Phase 2
Completed N=307
Study Evaluating the Safety and Efficacy of KTE-C19 in Adult Participants With Refractory Aggressive Non-Hodgkin Lymphoma
Source: ClinicalTrials.gov NCT02348216 ↗Enrolled (actual)
307
Serious AEs
57.6%
Results posted
Nov 2021
Primary outcomePrimary: Phase 1 Study: Number of Participants Experiencing Adverse Events (AEs) Defined as Dose Limiting Toxicities (DLTs) — 1 Participants
Summary
This study will be separated into 3 distinct phases designated as the Phase 1 study, Phase 2 pivotal study (Cohort 1 and Cohort 2), and Phase 2 safety management study (Cohort 3 and Cohort 4, Cohort 5 and Cohort 6).
The primary objectives of this study are:
* Phase 1 Study: Evaluate the safety of axicabtagene ciloleucel regimens
* Phase 2 Pivotal Study; Evaluate the efficacy of axicabtagene ciloleucel
* Phase 2 Safety Management Study: Assess the impact of prophylactic regimens or earlier interventions on the rate and severity of cytokine release syndrome (CRS) and neurologic toxicities
Subjects who received an infusion of KTE-C19 will complete the remainder of the 15 year follow-up assessments in a separate long-term follow-up study, KT-US-982-5968.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Phase 1 Study: Number of Participants Experiencing Adverse Events (AEs) Defined as Dose Limiting Toxicities (DLTs) |
1 | — |
| PRIMARY Phase 2 Pivotal Study (Cohorts 1 and 2): Overall Response Rate (ORR) as Assessed by Investigator Per Revised International Working Group (IWG) Response Criteria for Malignant Lymphoma |
83; 83 | — |
| PRIMARY Phase 2 Safety Management Study (Cohort 3): Percentage of Participants With Treatment-Emergent Cytokine Release Syndrome (CRS) and Neurologic Toxicities by Severity Grades |
34; 55; 0; 3; 0; 3 | — |
| PRIMARY Phase 2 Safety Management Study (Cohort 4): Percentage of Participants With Treatment-Emergent CRS and Neurologic Toxicities by Severity Grades |
32; 59; 2; 0; 0; 2 | — |
| PRIMARY Phase 2 Safety Management Study (Cohort 5): Percentage of Participants With Treatment-Emergent CRS and Neurologic Toxicities by Severity Grades |
38; 46; 0; 2; 0; 2 | — |
| PRIMARY Phase 2 Safety Management Study (Cohort 6): Percentage of Participants With Treatment-Emergent CRS and Neurologic Toxicities by Severity Grades |
35; 45; 0; 0; 0; 0 | — |
| SECONDARY Phase 2: Duration of Response (DOR) as Assessed by Investigator Per Revised IWG Response Criteria for Malignant Lymphoma |
5.0; 75.4; NA; NA; 27.5; NA | — |
| SECONDARY Phase 1 Study: ORR as Assessed by Investigator Per Revised IWG Response Criteria for Malignant Lymphoma |
71 | — |
| SECONDARY Phase 2 Pivotal Study (Cohorts 1 and 2): ORR Per Independent Radiological Review Committee (IRRC) |
70; 88 | — |
| SECONDARY Phase 2 Safety Management Study (Cohorts 3, 4, 5, and 6): ORR as Assessed by Investigator Per the Revised IWG Response Criteria for Malignant Lymphoma |
63; 76; 72; 95 | — |
| SECONDARY Phase 2: Progression-Free Survival (PFS) as Assessed by Investigator Per Revised IWG Response Criteria for Malignant Lymphoma |
5.1; 49.1; 6.2; NA; 3.1; NA | — |
| SECONDARY Phase 2: Overall Survival (OS) |
15.4; NA; 34.8; NA; 20.6; NA | — |
| SECONDARY Phase 2 Pivotal Study (Cohorts 1 and 2): Duration of Response (DOR) Using IRRC Per Cheson 2007 |
NA; NA | — |
| SECONDARY Phase 2 Pivotal Study (Cohorts 1 and 2): Best Overall Response Using IRRC Per Cheson 2007 |
51; 67; 19; 21; 21; 4 | — |
| SECONDARY Phase 2 Pivotal Study (Cohorts 1 and 2): PFS Using IRRC Per Cheson 2007 |
6.9; NA | — |
| SECONDARY Percentage of Participants Experiencing Treatment-Emergent Adverse Events (TEAEs) |
100; 100; 100; 100; 100; 100 | — |
| SECONDARY Percentage of Participants With Clinically Significant Changes in Laboratory Values Reported as Grade 3 or Higher TEAEs |
100; 96; 96; 97; 98; 100 | — |
| SECONDARY Percentage of Participants With Anti-Axicabtagene Ciloleucel Antibodies |
29; 5; 8; 11; 0; 8 | — |
| SECONDARY Pharmacokinetics: Peak Level of Anti-CD19 CAR T Cells in Blood |
58.512; 31.512; 58.633; 53.670; 52.91; 26.63 | — |
| SECONDARY Pharmacodynamics: Peak Level of Cytokines in Serum (Phase 1 and Phase 2 Cohorts 1, 2, and 3) |
2000.0; 2000.0; 2000.0; 2000.0; 33.1; 31.1 | — |
| SECONDARY Pharmacodynamics: Peak Level of Cytokines (IP-10, Granzyme B, IFN-gamma, IL-1 RA, IL-10, IL-15, IL-2, IL-6, IL-7, IL-8, TNF Alpha, and GM-CSF) in Serum (Phase 2 Cohorts 4, 5, and 6) |
1549.70; 1746.15; 1560.03; 23.10; 27.90; 18.40 | — |
| SECONDARY Pharmacodynamics: Peak Level of Cytokines (Ferritin, ICAM-1, IL-2 R, Perforin, and VCAM-1) in Serum (Phase 2 Cohorts 4, 5, and 6) |
1086.36; 1516.11; 903.50; 907.97; 636.74; 654.81 | — |
| SECONDARY Pharmacodynamics: Peak Level of Cytokine (CRP) in Serum |
112.6; 215.7; 186.6; 137.8; 126.53; 74.84 | — |
| SECONDARY Pharmacodynamics: Peak Level of Cytokine (Ferritin) in Serum (Phase 1 and Phase 2 Cohorts 1 and 2) |
1973400.0; 3681400.0; 1979360.0 | — |
| SECONDARY Pharmacodynamics: Peak Level of Cytokine (Ferritin) in Serum (Phase 2 Cohort 3) |
2440.2 | — |
| SECONDARY Percentage of Participants With Positive Replication Competent Retrovirus (RCR) |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Phase 2 Safety Management Study: Number of Participants With the European Quality of Life Five Dimension Five Level Scale (EQ-5D) Score |
30; 25; 33; 26; 7; 9 | — |
| SECONDARY Phase 2 Safety Management Study: EQ-5D Visual Analogue Scale (VAS) Score |
71.2; 69.5; 66.7; 70.9; 67.8; 67.2 | — |
Eligibility Criteria
Key Inclusion Criteria
- Histologically confirmed:
- Diffuse Large B Cell Lymphoma (DLBCL)
- Primary Mediastinal Large B Cell Lymphoma (PMBCL)
- Transformation Follicular Lymphoma (TFL)
- High grade B-cell lymphoma (HGBCL)
- Chemotherapy-refractory disease, defined as one of more of the following:
- No response to last line of therapy i. Progressive disease (PD) as best response to most recent therapy regimen ii. Stable disease (SD) as best response to most recent therapy with duration no longer than 6 month from last dose of therapy OR
- Refractory post-autologous stem cell transplant (ASCT) i. Disease progression or relapsed less than or equal to 12 months of ASCT (must have biopsy proven recurrence in relapsed individuals) ii. If salvage therapy is given post-ASCT, the individual must have had no response to or relapsed after the last line of therapy
- Individuals must have received adequate prior therapy including at a minimum:
- Anti-cluster of differentiate 20 (CD20) monoclonal antibody unless investigator determines that tumor is CD20-negative and
- an anthracycline containing chemotherapy regimen
- for individual with transformed FL must have chemorefractory disease after transformation to DLBCL.
- At least one measurable lesion per revised international working group (IWG Response Criteria
- Eastern cooperative oncology group (ECOG) performance status of 0 or 1
- Absolute neutrophil count (ANC) ≥ 1000/microliters (uL)
- Absolute lymphocyte count ≥ 100/uL
- Platelet count ≥ 75,000/uL
- Adequate renal, hepatic, pulmonary and cardiac function defined as:
- Creatinine clearance (as estimated by Cockcroft Gault) > 60 mL/min
- Serum alanine aminotransferase (ALT)/aspartate aminotransferase (AST) 50%, no evidence of pericardial effusion as determined by an echocardiogram (ECHO), and no clinically significant pleural effusion
- Baseline oxygen saturation >92% on room air
- All individuals or legally appointed representatives/caregivers, must personally sign and date the Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved consent form before initiating any study specific procedures or activities.
- Relapsed or refractory large B-cell lymphoma including DLBCL, PMBCL, TFL, and HGBCL after two systemic lines of therapy
Key Exclusion Criteria
- History of malignancy other than nonmelanoma skin cancer or carcinoma in situ (e.g. cervix, bladder, breast) or follicular lymphoma unless disease free for at least 3 years
- History of allogeneic stem cell transplantation
- Prior chimeric antigen receptor (CAR) therapy or other genetically modified T cell therapy
- Presence of fungal, bacterial, viral, or other infection that is uncontrolled or requiring intravenous (IV) antimicrobials for management. Simple urinary tract infection (UTI) and uncomplicated bacterial pharyngitis are permitted if responding to active treatment
- History of human immunodeficiency virus (HIV) infection or acute or chronic active hepatitis B or C infection. Individuals with history of hepatitis infection must have cleared their infection as determined by standard serological and genetic testing per current Infectious Diseases Society of America (IDSA) guidelines
- Individuals with detectable cerebrospinal fluid malignant cells, or brain metastases, or with a history of central nervous system (CNS) lymphoma or primary CNS lymphoma, cerebrospinal fluid malignant cells or brain metastases
- History or presence of CNS disorder such as seizure disorder, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or any autoimmune disease with CNS involvement
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Data sourced from ClinicalTrials.gov (NCT02348216). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.