This is a multicenter Phase 1b study evaluating the safety, tolerability, and preliminary anti-tumor activity of NT-I7 administration following standard of care CD19 chimeric antigen receptor T-cell (CAR T-cell) therapy for eligible subjects with relapsed/refractory (r/r) large B-cell lymphoma (LBCL).
This is a multicenter Phase 1b study evaluating the safety, tolerability, and preliminary anti-tumor activity of NT-I7 administration following standard of care CD19 CAR T-cell therapy for eligible subjects with r/r LBCL. The study consists of a Dose Escalation phase followed by a Dose Expansion phase. In the Dose Escalation phase, subjects will be enrolled in 1 of 7 dose levels, starting with 60 µg/kg and up to 720 µg/kg. A dose schedule for an individual dose level will not be taken into expansion until the Dose Escalation phase has been completed or a maximum tolerated dose (MTD) has been determined, whichever occurs first. In the Dose Expansion phase, up to 15 subjects will be enrolled and treated with the recommended dose identified in the Dose Escalation phase. Up to 17- 42 subjects in the Dose Escalation phase, and up to 15 subjects in the Dose Expansion phase will be enrolled at approximately 20 study centers. Treatment Plan: NT-I7 (aka rhIL-7-hyFc, efineptakin alpha), Tisagenlecleucel (Kymriah®), Axicabtagene ciloleucel (Yescarta®), Lisocabtagene Maraleucel (Breyanzi®) \*CAR-T Therapy will be administered per manufacturer's recommendations and in accordance with Food and Drug Administration (FDA) prescribing guidelines and best institutional practices for standard of care use.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
17
NT-I7 is administered via an intramuscular injection after CAR-T infusion on Day 21.
Administered as standard of care as described in the package insert on Day 0.
Administered as standard of care as described in the package insert on Day 0.
Administered as standard of care as described in the package insert on Day 0.
City of Hope
Duarte, California, United States
Washington University in St. Louis
St Louis, Missouri, United States
Duke Cancer Institute
Durham, North Carolina, United States
Incidence, Nature, and Severity of Adverse Events, Graded According to NCI CTCAE v5.0, Except for Cytokine Release Syndrome (CRS) and Immune Effector Cell-associated Neurotoxicity Syndrome (ICANS), Which Were Graded Based on ASTCT Guidelines
Treatment-Emergent Adverse Event (TEAE) is defined as an Adverse Event (AE) with an onset date on or after NT-I7 administration and on or before Day 100. A serious TEAE is defined as any AE that resulted in any of the following outcomes: death; a life-threatening AE; an AE that resulted in inpatient hospitalization or prolongation of existing hospitalization for ≥24 hours; a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions; a congenital anomaly/birth defect; important medical events that may not result in death, be life threatening, or require hospitalization may be considered serious when, based upon medical judgment, they may jeopardize the participant and may require medical or surgical intervention to prevent one of the outcomes listed in this definition.
Time frame: From NT-I7 administration (Day 21) to Day 100
Incidence and Nature of DLTs
A Dose-Limiting Toxicity (DLT) is defined as any TEAE occurring within the first 21 days after NT-I7 administration that is considered to be at least possibly, probably, or definitely related to NT-I7 per the investigator, and that meets at least one of the protocol-defined non-hematologic or hematologic criteria.
Time frame: From NT-I7 administration (Day 21) to Day 42
Potential Correlation of Dose Levels With Safety and Efficacy Parameters
The Recommended Phase 2 Dose (RP2D) was determined based on cumulative safety data and efficacy parameters (Objective Response Rate \[ORR\] and response rate at 6 months).
Time frame: Up to 24 months
Measurement of Duration of Response (DoR)
Duration of Response (DoR) for the responders is defined as the time from the first occurrence of a documented objective response (Partial Response \[PR\] or Complete Response \[CR\]) to the time of the first documented disease progression or death from any cause, whichever occurs first, per the Lugano classification as determined by the investigator. Only participants with a response were assessed. The median DoR was estimated using a Kaplan-Meier method.
Time frame: Up to 24 months
Measurement of Progression-Free Survival (PFS)
Progression-Free Survival (PFS) is defined as the time from CAR T-cell administration to the first occurrence of disease progression or death from any cause, whichever occurs first. The Median PFS was estimated using the Kaplan-Meier method.
Time frame: Up to 24 months
Measurement of Overall Survival (OS)
Overall Survival (OS) is defined as the time from CAR T-cell administration to death from any cause. The median OS was estimated using the Kaplan-Meier method.
Time frame: Up to 24 months
Rates of Grade 3 and Higher Cytokine Release Syndrome (CRS) or Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS)
The Grades of Cytokine Release Syndrome (CRS) or Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) are assessed based on the American Society for Transplantation and Cellular Therapy (ASTCT).
Time frame: From NT-I7 administration (Day 21) to Day 100
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