Chronic Lymphocytic Leukemia Clinical Trial

Study Evaluating Safety and Efficacy of JCAR017 in Subjects With Relapsed or Refractory Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL)

Summary

This is a Phase 1/2, open-label, multicenter study to determine the efficacy and safety of JCAR017 in adult subjects with relapsed or refractory leukemia-cll/" >CLL or SLL. The study will include a Phase 1 part to determine the recommended dose of JCAR017 monotherapy in subjects with relapsed or refractory CLL or SLL, followed by a Phase 2 part to further assess the efficacy and safety of JCAR017 monotherapy treatment at the recommended dose. A separate Phase 1 cohort will assess the combination of JCAR017 and concurrent ibrutinib. Another separate Phase 1 cohort will assess the combination of JCAR017 and concurrent venetoclax. In all subjects, the safety, efficacy, and pharmacokinetics (PK) of JCAR017 will be evaluated.

View Eligibility Criteria

Eligibility Criteria

Inclusion Criteria:

Diagnosis of:

CLL with an indication for treatment based on the Investigator's opinion and measurable disease, or
SLL (lymphadenopathy and/or splenomegaly and < 5×10^9 CD19+ CD5+ clonal B lymphocytes/L [< 5000/µL] in the peripheral blood at diagnosis with measurable disease that is biopsy-proven SLL)
Subjects (other than those in the ibrutinib + JCAR017 combination therapy cohort) must have received and failed Bruton tyrosine kinase inhibitor (BTKi) treatment or have been deemed ineligible for BTKi therapy.

Subjects (other than those in the ibrutinib + JCAR017 combination therapy cohort) must have received previous treatment as follows:

Subjects with CLL or SLL and high-risk features must have failed at least 2 lines of prior therapy.
Subjects with CLL or SLL and standard-risk features must have failed at least 3 lines of prior therapy.

Subjects in the ibrutinib + JCAR017 combination therapy cohort must either:

be receiving ibrutinib and progressing at the time of study enrollment
be receiving ibrutinib for at least 6 months with a response less than complete response/remission (CR) and have high-risk features as defined in inclusion criterion 5a
have BTK or PLCgamma2 mutations per local laboratory assessment, with or without progression on ibrutinib
have previously received ibrutinib and have no contraindications to restarting ibrutinib
Eastern Cooperative Oncology Group performance status of ≤ 1
Assessed by the Investigator to have adequate bone marrow function to receive lymphodepleting chemotherapy

Adequate organ function, defined as:

Serum creatinine ≤ 1.5 × age-adjusted upper limit of normal (ULN) OR calculated creatinine clearance > 30 mL/min
Alanine aminotransferase ≤ 5 × ULN and total bilirubin < 2.0 mg/dL (or < 3.0 mg/dL for subjects with Gilbert's syndrome or leukemic infiltration of the liver)
Adequate pulmonary function, defined as ≤ Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 dyspnea and saturated oxygen (SaO2) ≥ 92% on room air
Adequate cardiac function, defined as left ventricular ejection fraction ≥ 40% as assessed by echocardiogram or multiple uptake gated acquisition scan performed within 30 days prior to determination of eligibility
Subject either currently has central vascular access or is a candidate to receive central vascular access or peripheral vascular access for leukapheresis procedure.
If prior CD19-targeted therapy has been administered, subject must have CD19-positive disease confirmed by immunohistochemistry or flow cytometry since completing the prior CD19-targeted therapy.
Subjects in ibrutinib + JCAR017 combination cohort must have progressed on a BTKi and have received prior therapy with venetoclax

Subjects in venetoclax + JCAR017 combination cohort must:

have failed at least 1 prior line of therapy, including failed BTKi therapy or have been deemed ineligible to receive BTKi
be venetoclax naive (required for dose expansion) or
if prior venetoclax (only for dose escalation)
have no contraindictions to re-initiation of venetoclax based on prior intolerance and have had at least 6 months elapsed since the last dose of venetoclax, if either, best response was stable disease, or subject experienced disease progression on venetoclax, or within 6 months of venetoclax discontinuation
subjects in the venetoclax + JCAR017 combination must have hemoglobin >=9 g/dL, absolute neutrophil count >=500mm3 and platelets>= 75,000/mm3, unless cytopenias are judged by investigator to be due to CLL infiltration of the bone marrow
must have diagnosis of CLL or SLL with an indication for treatment based on the investigator's opinion and measurable disease (any of the following measurable lymph nodes ≥1.5 cm in the greatest transverse diameter and/or hepatomegaly or splenomegaly) and demonstration of CLL cells in the peripheral blood by flow cytometry

Exclusion Criteria:

