Study of LYL314 in Aggressive Large B-Cell Lymphoma

Last updated: April 10, 2025
Sponsor: Lyell Immunopharma, Inc.
Overall Status: Active - Recruiting

Phase

1/2

Condition

Anger

Hematologic Cancer

Lymphoma, B-cell

Treatment

IMPT-314

Cyclophosphamide

LYL314

Clinical Study ID

NCT05826535
LYL314-101
  • Ages > 18
  • All Genders

Study Summary

This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of LYL314, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Age 18 years or older at time of informed consent

  2. Willing and able to provide written informed consent

  3. Histologically confirmed aggressive NHL, including the following types defined bythe World Health Organization (WHO 2017):

  • DLBCL

  • DLBCL arising from follicular lymphoma (transformed FL, tFL)

  • Primary mediastinal (thymic) large B-cell lymphoma (PMBCL)

  • High-grade large B-cell lymphoma with or without MYC and BCL2 and/or BCL6rearrangement (HGBL)

  • Grade 3B follicular lymphoma/Large cell follicular lymphoma (FL3B)

  1. Received at least two prior lines of therapy for Cohorts 1, 2, and 4 and one priorline of therapy for Cohort 3. Prior therapy must have included:
  • Anti-CD20 monoclonal antibody, and

  • An anthracycline containing chemotherapy regimen

  • Participants with tFL must have received at least one of their prior lines oftherapy after transformation to DLBCL 4b. Cohort 5 (High-risk first-line) participants must have high-risk largeB-cell lymphoma

  1. Relapsed or refractory disease, defined by the following:
  • Disease progression after last regimen (including salvage therapy afterautologous stem cell transplantation [ASCT]). In participants who have onlyreceived front-line therapy, progression should be ≤ 12 months of first-linetherapy (applicable for Cohort 3)

  • In patients who received one line of therapy, refractory disease is defined asfailure to achieve at least a PR after at least 4 cycles of therapy (applicablefor Cohort 3)

  • In patients who received two or more lines of therapy (Cohorts 1, 2, and 4),refractory disease is defined as failure to achieve a CR to last line oftherapy (including CAR T and/or salvage therapy).

  1. At least 1 measurable lesion (per Lugano classification). Lesions that have beenpreviously irradiated will be considered measurable only if progression has beendocumented following completion of radiation therapy

  2. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 or ECOG 0 to 2 (Cohort 5)

  3. Absolute neutrophil count (ANC) ≥ 1000/uL

  4. Platelet count ≥ 50,000/uL

  5. Absolute lymphocyte count (ALC) ≥ 200/uL

Other protocol-defined criteria apply.

Exclusion

Exclusion Criteria:

  1. History of malignancy other than non-melanoma skin cancer or carcinoma in situ (e.g., cervix, bladder, breast) unless disease-free for at least 3 years.Participants who have received therapy for a prior malignancy within the prior 3years, e.g., in the adjuvant setting, are not excluded

  2. Active central nervous system (CNS) involvement by malignancy on magnetic resonanceimaging (MRI) or by lumbar puncture. Participants with prior evidence of brainmetastasis treated at least 8 weeks prior to enrollment will not be excluded forparticipation if CNS disease is deemed stable at the time of study enrollment

  3. History of cardiac lymphoma involvement or Epstein-Barr virus (EBV)+ lymphoma

  4. Ongoing or impending oncologic emergency (e.g., tumor mass effect, tumor lysissyndrome, known vascular invasion)

  5. Received the following therapies in the specified time frame prior toenrollment/leukapheresis

  6. Any systemic therapy within 2 weeks

  7. Any systemic inhibitory/stimulatory immune checkpoint molecule therapy within 3half-lives prior to enrollment (e.g., ipilimumab, nivolumab, pembrolizumab,atezolizumab, OX40 agonists, 4-1BB agonists)

  8. Fludarabine within 12 weeks

  9. Alemtuzumab, bendamustine or antithymocyte globuline (ATG) within 6 months

  10. Any T cell engager/bispecific antibody therapy such as CD20/CD3 or CD19/CD3bispecific antibodies within 4 weeks

  11. Any experimental therapy within 4 weeks or 5 half-lives (whichever is shorter)

  12. Received radiation therapy within 3 weeks prior to enrollment/leukapheresis

  13. Experiencing non-hematologic toxicities due to prior therapy. Exceptions include:stable and recovered to grade ≤ 1 or non-clinically significant toxicities such as (1) alopecia, (2) toxicities where Grade 2 is solely defined by participantreceiving hormone replacement therapy for endocrinopathies resulting from previouscheckpoint inhibitor therapy, (3) Grade 2 lymphopenia, and (4) hearing loss or Grade 2 neuropathy associated with prior treatment with taxanes or platinating agents

  14. History of allogeneic stem cell or solid organ transplantation

  15. Receipt of autologous stem cell transplantation within 6 weeks prior toenrollment/leukapheresis

  16. History of prior genetically modified cell therapy other than a product targetingCD19 with an FMC63-based CAR (e.g., axicabtagene ciloleucel (axi-cel),tisagenlecleucel (tisa-cel), or lisocabtagene maraleucel (liso-cel). For all otherCAR T cell therapy treatments, discussion with the Sponsor's Medical Monitor isrequired

  17. Primary immunodeficiency

  18. History of autoimmune disease (e.g., Crohn's disease, rheumatoid arthritis, systemiclupus) resulting in end organ injury or requiring systemicimmunosuppression/systemic disease modifying agents within the last 2 years.Participants who have other autoimmune condition(s) considered to be associated withunderlying malignancy may be enrolled in the study after discussion with andapproval of the Medical Monitor.

Other protocol-defined criteria apply.

Study Design

Total Participants: 270
Treatment Group(s): 4
Primary Treatment: IMPT-314
Phase: 1/2
Study Start date:
May 09, 2023
Estimated Completion Date:
January 01, 2028

Study Description

This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of LYL314, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma.

Five cohorts of participants will be enrolled:

Cohort 1: Participants who have not received a prior CAR T-cell product (CAR T naïve) and have received at least two or more prior lines of treatment (third-line or later).

Cohort 2: Participants who have received a prior CAR T-cell product (CAR T experienced) and have received at least two or more prior lines of treatment including one CAR T-cell therapy.

Cohort 3: Participants with refractory disease or relapse within one year of first-line therapy (second-line).

Cohort 4: Participants who have received prior T-cell engager (TCE) therapy and have received at least two or more prior lines of treatment including one TCE therapy.

Cohort 5: Participants receiving first-line treatment for high-risk large B-cell lymphoma who remain with disease on positron emission tomography scanning (PET-positive) after 2 to 3 cycles of standard-of-care chemoimmunotherapy (high-risk first-line).

Up to approximately 150 participants (across all cohorts) will be enrolled in the dose finding Phase 1 part of the study.

The Phase 2 pivotal study (PiNACLE) will expand enrollment of Cohort 1 to approximately 120 participants to further evaluate the safety and efficacy of LYL314.

LYL314 treatment consists of a single administration of CAR transduced autologous T-cells administered intravenously after a conditioning chemotherapy regimen consisting of fludarabine and cyclophosphamide, administered over 3 days.

Individual participants will remain in the active post-treatment follow-up (PTFU) period for approximately 2 years. Participants will continue in long-term follow-up (LTFU) for 15 years from LYL314 treatment.

Connect with a study center

  • University of California-Irvine Medical Center

    Irvine, California 92697
    United States

    Active - Recruiting

  • Cedars-Sinai Medical Center

    Los Angeles, California 90048
    United States

    Active - Recruiting

  • University of California, Los Angeles (UCLA) Medical Center

    Los Angeles, California 90095
    United States

    Active - Recruiting

  • University of California (UC) Davis Comprehensive Cancer Center

    Sacramento, California 95817
    United States

    Site Not Available

  • Scripps Clinic

    San Diego, California 92037
    United States

    Active - Recruiting

  • Augusta University Medical Center

    Augusta, Georgia 30912
    United States

    Active - Recruiting

  • St Luke's Cancer Institute

    Boise, Idaho 83712
    United States

    Site Not Available

  • Indiana Blood and Marrow Transplantation

    Indianapolis, Indiana 46237
    United States

    Active - Recruiting

  • University of Iowa

    Iowa City, Iowa 52242
    United States

    Active - Recruiting

  • University of Louisville Brown Cancer Center

    Louisville, Kentucky 40202
    United States

    Active - Recruiting

  • Corewell Health

    Grand Rapids, Michigan 49503
    United States

    Site Not Available

  • University of New Mexico Comprehensive Cancer Center

    Albuquerque, New Mexico 87131
    United States

    Active - Recruiting

  • Montefiore Medical Center

    Bronx, New York 10461
    United States

    Active - Recruiting

  • University of Cincinnati (UC) Physicians Company, LLC

    Cincinnati, Ohio 45267
    United States

    Active - Recruiting

  • Baylor College of Medicine

    Dallas, Texas 75246
    United States

    Site Not Available

  • Baylor University Medical Center

    Dallas, Texas 75246
    United States

    Active - Recruiting

  • Huntsman Cancer Institute

    Salt Lake City, Utah 84112
    United States

    Active - Recruiting

  • Intermountain Healthcare

    Salt Lake City, Utah 84143
    United States

    Active - Recruiting

  • University of Vermont Cancer Center

    Burlington, Vermont 05405
    United States

    Site Not Available

  • Virginia Commonwealth University-Massey Cancer Center

    Richmond, Virginia 23298
    United States

    Active - Recruiting

  • Medical College of Wisconsin

    Milwaukee, Wisconsin 53226
    United States

    Site Not Available

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