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To study the safety and effectiveness of cord blood-derived CAR-NK cells targeting CD19 in patients with B-cell non-Hodgkin's lymphoma
This is an open, single-arm, single-dose, dose-escalation clinical trial designed to evaluate the safety and the preliminary efficacy of CB CAR-NK019 cells. 9-18 patients are planned to be enrolled in the dose-escalation trial (2×10^6 cells/kg ,3×10^6 cells/kg, 4×10^6 cells/kg) . The primary endpoints are DLT, MTD, and the second endpionts are the overall response rates (CR and PR), overall survival, and progression-free survival. Based on the results in the dose-escalation trial, the recommended dose will be determined. Another 30 patients will be enrolled to estimate the safety and efficacy of CB CAR-NK019 under the best dose.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CB CAR-NK019 | Experimental | All subjects were intravenously administrated with CAR-NK019 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| anti-CD19 CAR-NK | Biological | lentiviral vector-transducted cord blood-derived NK cells to express anti-CD19 CAR |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of dose limiting toxicity (DLTs) | To evaluate the safety, tolerability, and determine the recommended dosage of cord blood-derived Anti-CD19 CAR-NK Cell Therapy for B-cell Non-Hodgkin Lymphoma | Up to 28 days |
| Measure | Description | Time Frame |
|---|---|---|
| Complete response rate (CR) | To determine the anti-tumor effectivity of CB CAR-NK019 | Up to 2 years |
| Progression free survival (PFS) | To determine the anti-tumor effectivity of CB CAR-NK019 |
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Inclusion Criteria:
Volunteer to participate in this study and sign an informed consent form; Age 18-75 years old, no gender limit;
Histologically diagnosed as diffuse large B-cell lymphoma (DLBCL), transforming follicular lymphoma (TFL), primary mediastinal B-cell lymphoma (PMBCL), mantle cell lymphoma (MCL) and other inert B-cells NHL conversion type:
Refractory or relapsed DLBCL refers to the failure to achieve complete remission after 2-line treatment; disease progression during any treatment, or disease stable time equal to or less than 6 months; or disease progression or recurrence within 12 months after autologous hematopoietic stem cell transplantation ; Refractory or relapsed MCL must be resistant to or intolerable to BTK inhibitors; Refractory or relapsed indolent B-cell NHL is the failure or recurrence of third-line treatment; Previous treatment must include CD20 monoclonal antibody treatment (unless the subject is CD20 negative) and anthracyclines; At least one measurable lesion with the longest diameter ≥ 1.5 cm exists; The expected survival period is ≥12 weeks; The puncture section of the tumor tissue was positive for CD19 expression; ECOG score 0-2 points;
Sufficient organ function reserve:
Alanine aminotransferase, aspartate aminotransferase ≤ 2.5× UNL (upper limit of normal value); Creatinine clearance rate (Cockcroft-Gault method) ≥60 mL/min; Serum total bilirubin and alkaline phosphatase ≤1.5× UNL; Glomerular filtration rate>50Ml/min Cardiac ejection fraction (EF) ≥50%; Under natural indoor air environment, basic oxygen saturation>92% Allow a previous stem cell transplantation The approved anti-B-cell lymphoma treatments, such as systemic chemotherapy, systemic radiotherapy, and immunotherapy, have been completed for at least 3 weeks before the study medication; Allow patients who have previously received CAR-T cell therapy and have failed or relapsed after 3 months of evaluation; Female subjects of childbearing age must have a negative pregnancy test and agree to take effective contraceptive measures during the trial Two tests for the new coronavirus were negative.
Exclusion Criteria:
Impaired subjects;
Those who have received anti-tumor therapy in the early stage but the toxic reaction has not recovered (the CTCAE 5.0 toxic reaction has not recovered to ≤1, except for fatigue, anorexia, and hair loss); Subjects with a history of epilepsy or other central nervous system diseases; Enhanced CT or MRI of the head showed evidence of central nervous system lymphoma; Have received any other drugs that target CD19; Women who are breastfeeding and unwilling to stop breastfeeding; Any other situation that the investigator believes may increase the risk of the subject or interfere with the results of the test.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wenbin Qian | Contact | +8613605801032 | qianwb@zju.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Wenbin Qian | 2nd Affiliated Hospital, School of Medicine, Zhejiang University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 2nd Affiliated Hospital, School of Medicine, Zhejiang University | Recruiting | Hanzhou | Zhejiang | 310009 | China |
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| ID | Term |
|---|---|
| D016393 | Lymphoma, B-Cell |
| ID | Term |
|---|---|
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| Up to 2 years |
| Duration of response (DOR) | To determine the anti-tumor effectivity of CB CAR-NK019 | Up to 2 years |
| Overall survival (OS) | To determine the anti-tumor effectivity of CB CAR-NK019 | Up to 2 years |
| Partial response rate (PR) | To determine the anti-tumor effectivity of CB CAR-NK019 | Up to 2 years |
| Overall response rate (ORR) | To determine the anti-tumor effectivity of CB CAR-NK019 | Up to 2 years |
| Immunogenicity after the infusion of CB CAR-NK019 | To evaluate the immunogenicity of CB CAR-NK019 | Up to 2 years |
| D008232 |
| Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |