CD19/CD20 Dual-CAR-T in B-cell Leukemia Patients

Lu Daopei Medical Group

Status and phase: Completed; Phase 1

Conditions: B-cell Leukemia

Treatments: Biological: CD19/CD20 Dual-CAR-T cells

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT04260945

HXYT-007

Details and patient eligibility

About

This is a single center, single arm, open-label, phase I study to evaluate the safety and efficacy of CD19/CD20 Dual-CAR-T cells in patients with refractory and relapsed B-cell leukemia.

Full description

This Phase I study is designed as a pilot trial evaluating the safety and efficacy of CD19/CD20 Dual-CAR-T cell therapy in subjects with refractory and relapsed B cell leukemia. Subjects will receive cytoreductive chemotherapy with cyclophosphamide and fludarabine on days -5, -4 and -3 followed by infusion of CD19/CD20 Dual-CAR-T cells. Safety and efficacy of CD19/CD20 Dual-CAR-T cells therapy will be monitored. The purpose of current study is to determine the clinical efficacy and safety of CD19/CD20 Dual-CAR-T cells therapy in patients with refractory and relapsed B-cell leukemia.

Enrollment: 12 patients

Sex: All

Ages: 1 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Relapsed and refractory B-cell acute malignancies with:

   • Relapsed after competed remission, could not get competed remission after at more than 1 course of chemotherapy (including MRD≥0.1%);
   • MRD≥0.1% after allogeneic hematopoietic stem cell transplantation(HSCT), or recurrence after complete remission or MRD ≥ 0.1% after HSCT;
   • Refractory: at least two courses of chemotherapy did not achieve complete remission or MRD ≥ 0.1%;

2. Patients must have evaluable evidence of disease, including minimal residual disease (MRD);

3. Ph + patients who meet the following criteria can register:Failure to tolerate TKI or TKI treatment failure, or failure to transplant;

4. Double positive expression of CD19 / CD20 in B cells;

5. Ages 1 to 70 years, including boundary values;

6. ECOG score 0-3 points;

7. Women of childbearing age (15-49 years old) must receive a pregnancy test within 7 days prior to initiation of treatment and the results are negative; male and female patients with fertility must use an effective contraceptive to ensure 3 months after discontinuation of treatment during the study period not pregnant inside.

8. Patients who voluntarily sign informed consent and are willing to comply with treatment plans.

Exclusion criteria

1. patients with organ failure:

   • Heart: NYHA heart function grade IV;
   • Liver: Grade C that achieves Child-Turcotte liver function grading;
   • Kidney: kidney failure and uremia;
   • Lung: symptoms of respiratory failure;
   • Brain: a person with a disability;

2. Active infections that are difficult to control;

3. Human immunodeficiency virus (HIV) positive;

4. Liver and kidney function: total bilirubin > 5 × ULN, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) > 5 × ULN, serum creatinine clearance rate 60mL / min;

5. GVHD ≥ 2 or anti-GVHD treatment;

6. Received allogeneic cell therapy within 4 weeks, such as donor lymphocyte infusion;

7. Subject received anti-tumor treatment (chemotherapy, mAb, or hormone) for less than 1 week;

8. Central nervous system white blood that is symptomatic or uncontrolled by systemic chemotherapy and intrathecal chemotherapy (a large number of tumor cells in CSF, white blood cell count >15WBCs/mL);

9. intracranial hypertension or unconsciousness; respiratory failure; diffuse vascular internal coagulation;

10. pregnant or lactating women;

11. The patient does not agree to use effective contraception during the treatment period and for the next 3 months;

12. Patients who participate in other clinical studies at the same time;

13. The investigator believes that there are other factors that are not suitable for inclusion or influence the subject's participation or completion of the study.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

12 participants in 1 patient group

CD19/CD20 Dual-CAR-T cells

Experimental group

Description:

CD19/CD20 Dual-CAR-T cells are prepared via lentiviral infection. 5 days prior to infusion of CAR-T cells, subjects receive fludarabine at dose 30mg/m2/day and cyclophosphamide treatment at dose 250mg/m2 for 3 days and take a rest for 2 days before infusion.

Treatment:

Biological: CD19/CD20 Dual-CAR-T cells