Sequential CAR-T Cells Therapy for CD5/CD7 Positive T-cell Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma Using CD5/CD7-Specific CAR-T Cells (BAH246)

Essen Biotech

Status and phase: Enrolling; Phase 2; Phase 1

Conditions: T-cell Acute Lymphoblastic Leukemia; T Cell Leukemia; T Cell Lymphoma; T Cell Prolymphocytic Leukemia; T-Cell Lymphoma of CNS; T Cell Childhood ALL

Treatments: Biological: CD5/CD7 CAR-T

Study type: Interventional

Funder types: Other

Identifiers

NCT06420076

ESBI202496

Details and patient eligibility

About

Chimeric antigen receptor (CAR)-modified T cells targeted against CD19 have demonstrated unprecedented successes in treating patients with hematopoietic and lymphoid malignancies. Besides CD19, many other molecules such as CD22, CD30,BCMA,CD123, etc. may be the potential to develop the corresponding CAR-T cells to treat patients whose tumors express those markers. In this study, investigators will evaluate the safety and efficacy of Sequential CAR-T Cells Targeting CD5/CD7 in patients with patients with relapsed or refractory T-ALL/LBL/ETP-ALL. The primary goal is safety assessment including cytokine storm response and any other adverse effects. In addition, disease status after treatment will also be evaluated.

Full description

Acute lymphoblast leukemia (T-ALL) is a neoplastic lymphoid leukemia characterized by the proliferation of immature precursor T cells. The combined chemotherapy has significantly improved the prognosis of T-acute lymphoblast leukemia/lymphoma. However, once the disease appears to be relapsed/refractory, there are limited treatment options, and the overall prognosis is extremely poor. Therefore, exploring safe and effective treatments is a critical unmet medical need. The patients will receive Sequential CAR-T Cells Targeting CD5/CD7 to examine the safety and, possibly the efficacy of CD5 CAR T-Cells in CD5+ CD7+ relapsed or refractory acute leukemia.

Enrollment: 60 estimated patients

Sex: All

Ages: 2 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Signed written informed consent; Patients volunteer to participate in the clinical trial;
• Diagnosis is mainly based on the World Health Organization (WHO) 2008;
• Complete remission cannot be achieved after induction therapy; recurrence occurs after completion remission; the burden of leukemic blasts in the peripheral blood or bone marrow is greater than 5%;
• Leukemic blast cells express CD7/CD5 (CD7 OR CD5 positive by flow cytometry or immunohistochemistry ≥70%);
• The expected survival period is greater than 12 weeks;
• ECOG score ≤2;
• Age 2-60 years old;
• HGB≥70g/L (can be transfused);
• Total bilirubin does not exceed 3 times the upper limit of normal value, and AST and ALT do not exceed 5 times the upper limit of normal value.

Exclusion criteria

• Patients declining to consent for treatment
• Prior solid organ transplantation
• One of the following cardiac issues: atrial fibrillation; myocardial infarction within the past 12 months; prolonged QT syndrome or secondary QT prolongation; clinically significant pericardial effusion; cardiac insufficiency NYHA (New York Heart Association) III or IV;
• History of severe pulmonary dysfunction diseases;
• Severe infection or persistent infection cannot be effectively controlled;
• Severe autoimmune disease or congenital immunodeficiency;
• Active hepatitis;
• Human immunodeficiency virus (HIV) infection;
• Clinically significant viral infections, or uncontrollable viral reactivation, including EBV (Epstein-Barr virus).

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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60 participants in 1 patient group

Sequential CAR-T Cells Targeting (CD5/CD7 CAR T cells, chemotherapy)

Experimental group

Description:

Patients will be administered fludarabine phosphate intravenously (IV) over a 30-minute period on days -4 to -2. Additionally, cyclophosphamide will be administered intravenously (IV) over 60 minutes on day -2. Subsequently, patients will receive CD5/CD7 CAR T cells intravenously (IV) over a duration of 10-20 minutes on day 0. Patients who exhibit positive responses to the initial dose of CD5/CD7 CAR T cells, do not experience unacceptable side effects, and have a sufficient quantity of cells available may be eligible to receive 2 or 3 additional doses of CD5/CD7 CAR T cells.

Treatment:

Biological: CD5/CD7 CAR-T