Relapsed/Refractory Large B Cell Lymphoma
Conditions
Keywords
CAR T, Cell Therapy, Allogeneic Cell Therapy, Cellular Immuno-therapy, AlloCAR T, ALLO-501A, ALLO-647, LBCL, Lymphoma, Large B-Cell Lymphoma
Brief summary
The purpose of the EXPAND study is to assess the safety and clinical efficacy of ALLO-647 combined with fludarabine and cyclophosphamide compared to fludarabine and cyclophosphamide alone in a lymphodepletion regimen prior to ALLO-501A CAR T therapy in adults with relapsed or refractory large B-cell lymphoma
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Histologically confirmed diagnosis of relapsed/refractory large B-cell lymphoma at last relapse * Relapsed or refractory disease after at least 2 lines of chemotherapy * ECOG performance status 0 or 1 * Absence of significant donor (product)-specific anti-HLA antibodies (DSA) * Adequate hematological, renal and liver function
Exclusion criteria
* Active central nervous system involvement by malignancy * Autologous or allogeneic HSCT within last 6 months prior to lymphodepletion * Hypocellular bone marrow for age
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression-Free Survival (PFS) of a Lymphodepletion Regimen Containing FCA vs FC Alone Per Independent Review Committee | Up to 60 months | To assess the clinical efficacy of ALLO-647 (in a lymphodepletion regimen before ALLO-501A) compared to FC alone as measured by PFS and assessed by Independent Review Committee (IRC) in subjects with R/R (Relapsed / Refractory) LBCL (Large B Cell Lymphoma). In this study, PFS is defined as the time from randomization to disease progression, or relapse per the Lugano classification criteria (Cheson et al, 2014) as assessed by IRC or death. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall-response Rate (ORR) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review Committee | Up to 60 months | To assess the clinical efficacy of ALLO-647 as measured by ORR and assessed by Independent Review Committee (IRC) between treatment arms. ORR is defined as best overall response (Complete Response and Partial Response, assessed using the Lugano classification criteria 2014; Cheson , et al, 2014) by IRC at any time up through commencement of new anti-cancer therapy or withdrawal of consent. |
| Event-Free-Survival (EFS) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review Committee | Up to 60 months | To assess clinical efficacy of ALLO-647 with FC (in a lymphodepletion regimen before ALLO-501A) compared to FC alone as measured by Event-Free Survival (EFS) and assessed by Independent Review Committee (IRC) in subjects with R/R LBCL. EFS is defined as the time from randomization to disease progression or relapse per the Lugano classification criteria 2014 as assessed by IRC, new anti-cancer therapy, or death. |
| Duration of Response (DOR) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review Committee | Up to 60 months | To characterize the efficacy of ALLO-647 as measured by Duration of Response (DOR) and assessed by Independent Review Committee (IRC) between treatment arms. DOR is defined as time from the first observed response to disease progression or relapse (per IRC) or death. |
| Overall Survival (OS) of a Lymphodepletion Regimen Containing FCA vs FC | Up to 60 months, study completion, or death, whichever occurs earlier. Specifically, OS was followed for 4.5 and 10.09 months for each participant in the FCA and FC arm, respectively. | To characterize the efficacy of ALLO-647 as measured by OS, defined as the time from randomization to death. |
| Duration of Response, Event-Free Survival and Progression-Free Survival of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review | Neither participant was a responder, therefore DOR was not followed. EFS and PFS were followed from first dose of study treatment until disease progression, subsequent anticancer therapy, or death. EFS and PFS were followed for 0.99 to 1.84 months. | To characterize the efficacy of ALLO-647 as measured by response rate per investigator, Duration of Response (DOR), Event-Free Survival (EFS), Progression-Free Survival (PFS), assessed by investigator assessments between treatment arms. DOR is defined as time from the first observed response to disease progression or relapse per investigator assessment, or death. EFS is defined as the time from randomization to disease progression or relapse per investigator assessment per the Lugano classification criteria, new anti-cancer therapy, or death. PFS is defined as time from the randomization to progression or relapse per investigator assessment per the Lugano classification criteria, or death. |