Subjects with known active central nervous system (CNS) involvement by malignancy. Those with prior CNS disease that has been effectively treated will be eligible if treatment was completed at least 3 months prior to enrollment with no evidence of symptomatic disease and stable abnormalities on repeat imaging.
History of another primary malignancy that has not been in remission for at least 2 years. (The following are exempt from the 2-year limit: nonmelanoma skin cancer, completely resected stage 1 solid tumor with low risk for recurrence, curatively treated localized prostate cancer, cervical carcinoma in situ on biopsy or a squamous intraepithelial lesion on Pap smear, and in situ breast cancer that has been completely resected.)
Subjects with Richter's transformation
Prior treatment with any gene therapy product
Active hepatitis B, active hepatitis C, or active human immunodeficiency virus (HIV) infection
Systemic fungal, bacterial, viral, or other infection that is not controlled
Presence of acute or extensive chronic graft versus host disease (GVHD)
History of any one of the following cardiovascular conditions within the past 6 months: Class III or IV heart failure as defined by the New York Heart Association (NYHA), cardiac angioplasty or stenting, myocardial infarction, unstable angina, or other clinically significant cardiac disease
History or presence of clinically relevant CNS pathology such as epilepsy, generalized seizure disorder, aphasia, stroke with current neurologic sequelae, severe brain injuries, dementia, Parkinson's disease, cerebellar disease,cerebral edema, or psychosis
Pregnant or nursing (lactating) women

Use of any of the following medications or treatments within the noted time prior to leukapheresis:

Alemtuzumab within 6 months prior to leukapheresis
Allogeneic hematopoietic stem cell transplant within 100 days prior to leukapheresis
Cladribine within 3 months prior to leukapheresis
Donor lymphocyte infusions (DLI) within 2 months prior to leukapheresis
Radiation including large bone marrow fields such as sternum or pelvis within 6 weeks prior to leukapheresis
Fludarabine within 4 weeks prior to leukapheresis
GVHD therapies such as calcineurin inhibitors, methotrexate or other chemotherapeutics, mycophenolate mofetil, rapamycin, or immunosuppressive antibodies (such as anti-tumor necrosis factor-α [TNFα], anti-interleukin-6 [IL-6], or anti-interleukin-6 receptor [IL 6R]) within 4 weeks prior to leukapheresis
Cyclophosphamide, ifosfamide, bendamustine, chlorambucil, or melphalan within 2 weeks prior to leukapheresis
Therapeutic doses of corticosteroids (defined as > 20 mg/day prednisone or equivalent) within 7 days prior to leukapheresis
Anti-CD20 monoclonal antibodies within 7 days prior to leukapheresis
Venetoclax within 4 days prior to leukapheresis
Idelalisib or duvelisib within 2 days prior to leukapheresis
Lenalidomide within 1 day prior to leukapheresis
Experimental agents, including off-label use of approved drugs (with the exception of acalabrutinib which may be continued up to the day before leukapheresis), within 4 weeks prior to leukapheresis unless progression is documented on the experimental therapy and at least 3 half-lives have elapsed prior to leukapheresis
Uncontrolled medical, psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol, as judged by the Investigator; or subject unwillingness or inability to follow the procedures required in the protocol
Progressive vascular tumor invasion, thrombosis, or embolism
Deep vein thrombosis or embolism not managed on a stable regimen of anticoagulation
Use of any of the following medications or treatments within the noted time prior to leukapheresis lenalidomide or acalabrutinib within 1 day prior to leukapheresis experimental agents, including off-label use of approved drugs, within 4 weeks prior to leukapheresis.
Venous thrombosis or embolism requiring treatment but not managed on a stable regimen of anticoagulation
For subjects in the venetoclax + JCAR017 combination cohorts only, concomitant treatment with CYP3A moderate/strong inducers or moderate/strong inhibitors which cannot be discontinued

Study is for people with:

Chronic Lymphocytic Leukemia

Phase:

Phase 1

Estimated Enrollment:

188

Study ID:

NCT03331198

Recruitment Status:

Active, not recruiting

Sponsor:

Juno Therapeutics, a Subsidiary of Celgene

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There are 38 Locations for this study

