Cellular Immunotherapy in Treating Patients With High-Risk Acute Lymphoblastic Leukemia

  • STATUS
    Not Recruiting
  • End date
    Dec 31, 2022
  • participants needed
    88
  • sponsor
    City of Hope Medical Center
Updated on 13 June 2022
renal function
cancer
corticosteroids
remission
oxygen saturation
stem cell transplantation
graft versus host disease
tyrosine
white blood cell count
flow cytometry
prednisone
immunosuppressive agents
leukemia
minimal residual disease
induction therapy
residual tumor
leukapheresis
hydrea

Summary

This phase I trial studies the side effects and best dose of cellular immunotherapy in treating patients with high-risk acute lymphoblastic leukemia. Placing a modified gene into white blood cells may help the body build an immune response to kill cancer cells.

Description

PRIMARY OBJECTIVES:

I. To examine the activity and safety of adoptive therapy using ex vivo expanded memory T cells that are enriched and genetically-modified to express a CD19-specific, hinge optimized, CD28-costimulatory chimeric antigen receptor (CAR) as well as a truncated human EGFR (Arm 1: CD19R(EQ)28zeta/truncated human EGFR [EGFRt]+ central memory T cells [TCM]; Arm 2: CD19R(EQ)28zeta/EGFRt+ naive and memory T cells [TN/NEM]) shortly following a lymphodepleting preparative regimen for adults with poor prognosis CD19+ acute lymphoblastic leukemia (ALL).

II. To determine the Phase II recommended dose (RP2D). III. To expand the maximum tolerated dose (MTD) dose to better describe the activity and safety of this dose.

SECONDARY OBJECTIVE:

I. To study additional antitumor activity endpoints of CD19R(EQ)28zeta/EGFRt+ TCM and CD19R(EQ)28zeta/EGFRt+ TN/NEM.

OUTLINE: This is a dose-escalation study.

ARM I (CLOSED TO ACCRUAL JANUARY 2019): Patients receive lymphodepleting regimen per treating physician's discretion 3-14 days before the T-cell infusion. Patients receive CD19CAR-CD28-CD3zeta-EGFRt-expressing Tcm-enriched T cells IV over 15 minutes on day 0. Patients who have evidence of disease, whose tumor(s) continue to express the appropriate antigen target may receive an optional second infusion of CD19CAR-CD28-CD3zeta-EGFRt-expressing Tcm-enriched T cells after 28 days.

ARM II: Patients receive lymphodepleting regimen per treating physician's discretion 3-14 days before the T-cell infusion. Patients receive CD19CAR-CD28-CD3zeta-EGFRt-expressing Tn/nem-enriched T cells IV over 15 minutes on day 0. Patients who have evidence of disease, whose tumor(s) continue to express the appropriate antigen target may receive an optional second infusion of CD19CAR-CD28-CD3zeta-EGFRt-expressing Tn/nem-enriched T cells after 28 days.

After completion of study treatment, patients are followed up at 24 hours, weekly for 1 month, monthly for 1 year, and then yearly for at least 15 years.

Details
Condition B Acute Lymphoblastic Leukemia, Recurrent Acute Lymphoblastic Leukemia, Refractory Acute Lymphoblastic Leukemia
Treatment laboratory biomarker analysis, Chimeric Antigen Receptor T-Cell Therapy, CD19CAR-CD28-CD3zeta-EGFRt-expressing Tcm-enriched T-lymphocytes, CD19CAR-CD28-CD3zeta-EGFRt-expressing Tn/mem-enriched T-lymphocytes
Clinical Study IdentifierNCT02146924
SponsorCity of Hope Medical Center
Last Modified on13 June 2022

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