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This study is a single-arm, open-label clinical investigation to evaluate the tolerance, safety and preliminary efficacy of CAR-T (U96) in the treatment of relapsed/refractory B-cell tumors. The study will be conducted in two disease types, acute B-lymphoblastic leukemia and B-cell lymphoma, with a dose escalation plan using the "3+3" method. Each dose group is planned to enroll 3 to 6 patients, with a total of approximately 30 to 48 patients to be enrolled in the entire study. After signing the informed consent form, patients will undergo screening tests. If they meet the inclusion and exclusion criteria, they will be enrolled in the study. After receiving U96 treatment, patients will be followed up. It is recommended that they stay in the hospital for at least 14 days after administration. Safety and efficacy follow-ups will be conducted at 28 days and 3, 6, 12, 18, and 24 months after treatment. The follow-up period after treatment will last for 2 years, with a long-term follow-up of 15 years to assess the efficacy and safety until the end of the study or the patient withdraws from the study. For patients who have received U96 treatment, even if they withdraw from the study early, the investigators should still conduct long-term safety follow-ups according to the protocol to evaluate the long-term safety of the product.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Acute B lymphocytic leukemia group1 | Experimental | Research product: U96 (CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR) Dosage: The dosage was 0.2 × 10^9 TU. Administration method: Intravenous injection, single administration. |
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| Acute B lymphocytic leukemia group2 | Experimental | Research product: U96 (CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR) Dosage: The dosage was 0.4× 10^9 TU. Administration method: Intravenous injection, single administration. |
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| Acute B lymphocytic leukemia group3 | Experimental | Research product: U96 (CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR) Dosage: The dosage was 0.8× 10^9 TU. Administration method: Intravenous injection, single administration. |
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| Acute B lymphocytic leukemia group4 | Experimental | Research product: U96 (CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR) Dosage: The dosage was 1.6× 10^9 TU. Administration method: Intravenous injection, single administration. |
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| B-cell lymphoma group1 | Experimental |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| U96 | Drug | U96(CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR) |
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| Measure | Description | Time Frame |
|---|---|---|
| Dose-limiting toxicity (DLT) | Description: DLT refers to any of the following conditions occurring within 28 days after cell reinfusion that are related to cell infusion: ① Hematologic DLT: Grade 4 toxicity (excluding lymphopenia) not caused by the underlying disease and taking more than 30 days to resolve to ≤ Grade 2. ② Non-hematologic DLT: Any toxicity ≥ Grade 4 that is possibly related to CAR-T therapy, or Grade 3 toxicity that requires ≥7 days to resolve to ≤ Grade 2 or to return to baseline. | Within 28 days after U96 infusion |
| Adverse Event (AE) | Description: Record the types, occurrence frequency and severity of adverse events (AEs) related to CAR-T, with specific definitions determined according to CTCAE v5.0.The CRS and ICANS ratings do not use CTCAE but adopt the evaluation criteria in the ASTCT standards. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) | The acute B lymphocytic leukemia group is defined as the proportion of patients who achieved complete remission (CR), complete remission with incomplete hematological recovery (CRh), and complete remission with incomplete bone marrow recovery (CRi); the B-cell lymphoma group is defined as the complete remission rate (CR) and partial remission (PR) as determined by the investigators. |
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Inclusion Criteria:
(All the following items must be met simultaneously)
Patients must voluntarily sign the informed consent form and have good compliance;
For different indications, patients must meet the following requirements:
2-1) Patients in the acute B lymphoblastic leukemia group:
Bone marrow or peripheral blood or immunohistochemistry or pathology shows CD19 antigen positive;
According to the Lugano Lymphoma Response Evaluation Criteria (Cheson 2014), B-cell lymphoma patients have at least one evaluable lesion, or positive lesions confirmed by PET-CT;
Eastern Cooperative Oncology Group (ECOG) performance status score is 0-3;
At screening, there is a certain degree of bone marrow reserve, defined as: absolute lymphocyte value (ALC) ≥ 0.3×109/L, platelet (PLT) ≥ 30×109/L (allowing the result after administration);
Have appropriate organ function, and need to meet the following standards: aspartate aminotransferase (AST) ≤ 3 times the upper limit of normal (ULN); alanine aminotransferase (ALT) ≤ 3 times ULN (for liver function abnormalities caused by tumor infiltration, AST and ALT ≤ 5 times ULN are required); total serum bilirubin The serum bilirubin should be ≤ 2 times the ULN, except for those with Gilbert syndrome who have a combined condition; the total bilirubin should be ≤ 3 times the ULN and the direct bilirubin should be ≤ 1.5 times the ULN. Patients with Gilbert syndrome who meet these criteria can be included. The serum creatinine should be ≤ 1.5 times the ULN, or the creatinine clearance rate should be ≥ 60 mL/min (Cockcroft and Gault formula); possess the lowest level of pulmonary reserve, defined as ≤ 1 grade of dyspnea and a blood oxygen saturation > 91% in non-oxygenated state; left ventricular ejection fraction of the left heart in echocardiography should be ≥ 50%; International Normalized Ratio (INR) should be ≤ 1.5 times the ULN, and activated partial thromboplastin time (APTT) should be ≤ 1.5 times the ULN;
The blood/urine pregnancy test for women of childbearing age during the screening period should be negative. Any male or female patient with reproductive capacity must agree to use an effective contraceptive method throughout the study process and for at least 1 year after the administration of the study treatment;
The expected survival period should be greater than 3 months.
