Clinical Trials /

Study of Efficacy and Safety of CTL019 in Adult ALL Patients

NCT02167360

Description:

This is a single arm, open-label, multi-center, phase II study to determine the efficacy and safety of CTL019 in adult patients with r/r B-cell ALL. The study will have the following sequential phases: Screening, Pre-Treatment, Treatment and Primary Follow-up, Secondary Follow-up (Relapse Follow-up) and Survival Follow-up. The total duration of the primary follow-up is 1 year from cell infusion. Safety will be assessed until the end of the treatment and primary follow-up phase.

Related Conditions:
  • B-Cell Acute Lymphoblastic Leukemia
Recruiting Status:

Withdrawn

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Study of Efficacy and Safety of CTL019 in Adult ALL Patients
  • Official Title: A Phase II, Single Arm, Multicenter Trial to Determine the Efficacy and Safety of CTL019 in Adult Patients With Relapsed and Refractory B-cell Acute Lymphoblastic Leukemia

Clinical Trial IDs

  • ORG STUDY ID: UPCC 07414
  • NCT ID: NCT02167360

Conditions

  • B-cell Acute Lymphoblastic Leukemia
  • Relapsed B-cell Acute Lymphoblastic Leukemia
  • Refractory B-cell Acute Lymphoblastic Leukemia

Interventions

DrugSynonymsArms
CTL019Single Arm

Purpose

This is a single arm, open-label, multi-center, phase II study to determine the efficacy and safety of CTL019 in adult patients with r/r B-cell ALL. The study will have the following sequential phases: Screening, Pre-Treatment, Treatment and Primary Follow-up, Secondary Follow-up (Relapse Follow-up) and Survival Follow-up. The total duration of the primary follow-up is 1 year from cell infusion. Safety will be assessed until the end of the treatment and primary follow-up phase.

Trial Arms

NameTypeDescriptionInterventions
Single ArmExperimental
  • CTL019

Eligibility Criteria

        Inclusion Criteria:

          -  Relapsed or refractory adult B-cell ALL a. First or greater Bone Marrow (BM) relapse
             OR b. Any BM relapse after allogeneic stem cell transplantation (SCT) and must be > 6
             months from SCT at the time of CTL019 infusion OR c. Refractory as defined by not
             achieving a CR (morphology <5% blasts) after 2 cycles of a standard chemotherapy
             regimen OR d. Patients with Philadelphia chromosome positive (Ph+) ALL are eligible if
             they are intolerant to or have failed tyrosine kinase inhibitor therapy (TKI), or if
             TKI therapy is contraindicated.

          -  For relapsed patients, documentation of CD19 tumor expression in bone marrow or
             peripheral blood by flow cytometry within 3 months of screening

          -  Adequate organ function defined as:

             a. Renal function defined as: i. A serum creatinine of <1.5 x ULN OR ii. Calculated
             creatinine clearance or radioisotope Glomerular Filtration Rate (GFR) > 60 mL/min/1.73
             m2 b. Alanine Aminotransferase (ALT) < 5 times the upper limit of normal (ULN) c.
             Bilirubin < 2.0 mg/dL d. Must have a minimum level of pulmonary reserve defined as
             ≤Grade 1 dyspnea and pulse oxygenation > 91% on room air e. Left Ventricular Ejection
             Fraction (LVEF) ≥ 45% confirmed by echocardiogram or Multiple Uptake Gated Acquisition
             (MUGA)

          -  Bone marrow with ≥ 5% lymphoblasts by morphologic assessment at screening

          -  Age > 18 years

          -  A ECOG Performance Status that is either 0 or 1 at screening

          -  Signed written informed consent must be obtained prior to any study procedures

          -  Once all other eligibility criteria are confirmed, must have an apheresis product of
             non-mobilized cells received and accepted by the manufacturing site. Note: Apheresis
             product will not be assessed for acceptance by the manufacturing site until documented
             confirmation of all other eligibility criteria.

          -  Women of child-bearing potential (defined as all women physiologically capable of
             becoming pregnant) must agree to use highly effective methods of contraception during
             the entire study period (1 year after the CTL019 infusion). Highly effective
             contraception methods include:

               1. Total abstinence (when this is in line with the preferred and usual lifestyle of
                  the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal,
                  post-ovulation methods) and withdrawal are NOT acceptable methods of
                  contraception)

               2. Female sterilization (have had surgical bilateral oophorectomy with or without
                  hysterectomy) or tubal ligation at least six weeks before taking study treatment.
                  In case of oophorectomy alone, only when the reproductive status of the woman has
                  been confirmed by follow up hormone level assessment

               3. Male sterilization (at least 6 months prior to screening). For female patients on
                  the study the vasectomized male partner should be the sole partner for that
                  patient

