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The goal of this clinical trial is to evaluate the safety, tolerability, and preliminary efficacy in adult patients with relapsed or refractory (r/r) CD19-positive B-cell Non-Hodgkin Lymphoma (B-NHL) or B-cell Leukemia. The main questions it aims to answer are:
Participants will:
Study Design and Methodology This is an investigator-initiated, open-label, single-arm, dose-escalation, and expansion exploratory clinical study. The study utilizes an "Accelerated Titration" combined with a standard "3+3" design to evaluate the safety, tolerability, and preliminary anti-tumor activity of GI001 injection-an innovative in vivo CAR-T therapy-in patients with relapsed or refractory (r/r) CD19+ B-cell malignancies.
Dose Escalation Phase Four dose levels have been pre-specified: 1E8, 3E8, 7E8 or 1E9 TU
Dose Expansion Phase Upon completion of the escalation phase and determination of the MTD or Recommended Dose for Expansion (RDE), an additional 12-18 subjects will be enrolled to further characterize the safety profile and provide a more comprehensive assessment of preliminary efficacy.
Treatment and Monitoring Subjects will receive a single intravenous infusion of GI001. Due to the risk of Cytokine Release Syndrome (CRS) and Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS), subjects must be hospitalized for intensive monitoring for at least 14 days post-infusion. Clinical assessments, including physical examinations, vital signs, and laboratory tests (hematology, biochemistry, and coagulation), will be conducted at frequent intervals.
Pharmacokinetics (PK) and Pharmacodynamics (PD)
A central laboratory will analyze peripheral blood, saliva, and urine samples to:
Long-Term Follow-up Following the initial 24-month efficacy and safety evaluation period, subjects will be invited to participate in a long-term safety follow-up study for up to 15 years, in accordance with regulatory guidelines for gene therapy products, to monitor for delayed adverse events such as secondary malignancies or prolonged B-cell aplasia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GI001 Experimental Group | Experimental | Patients with relapsed or refractory CD19-positive B-cell malignancies receiving a single intravenous infusion of GI001. The study includes a dose-escalation phase ( 1E8 to 1E9 TU) and a subsequent expansion phase at the recommended dose. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GI001 Injection | Biological | Biological: GI001 Injection GI001 is an innovative chimeric antigen receptor T-cell (CAR-T) therapy targeting CD19-positive B-cell malignancies. Administration: Subjects will receive a single dose of GI001 via intravenous (IV) infusion on Day 0. Dosing Logic: The study follows a dose-escalation design with four pre-specified dose levels: 1E8, 3E8, 7E8, and 1E9 Transducing Units (TU). The dosage is determined based on the total TU count as measured by flow cytometry. Pre-medication: Prior to infusion, subjects may receive pre-conditioning (lymphodepletion chemotherapy) as per protocol and prophylactic medication (e.g., promethazine or diphenhydramine) to prevent infusion reactions. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) |
| Baseline up to 24 months post-infusion |
| Number of Participants Experiencing Dose-Limiting Toxicities (DLTs) | DLTs are defined as specific severe toxicities occurring within the DLT observation period. This measure is used to evaluate safety, determine the Maximum Tolerated Dose (MTD), and identify the Recommended Dose for Expansion (RDE). | D0 up to D28 |
| Number of Participants with Clinically Significant Changes in Vital Signs | This measure reports the number of participants experiencing clinically significant abnormal changes from baseline in vital signs, including systolic/diastolic blood pressure, heart rate, respiratory rate, or body temperature. | Baseline up to 24 months post-infusion |
| Number of Participants with Clinical Laboratory Abnormalities | This measure reports the number of participants experiencing clinically significant laboratory abnormalities or Grade 3/4 toxicities (assessed via hematology, serum chemistry, coagulation, and urinalysis) from baseline. | Baseline up to 24 months post-infusion |
| Number of Participants with Clinically Significant Abnormal Physical Examination Findings | The number of participants who develop new, clinically significant abnormal findings during physical examinations compared to baseline. |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) | The proportion of participants achieving a Complete Response (CR) or Partial Response (PR). For B-NHL, tumor response is assessed per Lugano 2014 criteria; for B-ALL, response is defined according to protocol-specified clinical criteria. | D0 up to 24 months post-infusion |
| Complete Response Rate (CRR) |
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Inclusion Criteria:
Age: 18 years and older (inclusive).
