This research is being done to assess the effectiveness and safety of acalabrutinib combined with lisocabtagene maraleucel (liso-cel) for people with relapsed/refractory aggressive B-cell lymphoma. This research study involves the study drug acalabrutinib in combination with lisocabtagene maraleuce
This research study involves the study drug acalabrutinib in combination with lisocabtagene maraleucel. The research study procedures include screening for eligibility and study treatment including evaluations and follow up visits. \- Participants will receive one infusion of liso-cel and will receive acalabrutinib capsules twice daily as long as treatment is tolerated and disease does not worsen (disease progression) for up to one year. Participants will be followed by clinical visits for up to 5 years and the medical record will be monitored for up to 15 years. It is expected that about 27 people will take part in this research study. This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational intervention to learn whether the intervention works in treating a specific disease. "Investigational" means that the intervention is being studied. The U.S. Food and Drug Administration (FDA) has not approved acalabrutinib for this specific disease, but it has been approved for other uses. The U.S. FDA has approved lisocabtagene maraleucel for this specific disease. AstraZeneca, a pharmaceutical company, is supporting this research study by providing funding for the research study and supplying acalabrutinib.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
28
Oral, twice daily, timing and dosage per protocol
via IV timings and dosage per protocol
lymphodepleting chemotherapy with cyclophosphamide and fludarabine once a day for 3 days via IV about 2-4 hours. This will occur only once prior to lisocabtagene maraleucel infusion.
Massachusetts General Hospital
Boston, Massachusetts, United States
Beth-Israel Deaconess Medical Center
Boston, Massachusetts, United States
Complete Response Rate (CRR)
The CRR is defined as the percentage of subjects achieving an objective response of complete response (CR) according to the Lugano Classification (Chesson et al., 2014), prior to start of another non-study anticancer therapy. CR is defined as a complete metabolic and radiologic response (Lugano score 1-3, target nodes/nodal masses must regress to ≤ 1.5 cm in longest diameter.)
Time frame: 1 year 8 months
Overall Response Rate
Time frame: 3 Months
Overall Response Rate
Time frame: 6 Months
Overall Response Rate
Time frame: 12 Months
Progression Free Survival
PFS will be summarized using Kaplan-Meier estimates.
Time frame: as the time from registration to the earlier of progression or death due to any cause. Participants alive without disease progression are censored at date of last disease evaluation up to 15 years
Overall Survival
OS will be summarized using Kaplan- Meier estimates.
Time frame: defined as the time from registration to death due to any cause, or censored at date last known alive up to 15 years
Duration of Response
The duration of overall response is measured from the time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented (taking as reference for progressive disease the smallest measurements recorded since the treatment started, or death due to any cause. Participants without events reported are censored at the last disease evaluation).DOR will be summarized using Kaplan-Meier estimates.
Time frame: time from first response to disease progression or death up to 15 years
Event Free Survival
Time to event outcomes will be estimated using Kaplan Meier method or cumulative incidence curves
Time frame: from registration to death from any cause, disease progression, or starting a new anti-lymphoma therapy, whichever occurs first up to 15 years
Rates of Bridging Therapy
Rates of bridging therapy defined as the percentage of participants requiring any lymphoma-directed therapy other than the investigational therapy in order to control the disease prior to liso-cel infusion. Reported with descriptive statistics
Time frame: 1 years
FACT-G QOL
Functional Assessment of Cancer Treatment-General (FACT-G). The FACT-G consists of four subscales assessing well-being across four domains. These self-reported measures possess strong psychometric properties and have been validated for patients with cancer
Time frame: baseline, day -5 (+/- 3 days), day +7 (+/- 3 days), day +30 (+/- 7 days), day +90 (+/- 14 days), and day +180 (+/- 14 days) after liso-cel infusion
ICU Rates
ICU admission rates defined as the percentage of participants with an ICU admission within 90 days of liso-cel infusion. Reported with descriptive statistics
Time frame: up to 90 days
Re-hospitalization Rates
All cause re-hospitalization rates defined as the percentage of participants who experience an unplanned hospitalization within 90 days of liso-cel infusion. Planned hospital admissions for a procedure or treatment will be excluded. Reported with descriptive statistics
Time frame: up to 90 days
ER Visit Rates
All cause ER visit rates defined as the percentage of participants who experience an unplanned ER visit within 90 days of liso-cel infusion. Planned ER visits/hospital admissions for a procedure or treatment will be excluded.
Time frame: within 90 days
Length of Stay
Length of stay (LOS) defined as the number of days a participant is hospitalized for liso-cel infusion.
Time frame: 1 year
Rates of Acalabrutinib Discontinuation Due to Toxicity
Rates of acalabrutinib discontinuation in participants due to acalabrutinib toxicity NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.0
Time frame: time of their first treatment up to 3 years
Number of Participants Treatment Related Adverse Event NCI CTCAE 5.0
The descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.0
Time frame: up to 3 Years
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