               4. BOTH of the following forms of contraception must be utilized:

                    -  Use of oral, injected or implanted hormonal methods of contraception or
                       other forms of hormonal contraception that have comparable efficacy (failure
                       rate <1%), for example hormone vaginal ring or transdermal hormone
                       contraception

                    -  Barrier methods of contraception: Condom or Occlusive cap (diaphragm or
                       cervical/vault caps) with spermicidal foam/gel/film/cream/vaginal
                       suppository

               5. Use of intrauterine devices (IUD) are excluded due to increased risks of
                  infection and bleeding in this population

               6. In case of use of oral contraception, women must be stable on the same pill for a
                  minimum of 3 months before taking study treatment

        Women who are not of reproductive potential (defined as post-menopausal for at least 24
        consecutive months (i.e. have had no menses) or have undergone hysterectomy, salpingotomy,
        and/or bilateral oophorectomy) are eligible without requiring the use of contraception.
        Acceptable documentation includes written or oral documentation communicated by clinician
        or clinician's staff of one of the following:

          1. Physician report/letter

          2. Operative report or other source documentation in the patient record

          3. Discharge summary

          4. Follicle stimulating hormone measurement elevated into the menopausal range.

        Exclusion Criteria:

          -  Isolated extra-medullary disease relapse

          -  Patients with concomitant genetic syndrome such as Fanconi anemia, Kostmann syndrome,
             Shwachman syndrome or any other known bone marrow failure syndrome.

          -  Patients with Burkitt's lymphoma/leukemia (i.e. patients with mature B-cell ALL,
             leukemia with B-cell [surface Immunoglobulin (sIg) positive and kappa or lambda
             restricted positivity] ALL, with French, American, British [FAB] L3 morphology and /or
             a MYC translocation)

          -  Prior malignancy, unless treated with curative intent and with no evidence of active
             disease present for > 5 years before screening

          -  Treatment with any prior gene therapy product

          -  Has had treatment with any prior anti-CD19/anti-CD3 therapy, or any other anti-CD19
             therapy

          -  Active or latent hepatitis B or active hepatitis C, or any uncontrolled infection at
             screening 8. Human Immunodeficiency Virus (HIV) infection at screening 9. Presence of
             grade 2 to 4 acute or extensive chronic graft-versus-host disease (GVHD) 10. The
             following medications are excluded:

             a. Steroids: Therapeutic doses of steroids must be stopped > 72 hours prior to CTL019
             infusion. However, the following physiological replacement doses of steroids are
             allowed: < 6-12 mg/m2/day hydrocortisone or equivalent. Topical steroids are
             permitted.

             b. Allogeneic cellular therapy: Any donor lymphocyte infusions (DLI) must be completed
             > 6 weeks prior to CTL019 infusion c. GVHD therapies: Any drug used for GVHD must be
             stopped > 4 weeks prior to CTL019 infusion (e.g. calcineurin inhibitors, methotrexate
             or other chemotherapy drugs, mycophenolyate, University of Pennsylvania Page 20 of 138
             Oncology Protocol Protocol No. UPCC#07414/CCTL019B2207J V00.1 04-02-2014 steroids [see
             above], rapamycin, thalidomide, or immunosuppressive antibodies such as rituximab,
             anti-tumor necrosis factor [anti-TNF] , anti-interleukin 6 [anti-IL6] or
             anti-interleukin 6 receptor [anti-IL6R]) d. Chemotherapy: i. The following drugs must
             be stopped >1 week prior to CTL019 infusion: hydroxyurea, vincristine,
             6-mercaptopurine, 6-thioguanine, methotrexate <25 mg/m2, cytosine arabinoside <10
             mg/m2/day, asparaginase ii. The following drugs must be stopped >4 weeks prior to
             CTL019 infusion: salvage chemotherapy (e.g. clofarabine, cytosine arabinoside
             >100mg/m2, anthracyclines, cyclophosphamide), excluding the required lymphodepleting
             chemotherapy drugs e. CNS disease prophylaxis i. CNS prophylaxis treatment must be
             stopped > 1 week prior to CTL019 infusion (e.g. intrathecal methotrexate).

             11. Active Central Nervous System (CNS) involvement by malignancy, defined as CNS-3
             per National Comprehensive Cancer Network (NCCN) guidelines. Note: Patients with
             history of CNS disease that has been effectively treated will be eligible.

             12. Patient has received an investigational medicinal product within the last 30 days
             prior to screening 13. Pregnant or nursing (lactating) women. NOTE: female study
             participants of reproductive potential must have a negative serum or urine pregnancy
             test performed within 48 hours before infusion
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of Adverse Events
Time Frame:12 months
Safety Issue:
Description:

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Withdrawn
Lead Sponsor:Abramson Cancer Center of the University of Pennsylvania

Trial Keywords

  • adult patients
  • B-cell ALL
  • chemo-refractory
  • relapsed after allogeneic SCT
  • ineligible for allogeneic SCT

Last Updated

February 14, 2017