Description:
The main purpose of this study is to explore the therapeutic effect of CD20-targeted chimeric
antigen receptor T(CAR-T) cells in the treatment of B cell malignancies.
Title
- Brief Title: A Clinical Research of CD20-Targeted CAR-T in B Cell Malignancies
- Official Title: A Clinical Research of CD20-Targeted CAR-T in B Cell Malignancies
Clinical Trial IDs
- ORG STUDY ID:
TMMU-BTC-003
- NCT ID:
NCT02710149
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Anti-CD20-CAR-transduced T cells | CD20-targeted CAR-T cells | B Cell Malignancies |
Purpose
The main purpose of this study is to explore the therapeutic effect of CD20-targeted chimeric
antigen receptor T(CAR-T) cells in the treatment of B cell malignancies.
Detailed Description
The anti-CD20 antibody has been broadly used in the treatment of B cell malignancies and
exhibited good clinical outcomes. The CD19-targeted CAR-T has shown exellent therapeutic
efficiency in B cell malignancies,especially in acute lymphocytic leukemia. However, patients
treated with CD19-targeted CAR-T may face relapse of CD19 mutation. Other targets aimed CAR-T
is in need. Therefore we constructed CD20-targeted CAR-T cells and hope to start a
clinicaltrial to explore the therapeutic effect of CD20-targeted CAR-T cells in the treatment
of B cell malignancies.
Trial Arms
Name | Type | Description | Interventions |
---|
B Cell Malignancies | Experimental | The trial will be conducted in a manner of simon two-stage design with Anti-CD20-CAR-transduced T cells, beginning in the first stage with the aim of over 30% reaction rate among 15 patients with B cell malignancies. Only when the expected reaction rate is achieved the 30 patients left can be recruited. | - Anti-CD20-CAR-transduced T cells
|
Eligibility Criteria
Inclusion Criteria:
1. CD20-expressing B cell malignancy must be assured and must be relapsed or refractory
disease after at least one standard chemotherapy and one salvage regimen. According to
current traditional therapies, there must be no available alternative curative
therapies and subjects must be either ineligible for allogeneic stem cell transplant
(SCT), have refused SCT, or have disease activity that prohibits SCT at this time.
2. Patients enrolled must have an evaluated score above 60 with KPS.
3. CD20 expression of the malignant cells must be detected by immunohistochemistry or by
flow cytometry. In general immunohistochemistry will be used for lymph node biopsies,
flow cytometry will be used for peripheral blood and bone marrow samples.
4. Gender is not limited, age from 14 years to 75 years.
5. Patients must have measurable or evaluable disease at the time of enrollment, which
may include any evidence of disease including minimal residual disease detected by
flow cytometry, cytogenetics, or polymerase chain reaction (PCR) analysis.
6. Patients are expected to survive for more than 3 months by their physicians at the
time of enrollment.
7. Adequate absolute CD3 count estimated need to be assured for obtaining target cell
dose based on dosage cohorts.
8. Subjects with the following CNS status are eligible only in the absence of neurologic
symptoms suggestive of CNS leukemia, such as cranial nerve palsy:
CNS 1, defined as absence of blasts in cerebral spinal fluid (CSF) on cytospin
preparation, regardless of the number of WBCs; CNS 2, defined as presence of < 5/uL
WBCs in CSF and cytospin positive for blasts, or > 5/uL WBCs but negative by
Steinherz/Bleyer algorithm CNS3 with marrow disease who has failed salvage systemic
and intensive IT chemotherapy (and therefore not eligible for radiation)
9. Patients with isolated CNS relapse will be eligible if they have previously been
treated with cranial radiation (at least 1800 cGy).
10. Ability to give informed consent.
11. Females of child-bearing potential must have a negative pregnancy test because of the
potentially dangerous effects on the fetus.
12. 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.
13. Renal function: Creatinine level of peripheral blood is required no greater than
133umol/L.
14. Patients with history of allogeneic stem cell transplantation are eligible if there is
no evidence of active GVHD and no longer taking immunosuppressive agents for at least
30 days prior to enrollment.
15. Patients volunteer to participate in the research.
Exclusion Criteria:
Subjects meeting any of the following criteria are not eligible for participation in the
study:
1. Patients are evaluated below 60 scores with KPS.
2. Evident signs suggesting that patients are potentially allergic to cytokines.
3. Frequent infection history and recent infection is uncontrolled.
4. Patients with concomitant genetic syndrome: patients with Down syndrome, Fanconi
anemia, Kostmann syndrome, Shwachman syndrome or any other known bone marrow failure
syndrome
5. Active acute or chronic graft-versus-host disease (GVHD) or requirement of
immunosuppressant medications for GVHD within 4 weeks of enrollment.
6. Concurrent use of systemic steroids or chronic use of immunosuppressant medications.
Recent or current use of inhaled steroids is not exclusionary. For additional details
regarding use of steroid and immunosuppressant medications.
7. Pregnancy and nursing females.
8. HIV infection.
9. Active hepatitis B or active hepatitis C.
10. Participation in a prior investigational study within 4 weeks prior to enrollment or
longer if required by local regulation. Participation in non-therapeutic research
studies is allowed.
11. Class III/IV cardiovascular disability according to the New York Heart Association
Classification.
12. Patients with a known history or prior diagnosis of other serious immunologic,
malignant or inflammatory disease.
13. Other situations we think not eligible for participation in the research.
Maximum Eligible Age: | 75 Years |
Minimum Eligible Age: | 14 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Adverse Events That Are Related to Treatment |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Determine the toxicity profile of the CD20 targeted CAR T cells with Common Toxicity Criteria for Adverse Effects (CTCAE) version 4.0. |
Secondary Outcome Measures
Measure: | In vivo existence of Anti-CD20 CAR-T cells |
Time Frame: | 2 years |
Safety Issue: | |
Description: | |
Measure: | Reaction Rate of Treatment |
Time Frame: | 2 years |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Southwest Hospital, China |
Trial Keywords
Last Updated
June 25, 2019