Phase
Condition
Lymphoma
Lymphoma, B-cell
Treatment
zamtocabtagene autoleucel (MB-CART2019.1)
Fludarabine
MB-CART2019.1
Clinical Study ID
Ages > 18 All Genders
Study Summary
Eligibility Criteria
Inclusion
Inclusion Criteria:
Histologically confirmed B-cell non-Hodgkin's lymphoma:
DLBCL DLBCL or associated subtype, defined by WHO 2016 classification:
DLBCL not otherwise specified (NOS)
High-grade B cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements
High-grade B cell lymphoma (NOS)
Primary mediastinal (thymic) large B cell lymphoma
Transformed lymphoma (e.g., transformed follicular, or marginal zone lymphoma,follicular lymphoma (FL Grade 3)
CNS Cohort only: B-cell primary or secondary central nervous system lymphoma (PCNSLor SCNSL)
Mantle Cell Lymphoma (MCL) Cohort: Histologically confirmed MCL determined byoverexpression of cyclin D1 or presence of t(11;14) (q13; q32) translocation
Richter's Transformation (RT) Cohort: Histologically confirmed Richter'stransformation (RT) to a diffuse large B-cell lymphoma (DLBCL) subtype fromunderlying CLL (clonally related)
Relapsed or refractory disease is defined for DLBCL (and associated subtypes)population as failure of 2 or more lines of chemotherapy including rituximab orequivalent and anthracycline and either having failed autologous stem celltransplant (ASCT), or ineligible, not intended for or not consenting to ASCT
Chemotherapy-refractory disease is defined as persistent disease after last line oftherapy or relapsed or persistent disease after prior ASCT for lymphoma
Disease relapse in subjects without prior ASCT is defined as relapse of diseaseafter the last dose of most recent therapy regimen
CNS Cohort: Subjects with relapsed/refractory PCNSL that have failed (or unable totolerate) at least first-line therapy.
No contraindications for MRI evaluation
CNS Cohort: Subjects with SCNSL must have relapsed or refractory disease afterhaving received at least one prior line of systemic therapy
Prior lines of systemic therapy should include an anti-CD20 monoclonal antibody andanthracycline containing chemotherapy regimen and/or with or without an autologousstem cell transplant
No contraindications for MRI evaluation
MCL Cohort: Subjects with relapsed/refractory disease after at least one priorsystemic treatment, that must include:
Cytotoxic rituximab-based chemotherapy regimen (eg, rituximab bendamustine, R-CHOP,R-DHAP, R-ARA-C) AND
BTK inhibitor
RT Cohort: Subject must have relapsed/refractory disease after at least one priorsystemic treatment following Richter's Transformation
Age ≥18 years
Eastern Cooperative Oncology Group (ECOG) performance status that is either 0 or 1at screening. ECOG performance status of 2 at screen is allowed if the decrease inperformance status is due to lymphoma
Measurable disease according to Lugano 2014 criteria for assessing FDG-PET/CT insystemic lymphoma (Cheson et al, 2014). Measurable disease according to IPCGcriteria will be assessed by brain/spine MRI for CNS disease
Subject must have a tumor biopsy sample (at least 16 unstained slides of tissue ortissue block) from the most recent relapse available prior to MB-CART2019.1infusion. If medically not feasible to obtain a biopsy from the most recent relapseand for cases when the amount of tissue is limited, the sponsor should be consulted,to confirm adequacy of the sample for study required analyses
No clinical suspicion of central nervous system (CNS) lymphoma (not applicable toCNS cohort)
If the subject has history of CNS disease (not applicable to CNS cohort), thenhe/she must have no signs or symptoms of CNS disease, have no active disease onmagnetic resonance imaging (MRI), have no large cell lymphoma present in cerebralspinal fluid (CSF), regardless of the number of white blood cells (WBCs)
If has history of cerebral vascular accident (CVA), the CVA event must be greaterthan 12 months prior to leukapheresis. Any neurological deficits must be stable
A creatinine clearance (as estimated by direct urine collection or Cockcroft-GaultEquation) > 45mL/min
Cardiac ejection fraction (EF) ≥ 45% as determined by an echocardiogram (ECHO) orMultigated Radionuclide Angiography (MUGA)
Resting O2 saturation >90% on room air
Serum alanine aminotransferase (ALT) / aspartate aminotransferase (AST)<5 times theUpper Limit of Normal (ULN) for age
Total bilirubin <1.5 mg/dl, except in individuals with Gilbert's syndrome
Absolute neutrophil count (ANC) > 1000/μL
Absolute lymphocyte count > 100/μL
Platelet count > 50,000/µL
Estimated life expectancy of more than 3 months other than primary disease
Exclusion
Exclusion Criteria:
Primary CNS lymphoma (not applicable to CNS cohort)
Richter's transformed DLBCL arising from chronic lymphocytic leukemia (CLL) (notapplicable to RT cohort)
Unable to give informed consent
Known history of infection with human immunodeficiency virus (HIV) or activehepatitis B (HBsAg positive). If there is a history of treated hepatitis B orhepatitis C, the viral load must be quantitative polymerase chain reaction (PCR)negative; antiviral prophylaxis is required if HBsAg negative and anti-HBc positive
Known history of infection with hepatitis C virus (anti-HCV positive) unless viralload is undetectable per quantitative PCR and/or nucleic acid testing.
