A Multicenter Clinical Study on the Safety and Efficacy of CAR-T in the Treatment of Relapsed / Refractory Non Hodgkin's Lymphoma

Study Overview
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Brief Summary
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This study is a multicenter, non randomized, single arm, open clinical trial. The selected disease was relapsed / refractory NHL, and the disease was classified into highly aggressive lymphoma, invasive lymphoma and inert lymphoma; Highly invasive NHL included Burkitt lymphoma (BL), lymphoblastic lymphoma (LBL), high-grade B-cell lymphoma, etc; Invasive NHL includes diffuse large B-cell lymphoma, mantle cell lymphoma and peripheral T-cell lymphoma; Inert NHL contains follicular lymphoma, small lymphocytic lymphoma and marginal zone lymphoma.

Detailed Description
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A single car consists of scFv, hinge region, transmembrane region, costimulatory domain and zeta subunit of CD3.Prior to CAR-T cell infusion, the patients will be subjected to preconditioning treatment. After CAR-T cell infusion, the patients will be evaluated for adverse reactions and efficacy.

Official Title
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A Multicenter Clinical Study on the Safety and Efficacy of CAR-T in the Treatment of Relapsed / Refractory Non Hodgkin's Lymphoma

Conditions
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Non-hodgkin's Lymphoma

Intervention / Treatment
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* Biological: Auto CAR-T
* Drug: Cyclophosphamide,Fludarabine
* Procedure: Leukapheresis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Fully understand and voluntarily sign the informed consent form, and be willing and able to comply with the visit, treatment plan, laboratory examination and other requirements of the study specified in the test flow sheet; 2. Patients with hematopoiesis and lymphoid tissue tumors diagnosed as relapsed and refractory by clinical diagnosis were defined as relapse or refractory Primary drug resistance to standard treatment regimen; Or PD occurred after at least second-line standard treatment; Or the last treatment effect was SD and lasted no more than 6 months; Or CD20 positive patients were ineffective or relapsed after anti-CD20 mAb treatment; Or PD after autologous hematopoietic stem cell transplantation, or recurrence confirmed by biopsy within 12 months, or salvage treatment after autologous hematopoietic stem cell transplantation has no remission or recurrence after treatment. 3. According to RECIST version 1.1 , there should be at least one measurable tumor focus; 4. Subjects with ECoG score of 0-2 5. 14 years old ≤ age ≤ 75 years old, both male and female; 6. The tumor cells were positive for CD19 or CD22 / CD30 / CD7 / CD79 by immunohistochemistry or flow cytometry; 7. The expected survival time is more than 3 months from the date of signing the informed consent； 8. Laboratory examinations meet the following conditions: hemoglobin ≥80g/L, platelet count ≥50 × 10^9/L, absolute neutrophil count (ANC) ≥1.0 × 10^9/L, if the investigator believes that the above inspection value is below the lower limit It is caused by tumor invading bone marrow and can be included in the group after consultation with the sponsor; 9. The main organ function indicators meet the following conditions: AST (aspartate aminotransferase)/ALT (alanine aminotransferase)/ALP (alkaline phosphatase) ≤2.5 ULN, serum creatinine ≤1.5 ULN, total bilirubin ≤1.5 ULN, left Ventricular ejection fraction (LVEF) ≥50%, and minimum pulmonary function reserve (dyspnea is not higher than level 1 and blood oxygen saturation> 92% under indoor conditions). Exclusion Criteria: Severe cardiac insufficiency, left ventricular ejection fraction <50%; There is a history of severe lung dysfunction diseases; The patient has had other malignant tumors in the past 5 years, except for skin basal cell carcinoma, breast carcinoma in situ and cervical carcinoma in situ that have undergone radical treatment; Combined with severe or persistent infection and cannot be effectively controlled; Severe infection: Refers to sepsis or uncontrolled infection of the infected foci, and can be included in the group after infection is controlled Combined metabolic diseases (except diabetes); Combined with severe autoimmune disease or innate immune deficiency; Untreated active hepatitis (hepatitis B, defined as hepatitis B virus surface antigen [HBsAg] test results are positive, HBV-DNA ≥ 500 IU/ml and abnormal liver function; hepatitis C, defined as hepatitis C antibody [ HCV-Ab] positive, HCV-RNA higher than the detection limit of the analysis method and abnormal liver function) or combined with hepatitis B and C co-infection; Human immunodeficiency virus (HIV) infection or known acquired immunodeficiency syndrome (AIDS), or syphilis infection; A history of severe allergies to biological products (including antibiotics); Participate in any other clinical drug trials at the same time within one month; There are other serious physical or mental illnesses or laboratory abnormalities that may increase the risk of participating in the research, or interfere with the results of the research, and patients who the researcher believes are not suitable for participating in this research.

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 75 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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Auto CAR-T<br>Patients will be treated with Auto CAR-T cells | Biological: Auto CAR-T<br>* Biological: Auto CAR-T<br>Drug: Cyclophosphamide,Fludarabine<br>* Drug: Cyclophosphamide,Fludarabine<br>Procedure: Leukapheresis<br>* Leukapheresis<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Safety: Incidence and severity of adverse events | To evaluate the possible adverse events occurred within first one month after CAR-T infusion, including the incidence and severity of symptoms such as cytokine release syndrome and neurotoxicity | first one month after CAR-T infusion | 
| Efficacy: Remission Rate | Remission Rate including complete remission (CR), partial remission (PR), objective response (ORR = CR + PR), disease stability (SD), disease progression (PD) and unresponsive (NR) | 3 months post CAR-T cells infusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Efficacy:duration of response (DOR) | duration of response (DOR) | 24 months after CAR-T infusion | 
| Efficacy: progression-free survival (PFS) | progression-free survival (PFS) time | 24 months after CAR-T infusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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NHL