Cord Blood-derived CAR-NK Cells Targeting CD19 for Refractory/relapsed Central Nervous System Lymphoma

Study Purpose

This study is designed to evaluate the safety and efficacy of cord blood-derived CAR-NK019 in the treatment of refractory/relapsed central nervous system lymphoma.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years - 75 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Patients with refractory/recurrent CNS lymphoma must meet all of the following criteria to be eligible: 1.
Voluntarily participate in the study and sign the informed consent; 2. Age 18-75 years old, male or female; 3. Diffuse large B-cell lymphoma (DLBCL) was confirmed by histology. CD19 expression was positive by lymphoma pathology or flow cytometry, and CD19 expression was ≥20% by IHC. 4. Imaging showed no evidence of systemic lymphoma; 5. Meets any of the following definitions for refractory/relapsed CNS lymphoma: no complete response has been achieved with prior 2-line regimen including methotrexate or cytarabine-based regimen; Disease progression during any treatment; The stable time of disease after effective treatment is less than 6 months; Disease progression or recurrence within 12 months after autologous hematopoietic stem cell transplantation. 6. Imaging showed the presence of at least one measurable lesion, with a minimum diameter of ≥10mm; 7. Expected survival ≥3 months; 8. ECOG score 0-3 points; 9. Adequate organ function reserve:
  • - alanine aminotransferase, ASpartate aminotransferase ≤ 2.5× UNL (upper limit of normal); - Creatinine clearance (Cockcroft-Gault method) ≥60 mL/min; - Serum total bilirubin and alkaline phosphatase ≤1.5× UNL; - Glomerular filtration rate >50ml/min.
  • - cardiac ejection fraction (EF) ≥45%; - Basic oxygen saturation >92% in indoor natural air environment; - Blood routine: absolute number of neutrophils >×109/L, platelet count 45×109/L, hemoglobin 80g/L; 10.
Previous autologous hematopoietic stem cell transplantation is allowed, and the interval between stem cell transfusion and CAR-NK transfusion is ≥3 months; 11. Previous CAR-T cell therapy is allowed, and the time interval between CAR-T transfusion and CAR-NK transfusion is ≥3 months; 12. Female subjects of childbearing age must test negative for pregnancy and agree to use effective contraception during the test; 13. Approved anti-tumor therapies, such as systemic chemotherapy, whole body radiotherapy and immunotherapy, have been discontinued for at least 3 weeks before the study; Discontinuation of targeted drug regiments without chemotherapy for at least 2 weeks;

Exclusion Criteria:

  • - Subjects who meet any of the following criteria will not be admitted to the study: 1.
Allergic to any of the components of cell products; 2. History of other tumors; 3. Acute grade II-IV (Glucksberg standard) GvHD or generalized chronic GvHD occurred after previous allogeneic hematopoietic stem cell transplantation; Or are receiving anti-GVHD treatment; 4. Have received gene therapy within the past 3 months; 5. Active infections requiring treatment (except simple urinary tract infections, bacterial pharyngitis), but prophylactic antibiotic, antiviral and antifungal infection treatment is permitted; 6. Persons infected with hepatitis B (HBsAg positive, but HBV-DNA<103 is not excluded) or hepatitis C virus (including virus carriers), syphilis and other acquired and congenital immunodeficiency diseases, including but not limited to HIV-infected persons; 7. Subjects with Grade III or IV cardiac dysfunction according to the New York Heart Association's cardiac function grading criteria; 8. Patients who received antitumor therapy in the early stage but did not recover toxicity (CTCAE 5.0 toxicity did not recover to ≤ grade 1, except fatigue, anorexia, alopecia); 9. Previous history of epilepsy, autoimmune encephalitis, cerebral infarction or cerebral hemorrhage within 6 months; 10. Whole-body enhanced CT or PET/CT suggests evidence of systemic lymphoma; 11. Lactating women who are unwilling to stop breastfeeding; 12. Any other circumstances that the investigator believes may increase the risk to the subject or interfere with the test results; 13. Patients requiring more than 10mg of dexamethasone per day for 3 days prior to enrollment; 14. Patients who cannot tolerate ommaya capsule implantation; 15. Those who cannot tolerate enhanced magnetic resonance imaging.

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT06827782
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 1
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Second Affiliated Hospital, School of Medicine, Zhejiang University
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

N/A
Principal Investigator Affiliation N/A
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other
Overall Status Enrolling by invitation
Countries China
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Refractory/recurrent Central Nervous System Lymphoma
Additional Details

This study is a single-center, open, single-arm incremental, exploratory study designed to evaluate the safety and efficacy of cord blood-derived CAR-NK019 in the treatment of refractory/relapsed central nervous system lymphoma. The study will be divided into two stages: Phase I is the dose escalation study, which is strictly based on the "3+3" dose escalation principle, and three dose groups are set up, which are administered through the ommaya capsule ventricle, and each dose is infused once a week for 3 weeks. Three to six subjects are intended to be enrolled in each dose group, with each subject observed for at least 28 days after receiving the initial infusion and a long-term follow-up period of two years after each infusion. Phase II is the dose expansion phase: The recommended dose and administration mode for this phase will be determined after comprehensive consideration based on safety data obtained in phase I, the proliferation and survival of CAR-NK cells in vivo, and clinical efficacy data, and 24 effective subjects will be recruited for further evaluation of efficacy and safety. Long-term follow-up lasted up to 2 years after the first CAR-NK transfusion in each patient.

Arms & Interventions

Arms

Experimental: CB CAR-NK019

Interventions

Biological: - anti-CD19 CAR-NK cells

lentiviral vector-transducted cord blood-derived NK cells to express anti-CD19 CAR

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

International Sites

Hangzhou, Zhejiang, China

Status

Address

2nd Affiliated Hospital, School of Medicine, Zhejiang University

Hangzhou, Zhejiang,

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