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This study is an open-label, single-arm, prospective clinical trial involving patients with relapsed/refractory B-cell lymphoma, aimed at evaluating the safety and efficacy of CAR-T cell infusion.
This study is an open-label, single-arm, prospective clinical trial involving patients with relapsed/refractory B-cell lymphoma. It plans to enroll 9-18 participants and uses a "3+3" dose-escalation design (with 3 dose groups: 1×10^6, 2×10^6, and 3×10^6 CAR cells/kg) along with a dose-expansion study to administer CAR-T cell injection. Patients will be followed to observe adverse reactions and collect data on treatment efficacy, evaluating the safety and effectiveness of the CAR-T cell injection. The DLT observation period is 28 days after CAR-T cell infusion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CY-219 CAR-T | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CY-219 CAR-T | Drug | Eligible participants should receive preconditioning 5 to 3 days before CAR-T cell infusion. The recommended preconditioning regimen is fludarabine (30 mg/m²/day, for 3 consecutive days) and cyclophosphamide (300 mg/m²/day, for 3 consecutive days) (Flu/Cy). Thirty minutes before infusion, prophylactic medication for allergic reactions should be administered: 25 mg of promethazine hydrochloride or 12.5 mg of diphenhydramine, either intramuscularly or orally. A '3+3' dose-escalation study design will be used, aiming to recruit 9-18 subjects with relapsed/refractory B-cell lymphoma. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety indicators | Six months after CAR-T infusion, analyze the recorded possible adverse reactions, mainly including the number of cases, incidence, and severity of immune-related toxicities such as cytokine release syndrome, immune effector cell-associated neurotoxicity, hematologic toxicity, and organ toxicity. The incidence of DLT. | 6 months after CAR-T infusion |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy indicators | Tumor objective response rate (ORR) at 3 months follow-up after treatment. | Three months after treatment |
| Efficacy indicators | Complete remission (CR) rate at 3 months post-treatment follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| CAR-T single-cell phenotype and clonal characteristics | CY-219 CAR-T cell infusion product and the in vivo CAR-T single-cell phenotype, clonal characteristics of research participants, as well as other indicators of interest to researchers, such as cytokine profiles. | Test the product on the day of infusion. Follow-up will be conducted on day 10 and day 28 after infusion. From the 2nd month to the 3rd month, follow-up will be conducted once a month; from the 6th month to the 1st year, follow-up will be conducted once |
Inclusion Criteria:
1. The participant has given consent and signed the informed consent form, and is willing and able to comply with the planned visits, research treatments, laboratory tests, and other trial procedures;
2. Clinically diagnosed as a patient with relapsed/refractory B-cell lymphoma, and confirmed by pathological and histological examination as CD19 and/or CD22 B-cell lymphoma, including: diffuse large B-cell lymphoma, or transformed large B-cell lymphoma from indolent B-cell lymphoma (excluding Richter transformation, THRLBCL, BL). And meets the following criteria (meets any one of the first three items and the fourth): i. Recurrence ≥6 months after achieving remission with first-line full treatment, or ≥12 months after achieving remission following stem cell transplantation; ii. Progression during first-line treatment combined with high-risk factors (double-expressor lymphoma, double-hit lymphoma, TP53 gene mutation or deletion, IPI score ≥3); iii. Disease relapse after ≥2 lines of treatment or failure to achieve remission; iv. The participant has received the following treatment regimens after being diagnosed with LBCL:
3. Age 18 or older, both men and women are eligible;
4. Study participants with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2;
5. Expected survival of more than 3 months from the date of signing the informed consent;
6. HGB ≥ 60 g/L (transfusion allowed); LYM ≥ 0.3×10^9/L;
7. Liver and kidney function and cardiopulmonary function must meet the following requirements:
8. Participants intending to become pregnant must agree to use contraception before enrollment in the study and for one year after CAR-T cell infusion; if a participant becomes pregnant or suspects pregnancy, they should immediately inform the investigator.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Liang Huang | Contact | 02223608359 | huangliang@ihcams.ac.cn |
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|
| Three months after treatment |
| Efficacy indicators | Overall survival (OS) at 3 months post-treatment follow-up | Three months after treatment |
| Efficacy indicators | Progression-free survival (PFS) at 3 months after treatment follow-up | Three months after treatment |
| Cellular Metabolic Kinetics Indicators | Peripheral blood CAR copy number of research participants during follow-up | On the fourth, seventh, tenth, fourteenth, twenty-first, and twenty-eighth days after retransfusion |
| Cellular Metabolic Kinetics Indicators | Maximum concentration (Cmax) of CAR-T cells in peripheral blood and the time to reach it | Peripheral blood CAR copy number of research participants during follow-up |
| Cellular Metabolic Kinetics Indicators | Area under the CAR-T expansion curve AUC0-28d over 28 days | 28 days after treatment |
| ID | Term |
|---|---|
| D016393 | Lymphoma, B-Cell |
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| ID | Term |
|---|---|
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
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