| Overall Response Rate of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review | Overall Response Rate was followed until disease progression or subsequent anticancer therapy, whichever occurred earlier. Specifically, ORR was followed for 0.99 to 1.84 months for each participant in the FCA and FC arm, respectively. | To characterize the efficacy of ALLO-647 as measured by response rate per investigator, Overall Response Rate (ORR), and assessed by investigator assessments between treatment arms. ORR in FCA vs FC alone per investigator assessment at any time up through commencement of new anti-cancer therapy or withdrawal of consent. |
| Depth and Duration of a Lymphodepletion Regimen Containing FCA vs FC | From study treatment to study discontinuation, death, withdrawal of consent, or date of initiation of another anticancer therapy, whichever occurs first, for a maximum of 9 months. Only Day 28 lymphocyte counts are available for both participants. | To characterize the depth and duration of lymphodepletion with and without ALLO-647, as assessed by lymphocyte count. |
| Incidence of Treatment-Emergent Adverse Events (TEAEs) | Up to 60 months, study completion, or death, whichever occurs earlier. TEAEs were followed for 4.5 and 10.09 months for each participant in the FCA and FC arm, respectively. | To evaluate the overall safety profile of ALLO-647 by comparing FCA lymphodepletion with FC lymphodepletion. |
| Incidence of ALLO-501A Related Treatment Emergent Adverse Events | Up to 60 months, study completion, or death, whichever occurs earlier. Related TEAEs were followed for 4.5 and 10.09 months for each participant in the FCA and FC arm, respectively. | To evaluate the overall safety profile of ALLO-501A following lymphodepletion. |
Countries
Belgium, United States
Participant flow
Recruitment details
The study enrolled participants from the United States and Europe. The informed consent date of the first participant was 01 November 2023, and the informed consent date of the last participant was 04 December 2023. The study was terminated prior to completion for business reasons, not due to safety or efficacy concerns.
Participants by arm
| Arm | Count |
|---|---|
| Lymphodepletion With Fludarabine, Cyclophosphamide, and ALLO-647 (FCA) Lymphodepletion with FCA followed by treatment with ALLO-501A arm.
Lymphodepletion:
* Fludarabine (F) 30 mg/m\^2/day intravenously (IV) on Days -5, -4, -3
* Cyclophosphamide (C) 300 mg/m\^2/ day IV on Days -5, -4, -3
* ALLO-647 (A) 30 mg/day IV on Days -5, -4, -3
Treatment with ALLO-501A:
• ALLO-501A as a single IV dose of 120 × 10\^6 CAR+ T cells on Day 0 | 1 |
| Lymphodepletion With Fludarabine, and Cyclophosphamide (FC) Lymphodepletion with FC followed by treatment with ALLO-501A arm.
Lymphodepletion:
* Fludarabine 30 mg/m\^2/day IV, on Days -5, -4, -3
* Cyclophosphamide 300 mg/m\^2/ day IV on Days -5, -4, -3
Treatment with ALLO-501A:
• ALLO-501A as a single IV dose of 120 × 10\^6 CAR+ T cells on Day 0 | 1 |
| Total | 2 |
Baseline characteristics
| Characteristic | Lymphodepletion With Fludarabine, Cyclophosphamide, and ALLO-647 (FCA) | Lymphodepletion With Fludarabine, and Cyclophosphamide (FC) | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 1 Participants | 1 Participants | 2 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | NA Participants | NA Participants | NA Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | NA Participants | NA Participants | NA Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | NA Participants | NA Participants | NA Participants |
| Race (NIH/OMB) American Indian or Alaska Native | NA Participants | NA Participants | NA Participants |
| Race (NIH/OMB) Asian | NA Participants | NA Participants | NA Participants |
| Race (NIH/OMB) Black or African American | NA Participants | NA Participants | NA Participants |
| Race (NIH/OMB) More than one race | NA Participants | NA Participants | NA Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | NA Participants | NA Participants | NA Participants |
| Race (NIH/OMB) Unknown or Not Reported | NA Participants | NA Participants | NA Participants |
| Race (NIH/OMB) White | NA Participants | NA Participants | NA Participants |
| Region of Enrollment Belgium | 0 Participants | 1 Participants | 1 Participants |
| Region of Enrollment United States | 1 Participants | 0 Participants | 1 Participants |
| Sex: Female, Male Female | NA Participants | NA Participants | NA Participants |
| Sex: Female, Male Male | NA Participants | NA Participants | NA Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 1 / 1 | 1 / 1 |
| other Total, other adverse events | 1 / 1 | 1 / 1 |
| serious Total, serious adverse events | 0 / 1 | 0 / 1 |
Outcome results
Progression-Free Survival (PFS) of a Lymphodepletion Regimen Containing FCA vs FC Alone Per Independent Review Committee
To assess the clinical efficacy of ALLO-647 (in a lymphodepletion regimen before ALLO-501A) compared to FC alone as measured by PFS and assessed by Independent Review Committee (IRC) in subjects with R/R (Relapsed / Refractory) LBCL (Large B Cell Lymphoma). In this study, PFS is defined as the time from randomization to disease progression, or relapse per the Lugano classification criteria (Cheson et al, 2014) as assessed by IRC or death.
Time frame: Up to 60 months
Population: Intent-to-Treat (ITT) Analysis Set: All randomized participants. Data does not exist as assessment of efficacy per Independent Review Committee was not performed.
Depth and Duration of a Lymphodepletion Regimen Containing FCA vs FC
To characterize the depth and duration of lymphodepletion with and without ALLO-647, as assessed by lymphocyte count.
Time frame: From study treatment to study discontinuation, death, withdrawal of consent, or date of initiation of another anticancer therapy, whichever occurs first, for a maximum of 9 months. Only Day 28 lymphocyte counts are available for both participants.
Population: Safety-Analysis Set: All randomized participants who received at least one (partial or complete) dose of FCA/FC or ALLO-501A. Only Day 28 lymphocyte counts are available for both participants.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA) | Depth and Duration of a Lymphodepletion Regimen Containing FCA vs FC | 300 cells/cubic millimeter |
| Lymphodepletion with fludarabine, and cyclophosphamide (FC) | Depth and Duration of a Lymphodepletion Regimen Containing FCA vs FC | 417 cells/cubic millimeter |
Duration of Response (DOR) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review Committee
To characterize the efficacy of ALLO-647 as measured by Duration of Response (DOR) and assessed by Independent Review Committee (IRC) between treatment arms. DOR is defined as time from the first observed response to disease progression or relapse (per IRC) or death.
Time frame: Up to 60 months
Population: ITT Analysis Set: All randomized participants. Data does not exist as assessment of efficacy per Independent Review Committee was not performed.
Duration of Response, Event-Free Survival and Progression-Free Survival of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review
To characterize the efficacy of ALLO-647 as measured by response rate per investigator, Duration of Response (DOR), Event-Free Survival (EFS), Progression-Free Survival (PFS), assessed by investigator assessments between treatment arms. DOR is defined as time from the first observed response to disease progression or relapse per investigator assessment, or death. EFS is defined as the time from randomization to disease progression or relapse per investigator assessment per the Lugano classification criteria, new anti-cancer therapy, or death. PFS is defined as time from the randomization to progression or relapse per investigator assessment per the Lugano classification criteria, or death.
Time frame: Neither participant was a responder, therefore DOR was not followed. EFS and PFS were followed from first dose of study treatment until disease progression, subsequent anticancer therapy, or death. EFS and PFS were followed for 0.99 to 1.84 months.
Population: ITT Analysis Set: All randomized participants. Duration of Response data is not applicable since there are no responders per investigator assessment.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA) | Duration of Response, Event-Free Survival and Progression-Free Survival of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review | Progression-Free Survival | 0.99 Months |
| Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA) | Duration of Response, Event-Free Survival and Progression-Free Survival of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review | Event-Free Survival | 0.99 Months |
| Lymphodepletion with fludarabine, and cyclophosphamide (FC) | Duration of Response, Event-Free Survival and Progression-Free Survival of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review | Progression-Free Survival | 1.84 Months |
| Lymphodepletion with fludarabine, and cyclophosphamide (FC) | Duration of Response, Event-Free Survival and Progression-Free Survival of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review | Event-Free Survival | 1.84 Months |
| Unknown | Duration of Response, Event-Free Survival and Progression-Free Survival of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review | Duration of Response | — Months |
Event-Free-Survival (EFS) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review Committee
To assess clinical efficacy of ALLO-647 with FC (in a lymphodepletion regimen before ALLO-501A) compared to FC alone as measured by Event-Free Survival (EFS) and assessed by Independent Review Committee (IRC) in subjects with R/R LBCL. EFS is defined as the time from randomization to disease progression or relapse per the Lugano classification criteria 2014 as assessed by IRC, new anti-cancer therapy, or death.
Time frame: Up to 60 months
Population: ITT Analysis Set: All randomized participants. Data does not exist as assessment of efficacy per Independent Review Committee was not performed.
Incidence of ALLO-501A Related Treatment Emergent Adverse Events
To evaluate the overall safety profile of ALLO-501A following lymphodepletion.
Time frame: Up to 60 months, study completion, or death, whichever occurs earlier. Related TEAEs were followed for 4.5 and 10.09 months for each participant in the FCA and FC arm, respectively.
Population: Safety-Analysis Set: All randomized participants who received at least one (partial or complete) dose of ALLO-647 or ALLO-501A.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA) | Incidence of ALLO-501A Related Treatment Emergent Adverse Events | 1 Participants |
| Lymphodepletion with fludarabine, and cyclophosphamide (FC) | Incidence of ALLO-501A Related Treatment Emergent Adverse Events | 0 Participants |
Incidence of Treatment-Emergent Adverse Events (TEAEs)
To evaluate the overall safety profile of ALLO-647 by comparing FCA lymphodepletion with FC lymphodepletion.
Time frame: Up to 60 months, study completion, or death, whichever occurs earlier. TEAEs were followed for 4.5 and 10.09 months for each participant in the FCA and FC arm, respectively.
Population: Safety-Analysis Set: All randomized participants who received at least one (partial or complete) dose of ALLO-647 or ALLO-501A.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA) | Incidence of Treatment-Emergent Adverse Events (TEAEs) | 1 Participants |
| Lymphodepletion with fludarabine, and cyclophosphamide (FC) | Incidence of Treatment-Emergent Adverse Events (TEAEs) | 1 Participants |
Overall Response Rate of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review
To characterize the efficacy of ALLO-647 as measured by response rate per investigator, Overall Response Rate (ORR), and assessed by investigator assessments between treatment arms. ORR in FCA vs FC alone per investigator assessment at any time up through commencement of new anti-cancer therapy or withdrawal of consent.
Time frame: Overall Response Rate was followed until disease progression or subsequent anticancer therapy, whichever occurred earlier. Specifically, ORR was followed for 0.99 to 1.84 months for each participant in the FCA and FC arm, respectively.
Population: ITT Analysis Set: All randomized participants.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA) | Overall Response Rate of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review | 0 Participants |
| Lymphodepletion with fludarabine, and cyclophosphamide (FC) | Overall Response Rate of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review | 0 Participants |
Overall-response Rate (ORR) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review Committee
To assess the clinical efficacy of ALLO-647 as measured by ORR and assessed by Independent Review Committee (IRC) between treatment arms. ORR is defined as best overall response (Complete Response and Partial Response, assessed using the Lugano classification criteria 2014; Cheson , et al, 2014) by IRC at any time up through commencement of new anti-cancer therapy or withdrawal of consent.
Time frame: Up to 60 months
Population: ITT Analysis Set: All randomized participants. Data does not exist as assessment of efficacy per Independent Review Committee was not performed.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA) | Overall-response Rate (ORR) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review Committee | 0 Participants |
| Lymphodepletion with fludarabine, and cyclophosphamide (FC) | Overall-response Rate (ORR) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review Committee | 0 Participants |
Overall Survival (OS) of a Lymphodepletion Regimen Containing FCA vs FC
To characterize the efficacy of ALLO-647 as measured by OS, defined as the time from randomization to death.
Time frame: Up to 60 months, study completion, or death, whichever occurs earlier. Specifically, OS was followed for 4.5 and 10.09 months for each participant in the FCA and FC arm, respectively.
Population: ITT Analysis Set: All randomized participants.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA) | Overall Survival (OS) of a Lymphodepletion Regimen Containing FCA vs FC | 4.50 Months |
| Lymphodepletion with fludarabine, and cyclophosphamide (FC) | Overall Survival (OS) of a Lymphodepletion Regimen Containing FCA vs FC | 10.09 Months |