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Phase I/IIInterventional

A Phase 1/1b, Open-label, Dose-escalation, Dose-expansion, Parallel Assignment Study to Evaluate Safety and Clinical Activity of PBCAR0191 (Azercabtagene Zapreleucel or "Azer-cel") in Subjects With Relapsed/Refractory (r/r) Non-Hodgkin Lymphoma (NHL) and r/r B-cell Acute Lymphoblastic Leukemia (B-ALL)

Protocol: STUDY00004690NCT: NCT03666000

Overview

This is a Phase 1/1b, nonrandomized, open-label, parallel assignment, dose-escalation, and dose-expansion study to evaluate the safety and clinical activity of azer-cel, an allogeneic anti-CD19 CAR T, in adults with r/r B ALL, r/r B-cell NHL and CLL/SLL.

Eligibility

Ages18 Years and older
SexAll
Healthy VolunteersNo
Age GroupsAdult, Older Adult

Key Inclusion Criteria

Criteria for B-ALL:

• Participant has confirmed unequivocal r/r CD19+ B-ALL.

Criteria for NHL and CLL/SLL:

• Participant has unequivocal aggressive CD19+ r/r B-cell NHL that is confirmed by tumor biopsy tissue from last relapse after CD19-directed therapy.

For Phase 1 Dose Escalation:

  • Diffuse large B-cell lymphoma (DLBCL) including Richter's transformation
  • Follicular lymphoma (FL) including Grade 3 or transformed FL
  • High-grade B-cell lymphoma (HGBCL)
  • Primary mediastinal lymphoma

For Phase 1b Dose Expansion (CAR T-relapsed cohort):

  • DLBCL not otherwise specified (NOS)
  • HGBCL
  • DLBCL transformed from the following indolent lymphoma subtypes (FL, Marginal Zone lymphoma [MZL], and Waldenstrom's Macroglobulinemia [WM])
  • Other large B-cell lymphoma (LBCL) subtypes may be enrolled with approval from the Medical Monitor.
  • Participants previously treated with CD19-directed autologous CAR T therapies have received no more than 2 lines of therapy after administration of their previous CAR T product.
  • For the expansion CAR T-relapsed cohort only: Participants must have received autologous CD19-directed CAR T therapy and demonstrated clinical response to the treatment at Day 28 or later, followed by relapse or progression.

For Phase 1b dose expansion (CAR T-naive cohort):

  • DLBCL NOS
  • DLBCL transformed from the following indolent lymphoma subtypes (FL, MZL, and WM)
  • HGBCL
  • FL (Grade 1-3a)
  • MZL that is fluorodeoxyglucose (FDG)-avid on positron emission tomography (PET) scan
  • WM
  • CLL/SLL
  • Primary central nervous system (CNS) lymphoma (PCNSL)
  • Other LBCL subtypes may be enrolled with approval from the Medical Monitor.
  • Participant must have received at least 1-2 prior lines of therapy, depending on histological subtype but no more than 7 systemic lines of anti-cancer therapy.

Criteria for both B-ALL, NHL, and CLL/SLL:

  • Eastern Cooperative Oncology Group performance status score of 0 or 1.
  • An estimated life expectancy of at least 12 weeks according to the investigator's judgment.
  • Seronegative for human immunodeficiency virus antibody.
  • Participant has adequate bone marrow, renal, hepatic, pulmonary, and cardiac function.

Key Exclusion Criteria

Criteria for B-ALL:

• Burkitt cell (L3 ALL) or mixed-lineage acute leukemia.

Criteria for NHL:

  • Requirement for urgent therapy due to tumor mass effects such as bowel obstruction or blood vessel compression.
  • Active hemolytic anemia.

Criteria for B-ALL and NHL:

  • No active CNS disease, excluding PCNSL
  • History of another primary malignancy
  • Any form of primary immunodeficiency (for example, severe combined immunodeficiency disease).
  • History of hepatitis B or hepatitis C currently receiving ongoing antiviral therapy.

Any known uncontrolled cardiovascular disease at the time of Screening that, in the investigator's opinion, renders the participant ineligible

  • History of hypertension crisis or hypertensive encephalopathy within 3 months prior to Screening.
  • History of severe immediate hypersensitivity reaction to any of the agents used in this study.
  • Presence of a CNS disorder that, in the opinion of the investigator, renders the participant ineligible for treatment.
  • History of concomitant genetic syndrome such as Fanconi anemia, Kostmann syndrome, Shwachman-Diamond syndrome, or any other known bone marrow failure syndrome.
  • Active uncontrolled autoimmune disease requiring active immunosuppression at the time of Screening (excluding participants needing steroids for physiologic replacement).
  • Participant has received stem cell transplant within 90 days before Screening.
  • Participant has active graft-versus-host disease (GvHD) symptoms.
  • Participant has received a systemic biologic agent for treatment of the disease under study within 28 days of LD, other systemic anti-cancer therapy within 10 days or 5 half-lives (whichever is shorter) of LD, and no pulse steroid for disease control within 3 days of LD.
  • Radiotherapy within 4 weeks before Screening.
  • Presence of pleural/peritoneal/pericardial catheter, as well as permeant biliary and ureteral stents (does not apply to intravenous lines).
  • Participant has received live vaccine within 4 weeks before Screening. Note: Non-live virus vaccines are not excluded.
  • Participant has received CD19-directed therapy other than autologous CD19-directed CAR T therapy within 90 days of the anticipated start date of LD.

Additional criteria apply.

Location
Winship Cancer Institute
View on ClinicalTrials.gov