The Clinical Application of Chimeric Antigen Receptor T Cells in the Treatment of CD19 Positive Recurrent Refractory B Cell-derived Hematological Malignancies
CD19-CART Cells in the Treatment of CD19+ r/r B Cell-derived Hematological Malignancies
1 other identifier
interventional
10
1 country
1
Brief Summary
CD19 is expressed in most B malignant tumors, especially in the former B cells ALL. This makes CD19 a natural target of immunotherapy. In terms of safety, the lack of B cells caused by CD19 targeted therapy will not cause life-threatening side effects (of course, Ig supplementation is necessary in the long-term B cell inhibition therapy). Moreover, the number of B cells can be restored after removing anti-CD19 treatment measures (such as anti-CD19 CART cells). In addition, CD19 has been chosen as the target of B-ALL therapy for the following reasons: ① as the BCR signal "amplifier", CD19 plays a role in PAX-5-mediated tumor formation; ② by activating MYC (as the oncogene controlled by PAX-5, C-MYC plays a key role in promoting the malignant proliferation of B cells), CD19 can cause B-ALL formation. Based on the above reasons, CD19 has become an ideal target in the treatment of B-cell cancer.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for early_phase_1
Started Jan 2018
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
January 9, 2018
CompletedFirst Submitted
Initial submission to the registry
November 4, 2019
CompletedFirst Posted
Study publicly available on registry
December 3, 2019
CompletedPrimary Completion
Last participant's last visit for primary outcome
January 1, 2020
CompletedStudy Completion
Last participant's last visit for all outcomes
January 1, 2020
CompletedDecember 3, 2019
December 1, 2019
2 years
November 4, 2019
December 1, 2019
Conditions
Outcome Measures
Primary Outcomes (1)
CR
Complete response rate (CR)
12 weeks after infusion of the study drug
Secondary Outcomes (2)
PR
12 weeks after infusion of the study drug
2-year disease-free survival rate 2-year disease-free survival rate
12 weeks after infusion of the study drug
Study Arms (1)
CART cells
EXPERIMENTALdosage:Once dose,1.0\*10\^6cells/kg CART cells Administration mode:Intravenous infusion
Interventions
1-10x106 / kg CD19 CART cells
Eligibility Criteria
You may qualify if:
- \. At the time of initial diagnosis, the age is 18-70 years old, regardless of gender or race
- \. Morphological analysis showed that the load of lymphoma was ≥ 5%
- \. Estimated survival time \> 12 weeks
- \. The main investigator and the attending physician of the patient think that there is no other feasible and effective alternative treatment, such as hematopoietic stem cell transplantation
- \. Relapsed / refractory B-cell acute lymphocytic leukemia (all): A. objective remission rate (or) of grade 2 or higher bone marrow recurrence B. bone marrow relapse after allogeneic stem cell transplantation (SCT), SCT treatment is more than 6 months and in or state before cart-19 reinfusion C. refractory patients (CR status is not reached after 2 rounds of standard chemotherapy (CR refers to the load of myeloma detected by morphology \< 5%)) D. Philadelphia chromosome positive (Ph +) and tyrosine kinase inhibitor (TKI) treatment failed twice or TKI failed to maintain or E. treatment with allogeneic SCT
- \. For patients with relapse, CD19 was detected in bone marrow or peripheral blood by flow cytometry within 3 months before admission
- \. CD19 expression on lymphoma cells: immunohistochemistry \> 15% or flow cytometry \> 30%
- \. The main organ functions are sound, including: A. renal function: radioisotope glomerular filtration rate \> 60 ml / min / 1.73 m2, or serum creatinine clearance rate in line with relevant age / gender standards B. alanine transferase (ALT) \< 5 times the normal maximum value of the same age C. bilirubin \< 2.0 mg / dl D. to achieve the minimum pulmonary function: ≤ grade I dyspnea and indoor blood oxygen concentration \> 91% E. echocardiography or multi gated angiography (MUGA) showed that the left ventricular short axis shortening rate (LVSF) was ≥ 28%, or left ventricular ejection fraction (LVEF) was ≥ 45%
- \. Karnofsky score (age ≥ 16 years old) ≥ 50 or zubrod-ecog-who score ≤ 2
- \. Sign written informed consent and obtain consent before any research is carried out
- \. When the above other conditions are met, the cell culture factory must receive fresh blood samples from patients. In the case of monocultured cells, they can only be accepted by the cell culture factory if the relevant tests are qualified
You may not qualify if:
- \. Recurrence of isolated extramedullary diseases
- \. Patients with Burkitt's lymphoma / leukemia (i.e. patients with mature B cell all, B cell surface immunoglobulin positive (SIG +) and light chain kappa or lambda type, morphology Fab L3 or myc ectopic expression)
- \. Previous use of gene therapy
- \. Previous use of anti-CD19 / CD3 combination therapy or any other anti-CD19 treatment
- \. Hepatitis B or C or HBV / HCV or other uncontrolled infection at the time of screening
- \. Screening with HIV infection
- \. Acute or chronic graft-versus-host reaction (GVHD) of level 2-4
- \. Pregnant or lactating women: 48 hours before reinfusion, the female test participants must carry out serum or urine pregnancy test, and the test result is positive
- \. Women of childbearing age and all men did not take effective contraceptive methods within one year after cart-19 transfusion
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Hematology Department of the Second Affiliated Hospital of Suzhou University
Suzhou, Jiangsu, China
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- early phase 1
- Allocation
- NA
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- SINGLE GROUP
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
November 4, 2019
First Posted
December 3, 2019
Study Start
January 9, 2018
Primary Completion
January 1, 2020
Study Completion
January 1, 2020
Last Updated
December 3, 2019
Record last verified: 2019-12
Data Sharing
- IPD Sharing
- Will not share