Description:
This is a global, open-label, multi-arm, parallel multi-cohort, multi-center, Phase 1/2 study
to determine the safety, tolerability, PK, efficacy and patient-reported quality of life of
JCAR017 in combination with various agents. This protocol is intended to evaluate various
drug combinations with JCAR017, as separate arms, over the life of the protocol, using the
same objectives. Each combination will be evaluated separately (ie, the intention is not to
compare between combinations) for the purposes of the objectives, trial design, and
statistical analysis. The following combinations will be tested:
Arm A: JCAR017 in combination with durvalumab Arm B: JCAR017 in combination with CC-122
(avadomide) Arm C: JCAR017 in combination with CC-220 (iberdomide) Arm D: JCAR017 in
combination with ibrutinib Arm E: JCAR017 in combination with relatlimab and/or nivolumab Arm
F: JCAR017 in combination with CC-99282 Additional arms will be added by way of amendment
once combination agents have been selected.
The study will consist of 2 parts: dose finding (Phase 1) and dose expansion (Phase 2). Dose
expansion may occur in one or more arms.
Title
- Brief Title: A Safety and Efficacy Trial of JCAR017 Combinations in Subjects With Relapsed/Refractory B-cell Malignancies (PLATFORM)
- Official Title: An Exploratory Phase 1/2 Trial To Evaluate The Safety And Efficacy Of JCAR017 Combinations In Subjects With Relapsed/Refractory B-Cell Malignancies (PLATFORM)
Clinical Trial IDs
- ORG STUDY ID:
JCAR017-BCM-002
- SECONDARY ID:
U1111-1201-2046
- NCT ID:
NCT03310619
Conditions
- Lymphoma, Non-Hodgkin
- Lymphoma, Large B-Cell, Diffuse
- Lymphoma, Follicular
Interventions
Drug | Synonyms | Arms |
---|
JCAR017 | | Arm A: JCAR017 in combination with Durvalumab |
Durvalumab | MEDI4736 | Arm A: JCAR017 in combination with Durvalumab |
CC-122 | | Arm B: JCAR017 in combination with CC-122 |
Ibrutinib | | Arm D: JCAR017 in combination with Ibrutinib |
CC-220 | | Arm C: JCAR017 in combination with CC-220 |
Relatlimab | | Arm E: JCAR017 in combination with relatlimab and/or nivolumab |
Nivolumab | | Arm E: JCAR017 in combination with relatlimab and/or nivolumab |
CC-99282 | | Arm F: JCAR017 in combination with CC-99282 |
Purpose
This is a global, open-label, multi-arm, parallel multi-cohort, multi-center, Phase 1/2 study
to determine the safety, tolerability, PK, efficacy and patient-reported quality of life of
JCAR017 in combination with various agents. This protocol is intended to evaluate various
drug combinations with JCAR017, as separate arms, over the life of the protocol, using the
same objectives. Each combination will be evaluated separately (ie, the intention is not to
compare between combinations) for the purposes of the objectives, trial design, and
statistical analysis. The following combinations will be tested:
Arm A: JCAR017 in combination with durvalumab Arm B: JCAR017 in combination with CC-122
(avadomide) Arm C: JCAR017 in combination with CC-220 (iberdomide) Arm D: JCAR017 in
combination with ibrutinib Arm E: JCAR017 in combination with relatlimab and/or nivolumab Arm
F: JCAR017 in combination with CC-99282 Additional arms will be added by way of amendment
once combination agents have been selected.
The study will consist of 2 parts: dose finding (Phase 1) and dose expansion (Phase 2). Dose
expansion may occur in one or more arms.
Detailed Description
During Phase 1, different arms may be opened to test JCAR017 in combination with combination
agent(s) in adult subjects with R/R aggressive B-cell NHL. Within each arm, different doses
and schedules of JCAR017 and the combination agent(s) may be tested in several cohorts and
subcohorts per arm. During Phase 2 of the study, the expansion of any dose level and schedule
for any arm that has been shown to be safe may occur.
Arm A will test JCAR017 in combination with Durvalumab Arm B will test JCAR017 in combination
with CC-122 Arm C will test JCAR017 in combination with CC-220 (iberdomide ) Arm D will test
JCAR017 in combination with ibrutinib. Arm E will test JCAR017 in combination with relatlimab
and/or nivolumab Arm F will test JCAR017 in combination with CC-99282 All subjects from Phase
1 and Phase 2 will be followed for 24 months following JCAR017 infusion. Post-study follow-up
for survival, relapse, long-term toxicity (including new malignancies), and viral vector
safety will continue under a separate long-term follow-up (LTFU) protocol for up to 15 years
after the JCAR017 dose as per health authority regulatory guidelines.
Trial Arms
Name | Type | Description | Interventions |
---|
Arm A: JCAR017 in combination with Durvalumab | Experimental | JCAR017 will be administered at a single flat dose of 50 x 10^6 CAR+T cells or 100 x 10^6 CAR+T cells. The combination agent will be administered at different doses and/ or schedules | |
Arm B: JCAR017 in combination with CC-122 | Experimental | This arm will test JCAR017 in combination with the CC-122. In adult subjects with R/R aggressive B-cell NHL. JCAR017 will be administered at a dose of 100 x 10^6 CAR+T cells. The combination agent will be administered at different doses | |
Arm C: JCAR017 in combination with CC-220 | Experimental | This arm will test JCAR017 in combination with CC-220. In adult subjects with R/R aggressive B-cell NHL. JCAR017 will be administered at a dose of 100 x 10^6 CAR+T cells. The combination agent will be administered at different doses | |
Arm D: JCAR017 in combination with Ibrutinib | Experimental | This arm will test JCAR017 in combination with ibrutinib. In adult subjects with R/R aggressive B-cell NHL. JCAR017 will be administered at a dose of 100 x 10^6 CAR+T cells. The combination agent will be administered at a fixed dose of 420 mg daily | |
Arm E: JCAR017 in combination with relatlimab and/or nivolumab | Experimental | This arm will test JCAR017 in combination with relatlimab and/or nivolumab in adult subjects with R/R aggressive B-cell NHL. JCAR017 will be administered at a dose of 100 x 10^6 CAR+T cells. The combination agent will be administered at different doses and/or schedules | - JCAR017
- Relatlimab
- Nivolumab
|
Arm F: JCAR017 in combination with CC-99282 | Experimental | This arm will test JCAR017 in combination with CC-99282 in adult subjects with R/R aggressive B-cell NHL. JCAR017 will be administered at a dose of 100 x 10^6 CAR+T cells. The combination agent will be administered at different doses and/or schedules. | |
Eligibility Criteria
Inclusion Criteria:
1. Subject is ≥ 18 years of age at the time of signing the informed consent form ().
2. Subject must understand and voluntarily sign an ICF prior to any study-related
assessments/procedures being conducted.
3. Subject is willing and able to adhere to the study visit schedule and other protocol
requirements.
4. Subject must have histologically confirmed at last relapse aggressive B-cell NHL
according to "The 2016 revision of the WHO classification of lymphoid neoplasms"
defined as:
1. Diffuse large B-cell lymphoma (DLBCL) Not otherwise specified (NOS) including
transformed indolent Non-Hodgkin lymphoma (NHL)
2. Follicular lymphoma Grade 3B
3. T cell/histiocyte-rich large B-cell lymphoma
4. Epstein-Barr virus (EBV) positive DLBCL, NOS
5. Primary mediastinal (thymic) large B-cell lymphoma
6. High grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements with
DLBCL histology (double/triple-hit lymphoma)
5. Subjects disease must have relapsed or be refractory to at least 2 prior lines of
therapy. Previous therapy must have included a CD20-targeted agent and an
anthracycline.
6. Subject must have
1. Positron emission tomography (PET)-positive (Deauville score 4 or 5) and computed
tomography (CT) measurable disease as per Lugano Classification
2. Sum of product of perpendicular diameters (SPD) of up to 6 index lesions ≥ 25 cm2
by CT scan (not applicable to Arm A or B or subjects with Richter's
transformation)
7. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 at screening
8. Adequate organ function
9. Subjects must agree to not donate blood, organs, sperm or semen, and egg cells for
usage in other individuals
10. Participants must agree to use effective contraception
Exclusion Criteria:
1. Subject has any significant medical condition, laboratory abnormality, or psychiatric
illness that would prevent the subject from participating in the study based on
investigator´s judgment.
2. Subject has any condition including the presence of laboratory abnormalities, which
places the subject at unacceptable risk if he/she were to participate in the study
based on investigator´s judgment.
3. Subject has any condition that confounds the ability to interpret data from the study
based on investigator´s judgment.
4. Subjects with prior history of malignancies, other than aggressive R/R NHL, unless the
subject has been free of the disease for ≥ 2 years with the exception of the following
non-invasive malignancies:
1. Basal cell carcinoma of the skin
2. Squamous cell carcinoma of the skin
3. Carcinoma in situ of the cervix
4. Carcinoma in situ of the breast
5. Incidental histologic finding of prostate cancer (T1a or T1b using the TNM
[tumor, nodes, metastasis] clinical staging system) or prostate cancer that is
curative.
6. Other completely resected stage 1 solid tumor with low risk for recurrence
5. Prior treatment with any prior gene therap y product
6. Prior treatment with any adoptive T cell therapy; prior hematopoietic stem cell
transplant (HSCT) is allowed
7. Allogeneic HSCT within 90 days of leukapheresis
8. Prior treatment with the combination agent from the assigned arm:
1. Anti PD-1 or PD-L1 (Arm A and E)
2. CC-122 (Arm B)
3. CC-220 (Arm C)
4. Prior treatment with ibrutinib is not exclusionary for subjects on any study arm
5. Anti LAG-3 targeted agent (Arm E)
6. CC-99282 (Arm F)
9. Presence of acute or chronic graft-versus-host disease (GVHD)
10. History of or active hepatitis B or hepatitis C or human immunodeficiency virus (HIV)
infection
11. Uncontrolled bacterial, viral or fungal infection at the time of leukapheresis,
lymphodepleting chemotherapy or JCAR017 infusion
12. Any history of myocarditis (Arm E); history of any one of the following cardiovascular
conditions within the past 6 months: Class III or IV heart failure as defined by the
New York Heart Association (NYHA), cardiac angioplasty or stenting, myocardial
infarction, unstable angina, or other clinically significant cardiac disease (all
arms)
13. History or presence of clinically relevant central nervous system (CNS) pathology such
as epilepsy, seizure, paresis, aphasia, stroke, severe brain injuries, dementia,
Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis
14. Subjects with active CNS or cerebrospinal fluid (CSF) involvement by malignancy
15. Pregnant or nursing (lactating) women.
16. Subjects with active auto immune disorders/processes or active neurological or
inflammatory disorders
17. For subjects to receive oral combination therapy (Arms B, C, D or F): History of a
gastrointestinal (GI) condition or procedure that in the opinion of the investigator
may affect oral drug absorption.
18. Progressive tumor invasion of venous or arterial vessels.
19. Deep venous thrombosis (DVT)/pulmonary embolism (PE) not managed on a stable regimen
of anticoagulation.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Dose-limiting toxicity (DLT) rates |
Time Frame: | From first dose of the combination agent until 1 month (28 days) after JCAR017 infusion or from JCAR017 infusion until 1 month (28 days) after the first dose of combination agent |
Safety Issue: | |
Description: | Percentage of participants experiencing DLTs |
Secondary Outcome Measures
Measure: | Adverse Events (AEs) |
Time Frame: | Up to approximately 24 months |
Safety Issue: | |
Description: | Number of participants with adverse events, type of adverse events, severity of adverse events, and number of participants with laboratory abnormalities, type of laboratory abnormalities and severity of laboratory abnormalities. |
Measure: | Progression-free survival (PFS) |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion |
Safety Issue: | |
Description: | Time from start of JCAR017, or start of combination agent, whichever occurs first, to progressive disease (PD) or death from any cause |
Measure: | Overall survival (OS) |
Time Frame: | Up to approximately 3.5 years |
Safety Issue: | |
Description: | Time from start of JCAR017, or start of combination agent, whichever occurs first, to death due to any cause |
Measure: | Overall response rate (ORR) |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion |
Safety Issue: | |
Description: | Percentage of subjects achieving an objective response of partial response (PR) or better according to the Lugano Classification |
Measure: | Duration of response (DOR) |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion |
Safety Issue: | |
Description: | Time from first response to disease progression or death from any cause |
Measure: | Event-free survival (EFS) |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion |
Safety Issue: | |
Description: | Time from start of JCAR017, or start of combination agent, whichever occurs first, to death from any cause, disease progression, or starting a new antilymphoma therapy whichever occurs first |
Measure: | Pharmacokinetic (PK)- Cmax |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion |
Safety Issue: | |
Description: | Maximum observed concentration in plasma |
Measure: | Pharmacokinetic (PK)- Tmax |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion |
Safety Issue: | |
Description: | Time to maximum concentration |
Measure: | Pharmacokinetic (PK)- AUC |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion |
Safety Issue: | |
Description: | Area under the plasma concentration vs time curve |
Measure: | Health-related quality of life (HRQoL) |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion |
Safety Issue: | |
Description: | Is described as parameters assessed by European Organization for Research and Treatment of Cancer |
Measure: | Quality of Life C30 questionnaire (EORTC-QLQ-C30) |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion, for Phase I of Arm A and Arm B. |
Safety Issue: | |
Description: | EORTC-QLQ-C30 is composed of both multi-item scales and single item measures. These include five functional scales (physical, role, emotional, cognitive and social), three symptom scales (fatigue, nausea/vomiting, and pain), a global health status/health-related quality of life (HRQoL) scale, and six single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Each of the multi-item scales includes a different set of items - no item occurs in more than one scale. |
Measure: | European Quality of Life-5 Dimensions health state classifier to 5 Levels (EQ-5D-5L) |
Time Frame: | Up to approximately 24 months post-JCAR017 infusion, for Phase I of Arm A and Arm B |
Safety Issue: | |
Description: | The EQ-5D-5L consists of the EQ-5D-5L descriptive system and the EQ visual analogue scale (EQ VAS). The descriptive system comprises dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Each dimension has 5 levels (no problems, slight problems, moderate problems, severe problems, extreme problems) |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Celgene |
Trial Keywords
- JCAR017
- B-Cell Malignancies
- NHL
- non-Hodgkin lymphoma
- CAR T cells
- chimeric antigen receptor
- CC-220
- Ibrutinib
- relatlimab
- nivolumab
- CC-99282
Last Updated
May 3, 2021