Diagnosis: Diagnosis of CD19-positive relapsed/refractory B-cell lymphoma/leukemia:
CD19 expression: CD19 positivity detected by IHC or FACS in tumor specimens, bone marrow, or peripheral blood during screening.
Measurable disease: B-cell lymphoma subjects must have measurable lesions per Lugano 2014 (LDi > 1.5 cm for nodal, LDi > 1.0 cm for extranodal); B-lymphoma/leukemia subjects must have B-lymphoma cell proportion 5% at screening.
ECOG performance status: 0-2.
Life expectancy: 12 weeks.
Organ function: Adequate organ function meeting the following laboratory results before enrollment:
Steroids: Therapeutic doses of steroids must be stopped 72 hours before GI001 infusion (except physiological replacement doses).
CNS prophylaxis: Must be stopped 1 week before GI001 infusion (e.g., intrathecal methotrexate).
Contraception: Subjects and spouses agree to use effective contraception from signing ICF until one year after GI001 infusion or until CAR-T cells are not detected in two consecutive PCR tests (whichever is longer).
Informed Consent: Voluntarily sign the EC-approved ICF before screening.
Exclusion Criteria:
Prior antitumor therapy (except drugs proven to enhance or not affect CAR-T efficacy after elution):
Other malignancies: Malignancies within 2 years before screening, excluding adequately treated cervical carcinoma in situ, skin cancers, or radically treated localized prostate, breast (DCIS), or papillary thyroid cancers.
Organ transplant: History of solid organ transplantation.
Immunomodulators: Use within 2 weeks before administration or potential use during the study (e.g., thalidomide, lenalidomide, pomalidomide).
Corticosteroids: Requirement for long-term therapeutic doses (Prednisone > 15 mg/day or equivalent), except physiological replacement or topical/inhaled use.
CNS involvement: History or presence of CNS infiltration (leukemia/lymphoma cells in CSF; imaging showing masses/enhancement; or neurological symptoms with abnormal CSF).
Hypertension: Uncontrolled hypertension despite drug therapy.
Cardiac disease: Severe cardiac disease: MI or CABG/stenting within 6 months; unstable angina; NYHA Class III heart failure; severe arrhythmia; severe non-ischemic cardiomyopathy.
Systemic disease: Unstable systemic disease: severe liver, kidney, or metabolic disease requiring medication.
Infection: Uncontrolled active infection (bacterial, fungal, viral) requiring IV anti-infectives (continuous signs/symptoms without improvement).
Neurological/Psychiatric: Stroke or epilepsy within 6 months; other CNS diseases; uncontrolled psychiatric disorders; history deemed to increase risk or interfere with results.
Thrombosis: History of DVT or PE within 6 months.
Vaccine: Live vaccine within 6 weeks before screening.
Surgery: Major surgery within 2 weeks before screening or planned surgery within 2 weeks after administration (except local anesthesia).
Pregnancy/Lactation: Pregnant or nursing women, or those planning pregnancy during/after treatment.
Toxicity: Prior non-hematological toxicities not resolved to baseline or Grade 2 (except alopecia, fatigue, peripheral neuropathy).
Viral pseudotyping: Prior treatment using VSV-G or Nipah virus pseudotyping.
Infectious serology: HBsAg+ and/or HBcAb+ with HBV-DNA > detection limit; HCV antibody+ with HCV-RNA > detection limit; HIV antibody+; Syphilis serology+.
Extramedullary relapse: B-cell leukemia patients with isolated extramedullary relapse.
