Effective treatment options for relapsed/refractory acute myeloid leukemia (AML) and T-cell non-Hodgkin lymphoma (T-NHL) represent a significant unmet medical need. CAR T therapy has offered durable remissions and potential cures in some forms of hematologic malignancy, including B-cell acute lymphoblastic leukemia. In AML, however, CAR T approaches have been limited by the lack of suitable antigens, as most myeloid markers are shared with normal hematopoietic stem cells and targeting of these antigens by CAR T therapy leads to undesirable hematologic toxicity. Similarly, T-NHL has not yet benefited from CAR T therapy due to a lack of suitable markers. One potential therapeutic target is CD7, which is expressed normally on mature T-cells and NK-cells but is also aberrantly expressed on \~30% of acute myeloid leukemias. CAR T therapy for patients with CD7+ AML and T-NHL will potentially offer a new therapeutic option which has a chance of offering durable benefit. WU-CART-007 is a CD7-directed, genetically modified, allogeneic, fratricide-resistant chimeric antigen receptor (CAR) T-cell product for the treatment of CD7+ hematologic malignancies. These cells have two key changes from conventional, autologous CAR T-cells. First, because CD7 is present on normal T-cells including conventional CAR T products, CD7 is deleted from WU CART-007. This allows for targeting of CD7 without the risk of fratricide (killing of WU-CART-007 cells by other WU-CART-007 cells). Second, the T cell receptor alpha constant (TRAC) is also deleted. This makes WU CART 007 cells incapable of recognizing antigens other than CD7 and allows for the use of an allogeneic product without causing Graft-versus-Host-Disease (GvHD).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Provided by Miltenyi Biotec
Washington University School of Medicine
St Louis, Missouri, United States
Recommended phase II dose (Dose Escalation only)
-The recommended phase II dose (RP2D) will be determined independently for each disease cohort (CD7+ AML and T-NHL). The RP2D will not be greater than the maximum tolerated dose (MTD). However, the RP2D may be a lower dose level in certain circumstances: * If emerging toxicity at the MTD is unpredictable or undesirable for other reasons. * If clear evidence of efficacy is noted at lower doses with a cleaner safety profile. * If the cellular pharmacokinectic (cPK) profile that emerges results in similar numbers of clonal cells over time that is independent of administered dose level. * If longer follow-up on earlier patient cohorts suggests the emergence of delayed toxicity.
Time frame: Through completion of day 42 for all Part A participants (estimated to be 18 months and 42 days)
Number of participants with complete metabolic response or partial metabolic response (Dose expansion only - Cohort A)
-Per Lugano criteria for patients with T-cell lymphoma (T-NHL). Per Global Response Criteria for cutaneous T-cell lymphoma (CTCL). Per the T-PLL International Study Group criteria for T-cell prolymphocytic leukemia (T-PLL)
Time frame: Through completion of response assessments (estimated to be 24 months)
Number of participants with complete remission, complete remission with incomplete blood count recovery, complete remission with partial hematologic recovery, or morphologic leukemia free state (Dose expansion only - Cohort B)
-Per modified 2017 ELN criteria for patients with AML
Time frame: Through completion of response assessments (estimated to be 24 months)
Number of participants with treatment-emergent adverse events as measured by CTCAE v 5.0
-Treatment-emergent adverse events are those with an onset on or after the initiation of therapy, and, with the exception of cytokine release syndrome and neurotoxicity
Time frame: From start of treatment through completion of follow-up (estimated to be 24 months)
Number of participants with cytokine release syndrome
-Cytokine release syndrome will be graded accorded to the ASTCT Consensus Guidelines
Time frame: From start of treatment through Day 7 (estimated to be 8 days)
Number of participants with immune effector cell-associated neurotoxicity syndrome (ICANS) as measured by ASTCT Consensus Grading
Time frame: From start of treatment through Day 7 (estimated to be 8 days)
Duration of remission (DoR) (Dose Expansion only)
* DoR for patients who achieve CR/CRi/CRMLFS/PR is measured from the time measurement criteria are met for CR/CRi/CRh/MLFS/PR (whichever is first recorded) until the first date that relapse is objectively documented. * Also includes patients who were treated at the recommended phase II dose in Dose Escalation.
Time frame: Through completion of response assessments (estimated to be 24 months)
Relapse-free survival (RFS) (Dose Expansion only)
* RFS is defined for patients who achieve CR/CRi/CRh/MLFS/PR as the duration of time measurement criteria are met for CR/CRi/CRh/MLFS/PR (whichever is first recorded) to time of relapse or death, whichever occurs first. * Also includes patients who were treated at the recommended phase II dose in Dose Escalation.
Time frame: Through completion of follow-up (estimated to be 24 months)
Event-free survival (EFS) (Dose Expansion only)
* EFS is defined for all patients and measured from the date of entry on study until treatment failure, relapse from CR, or death from any cause. * Also includes patients who were treated at the recommended phase II dose in Dose Escalation.
Time frame: Through completion of follow-up (estimated to be 24 months)
Overall survival (OS) (Dose Expansion only)
* OS is defined as the time from date of entry on study to time of death. * Also includes patients who were treated at the recommended phase II dose in Dose Escalation.
Time frame: Through completion of follow-up (estimated to be 24 months)
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