CD19-specific CAR T Cells With a Fully Human Binding Domain for CD19+ Leukemia or Lymphoma

Study Overview
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Brief Summary
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Patients with relapsed or refractory leukemia or lymphoma are often refractory to further chemotherapy. In this study, the investigators will attempt to use T cells obtained directly from the patient, which can be genetically engineered to express a fully human chimeric antigen receptor (CAR). The CAR used in this study can recognize CD19, a protein expressed on the surface of leukemia and lymphoma cells. The fully human CAR used in this study may help protect against rejection of the CAR T cells, which in turn could lead to lasting protection against return of the leukemia or lymphoma. The phase 1 part of this study will determine the safety of these CAR T cells, and the phase 2 part of the study will determine how effective this CAR T cell therapy is. Both patients who have never had prior CAR T cell therapy and those who have had prior CAR T cell therapy may be eligible to participate in this study.

Official Title
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Pediatric and Young Adult Leukemia Adoptive Therapy (PLAT)-06: A Phase 1/2 Study of CD19-specific CAR T Cells With a Fully Human Binding Domain for CD19+ Leukemia or Lymphoma

Conditions
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Leukemia, Lymphoma

Intervention / Treatment
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* Biological: SCRI-huCAR19v1
* Biological: SCRI-huCAR19v2


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male and female subjects age ≥ 1 and ≤ 30 years First 2 enrolled subjects: age ≥ 18 and ≤ 30 years Disease requirements: Phase 1: Evidence of refractory or recurrent CD19+ leukemia or lymphoma following previous CAR T cell immunotherapy Phase 2: Evidence of refractory or recurrent CD19+ leukemia or lymphoma Able to tolerate apheresis, or has sufficient existing apheresis product or T cells for manufacturing investigational product Life expectancy ≥ 8 weeks Lansky or Karnofsky, as applicable, score ≥ 50 Recovered from acute toxic effects of all prior chemotherapy, immunotherapy, and radiotherapy, if the subject does not have a previously obtained apheresis product that is acceptable and available for manufacturing of CAR T cells ≥ 7 days post last chemotherapy and biologic therapy, with the exception of intrathecal chemotherapy and maintenance chemotherapy No prior virotherapy ≥ 7 days post last corticosteroid therapy ≥ 3 days post Tyrosine Kinase Inhibitor (TKI) use ≥ 1 day post hydroxyurea 30 days post most recent CAR T cell infusion Adequate organ function Adequate laboratory values, including absolute lymphocyte count ≥ 100 cells/uL Subjects of childbearing or child-fathering potential must agree to use highly effective contraception from consent through 12 months following infusion of investigational product on trial Subject and/or legally authorized representative has signed the informed consent form for this study Exclusion Criteria: Presence of active malignancy other than disease under study History of symptomatic CNS pathology or ongoing symptomatic CNS pathology CNS involvement of leukemia or lymphoma that is symptomatic and in the opinion of the investigator, cannot be controlled during the interval between enrollment and CAR T cell infusion Presence of active GVHD, or receiving immunosuppressive therapy for treatment or prevention of GVHD within 4 weeks prior to enrollment Presence of active severe infection Presence of primary immunodeficiency syndrome Subject has received prior virotherapy Pregnant or breastfeeding Subject and/or legally authorized representative unwilling to provide consent/assent for participation in the 15-year follow up period, required if CAR T cell therapy is administered Presence of any condition that, in the opinion of the investigator, would prohibit the patient from undergoing treatment under this protocol

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SCRI-huCAR19v2<br>Patients will receive SCRI-huCAR19v2 in either Phase 1 or Phase II | Biological: SCRI-huCAR19v2<br>* Mixture of CD4:CD8 autologous T cells lentivirally transduced to express a second generation 4-1BB-ζ human CD19-specific CAR and Her2tG<br>|
| Experimental: SCRI-huCAR19v1 - [CLOSED]<br>Patients will receive SCRI-huCAR19v1 in either Phase 1 or Phase II. As of 02/13/2020 this study cohort is permanently closed. | Biological: SCRI-huCAR19v1<br>* 1:1 mixture of CD4:CD8 autologous T cells lentivirally transduced to express a second generation 4-1BB-ζ human CD19-specific CAR and Her2tG<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The adverse events associated with CAR T cell product infusions will be assessed | The type, frequency, severity, and duration of adverse events will be summarized | 30 days | 
| The leukemia response to SCRI-huCAR19 in subjects with relapsed or refractory CD19+ leukemia will be assessed | Response will be defined by standard bone marrow assessment and standard response criteria | 63 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CAR T cell, CD19, pediatric, young adults