Clinical Trial

Disease: Relapsed or Refractory B-cell Acute Lymphoblastic Leukaemia, B-ALL, (NCT02746952)

Disease info:

Leukaemia is cancer of the white blood cells which are responsible for fighting infection. In leukaemia, the bone marrow produces abnormal levels of white blood cells. B-cell acute lymphoblastic leukaemia (B-ALL) is an aggressive (fast-growing) type of leukaemia in which too many B-cell lymphoblasts (immature white blood cells) are found in the bone marrow and blood. It is the most common type of ALL. Also called B-cell acute lymphocytic leukaemia and precursor B-lymphoblastic leukaemia. 

 

Frequency:
ALL accounts for less than 1% of all cancers in the U.S., with around 6,540 new cases estimated in the U.S. in 2023. ALL is the most common type of cancer found in children, though it can affect adults too.
Official title:
Phase I, Open Label, Dose-escalation Study Followed by a Safety Expansion Part to Evaluate the Safety, Expansion and Persistence of a Single Dose of UCART19 (Allogeneic Engineered T-cells Expressing Anti-CD19 Chimeric Antigen Receptor), Administered Intravenously in Patients With Relapsed or Refractory CD19 Positive B-cell Acute Lymphoblastic Leukaemia (B-ALL)
Who:

Reuben Benjamin, MD, PhD King's College Hospital NHS Trust

Partners:

ADIR, a Servier Group company

Locations:

United States, Massachusetts

Massachusetts General Hospital, Boston, Massachusetts, United States, 02114

 

United States, Pennsylvania

Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States, 19104

 

United States, Texas

University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030

 

France

Hôpital Saint-Antoine, PARIS Cedex 12, France, 75571

Hôpital Saint-Louis, Paris, France, 75010

 

Japan

Kyushyu University Hospital, Fukuoka, Japan, 812-8582

Hokkaido University Hospital, Sapporo, Japan, 060-8648

 

United Kingdom

King's College Hospital NHS Foundation Trust, London, United Kingdom, SE5 9RS

The Christie NHS Foundation Trust, Manchester, United Kingdom, M20 4BX

Study start:
Aug. 1, 2016
Enrollment:
25 participants
Gene editing method:
TALENs
Type of edit:
Gene knock-out
Gene:
T Cell Receptor alpha locus (TCRα), CD52 molecule
Delivery method:
Electroporation and Lentivirus (LV) - Ex-vivo
Note:
Electroporation of TALEN gene editing tools. Lentiviral transduction of CAR-T.
Indicator
IND Enabling Pre-clinical
Phase I Safety
Phase II Safety and Dosing
Phase III Safety and Efficacy

Status: Completed

Description

The study is in two parts: a dose escalation then a safety dose expansion. The purpose of the dose escalation part is to evaluate the safety and tolerability of ascending doses of UCART19 (dose-escalation part) given as a single infusion in patients with relapsed / refractory (R/R) B-cell acute lymphoblastic leukaemia (B-ALL), to determine the maximum tolerated dose (MTD), the recommended dose and the lymphodepletion regimen. The purpose of the safety dose expansion is to assess the safety and tolerability of the RD for UCART19.

A preparation of allogeneic, frozen, ‘off-the-shelf’, universal transcription activator-like effector nuclease (TALEN)-engineered, gene-edited T lymphocytes expressing a chimeric antigen receptor (CAR) targeting the tumor-associated antigen (TAA) CD19, and containing a RQR8 transgene, with potential immunostimulating and antineoplastic activities. Using TALEN technology, the T-cell receptor (TCR) alpha chain and CD52 genes are deleted from the CAR19 T cells. Upon infusion, allogeneic universal CD19-specific CAR-modified T cells (UCART19) specifically target and bind to CD19-expressing tumor cells, thereby selectively lysing CD19-expressing tumor cells. CD19 antigen is a B-cell specific cell surface antigen expressed in all B-cell lineage malignancies. Deletion of the CD52 gene makes the modified donor T cells resistant to the anti-CD52 monoclonal antibody alemtuzumab, which is used during lymphodepletion. The knockout of the TCR alpha gene eliminates TCR expression and is intended to abrogate the potential induction of graft-versus-host disease (GvHD) by the donor T cells. The gene-edited allogeneic, frozen UCART19 have reduced production times and provide off-the-shelf CAR-T cells when compared to autologous CAR-T cells, which use the patient's own cells and are produced on an individual basis. The protein expressed by the RQR8 transgene contains epitopes from CD34 and CD20, which allows tracking of the UCART19 cells with a clinically-approved anti-CD34 antibody. Additionally if the UCART19 cells cause unacceptable side effects, the CD20 portion of the protein permits selective depletion of the UCART19 cells when the anti-CD20 monoclonal antibody rituximab is administered.

Last updated: Apr. 20, 2024
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