Phase I/II Study of Rapcabtagene Autoleucel in CLL, 3L+ DLBCL, ALL and 1L HR LBCL
18 Years and older, Male and Female
CYTB323A12101 (primary)
NCI-2020-08168
Summary
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).
Objectives
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 (or relapsed) after
autologous HSCT or being ineligible for or not consenting to the procedure.
- Rapcabtagene autoleucel single agent in adult relapsed/refractory ALL participants
The Phase II part of the study comprises two independent cohorts:
- Rapcabtagene autoleucel single agent in adult 3L + DLBCL participants having failed
two or more lines of chemoimmunotherapy and either having progressed (or relapsed)
after autologous HSCT or being ineligible for or not consenting to the procedure.
This is an extension of the Phase I r/r DLBCL treatment arm to support Phase II
objectives
- Rapcabtagene autoleucel single agent in newly diagnosed, adult 1L HR LBCL
participants defined as IPI 3-5 and/or DH/TH disease who have completed 2 cycles of
CIT and have a response of PR/SD (with a Deauville score of 4-5).
In the Phase I part of the trial, the 3L+ DLBCL and ALL arms consist of two parts: a dose
escalation part to evaluate feasibility, characterize safety and identify the recommended
dose (RD) of rapcabtagene autoleucel, and a dose expansion part to further characterize
safety, study rapcabtagene autoleucel cellular kinetics and assess preliminary antitumor
activity. Once the RD of rapcabtagene autoleucel is determined for each arm, the
corresponding expansion part will commence.
In the Phase II part of the trial, approximately 70 additional participants will be
enrolled in a 3L+ DLBCL cohort treated at the recommended dose (RD). Including the 3L+
DLBCL participants who were treated at the RD from the Phase I part, it is planned to
have in total a cohort of approximately 100 participants included in the primary efficacy
analysis based on the efficacy analysis set. In addition, a separate cohort in 1LHR LBCL
will be included, with approximately 40 participants planned for the primary efficacy
analysis based on the efficacy analysis set.
Participants will be followed under the current treatment protocol for safety and
efficacy within this trial for a minimum of 2 years before being transferred to the
long-term follow-up trial. Once the study is complete, participants will be enrolled in a
post-study long term follow-up for lentiviral vector safety for up to 15 years. This
post-study long term follow-up for lentiviral vector safety will continue under a
separate destination protocol.
Eligibility
- ECOG performance status 0-1
- 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/THL)
- 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 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.
Treatment Sites in Georgia
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