Clinical Study of Anti-CD56-CAR-T in the Treatment of Relapsed/Refractory NK/T Cell Lymphoma /NK Cell Leukemia

Last updated: July 10, 2023
Sponsor: The Affiliated Hospital of Xuzhou Medical University
Overall Status: Active - Recruiting

Phase

2

Condition

Lymphoma

Non-hodgkin's Lymphoma

Leukemia

Treatment

Anti-CD56 CAR T

Clinical Study ID

NCT05941156
XYFY2023-KL123-01
  • Ages 18-70
  • All Genders

Study Summary

To evaluate the safety and efficacy of anti-CD56-CAR T in the treatment of relapsed refractory NK/T cell lymphoma /NK cell leukemia

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Patients or their legal guardians voluntarily participate and sign the informedconsent;
  2. Male or female patients aged 18-70 years (including 18 and 70 years);
  3. The patient was diagnosed as NK/T cell lymphoma /NK cell leukemia by pathology or flowcytometry, and currently has no effective treatment options, such as relapse afterchemotherapy or hematopoietic stem cell transplantation; Alternatively, patientsvoluntarily choose to administer anti-CD56-CAR T cells as salvage therapy.
  4. The following two categories are included:(1)NK/T cell lymphoma;(2) NK cell leukemia.
  5. Subject:

(1)There was no remission or residual lesions after treatment, and HSCT (auto/allo-HSCT)was not suitable; (2)Relapse occurred after CR, and HSCT (auto/allo-HSCT) was not suitable; (3)Patients with high risk factors; (4)Relapse or no remission after hematopoietic stemcell transplantation or cellular immunotherapy. 6. Measurable or evaluable lesions; 7. The patient's main tissues and organs function well:

  1. Liver function: ALT/AST < 3 times the upper limit of normal (ULN) and total bilirubin ≤34.2μmol/L;
  2. Renal function: creatinine < 220 μmol/L;
  3. Lung function: indoor oxygen saturation ≥95%;
  4. Cardiac function: left ventricular ejection fraction (LVEF) ≥40%.
  5. The patients had not received any anti-cancer treatment such as chemotherapy,radiotherapy, immunotherapy (such as immunosuppressive drugs) within the first 4 weeks ofenrollment, and their previous treatment-related toxic reactions had recovered to ≤ grade 1at the time of enrollment (except low toxicity such as hair loss);
  6. The patient's peripheral shallow venous blood flow is smooth, which can meet the needsof intravenous infusion;
  7. Patients with ECOG score ≤2 and expected survival time ≥3 months.

Exclusion

Exclusion Criteria:

  1. Women who are pregnant (urine/blood pregnancy test positive) or breastfeeding;
  2. Men or women who have planned to become pregnant within the last 1 year;
  3. The patients were not guaranteed to take effective contraceptive measures (condoms orcontraceptives, etc.) within 1 year after enrollment;
  4. Patients had uncontrollable infectious diseases within 4 weeks prior to enrollment;
  5. Active hepatitis B/C virus;
  6. HIV-infected patients;
  7. Suffering from a serious autoimmune disease or immunodeficiency disease;
  8. The patient is allergic to antibodies, cytokines and other macromolecular biologicaldrugs;
  9. The patient had participated in other clinical trials within 6 weeks prior toenrollment;
  10. Systemic use of hormones within 4 weeks prior to enrollment (except for inhaledhormones);
  11. Suffers from mental illness;
  12. The patient has substance abuse/addiction;
  13. According to the researchers' judgment, the patient had other conditions that were notsuitable for inclusion.

Study Design

Total Participants: 20
Treatment Group(s): 1
Primary Treatment: Anti-CD56 CAR T
Phase: 2
Study Start date:
May 01, 2023
Estimated Completion Date:
May 31, 2026

Study Description

Extranodal NK/TCL is an aggressive disease with a poor prognosis and a 5-year survival rate of less than 50%. In the absence of effective treatment, median survival for advanced disease is only 6-12 months. A retrospective review of the International Peripheral T-Cell Lymphoma Project recently reported that the median overall survival of NK/TCL was 7.8 months, corresponding to the worst survival of all T-cell lymphoma entities. Therefore, despite good results in the combination of chemoracal-chemotherapy strategies, autologous bone marrow transplantation, and L-asparagase in the treatment of recurrent cases, NK/TCL remains difficult to cure, and the need for alternative therapeutic strategies has prompted researchers to explore new molecular targets.

Nerve cell adhesion molecule 1 (NCAM-1) -CD56 is a member of the immunoglobulin superfamily and is a biomarker of nerve cell adhesion molecule and NK cell. CD56 is highly expressed in NK/T cell lymphomas, skeletal muscle tumors, and malignancies with neurological or neuroendocrine differentiation. CD56-CAR T cells can kill CD56+ neuroblastoma, glioma, and SCLC tumor cells in vitro coculture, and CD56R-CAR+T cells can inhibit tumor growth in vivo when tested against CD56+ human neuroblastoma xenogeneic and SCLC models. CD56-CAR T cells have also been reported as a safe and effective treatment for refractory/relapsing rhabdomyosarcoma. This indicates that CD56 CAR has a wide clinical application prospect and strong potential therapeutic value as a new CAR T target.

CD56 CAR T cells constructed by our laboratory can produce more precise killing effect on tumor cells by converting the immune checkpoint PD-1 signal. The results showed that CD56 CAR T cells could be prepared effectively and kill NK/ T-cell lymphoma cell line SNK-6 in vitro. Compared with traditional second-generation CAR T cells, CD56-CAR T cells prepared in our laboratory showed better killing effect on SNK-6 cells in vitro. At present, no clinical studies on CD56 CAR T therapy for NK/T cell lymphoma have been reported. Therefore, in this study, CD56 CAR T was used to treat relapsed and refractory NK/T cell lymphoma /NK cell leukemia to observe its safety and efficacy.

Connect with a study center

  • The Affiliated Hospital of Xuzhou Medical University

    Xuzhou, Jiangsu 221002
    China

    Active - Recruiting

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