Phase 2
N=74
Lisocabtagene Maraleucel (JCAR017) as Second-Line Therapy (TRANSCEND-PILOT-017006)
Lymphoma, Non-Hodgkin · Lymphoma, Nonhodgkin · Lymphoma, B-Cell · Lymphoma, Large B-Cell, Diffuse
Bottom Line
View on ClinicalTrials.gov: NCT03483103 ↗Enrolled (actual)
74
Serious AEs
32.8%
Results posted
Dec 2022
Primary outcome: Primary: Overall Response Rate (ORR) — 80.3 Percent of Participants — p=<.0001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- lisocabtagene maraleucel (Biological)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Juno Therapeutics, a Subsidiary of Celgene
- Primary completion
- Sep 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Overall Response Rate (ORR) |
80.3 | <.0001 sig |
| SECONDARY Number of Participants With Any Treatment-Emergent Adverse Events (TEAEs) |
59; 20; 48; 48 | — |
| SECONDARY Change From Baseline of Hematology Laboratory Results: Hemoglobin |
1.9 | — |
| SECONDARY Change From Baseline of Hematology Laboratory Results: Leukocytes, Lymphocytes, Neutrophils, Platelets |
0.921; 0.537; -0.216; -61.6 | — |
| SECONDARY Change From Baseline of Chemistry Laboratory Results: Albumin |
3.05 | — |
| SECONDARY Change From Baseline of Chemistry Laboratory Results: Alanine Aminotransferase, Aspartate Aminotransferase, Lactate Dehydrogenase |
4.6; -3.9; -138.2 | — |
| SECONDARY Change From Baseline of Chemistry Laboratory Results: Bilirubin, Creatinine, Direct Bilirubin, Urate |
-0.1741; 5.8734; 0.0306; 5.7897 | — |
| SECONDARY Change From Baseline of Chemistry Laboratory Results: Calcium Corrected, Magnesium, Phosphate, Potassium, Sodium |
-0.0261; -0.0209; 0.0479; -0.05; 1.0 | — |
| SECONDARY Complete Response (CR) Rate |
54.1 | — |
| SECONDARY Duration of Response (DOR) |
23.26 | — |
| SECONDARY Duration of Response (DOR) in Participants With Complete Response (CR) |
NA | — |
| SECONDARY Progression-Free Survival (PFS) |
9.03 | — |
| SECONDARY Event-Free Survival (EFS) |
7.23 | — |
| SECONDARY Overall Survival (OS) |
NA | — |
| SECONDARY PK Parameters of JCAR017 in Blood as Assessed by qPCR: Cmax |
22516.3 | — |
| SECONDARY PK Parameters of JCAR017 in Blood as Assessed by qPCR: Tmax |
10.0 | — |
| SECONDARY PK Parameters of JCAR017 in Blood as Assessed by qPCR: AUC (0-28) |
178631.0 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Fatigue Subscale |
36.706; 37.731 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Physical Functioning Subscale |
77.827; 71.667 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Cognitive Functioning Subscale |
83.333; 88.194 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Global Health/QoL Subscale |
66.815; 72.049 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Role Functioning Subscale |
77.083; 69.792 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Emotional Functioning Subscale |
81.061; 86.806 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Social Functioning Subscale |
74.702; 72.917 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Pain Subscale |
26.488; 13.542 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Nausea/Vomiting Subscale |
5.655; 6.250 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Constipation Subscale |
11.905; 6.944 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Diarrhea Subscale |
13.690; 11.806 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Insomnia Subscale |
25.595; 20.139 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Dyspnea Subscale |
10.714; 13.194 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Appetite Loss Subscale |
18.788; 22.222 | — |
| SECONDARY Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Financial Difficulties Subscale |
13.690; 14.583 | — |
| SECONDARY Health-Related Quality of Life (HRQoL) Assessed by the FACT-Lym Subscale |
44.22; 48.71 | — |
| SECONDARY Health-Related Quality of Life (HRQoL) Assessed by the EuroQol Instrument EQ-5D-5L |
0.7378; 0.7719 | — |
| SECONDARY Numbers of Intensive Care Unit (ICU) Inpatient Days |
0.0 | — |
| SECONDARY Numbers of Non-intensive Care Unit (ICU) Inpatient Days |
14.0 | — |
| SECONDARY The Number of Participants That Were Hospitalized For Adverse Events, Prophylaxis, Other |
2; 36; 3 | — |
Summary
This is a Phase 2, open-label, multicenter study to determine the efficacy and safety of lisocabtagene maraleucel (JCAR017) in adult subjects who have relapsed from, or are refractory to, a single line of immunochemotherapy for aggressive B-cell non-Hodgkin lymphoma (NHL) and are ineligible for hematopoietic stem cell transplant (based on age, performance status, and/or comorbidities). Subjects will receive treatment with lisocabtagene maraleucel and will be followed for 2 years for safety, pharmacokinetics and biomarkers, disease status, quality of life, and survival.
Eligibility Criteria
Inclusion Criteria
- Confirmation of relapsed or refractory aggressive B-cell non-Hodgkin lymphoma of the following histology at relapse: diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS; de novo or transformed follicular lymphoma [tFL]), high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements with DLBCL histology (double/triple hit lymphoma [DHL/THL]), and follicular lymphoma Grade 3B per WHO 2016 classification
- Previous treatment must include treatment with a single line of chemoimmunotherapy containing an anthracycline and a CD20-targeted agent
- Subjects must be deemed ineligible for both high-dose chemotherapy and hematopoietic stem cell transplant (based on age, performance status and/or comorbidities) while also having adequate organ function for CAR T cell treatment.
- Positron emission tomography (PET)-positive disease
- Histological confirmation of diagnosis at last relapse. Enough tumor material must be available for central confirmation of diagnosis, otherwise a new tumor biopsy is mandated.
- ECOG performance status of 0, or 1, or 2
- Adequate vascular access for leukapheresis procedure (either peripheral line or surgically-placed line)
- Subjects must agree to use appropriate contraception
- Subjects must agree to not donate blood, organs, semen, and egg cells for usage in other individuals for at least 1 year following lymphodepleting chemotherapy
Exclusion Criteria
- Subjects with central nervous system (CNS)-only involvement by malignancy (note: subjects with secondary CNS involvement are allowed on study)
- History of another primary malignancy that has not been in remission for at least 2 years.
- Previous treatment with CD19-targeted therapy, with the exception of prior lisocabtagene maraleucel treatment in this protocol for subjects receiving retreatment
- Active hepatitis B or hepatitis C infection at the time of screening
- History of or active human immunodeficiency virus (HIV) infection at the time of screening
- Uncontrolled systemic fungal, bacterial, viral or other infection despite appropriate antibiotics or other treatment at the time of leukapheresis or lisocabtagene maraleucel administration
- History of any one of the following cardiovascular conditions within the past 6 months: Class III or IV heart failure as defined by the New York Heart Association, cardiac angioplasty or stenting, myocardial infarction, unstable angina, or other clinically significant cardiac disease
- History or presence of clinically relevant CNS pathology
- Pregnant or nursing women
- Subject does not meet protocol-specified washout periods for prior treatments
- Prior hematopoietic stem cell transplant
- Progressive vascular tumor invasion, thrombosis, or embolism
- Venous thrombosis or embolism not managed on stable regimen of anticoagulation
- Uncontrolled medical, psychological, familial, sociological, or geographical conditions
Data sourced from ClinicalTrials.gov (NCT03483103). 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.