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Evaluate the safety (P-I), pharmacokinetics and anti-tumor effect of immunotherapy of autologous T cells genetically modified to express anti-CD19 chimeric antigen receptor (CAR) (TBI-1501) for relapsed or refractory CD19+ B-cell acute lymphoblastic leukemia.
Enroll patients after confirming eligibility. Following enrollment, peripheral blood mononuclear cells and blood plasma will be obtained from each subject by apheresis to start the manufacturing of TBI-1501.
Before TBI-1501 administration, it is necessary to pass the quality tests. Subject will be hospitalized from Day -3 to Day 28, and administered Cyclophosphamide (1,000 mg/m2/day×2 days) on Day -3 and Day -2.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose Level -1 to 2 | Experimental | 0.3 to 3 x 10^6 autologous CD19-CAR-T cells/kg per patient will be administered intravenously after a conditioning chemotherapy with cyclophosphamide. cohort -1: 3×10^5 cells/kg cohort 1: 1×10^6 cells/kg cohort 2: 3×10^6 cells/kg. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TBI-1501 | Biological | Phase-I portion: Cyclophosphamide is administered for conditioning medication of TBI1501, that is CD19-CAR-T cells, (cohort -1: 3×10^5 cells/kg, cohort 1: 1×10^6 cells/kg, cohort 2: 3×10^6 cells/kg). Phase-II portion: Recommended dose of Phase-II part will be administered. Cyclophosphamide will be administered as conditioning. The end of study will be Week 52 after administration of TBI-1501. |
| Measure | Description | Time Frame |
|---|---|---|
| Phase-I portion: Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 | Adverse event (frequency, seriousness, duration, causality, severity, classification), mortality, severe adverse event, discontinuation due to adverse event. | One year |
| Phase-II portion: Anti-tumor effect (CR+CRi rate) | Complete Remission (CR)+Complete Remission with Incomplete Blood Count Recovery (CRi) , as determined by assessments of peripheral blood and bone marrow. | 56 days |
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Inclusion Criteria:
In phase-1 study, patients must be ≥ 18 years of age. In phase-2 study, patients must be ≥ 16 years of age.
Patients with relapse or refractory CD19+ acute B-cell lymphoblastic leukemia
Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2.
Patients must have adequate key organ function (bone marrow, heart, lung, liver, renal, etc), as defined below
Patients must be able to understand and willing to sign a written informed consent document (for patients <20 years of age their legal guardian must give informed consent).
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Akita University Hospital | Akita | Akita | 010-8543 | Japan | ||
| University Of Fukui Hospital |
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| ID | Term |
|---|---|
| D054198 | Precursor Cell Lymphoblastic Leukemia-Lymphoma |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009374 | Neoplasms, Experimental |
| D007154 | Immune System Diseases |
| ID | Term |
|---|---|
| D007945 | Leukemia, Lymphoid |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D008232 | Lymphoproliferative Disorders |
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Peripheral blood will be collected from a subject after obtaining a written informed consent. Peripheral blood mononuclear cells (PBMCs) and plasma are obtained from the blood, and T cells contained in the PBMCs are transduced with anti-CD19 CAR gene by using retroviral vector.
Cyclophosphamide will be administered after obtaining a written informed consent and completing registration.
CD19-CAR-T will be administered in the split dose. Phase 2 recommended dose will be applied for phase 1 portion. The investigator assesses efficacy of CD19-CAR-T in accordance with study-specific criteria, at 8 week after the infusion of CD19-CAR-T (or at the time of termination). The investigator also assesses the safety during the follow-up period. Long-term follow-up study is conducted at frequency of once a year for 15 years after the infusion of CD19-CAR-T in reference to guidelines of FDA.
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|
| Yoshida |
| Fukui |
| 910-1193 |
| Japan |
| Kyushu University Hospital | Higashiku | Fukuoka | 812-8582 | Japan |
| Hokkaido University Hospital | Sapporo | Hokkaido | 060-8648 | Japan |
| Kobe City Medical Center General Hospital | Kobe | Hyōgo | 650-0047 | Japan |
| Mie University Hospital | Tsu | Mie-ken | 514-8507 | Japan |
| Tohoku University Hospital | Sendai | Miyagi | 980-8574 | Japan |
| Okayama University Hospital | Okayama | Okayama-ken | 700-8558 | Japan |
| Jichi Medical University hospital | Shimotsuke-shi | Tochigi | 329-0498 | Japan |
| Cancer Institute Hospital Of JFCR | Kōto | Tokyo | 135-8550 | Japan |
| The Institute of Medical Science, The University of Tokyo | Minato-ku | Tokyo | 108-8639 | Japan |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |