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This single-arm, open-label pilot study will assess the safety and efficacy of RN1701, a bispecific CD19/CD20-targeted allogeneic CAR-T-cell product, in patients with relapsed or refractory B-cell lymphoma. Up to 19 participants will be enrolled in a conventional 3 + 3 dose-escalation scheme. The primary objective of the study is to evaluate the safety and feasibility of RN1701 for the treatment of relapsed/refractory B-cell lymphoma. The secondary objective is to evaluate the efficacy of RN1701 for the treatment of relapsed/refractory B-cell lymphoma. The exploratory objective is to evaluate the expansion, persistence, and ability of RN1701 to deplete CD19- and/or CD20-positive cells in patients with relapsed/refractory B-cell lymphoma.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Relapsed/refractory B-cell lymphoma | Experimental | Relapsed/refractory B-cell lymphoma patients to be treated with a single dose of RN1701 cells |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| RN1701 injection | Biological | RN1701 injection is a bispecific CD19/CD20-targeted allogeneic CAR-T. A single infusion of CAR-T cells will be administered intravenously |
|
| Measure | Description | Time Frame |
|---|---|---|
| Toxicity and adverse event grading after RN1701 treatment | all toxicities and AEs will be assessed according to the National Cancer Institute CTCAE v5.0 | up to 12 months after infusion |
| CRS grading after RN1701 treatment | CRS will be graded using the Lee DW et al. CRS grading scale. Grade 1: Fever, mild symptoms, manageable with supportive care Grade 2: Moderate symptoms (eg, hypotension, hypoxia), requires intervention (eg, intravenous fluids, antipyretics) Grade 3: Severe symptoms (eg, multiorgan involvement), requires corticosteroids and tocilizumab Grade 4: Life-threatening, requires intensive care unit (ICU) care and urgent interventions | up to 12 months after infusion |
| Measure | Description | Time Frame |
|---|---|---|
| Overall response rate (ORR =CR + PR) of patients receive RN1701 treatment | according to the Lugano criteria and CSCO guidelines | 1,3,6,and 12months after infusion |
| Disease control rate (DCR=CR +PR +SD) of patients receive RN1701 treatment |
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Inclusion Criteria:
Voluntary participation; full understanding of the study and provision of written informed consent obtained before any study-related procedure not part of standard care; willingness to comply with follow-up.
Age 18-75 years; either sex.
ECOG performance status 0-1.
Histologically confirmed large B-cell lymphoma, follicular lymphoma, mantle-cell lymphoma, or indolent lymphoma transformed to DLBCL; CD19 and/or CD20 positive.
At least one measurable lesion per Lugano criteria: nodal lesion longest diameter >1.5 cm, extranodal lesion >1.0 cm.
Prior treatment response must meet one of the following:
• Large B-cell lymphoma, grade 3B follicular lymphoma, transformed indolent lymphoma: i. Primary refractory and ineligible/unable to receive autologous CAR-T: best response PD after ≥2 cycles of first-line therapy, or SD after ≥4 cycles.
ii. Relapse ≤12 months after achieving CR with first-line chemo-immunotherapy. iii. Relapse/progression ≤12 months after autologous HSCT. iv. Refractory to, relapsed after, or progressed on ≥2 prior lines (including autologous CAR-T): best response PD or SD after ≥2 cycles of the most recent regimen.
v. Transformed indolent lymphoma: prior chemotherapy for iNHL and ≥1 systemic regimen after transformation, fulfilling the above refractory/relapse criteria.
• Grade 1, 2, or 3A follicular lymphoma: i. Primary refractory and ineligible/unable to receive autologous CAR-T: best response PD after ≥2 cycles of first-line therapy.
ii. Refractory to, relapsed after, or progressed on ≥2 prior lines (including autologous CAR-T): best response PD or SD after ≥2 cycles of the most recent regimen.
• Mantle-cell lymphoma: i. Primary refractory and ineligible/unable to receive autologous CAR-T: best response PD after ≥2 cycles of first-line therapy, or SD after ≥4 cycles.
ii. Refractory to, relapsed after, or progressed on ≥2 prior lines (including autologous CAR-T): best response PD or SD after ≥2 cycles of the most recent regimen.
Estimated life expectancy ≥3 months.
Screening laboratory values (may be repeated once):
Toxicities from prior anti-cancer therapy (except alopecia, nausea, and the above lab values) must have stabilized at baseline or resolved to ≤Grade 1.
WOCBP must have a negative high-sensitivity serum β-hCG pregnancy test at screening and again before the first dose of cyclophosphamide/fludarabine.
Subjects of reproductive potential must use effective contraception for ≥12 months after completing study therapy.
Exclusion Criteria:
Subjects with any of the following conditions are ineligible for this trial:
Any malignancy other than B-cell non-Hodgkin lymphoma ever diagnosed or treated, except:
Prior anti-cancer therapy within the stated windows (before lymphodepletion):
Any autologous cellular or gene therapy other than CD19-directed autologous CAR-T.
Any allogeneic cellular (including CAR-T) or gene therapy.
Prior allogeneic haematopoietic stem-cell transplantation.
Positive donor-specific antibody (DSA).
At least one of the following high-risk features:
Active CNS involvement (symptomatic or positive CSF/imaging); subjects with prior CNS disease now in remission (asymptomatic with negative CSF and imaging) are eligible.
Significant bleeding diathesis: gastrointestinal bleeding, haemorrhagic cystitis, coagulopathy, hypersplenism (splenomegaly on exam/US, cytopenias, hyperplastic marrow) or ongoing anticoagulation.
Chronic concomitant systemic corticosteroids or other immunosuppressants, except: topical, ocular, intra-articular, nasal or inhaled corticosteroids; short-course steroids for prophylaxis (e.g., contrast allergy).
Severe underlying medical conditions:
Significant cardiac disease:
Resting oxygen saturation <92%.
Clinically relevant prior or current CNS disorder: epilepsy, seizure-like episodes, paralysis, aphasia, stroke, severe head trauma, dementia, Parkinson's disease, cerebellar disorder, organic brain syndrome or major psychiatric illness.
Live-attenuated vaccine within 4 weeks before screening.
Major surgery within 2 weeks before screening or planned within 2 weeks after study treatment (local anaesthesia allowed).
Positive screen for HBsAg, HBeAg, HBV DNA, HCV antibody, HCV RNA, or HIV antibody.
Life-threatening allergy, hypersensitivity or intolerance to study-drug excipients including, but not limited to, DMSO.
Lactating women.
Any condition that, in the investigator's opinion, renders the subject unsuitable for the study.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wenyu Shi | Contact | 13515203737 | shiwenyu@hotmail.com |
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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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according to the Lugano criteria and CSCO guidelines
| 1, 3, 6 and 12 months after infusion |
| Assessment includes contrast enhanced CT of head/neck, chest, abdomen,and pelvis, plus whole-body PET-CT | Tumor measurements and evaluations must be performed with the same technique used at baseline | 1,3,6,and 12 months after infusion |
| CAR copies of CAR-T in blood after RN1701 treatment | CAR copies in copies/ug genome DNA | Days 0, 1, 3, 5, 7, 9,11, 14, 21, 28 and month 2, 3, 6, 9, 12 after infusion |
| Cell count of CAR-T in blood after RN1701 treatment | Cell count of CAR-T in cells/ul | Days 0, 1, 3, 5, 7, 9,11, 14, 21, 28 and month 2, 3, 6, 9, 12 after infusion |
| D008232 |
| Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |