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ACTIVE NOT RECRUITING

NCT04499573

PHASE1/PHASE2

Bispecific CD19/CD22 CAR-T for Treatment of Children and Young Adults With r/r B-ALL

Sponsor: Federal Research Institute of Pediatric Hematology, Oncology and Immunology

View on ClinicalTrials.gov

Summary

The purpose of this study is to evaluate the safety and efficiency of autologous CD19/CD22 CAR-T lymphocytes in a cohort of pediatric and young adult patients with relapsed /refractory B-lineage acute lymphoblastic leukemia

Official title: Safety and Efficiency of Anti-CD19/CD22 Tandem Fully Human Chimeric Antigen Receptor (CAR)-Transduced T-cell Therapy for Pediatric and Young Adult Patients With Relapsed/Refractory B-cell Acute Lymphoblastic Leukemia: a Single Centre, Non-randomised, Open Label Phase I-II Clinical Trial of Automatically Produced Cell Therapy Product MB-CAR-T19-22 Using CliniMACS Prodigy

Key Details

Gender

All

Age Range

3 Months - 25 Years

Study Type

INTERVENTIONAL

Enrollment

Start Date

2020-07-27

Completion Date

2027-03-13

Last Updated

2023-02-22

Healthy Volunteers

Conditions

B-ALL

Interventions

DRUG

CD19/CD22 CAR-T

The treatment plan will be based on stratification by the initial leukemia burden. Patients with "low disease burden" will receive a lymphodepletion chemotherapy of fludarabine (total dose 120mg/m2) and cyclophosphamide (total dose 750mg/m2) over 5 days. Patients will "high disease burden" will receive a lymphodepletion chemotherapy of fludarabine (total dose 120 mg/m2), cyclophosphamide (total dose 750 mg/m2), cytarabine (total dose 900 mg/m2), etoposide (total dose 450 mg/m2), dexamethasone (total dose 30 mg/m2) over 5 days. Based on interim analysis the following dosing approach will be implemented starting April 2021: Cohort 1: CD19+ disease, low and high burden: 1st dose - 150k/kg, 2nd dose - 850k/kg Cohort 2: CD19- disease, low and high burden: 1st dose - 500k/kg, 2nd dose - 500k/kg Cohort 3: HSCT+CAR-T: 100k/kg

Inclusion Criteria: * Ability to give informed consent (for patients \> 14 years old). For subjects \< 18 years old their legal guardian must give informed consent * CD19 or CD22 expression must be detected on greater than 50% of leukemic cells by flow cytometry * Presence of a measurable mass of tumor cells in the bone marrow or extramedullary sites at the time of patient's inclusion in the study * Patients with relapsed or refractory CD19 and CD22-expressing B-cell ALL: * Induction failure * MRD ≥ 0,1% after 2nd chemotherapy course for high-risk group patients. * First bone marrow or combined relapse of acute lymphoblastic leukemia, no CR or MRD ≥ 0,1% after 1-course 2nd line therapy * Second and further relapse of ALL * Relapse or MRD ≥ 0,1% of ALL after hematopoietic stem cell transplant (\> 60 days post alloHSCT)o There must be no available alternative approved curative therapies * Patient Clinical Performance Status: Karnofsky \>50% or Lansky \>50% * Patient Life Expectancy \> 4 weeks * Patients recovered from acute toxic effects of prior chemotherapy, immune- or radiotherapy * Patient absolute blood naïve (CD45RA+) T-lymphocyte count ≥ 50/mm3 * Patient cardiac function left ventricular ejection fraction greater than or equal to 40% by MUGA or cardiac MRI, or fractional shortening greater than or equal to 28% by ECHO or left ventricular ejection fraction greater than or equal to 50% by ECHO. * Patients who agree to long-term follow up for up to 5 years (if received CD19/CD22 CAR-T cell infusion) * March 2021 amendment: Healthy HLA-matched related or haploidentical donor (only for HSCT cohort) Exclusion Criteria: * \<50% expression of both CD19 and CD22 on the leukemic population * Active (detectable viremia) hepatitis B, C or HIV infection * Oxygen saturation ≤ 90% * Bilirubin \>3x upper norma limit * Creatinine \>3x upper norma limit * Active acute GVHD overall grade ≥2 (Seattle criteria) * Moderate/severe chronic GVHD (NIH consensus) requiring systemic steroids * Clinical signs of grade \> 3 CNS disorders (seizure disorder, paresis, aphasia, cerebrovascular, ischemia/hemorrhage, severe brain injuries, dementia, cerebellar disease, organic brain syndrome, psychosis, coordination or movement disorder) * Pregnant or lactating women. * Active (unresolved) severe infection

Locations (1)

Federal Research Institute of Pediatric Hematology, Oncology and Immunology

Moscow, Russia