Relapsed or Refractory Lymphoma
Conditions
Keywords
CD30, CD30-CART
Brief summary
This is a single-center, open-label study conducted in subjects with relapsed or refractory CD30-positive lymphoma, with priority given to Hodgkin lymphoma and anaplastic large cell lymphoma.
Detailed description
The primary purpose of this study is to evaluate the preliminary efficacy, safety, and tolerability of CD30-targeted CAR-T cell therapy in participants with CD30-positive relapsed or refractory lymphoma.
Interventions
DRUGCD30 CAR-T Cells
Lymphodepletion preconditioning is required prior to CAR-T cell therapy. Lymphodepletion will be performed using a regimen of cyclophosphamide (250-500 mg/m²) and fludarabine (25-30 mg/m²), each administered for 3 consecutive days.
Sponsors
Shanghai Unicar-Therapy Bio-medicine Technology Co.,Ltd
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. Subjects must provide written informed consent and demonstrate good compliance with study procedures. 2. Age between 18 and 70 years, inclusive; male or female. 3. Histologically confirmed relapsed or refractory lymphoma (with priority for Hodgkin lymphoma, anaplastic large cell lymphoma, or other lymphoproliferative disorders), with CD30 expression confirmed by immunohistochemistry or flow cytometry (≥50% positive cells). 4. Relapsed or refractory disease, defined as: * \*\*Hodgkin Lymphoma (HL):\*\* 1. Failure to achieve remission or disease progression after autologous hematopoietic stem cell transplantation (auto-HSCT); OR 2. Failure of at least two prior lines of systemic chemotherapy; OR 3. Ineligibility for auto-HSCT due to: 1. Chemotherapy resistance (failure to achieve CR or PR after salvage chemotherapy); 2. Failed stem cell collection, or investigator-assessed inability to collect, or severe comorbidities, or patient refusal of auto-SCT. * \*\*Anaplastic Large Cell Lymphoma (ALCL):\*\* Failure of at least two prior lines of systemic chemotherapy or relapse after response. * \*\*Other CD30+ lymphomas:\*\* No standard treatment options available, or failure after standard therapy. 5. At least one evaluable lesion according to the Lugano Classification for Malignant Lymphomas (Cheson 2014). 6. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 3. 7. Adequate bone marrow reserve at screening: * Absolute lymphocyte count (ALC) ≥ 0.3 × 10⁹/L; * Platelet count (PLT) ≥ 30 × 10⁹/L (transfusion-supported values are acceptable). 8. Adequate organ function, defined as: * Aspartate aminotransferase (AST) ≤ 3 × upper limit of normal (ULN); * Alanine aminotransferase (ALT) ≤ 3 × ULN (≤ 5 × ULN if due to tumor infiltration); * Total serum bilirubin ≤ 2 × ULN, except for Gilbert's syndrome (total bilirubin ≤ 3 × ULN and direct bilirubin ≤ 1.5 × ULN); * Serum creatinine ≤ 1.5 × ULN OR creatinine clearance ≥ 60 mL/min (Cockcroft and Gault formula); * No more than grade 1 dyspnea, and oxygen saturation \> 91% on room air; * Left ventricular ejection fraction (LVEF) ≥ 50% on echocardiogram; * International Normalized Ratio (INR) ≤ 1.5 × ULN and activated partial thromboplastin time (APTT) ≤ 1.5 × ULN. 9. Female subjects of childbearing potential must have a negative serum or urine pregnancy test within 7 days prior to CAR-T infusion. All sexually active males and females of childbearing potential must agree to use effective contraception throughout the study and for at least 1 year after the last dose of study treatment. 10. Adequate venous access for leukapheresis or blood collection, and no contraindications to leukapheresis. 11. Expected survival of at least 3 months.
Exclusion criteria
1. History of another malignancy, except for malignancies in complete remission for \> 3 years or carcinoma in situ. 2. Lymphoma infiltration of the cardiac atria or ventricles. 3. Use of immunosuppressive agents or corticosteroids within 1 week prior to leukapheresis, unless the investigator determines that the impact on T cells is minimal. 4. Presence of any of the following: * Positive hepatitis B e antibody (HBe-Ab) and/or hepatitis B core antibody (HBc-Ab) with HBV-DNA copy number above the lower limit of quantification; * Positive hepatitis C antibody (HCV-Ab) with HCV-RNA copy number above the lower limit of quantification; * Positive Treponema pallidum antibody (TP-Ab); * Positive human immunodeficiency virus (HIV) antibody test. 5. Bacterial, fungal, viral, mycoplasmal, or other type of infection that is judged by the investigator to be difficult to control. 6. Previous or current central nervous system (CNS) disease unrelated to the current lymphoma, such as seizures, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or any CNS-related autoimmune disease, unless judged by the investigator to be controllable. 7. Any of the following within 12 months prior to signing informed consent: * Cardiac angioplasty or stenting; * New York Heart Association (NYHA) Class III-IV congestive heart failure; * Myocardial infarction, unstable angina, or other clinically significant cardiac history as judged by the investigator; * QTc interval \> 480 ms (calculated using the Fridericia formula) at screening; * Left ventricular ejection fraction (LVEF) \< 50% on echocardiogram. 8. Primary immunodeficiency. 9. History of severe immediate hypersensitivity reaction to any of the study drugs. 10. Administration of a live vaccine within 6 weeks prior to screening. 11. Pregnant or lactating female. 12. Active autoimmune disease. 13. Active acute or chronic graft-versus-host disease (GVHD) at the time of signing informed consent. 14. Allogeneic hematopoietic stem cell transplantation within 6 months prior to signing informed consent. 15. Participation in any other interventional clinical trial within 30 days prior to signing informed consent. 16. Any other condition that, in the opinion of the investigator, makes the subject unsuitable for participation in this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Dose-Limiting Toxicity (DLT) and Treatment-Emergent Adverse Events (TEAEs) Within 28 Days Post CAR-T Infusion | 28 days post CAR-T cell infusion (for DLT); up to 24 months post CAR-T cell infusion (for other safety assessments) | Incidence, type, frequency, and severity of DLT within 28 days post CAR-T infusion; incidence of TEAEs, clinically significant abnormalities in laboratory tests, vital signs, electrocardiogram (ECG), and echocardiography results after CAR-T infusion, graded by CTCAE v5.0. |
| Objective Response Rate (ORR), as assessed by Investigators | 2 years post CAR T cell infusion | The Objective Response Rate (ORR) is the percentage of participants who achieved a best overall response of Complete Remission (CR) or Partial Remission(PR) |
| Duration of response (DOR) | 2 years post CAR T cell infusion | Duration of response (DOR) is defined as the time from the first documented objective response to the first documented disease progression or death. |
| Overall survival (OS) | 2 years post CAR T cell infusion | Overall Survival (OS) was defined as the time from the date of first infusion of U01 to the date of death due to any cause. |
| Progression-free survival (PFS) | 2 years post CAR T cell infusion | Progression-free survival (PFS) was defined as the time from the date of infusion to the earliest date of the first objective documentation of progressive disease (PD) or death due to any cause. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pharmacokinetics of U29 | 2 years post CAR T cell infusion | Time at the maximal concentration(Tmax) |
| Pharmacodynamics of U29 | 2 years post CAR T cell infusion | Concentration levels of CAR-T-related serum cytokines such as IL-6, IFN γ, ferritin and CRP at each time point |
Countries
China
Outcome results
None listed