Pharmacologically uncontrolled seizures.
Known history or presence of autoimmune CNS disease, such as multiple sclerosis,optic neuritis, or other immunologic or inflammatory disease
Presence of CNS disorder that, in the judgment of the investigator, may impair theability to evaluate neurotoxicity. For CNS Cohort:
Midline shift on MRI
Abnormal high CSF opening pressure and or CSF protein >150 mg/dL Recent (within 3months) whole brain radiotherapy (WBRT)
Active systemic fungal, viral, or bacterial infection
Pregnant or breast-feeding woman
Previous or concurrent malignancy with the following exceptions:
Adequately treated basal cell or squamous cell carcinoma (adequate wound healingrequired prior to study entry)
In situ carcinoma of the cervix or breast, treated curatively and without evidenceof recurrence for at least 2 years prior to the study
Adequately treated breast or prostate carcinoma on hormonal therapies such as Lupronor tamoxifen and in clinical remission of ≥ 2 years
A primary malignancy which has been completely resected / treated with curativeintent and in complete remission of ≥ 2 years
Severely immunocompromised subjects e.g., due to current treatment of non-neurologicautoimmune disease (e.g., Crohn's disease, rheumatoid arthritis, systemic lupuserythematosus).
Medical condition requiring prolonged use of systemic corticosteroids equivalent toprednisone >10 mg/day. For CNS cohort: Up to 2 mg/day dexamethasone (or equivalence)may be allowed at any time, higher doses allowed up to 7 days prior to apheresis orafter apheresis until lymphodepletion.
History of myocardial infarction, cardiac angioplasty or stenting, unstable angina,or other clinically significant cardiac disease within 6 months of enrollment
Concurrent radiotherapy (normal tissue sparing palliative radiotherapy allowed up totime of lymphodepletion). For systemic therapy, at least 2 weeks or 5 half-lives,whichever is shorter, must have elapsed at the time of scheduled leukapheresis.
Baseline dementia that would interfere with therapy or monitoring, determined usingImmune Effector Cell-Associated Encephalopathy (ICE) Assessment at baseline
History of severe immediate hypersensitivity reaction to any of the agents used inthis study
Refusal to participate in additional lentiviral gene therapy LTFU protocol
Prior CAR-T therapy for any indication or systemic gene modifying therapy for B-celllymphoma
Prior allogeneic stem cell transplant for any indication
Prior BITE antibodies for cancer therapy
Prior T cell receptor-engineered T cell therapy
Study Design
Study Description
Connect with a study center
University of Alberta Cross Cancer Institute
Edmonton, Alberta AB T6G 1Z2
CanadaActive - Recruiting
Princess Margaret Cancer Centre
Toronto, Ontario ON M5G 2C4
CanadaActive - Recruiting
Banner MD Anderson Cancer Center
Gilbert, Arizona 85234
United StatesActive - Recruiting
Mayo Clinic
Phoenix, Arizona 85054
United StatesActive - Recruiting
UC San Diego Health
La Jolla, California 92037
United StatesActive - Recruiting
Stanford University
Stanford, California 94305
United StatesActive - Recruiting
Yale University
New Haven, Connecticut 06520
United StatesActive - Recruiting
Baptist Health Miami Cancer Institute
Miami, Florida 33176
United StatesActive - Recruiting
Winship Cancer Institute of Emory University
Atlanta, Georgia 30322
United StatesActive - Recruiting
Georgia Cancer Center at Augusta University
Augusta, Georgia 30912
United StatesActive - Recruiting
Robert H Lurie Cancer Center
Chicago, Illinois 60611
United StatesActive - Recruiting
University of Kansas Cancer Center
Westwood, Kansas 66205
United StatesActive - Recruiting
University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center
Baltimore, Maryland 21201
United StatesActive - Recruiting
Dana Farber Cancer Institute
Boston, Massachusetts 02215
United StatesActive - Recruiting
University of Michigan
Ann Arbor, Michigan 48109
United StatesActive - Recruiting
Mayo Clinic
Rochester, Minnesota 55905
United StatesActive - Recruiting
University of Nebraska Medical Center
Omaha, Nebraska 68198
United StatesTerminated
Memorial Sloan Kettering Cancer Center
New York, New York 10065
United StatesActive - Recruiting
Duke University Medical Center - Division of Hematologic Malignancies
Durham, North Carolina 27705
United StatesActive - Recruiting
The Ohio State University Wexner Medical Center James Cancer
Columbus, Ohio 43210
United StatesActive - Recruiting
Oregon Health and Science University Knight Cancer Institute
Portland, Oregon 97239
United StatesActive - Recruiting
Allegheny Health Network Cancer Institute
Pittsburg, Pennsylvania 15212
United StatesActive - Recruiting
Allegheny Health Network Cancer Institute
Pittsburgh, Pennsylvania 15212
United StatesActive - Recruiting
University of Pittsburgh - Hillman Cancer Center
Pittsburgh, Pennsylvania 15260
United StatesSite Not Available
UT Southwestern Medical Center
Dallas, Texas 75390
United StatesActive - Recruiting
Froedtert Hospital and the Medical College of Wisconsin
Milwaukee, Wisconsin 53226
United StatesActive - Recruiting
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