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Evaluation of Lymphodepletion With ALLO-647 in Adults With R/R Large B Cell Lymphoma Receiving ALLO-501A Allogeneic CAR T Cell Therapy

A Randomized, Open-Label, Phase 2 Study Evaluating Lymphodepletion With ALLO-647, Fludarabine, and Cyclophosphamide, vs. Fludarabine and Cyclophosphamide Alone, in Subjects With Relapsed/Refractory Large B-Cell Lymphoma Receiving ALLO-501A Allogeneic CAR T Cell Therapy

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05714345
Acronym
EXPAND
Enrollment
2
Registered
2023-02-06
Start date
2023-11-01
Completion date
2024-10-28
Last updated
2026-03-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Relapsed/Refractory Large B Cell Lymphoma

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

BIOLOGICALALLO-647

ALLO-647 is a monoclonal antibody that recognizes a CD52 antigen

DRUGFludarabine

Chemotherapy for lymphodepletion

DRUGCyclophosphamide

Chemotherapy for lymphodepletion

GENETICALLO-501A

ALLO-501A is an allogeneic CAR T cell therapy targeting CD19

Sponsors

Allogene Therapeutics
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

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

MeasureTime frameDescription
Progression-Free Survival (PFS) of a Lymphodepletion Regimen Containing FCA vs FC Alone Per Independent Review CommitteeUp to 60 monthsTo 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

MeasureTime frameDescription
Overall-response Rate (ORR) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review CommitteeUp to 60 monthsTo 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 CommitteeUp to 60 monthsTo 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 CommitteeUp to 60 monthsTo 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 FCUp 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 ReviewNeither 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 ReviewOverall 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 FCFrom 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 EventsUp 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

ArmCount
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
Total2

Baseline characteristics

CharacteristicLymphodepletion With Fludarabine, Cyclophosphamide, and ALLO-647 (FCA)Lymphodepletion With Fludarabine, and Cyclophosphamide (FC)Total
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
1 Participants1 Participants2 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
NA ParticipantsNA ParticipantsNA Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
NA ParticipantsNA ParticipantsNA Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
NA ParticipantsNA ParticipantsNA Participants
Race (NIH/OMB)
American Indian or Alaska Native
NA ParticipantsNA ParticipantsNA Participants
Race (NIH/OMB)
Asian
NA ParticipantsNA ParticipantsNA Participants
Race (NIH/OMB)
Black or African American
NA ParticipantsNA ParticipantsNA Participants
Race (NIH/OMB)
More than one race
NA ParticipantsNA ParticipantsNA Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
NA ParticipantsNA ParticipantsNA Participants
Race (NIH/OMB)
Unknown or Not Reported
NA ParticipantsNA ParticipantsNA Participants
Race (NIH/OMB)
White
NA ParticipantsNA ParticipantsNA Participants
Region of Enrollment
Belgium
0 Participants1 Participants1 Participants
Region of Enrollment
United States
1 Participants0 Participants1 Participants
Sex: Female, Male
Female
NA ParticipantsNA ParticipantsNA Participants
Sex: Female, Male
Male
NA ParticipantsNA ParticipantsNA Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
1 / 11 / 1
other
Total, other adverse events
1 / 11 / 1
serious
Total, serious adverse events
0 / 10 / 1

Outcome results

Primary

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.

Secondary

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.

ArmMeasureValue (MEAN)
Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA)Depth and Duration of a Lymphodepletion Regimen Containing FCA vs FC300 cells/cubic millimeter
Lymphodepletion with fludarabine, and cyclophosphamide (FC)Depth and Duration of a Lymphodepletion Regimen Containing FCA vs FC417 cells/cubic millimeter
Secondary

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.

Secondary

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.

ArmMeasureGroupValue (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 ReviewProgression-Free Survival0.99 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 ReviewEvent-Free Survival0.99 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 ReviewProgression-Free Survival1.84 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 ReviewEvent-Free Survival1.84 Months
UnknownDuration of Response, Event-Free Survival and Progression-Free Survival of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator ReviewDuration of Response Months
Secondary

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.

Secondary

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.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA)Incidence of ALLO-501A Related Treatment Emergent Adverse Events1 Participants
Lymphodepletion with fludarabine, and cyclophosphamide (FC)Incidence of ALLO-501A Related Treatment Emergent Adverse Events0 Participants
Secondary

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.

ArmMeasureValue (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
Secondary

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.

ArmMeasureValue (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 Review0 Participants
Lymphodepletion with fludarabine, and cyclophosphamide (FC)Overall Response Rate of a Lymphodepletion Regimen Containing FCA vs FC Based on Response Assessment Per Investigator Review0 Participants
Secondary

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.

ArmMeasureValue (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 Committee0 Participants
Lymphodepletion with fludarabine, and cyclophosphamide (FC)Overall-response Rate (ORR) of a Lymphodepletion Regimen Containing FCA vs FC Per Independent Review Committee0 Participants
Secondary

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.

ArmMeasureValue (MEDIAN)
Lymphodepletion with fludarabine, cyclophosphamide, and ALLO-647 (FCA)Overall Survival (OS) of a Lymphodepletion Regimen Containing FCA vs FC4.50 Months
Lymphodepletion with fludarabine, and cyclophosphamide (FC)Overall Survival (OS) of a Lymphodepletion Regimen Containing FCA vs FC10.09 Months

Source: ClinicalTrials.gov · Data processed: Mar 3, 2026