Exclusion Criteria:
(Any of the following conditions will disqualify one from participating)
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sheng-Li Xue | Contact | 008651267781139 | slxue@suda.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital of Soochow University | Suzhou | Jiangsu | 215006 | China |
Baseline characteristics of patients, outcomes
one year after the study termination
Clinical researchers worldwide can access the IPD and supporting information after author authorization.
They can get IPD details by visiting the ResMan system.
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| ID | Term |
|---|---|
| D012008 | Recurrence |
| D015448 | Leukemia, B-Cell |
| D008223 | Lymphoma |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007945 | Leukemia, Lymphoid |
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Research product: U96 (CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR) Dosage:The dosage was 0.2 × 10^9 TU. Administration method: Intravenous injection, single administration.
|
| B-cell lymphoma group2 | Experimental | Research product: U96 (CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR) Dosage:The dosage was 0.4 × 10^9 TU. Administration method: Intravenous injection, single administration. |
|
| B-cell lymphoma group3 | Experimental | Research product: U96 (CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR) Dosage:The dosage was 0.8× 109 TU. Administration method: Intravenous injection, single administration. |
|
| B-cell lymphoma group4 | Experimental | Research product: U96 (CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR) Dosage:The dosage was 1.6× 109 TU. Administration method: Intravenous injection, single administration. |
|
| 28 days and within 3 months after infusion of U96 |
| MRD-negative rate (for B-ALL) | The proportion of B-ALL patients with negative MRD in the bone marrow when the therapeutic effect reaches remission. B-ALL patients have residual leukemia cells in the bone marrow detected by flow cytometry below 10-⁴ and/or negative qualitative or quantitative detection of bone marrow fusion genes (if any).MRD is detected by CD19 flow cytometry immunophenotyping (bone marrow). | 28 days and within 3 months after infusion of U96 |
| Duration of Response (DOR) | It refers to the time from the evaluation of CR/CRh/CRi in patients with acute B-cell leukemia, or from the time when patients with B-cell lymphoma first reach response (CR or PR) to disease recurrence/disease progression/death due to disease.Subjects who have not experienced disease progression or death by the time of the final data collection will be censored at the time of their last valid tumor assessment. Common reasons for censoring include, but are not limited to: ①Loss to follow-up; ②Withdrawal from the study; ③Initiation of a new anticancer therapy. | 2 years |
| Best Overall Response (BOR) | The Best Overall Response is defined as the proportion of patients who achieve the best response (CR or CRi) after study treatment.The review period extends from the start of infusion of U96 until the initiation of subsequent anti-cancer therapy, disease progression, withdrawal of consent, death, or study closure, whichever comes first. | 2 years |
| Overall Survival (OS) | Defined as the time from the date of cell infusion to the date of death from any cause. For subjects who are still alive at the time of analysis, OS will be censored on the date of last known contact. | 2 years |
| Progression-Free Survival (PFS) | The duration from the start of the treatment to the onset of disease progression or death for patients with B-cell lymphoma. For patients who did not experience disease progression or death by the analysis cutoff date, the last tumor evaluation time was used for censored processing. | 2 years |
| Relapse-Free Survival (RFS) | Defined as the time from the start of study treatment to the date of first documented relapse in patients with B-cell acute lymphoblastic leukemia (B-ALL). | 2 years |
| Event-Free Survival (EFS) | Defined as the time from the date of cell infusion to the occurrence of any of the following events (whichever comes first): ①Death from any cause after achieving remission ②Disease relapse or progression ③Treatment failure, defined as either lack of efficacy or discontinuation of the clinical trial due to: -Death -Adverse events -Lack of efficacy or disease progression -Initiation of new antitumor therapy | 2 years |
| Pharmacokinetics-AUC(0-28) | The area under the curve from 0 to 28 days for the reinfusion. | 2 years |
| Pharmacokinetics-Cmax | The peak concentration of the drug in the peripheral blood sample. | 2 years |
| Pharmacokinetics-Tmax | The time at which the peak concentration of the drug is reached in the peripheral | 2 years |
| IL-6 | Changes in the levels of IL-6 | Within 28 days after U96 infusion |
| Ferritin | Changes in the levels of Ferritin | Within 28 days after U96 infusion |
| C-reactive protein(CRP) | Changes in the levels of CRP | Within 28 days after U96 infusion |
| Pharmacokinetics-Proportion of B cells. | Change from baseline in peripheral blood B cell ratio | Within 28 days after U96 infusion |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |