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Phase 1/2 Multi-Center Study to Evaluate the Safety and Efficacy of ONCT-808 in Adult Subjects With Relapsed or Refractory Aggressive B-Cell Malignancies


Description

This is a Phase 1/2 study to investigate the safety and efficacy of the CAR-T therapy, ONCT-808, in patients with relapsed/refractory (R/R) aggressive B cell malignancies.Study ONCT-808-101 is a Phase 1/2, single-arm, open-label, multi-center study to evaluate the safety and tolerability, pharmacokinetics, and anti-tumor activity of ONCT-808 in subjects with aggressive B cell lymphoma (BCL), including large B-cell lymphoma (LBCL) and mantle cell lymphoma (MCL). The study will be separated into two distinct phases designated as Phase 1 and Phase 2. After the safety and tolerability of ONCT-808 have been assessed to select the recommended Phase 2 dose (RP2D) in Phase 1, Phase 2 will commence to further validate the dose and evaluate the safety and efficacy of ONCT-808. In Phase 2, subjects with LBCL or MCL will be enrolled into 2 separate dose expansion cohorts.

Trial Eligibility

Key Inclusion Criteria: * Over 18 years old * Histologically confirmed aggressive B-cell NHL, including: * MCL, with diagnosis confirmed by cyclin D1 overexpression or evidence of t (11;14) translocation * LBCL, including: * DLBCL NOS * Primary mediastinal LBCL * High-grade BCL * DLBCL arising from follicular lymphoma * Follicular lymphoma grade 3B * Richter's syndrome * Availability of archival tissue for immunohistology, or willing to undergo baseline biopsy if not available * R/R with no available therapy. Subject must have: * Received prior systemic therapy that has included an alkylating agent, anthracycline, and an anti-CD20 mAb * Received and progressed after autologous hematopoietic stem cell transplant (HSCT) or is ineligible for or has refused to receive HSCT * Received prior approved CD19 CAR T-cell therapy or is ineligible for or has refused CD19 CAR-T * Minimum washout period between previous systemic therapy and leukapheresis includes: * Chemotherapy: at least 14 days or 5 half-lives, whichever is shorter * Autologous HSCT: at least 3 months * CD19 CAR T-cell therapy: at least 6 months * ≥1 measurable lesion per Lugano criteria (Cheson, 2014) * Subject has Fluorodeoxyglucose (FDG)-avid disease. * Subject has an ECOG performance status of 0 or 1. * Subject has adequate organ function: * ALC ≥100/uL * ANC ≥1000/uL (≥500/uL if due to lymphoma; growth factors allowed) * Hgb ≥8 g/dL (transfusion allowed) * Platelets ≥75,000/uL (≥50,000/uL if due to lymphoma; transfusion allowed) * CrCL ≥50 ml/min; AST/ALT ≤2.5x ULN, T. bili ≤1.5 mg/dl (except Gilbert's) * EF ≥50% by ECHO/MUGA; NCS ECG, NCS pleural effusion; O2 sat \>92% * Subject has an estimated life expectancy of \>12 weeks Key Exclusion Criteria: * Prior ROR1-targeted therapy * Current or anticipated systemic immunosuppressive therapy (e.g., prednisone \>5 mg) from LD chemo until Day 28 post ONCT-808 dosing * If receiving anticoagulation therapy, subject is unable to hold therapy for 3 days prior and 28 days following ONCT-808 administration * Known CNS involvement by malignancy within 6 months * H/o or current CNS disorder (e.g., seizure, CVA, dementia, cerebellar disease, cerebral edema, posterior reversible encephalopathy syndrome or any autoimmune disease with CNS involvement) within 6 months of study entry * Clinically significant cardiovascular disease (e.g., MI, UA, CABG, or CHF grade ≥2 NYHA within 12 months of planned ONCT-808 dosing) or serious arrhythmia requiring medication * Evidence of HIV infection or active HBV, HCV * Systemic fungal infection requiring medication in the last 12 months * H/o Covid-19 infection with residual lung infiltrate/fibrosis * H/o other malignancy except non-melanoma skin cancer or carcinoma in situ not in remission for ≥2 years * H/o autoimmune disease resulting in end organ injury or require systemic immunosuppression within last 2 years * H/o allogeneic HSCT or organ transplant

Study Info

Organization

Oncternal Therapeutics, Inc


Primary Outcome

To evaluate the incidence, severity, and relationship of Dose Limiting Toxicities (DLT)


Outcome Timeframe 28 days after last dose of ONCT-808

NCTID NCT05588440

Phases PHASE1,PHASE2

Primary Purpose TREATMENT

Start Date 2023-05-09

Completion Date 2026-12

Enrollment Target 57

Interventions

BIOLOGICAL ONCT-808

DRUG Bridging Therapy

Locations Recruiting

City of Hope National Medical Center

United States, California, Duarte


Massachusetts General Hospital

United States, Massachusetts, Boston


Dana Farber Cancer Institute

United States, Massachusetts, Boston


The University of Texas MD Anderson Cancer Center

United States, Texas, Houston


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