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New treatment option for Central Nervous System Lymphoma
Official title Intracerebroventricular Administration of CD19-CAR T Cells (CD19CAR-CD28-CD3zeta-EGFRt-expressing Tn/Mem T-lymphocytes) for the Treatment of Central Nervous System Lymphoma
ClinicalTrials.gov ID: NCT05625594
What this study is testing
What is CD19CAR-CD28-CD3zeta-EGFRt-expressing Tn/mem T-lymphocytes?
CD19CAR-CD28-CD3zeta-EGFRt-expressing Tn/mem T-lymphocytes is an investigational medicine, given as an infusion into a vein, being studied as a potential treatment for central nervous system lymphoma.
Also referred to as CD19-CAR-specific/truncated EGFR Lentiviral Vector-transduced T Cells, CD19CAR-CD28-CD3zeta-EGFRt-expressing Tcm-enriched T Cells.
Plain-language explanation of the investigational treatment - it is being studied and is not an approved or proven therapy. The study team can confirm the details.
- What it's testing
- This phase I trial tests the safety, side effects, and best dose of intracerebroventricularly (ICV) administered CD19-chimeric antigen receptor (CAR) T cells in treating patients with central nervous system (CNS) lymphoma. CAR T cell therapy is a type of treatment in which a patient's T cells (a type of immune system cell) are changed in the laboratory so they will attack cancer cells.
- Phase 1: an early, usually small safety study
A plain-language read of the study's public ClinicalTrials.gov listing. The study team confirms the details.
Who can take part
Ages 18 and older
You may be able to join if
- Participant must have the ability to understand and the willingness to sign a written informed consent
- Note: For research participants who do not speak English, a short form consent may be used with a City of Hope (COH) certified interpreter/translator...
- Agreement to allow the use of archival tissue from diagnostic tumor biopsies. If unavailable exceptions may be granted with study principal...
- Age \>= 18 years
- Eastern Cooperative Oncology Group (ECOG) performance status 0 - 2
You likely can't join if
- Participant has not yet recovered from toxicities of prior therapy
- Presence of systemic lymphoma
- Participant with clinically significant arrhythmia or arrhythmias not stable on medical management within two weeks of signing the screening and...
- Participant with known history or prior diagnosis of optic neuritis or other immunologic or inflammatory disease affecting the central nervous...
- Active autoimmune disease requiring systemic immunosuppressive therapy
- Needing dexamethasone more than 4mg/day (or equivalent) within 72 hours prior to leukapheresis or CAR T cell infusion
See the full eligibility criteria
Who can join
- Participant must have the ability to understand and the willingness to sign a written informed consent
- Note: For research participants who do not speak English, a short form consent may be used with a City of Hope (COH) certified interpreter/translator to proceed with screening and leukapheresis, while the request for a...
- Agreement to allow the use of archival tissue from diagnostic tumor biopsies. If unavailable exceptions may be granted with study principal investigator (PI) approval
- Age \>= 18 years
- Eastern Cooperative Oncology Group (ECOG) performance status 0 - 2
- Documented primary CNS lymphoma. Progression must be determined radiographically. Participant must have measurable disease which could be a measurable lymphomatous mass or, in the case of leptomeningeal only disease...
- Patients with secondary CNS lymphoma with CNS only relapse, confirmed by PET-CT, may also be eligible, per PI discretion.
- Documented current CD19+ tumor expression if prior CD19 directed therapy was used
- Participant must have received and failed or have been intolerant to CNS directed therapy like high dose methotrexate or high dose cytarabine based regimens. Participants are not required to have failed all of these...
- Prior CAR T cell therapy is allowed if at least 3 months have elapsed prior to leukapheresis procedure
- If participant received prior CD19-CAR T cells persistence must be evaluated and found to be \<5% prior to leukapheresis procedure
- No known contraindications to leukapheresis, steroids or tocilizumab
- Participant of reproductive potential must agree to use acceptable birth control methods throughout study therapy and for 3 months after final dose of study treatment
- Total serum bilirubin =\< 2.0 mg/dL (within 14 days of signing the screening and leukapheresis consent)
- Patients with Gilbert syndrome may be included if their total bilirubin is =\< 3.0 x upper limit of normal (ULN) and direct bilirubin =\< 1.5 x ULN
- Aspartate aminotransferase (AST) =\< 2.5 x ULN (within 14 days of signing the screening and leukapheresis consent)
- Alanine aminotransferase (ALT) =\< 2.5 x ULN (within 14 days of signing the screening and leukapheresis consent)
- Creatinine clearance of \>= 50 mL/min per the Cockcroft-Gault formula (within 14 days of signing the screening and leukapheresis consent)
- Cardiac function (12 lead-electrocardiogram [ECG]) without acute abnormalities requiring investigation or intervention (within 14 days of signing the screening and leukapheresis consent)
- Absolute neutrophil count \>= 750/uL (within 14 days of signing the screening and leukapheresis consent)
- Hemoglobin (Hb) \>= 8 g/dl (within 14 days of signing the screening and leukapheresis consent)
- Platelet count \>= 50,000/uL (within 14 days of signing the screening and leukapheresis consent)
- Ejection fraction measured by echocardiogram or multigated acquisition scan (MUGA) \> 40% (evaluation within 6 weeks of screening does not need to be repeated) (within 14 days of signing the screening and leukapheresis...
- Oxygen (O2) saturation \> 92% not requiring oxygen supplementation (within 14 days of signing the screening and leukapheresis consent)
- Seronegative for HIV qPCR, HCV\ , active HBV (Surface Antigen Negative), and syphilis (RPR)
- If positive, Hepatitis C RNA quantitation must be performed. OR
- If seropositive for HIV, HCV or HBV, nucleic acid quantitation must be performed. Viral load must be undetectable. Meets other institutional and federal requirements for infectious disease titer requirements Note...
- Women of childbearing potential (WOCBP): negative urine or serum pregnancy test (within 14 days of signing the screening and leukapheresis consent)
- If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
What rules you out
- Participant has not yet recovered from toxicities of prior therapy
- Presence of systemic lymphoma
- Participant with clinically significant arrhythmia or arrhythmias not stable on medical management within two weeks of signing the screening and leukapheresis consent
- Participant with known history or prior diagnosis of optic neuritis or other immunologic or inflammatory disease affecting the central nervous system, including seizure disorder
- Active autoimmune disease requiring systemic immunosuppressive therapy
- Needing dexamethasone more than 4mg/day (or equivalent) within 72 hours prior to leukapheresis or CAR T cell infusion
- History of allergic reactions attributed to compounds of similar chemical or biologic composition or other agents used in this study
- Known bleeding disorders (e.g., von Willebrand's disease) or hemophilia
- History of stroke or intracranial hemorrhage within 6 months prior to signing the screening and leukapheresis consent
- History of other malignancies, except for malignancy surgically resected (or treated with other modalities) with curative intent with no known active disease present for \>= 3 years, basal cell carcinoma of the skin or...
- Uncontrolled active infection
- Active hepatitis B or hepatitis C infection: people who are hepatitis B core antibody (anti-HBc) positive and who are surface antigen negative will need to have a negative polymerase chain reaction (PCR) result. Those...
- people who are hepatitis B core antibody positive (or have a known history of hepatitis B virus [HBV] infection) should be monitored quarterly with a quantitative PCR test for HBV deoxyribonucleic acid (DNA). HBV...
- people who are hepatitis C antibody positive will need to have a negative PCR result. Those who are hepatitis C PCR positive will be excluded
- people who are hepatitis C antibody positive will need to have a negative PCR result. Those who are hepatitis C PCR positive will be excluded
- Human immunodeficiency virus (HIV) infection
- Active significant bacterial, fungal or viral (other than those listed) infections
- Any other condition that would, in the investigator's judgment, contraindicate the subject's participation in the clinical study due to safety concerns with clinical study procedures
- Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)
The study team makes the final eligibility decision.
Where it's taking place
- Duarte, California, United States
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.
How long does this study last?
The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.
Who can join this trial?
This study is enrolling all sexes, 18 years and older. The study team makes the final eligibility decision.
Where is this trial taking place?
Study sites include Duarte, California, United States. Enter your location above to see the nearest site and check your eligibility.
Explore other conditions
BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from ClinicalTrials.gov; the study team decides eligibility.