, cMolCR
The conduct of SCT will be assessed in patients with CR (ORR), MolCR, cMolCR, SCT parameters and outcome
Measured: Through completion of the trial, average 18 months
Measurement of Quality of Life
Measurement of Quality of Life with EORTC instruments (e.g. EORTC QLQ-C30) at different time-points during treatment
Measured: Day 22, Week 9
Hospitalisation days
Hospitalisation days
Measured: Day 22, Week 9, month 3 and 6 (depending on treatment duration which is individual)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Oct 2024
- Study start22 Oct 2024
- Primary completionJun 2029 (estimated)
- Study completionJun 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for T-ALLStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 28 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Goethe University
- Sponsor type
- University, hospital or other
- Collaborators
- Sanofi
- Responsible party
- Principal investigator, Nicola Goekbuget, Goethe University
- Investigators
- Nicola Goekbuget, MD, Study director, Department of Medicine, Hematology and Oncology, Goethe University Frankfurt, Frankfurt, GermanyAnjali Cremer, MD, Principal investigator, Department of Medicine, Hematology and Oncology, Goethe University Frankfurt, Frankfurt, Germany
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06648889
- Sponsor's protocol ID
- GMALL-Isatuximab
- Other IDs
- 2023-507899-47-00, 2023
- Status last verified
- Jan 2026
- First submitted
- 15 Jul 2024
- Last updated
- 28 Aug 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No