See Locations Near You

Local Institution - 0006
Birmingham Alabama, 35294, United States
University of Alabama at Birmingham
Birmingham Alabama, 35294, United States
Banner MD Anderson Cancer Center
Gilbert Arizona, 85234, United States
Local Institution - 0043
Gilbert Arizona, 85234, United States
Local Institution - 0007
Duarte California, 91010, United States
City of Hope
Duarte California, 91010, United States
Local Institution - 0025
La Jolla California, 92093, United States
UC San Diego Moores Cancer Center
La Jolla California, 92093, United States
Local Institution - 0059
Los Angeles California, 90095, United States
University of California, Los Angeles
Los Angeles California, 90095, United States
Local Institution - 0010
San Francisco California, 94142, United States
University of California, San Francisco
San Francisco California, 94143, United States
Georgetown University Medical Center
Washington District of Columbia, 20007, United States
Local Institution - 0080
Jacksonville Florida, 32224, United States
Mayo Clinic
Jacksonville Florida, 32224, United States
Local Institution - 0019
Atlanta Georgia, 30342, United States
The Blood and Marrow Transplant Group of Georgia (BMTGA)
Atlanta Georgia, 30342, United States
Local Institution - 0003
Chicago Illinois, 60611, United States
Northwestern University
Chicago Illinois, 60611, United States
Local Institution - 0016
Chicago Illinois, 60637, United States
University of Chicago Medical Center
Chicago Illinois, 60637, United States
Local Institution - 0005
Boston Massachusetts, 02114, United States
Massachusetts General Hospital
Boston Massachusetts, 02114, United States
Beth Israel Deaconess Medical Center
Boston Massachusetts, 02215, United States
Local Institution - 0015
Boston Massachusetts, 02215, United States
University of Michigan Comprehensive Cancer Center
Ann Arbor Michigan, 48109, United States
Local Institution - 0084
Ann Arbor Michigan, 48109, United States
Barbara Ann Karmanos Cancer Institute
Detroit Michigan, 48201, United States
Local Institution - 0062
Detroit Michigan, 48201, United States
Local Institution - 0054
Rochester Minnesota, 55905, United States
Mayo Clinic
Rochester Minnesota, 55905, United States
Local Institution - 0008
Omaha Nebraska, 68198, United States
University of Nebraska Medical Center
Omaha Nebraska, 68198, United States
Local Institution - 0038
Hackensack New Jersey, 07601, United States
Hackensack University Medical Center
Hackensack New Jersey, 07601, United States
Local Institution - 0077
New Brunswick New Jersey, 08903, United States
Rutgers Cancer Institute of New Jersey
New Brunswick New Jersey, 08903, United States
Local Institution - 0035
New York New York, 10021, United States
Local Institution - 0026
New York New York, 10032, United States
Weill Cornell Medical College
New York New York, 10065, United States
Local Institution - 0030
Durham North Carolina, 27705, United States
Duke University Medical Center
Durham North Carolina, 27710, United States
University Hospitals Seidman Cancer Center (Case Western)
Cleveland Ohio, 44106, United States
Local Institution - 0078
Cleveland Ohio, 44106, United States
Local Institution - 0082
Oklahoma City Oklahoma, 73104, United States
University of Oklahoma Health Sciences Center (Stephenson Cancer Center)
Oklahoma City Oklahoma, 73104, United States
Local Institution - 0088
Philadelphia Pennsylvania, 19104, United States
University of Pennsylvania Perelman Center for Advanced Medicine
Philadelphia Pennsylvania, 19104, United States
Local Institution - 0032
Philadelphia Pennsylvania, 19107, United States
Thomas Jefferson University
Philadelphia Pennsylvania, 19107, United States
Local Institution - 0029
Pittsburgh Pennsylvania, 15232, United States
UPMC Hillman Cancer Center
Pittsburgh Pennsylvania, 15232, United States
Baylor University Medical Center
Dallas Texas, 75246, United States
University of Texas Southwestern Medical Center
Dallas Texas, 75390, United States
Local Institution - 0079
Dallas Texas, 75426, United States
Local Institution - 0002
Houston Texas, 77030, United States
The University of Texas MD Anderson Cancer Center
Houston Texas, 77030, United States
Huntsman Cancer Institute
Salt Lake City Utah, 84112, United States
Local Institution - 0028
Salt Lake City Utah, 84112, United States
Local Institution - 0087
Richmond Virginia, 23298, United States
Fred Hutchinson Cancer Research Center
Seattle Washington, 98109, United States
Local Institution - 0018
Seattle Washington, 98109, United States
Local Institution - 0055
Milwaukee Wisconsin, 53226, United States
Medical College of Wisconsin
Milwaukee Wisconsin, 53226, United States

How clear is this clinincal trial information?

Study is for people with:

Chronic Lymphocytic Leukemia

Phase:

Phase 1

Estimated Enrollment:

188

Study ID:

NCT03331198

Recruitment Status:

Active, not recruiting

Sponsor:


Juno Therapeutics, a Subsidiary of Celgene

How clear is this clinincal trial information?

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