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Phase I/II, Open Label, Multicenter Study of Rapcabtagene Autoleucel in Adult Patients With CLL/SLL, 3L+ DLBCL, r/r ALL and 1L HR LBCL


Description

This is a phase I/II study to evaluate the feasibility, safety and preliminary antitumor efficacy of rapcabtagene autoleucel (also known as YTB323). Rapcabtagene autoleucel will be investigated in combination with ibrutinib in chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) and as single agent in diffuse large B-cell lymphoma (3L+ DLBCL), adult acute lymphoblastic leukemia (ALL) and 1st Line High Risk Large B-Cell Lymphoma (1L HR LBCL).This clinical trial is phase I/II open label, multi-center study of rapcabtagene autoleucel. The Phase I part of the study comprises three independent treatment arms: * Rapcabtagene autoleucel in combination with ibrutinib in adult CLL/SLL participants with SD or PR after at least 6 months of second or subsequent line ibrutinib therapy. As of 05-May-2021, this arm had completed enrollment. * Rapcabtagene autoleucel single agent in adult DLBCL participants having failed two or more lines of chemotherapy and either having progressed (

Trial Eligibility

Inclusion Criteria: * ECOG performance status 0-1 for ALL and DLBCL * ECOG performance status 0-2 for 1L HR LBCL at screening * CLL or SLL diagnosis according to iwCLL criteria * CLL/SLL in SD or PR after at least 6 months of ibrutinib, either as second or subsequent line of therapy * DLBCL diagnosis by local histopathology * DLBCL relapsed or refractory after 2 or more lines of therapy, including autologous hematopoietic stem cell transplantation (HSCT) * Refractory or relapsed CD19-positive ALL * ALL with morphologic disease in the bone marrow 1L HR LBCL - Considered to be high-risk based on at least 1 of the following at diagnosis: * IPI score of 3, 4 or 5 * MYC and BCL2 and/or BCL6 rearrangement (DH/TH lymphoma) * Participants must have received 2 cycles of frontline therapy for LBCL with R-CHOP or Pola-R-CHP or DA-EPOCH-R. Participants with DH/TH lymphoma must have received at least one cycle (the most recent) DA-EPOCH-R. * Participants must have a positive PET per Lugano classification (Deauville PET score of 4 or 5 and an overall response of PR/SD) after 2 cycles of frontline CIT. Note: Patient's with Deauville PET score of 5 and overall response of PD, or with Deauville PET score of 1, 2, or 3 and overall response of CR, are not eligible for this trial. Exclusion Criteria: * Prior CD19-directed therapy * Prior administration of a genetically engineered cellular product * Prior allogeneic HSCT * Richter's transformation * For 1L HR LBCL: Richter's transformation, Burkitt lymphoma, primary DLBCL of CNS, DLBCL associated with chronic inflammation, intravascular large B-cell lymphoma, ALK- positive large B-cell lymphoma, HHV8 positive LBCL, DLBCL leg type or EBV positive DLBCL, NOS. * Active CNS lymphoma * For 1L HR LBCL: Active CNS involvement by malignancy * Targeted small molecule or kinase inhibitor within 2 weeks from leukapheresis Other protocol-defined inclusion/exclusion may apply.

Study Info

Organization

Novartis


Primary Outcome

Phase 1: Dose recommendation: Incidence and nature of Dose Limiting Toxicities (Dose Escalation part only)


Outcome Timeframe 28 days

NCTID NCT03960840

Phases PHASE1,PHASE2

Primary Purpose TREATMENT

Start Date 2019-06-26

Completion Date 2027-06-30

Enrollment Target 225

Interventions

BIOLOGICAL Rapcabtagene autoleucel single agent

DRUG Ibrutinib

Locations Recruiting

University Of California LA UCLA Hematology Oncology

United States, California, Los Angeles


Stanford University Medical Center

United States, California, Stanford


H Lee Moffitt Cancer Center and Research Institute .

United States, Florida, Tampa


Northside Hospital .

United States, Georgia, Atlanta


Northwestern University Northwestern Memorial Hospital Trans

United States, Illinois, Chicago


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