Allergy: Allergy to the study drug, excipients, or Tocilizumab.
Immunodeficiency: Patients with primary immunodeficiency.
HSCT: Planned HSCT within 28 days after GI001 injection.
Other: Other conditions deemed unsuitable by the investigator.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Li Wang | Contact | +86 15214370575 | wl_wangdong@126.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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|
| Baseline up to 24 months post-infusion |
| Changes in 12-Lead Electrocardiogram (ECG) Parameters from Baseline | Includes changes in heart rate, PR interval, QRS duration, and QTcF interval from baseline to assess cardiac safety. | Baseline up to 24 months post-infusion |
| Changes in Eastern Cooperative Oncology Group (ECOG) Performance Status Score from Baseline | The ECOG performance status scale ranges from 0 (fully active) to 5 (dead). Higher scores indicate worse performance status. The change in score from baseline will be reported. | Baseline up to 24 months post-infusion |
The proportion of participants achieving a Complete Response (CR) as their best overall response. |
| D0 up to 24 months post-infusion |
| Duration of Response (DOR) in Months | Defined as the time from the first documented disease response (CR or PR) to the date of first documented disease progression or death from any cause.Reported in months. | D0 up to 24 months post-infusion |
| Progression-Free Survival (PFS) | Defined as the time from the date of first study drug infusion to the date of first documented disease progression or death from any cause. | D0 up to 24 months post-infusion |
| Overall Survival (OS) | Defined as the time from the date of first study drug infusion to the date of death from any cause. | D0 up to 24 months post-infusion |
| Minimal Residual Disease (MRD) Negativity Rate | The proportion of participants achieving MRD negativity as determined by highly sensitive detection methods (applicable primarily for B-ALL participants). | D0 up to 24 months post-infusion |
| Peak Concentration (Cmax) of CAR-T Cells and CAR Copies | The maximum observed concentration of CD19 CAR-T cells and CAR copy numbers in peripheral blood following GI001 infusion. | Baseline, and multiple time points up to Day 28" |
| Time to Peak Concentration (Tmax) of CAR-T Cells | The time required to reach the maximum observed concentration (Cmax) of CD19 CAR-T cells and CAR copy numbers in peripheral blood following GI001 infusion. | Baseline, and multiple time points up to Day 28" |
| Area Under the Curve from Day 0 to Day 28 (AUC 0-28d) | The area under the concentration-time curve from the time of GI001 infusion (Day 0) to Day 28 for CD19 CAR-T cells and CAR copy numbers in peripheral blood. | Baseline, and multiple time points up to Day 28" |
| Changes in Serum Cytokine Concentrations from Baseline | ncludes changes in levels of systemic inflammatory markers such as IL-2, IL-6, IL-10, IFN-γ, and TNF-α from baseline to evaluate the pharmacodynamic activity and biological impact of the CAR-T treatment. | Baseline, and multiple time points through 6 months post-infusion |
| Changes in Serum C-Reactive Protein (CRP) Levels from Baseline | Measurement of changes in serum CRP levels from baseline to monitor systemic inflammatory response. | Baseline, and multiple time points through 6 months post-infusion |
| Changes in Serum Ferritin Levels from Baseline | Measurement of changes in serum ferritin levels from baseline to monitor systemic inflammatory response. | Baseline, and multiple time points through 6 months post-infusion |
| Changes in Peripheral Blood Lymphocyte Subset Counts from Baseline | Includes changes in the absolute cell counts of CD19+ B cells, CD3+ T cells, CD4+ T cells, and CD8+ T cells from baseline to evaluate immune cell profiles. | Baseline, and multiple time points through 6 months post-infusion |
| Changes in CD4/CD8 T-Cell Ratio from Baseline | Measurement of changes in the ratio of CD4+ T cells to CD8+ T cells in peripheral blood from baseline. | Baseline, and multiple time points through 6 months post-infusion |
| D008232 |
| Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |