Study of Efficacy and Safety of CTL019 in Adult ALL Patients

Overview

About this study

The purpose of this study is to determine the effectiveness and safety of CTL019 in adult patients with r/r B-cell ALL. The study will have the following sequential phases: Screening, Pre-Treatment, Treatment and Primary Follow-up, Secondary Follow-up (Relapse Follow-up) and Survival Follow-up. The total duration of the primary follow-up is 1 year from cell infusion. Safety will be assessed until the end of the treatment and primary follow-up phase.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria: 

  • Patients eligible for inclusion in this study have to meet all of the following criteria:
    • Signed written informed consent, or signed parental permission form and assent form (as applicable), must be obtained prior to any study procedures.
    • CD19 expressing malignancy for which a CTL019 treatment protocol is currently enrolling or under IRB/EC review.
    • Hemoglobin level ≥ 9.0 g/dL at screening. Transfusion support can be provided within 24 hours of starting the leukapheresis procedure to meet this criterion.
    • Platelet count ≥ 50,000/microliter at screening. Transfusion support can be provided within 24 hours of starting the leukapheresis procedure to meet this criterion.
    • Prothrombin Time (PT)/ Activated Partial Thromboplastin Time (aPTT) ≤ 1.5 x ULN at screening. Transfusion support can be provided within 24 hours of starting the leukapheresis procedure to meet this criterion.
    • Peripheral blood absolute lymphocyte count (ALC) ≥ 500/microliter at screening or if ALC <500/μL, then the absolute CD3 lymphocyte count must be ≥50/μL at screening.
    • For patients who have undergone allogeneic transplant, must be ≥3 months from allogeneic SCT at the time of leukapheresis.
    • Males and females weighing ≥10 kg who are eligible to undergo a PBMC collection by leukapheresis for potential future CTL019 manufacturing for use in a CTL019 trial.
  • PBMC collection by leukapheresis is not recommended for patients < 3 years of age due to high manufacturing failure rates with leukapheresis collections performed at this age, unless a specific Novartis CTL019 treatment protocol is open for patients < 3 years of age.

Exclusion Criteria:

  • Patients eligible for this study must not meet any of the following criteria:
    • Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test at screening;
    • Human Immunodeficiency Virus (HIV) infection at screening;
    • Presence of grade 2 to 4 acute or extensive chronic graft-versus-host disease (GVHD) at screening;
    • Any patient that in the opinion of the investigator is not medically stable to undergo the leukapheresis procedure or will not comply with the visit schedules or procedures;
    • Treatment with any prior gene therapy product;
    • Patient has participated in a research study using an investigational agent within the last 30 days prior to screening;
    • Patient should not have received long-acting growth factors or drugs used for cell mobilization (e.g., Neulasta/pegflilgrastim) within 14 days of the leukapheresis procedure. Use of short-acting growth factors of drugs used for cell mobilization (e.g., G-CSF/Neupogen/filgrastim, plerixafor) must be ≥ 5 days of leukapheresis procedure.

The following treatments/medications are excluded:

  • Chemotherapy
  • Cytotoxic chemotherapy drugs must not be given within 2 weeks of leukapheresis.
  • Intrathecal chemotherapy (IT): Recommend holding IT prior to leukapheresis collection. If clinically indicated, IT Ara-C may be given and leukapheresis collection started any time following IT Ara-C. Leukapheresis collection may be started ≥ 7 days after IT methotrexate (MTX).Pegylated-asparaginase must be stopped >4 weeks prior to leukapheresis
  • Low dose daily or weekly maintenance chemotherapy should be stopped ≥ 2 weeks prior to leukapheresis.
  • Clofarabine may be associated with prolonged lymphopenia. This should be taken into consideration when evaluation the optimal timing for leukapheresis collection. An interval of ≥8 weeks from the patient’s last clofarabine treatment is recommended.
  • Short-acting drugs(e.g tyrosine kinase inhibitors, ibrutinib and hydroxyurea) must not be given within a 72 hour window of the leukapheresis procedure.
  • Steroids
  • Therapeutic doses of steroids must be stopped > 72 hours prior to leukapheresis. However, the following physiological replacement doses of steroids are allowed: ≤ 12 mg/m2/day hydrocortisone or equivalent.
  •  
  • Immunomodulatory drugs (e.g., IFN-gamma, anti-TNF-alpha)
  • Should be stopped ≥ 2 weeks prior to leukapheresis.
  • Allogeneic cellular therapy
  • Must be ≥ 3 months from allogeneic stem cell transplant at the time of leukapheresis.
  • Any donor lymphocyte infusions (DLI) must be completed > 4 weeks prior to leukapheresis.
  • Must not have presence of grade 2 to 4 acute graft-versus-host disease (GVHD) or extensive chronic GVHD.
  • GVHD therapies
  • Any drug used to prevent or treat GVHD must be stopped > 2 weeks prior to leukapheresis (e.g., calcineurin inhibitors, methotrexate or other chemotherapy drugs, mycophenolate, rapamycin, thalidomide, or immunosuppressive antibodies such as anti-TNF-α, anti-IL6 or anti-IL6R). Topical steroids for localized treatment of GVHD are allowed.
  • Anti T-cell Directed Therapy
  • Administration of any T cell lytic or toxic agent (e.g. alemtuzumab) is strongly discouraged since residual lytic levels may destroy T-cells in the leukapheresis collection and/or prevent their in vitro CTL019 manufacturing. If such an agent has been administered within 6 weeks prior to a planned leukapheresis collection of PBMCs, contact the Sponsor, consider consultation with a pharmacology expert, and consider measuring residual drug levels, if feasible, prior to leukapheresis.
  • Anti-CD19 directed therapy
  • Has had treatment with any prior anti-CD19/anti-CD3 therapy, or any other anti-CD19 therapy unless a specific Novartis CTL019 treatment protocol would allow for prior anti-CD19 directed therapy.
  • Hepatitis B or active hepatitis C (HCV RNA positive).
  • Patients with an acute infection (bacterial, viral or fungal) or a positive blood culture should not undergo leukapheresis collection. A full course of anti-infective therapy must be administered before leukapheresis collection can occur to avoid contamination of the product.
  • Patient should not receive long-acting growth factors or drugs used for cell mobilization (e.g., Neulasta/pegfilgrastim) within 14 days of the leukapheresis procedure. Use of short-acting growth factors (e.g. G-CSF/Neupogen/filgrastim, plerixafor) must be ≥ 5 days of leukapheresis procedure.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Scottsdale/Phoenix, Ariz.

Mayo Clinic principal investigator

Jose Leis, M.D., Ph.D.

Closed for enrollment

Contact information:

Cancer Center Clinical Trials Referral Office

855-776-0015

More information

Publications

Publications are currently not available

Additional contact information

Cancer-related trials contact form

Phone: 855-776-0015 (toll-free)

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