This is a phase I, open-label, single-arm study conducted in China to evaluate the safety, tolerability, PK, and determine the recommended phase II dose (RP2D) and/or maximum tolerated dose (MTD) (if applicable) of JWCAR029 in pediatric and young adult subjects with r/r B-ALL.
Dose exploration for this study will be a 3+3 design with a target DLT rate of \<1/3. Dose exploration can be discontinued once one or more dose levels with an acceptable safety profile and satisfactory antitumor activity have been selected for subsequent evaluation. The maximum tolerated dose (MTD) may not be achieved at the dose levels predetermined in this study as described below. During the treatment period of the study, four dose levels of JWCAR029 will be evaluated. enrollment will begin at dose level 1, follow a 3+3 dose exploration design protocol, and finally select one or more dose levels with an acceptable safety profile and good antitumor activity as the recommended dose, after which dose exploration will be discontinued. Dose limiting toxicity (DLT) will be evaluated within 28 days after JWCAR029 infusion. Each dose cohort is planned to enroll three subjects initially, and at least one pediatric subject younger than 10 years of age who can be evaluated for DLT will be enrolled at each dose level. In the first dose cohort, the first 3 subjects will be infused at least 14 days apart. At each higher dose level, the first 3 patients within the dose cohort will be treated at least 7 days apart. For dose levels considered safe, at least 3 subjects with assessable DLT must complete a 28-day DLT assessment period.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
33
Subjects will receive Lymphodepleting chemotherapy with intravenous (IV) fludarabine (25 mg/m2/day for 3 days) plus cyclophosphamide IV (250 mg/m2/day for 3 days) (flu/cy) concurrently, followed by JWCAR029 cells infusion. Phase 1 will evaluate up to 4 JWCAR029 cells dose levels.
Hematology Hospital, Chinese Academy of Medical Sciences
Tianjin, Tianjin Municipality, China
RECRUITINGPercentage of Participants Experiencing Dose Limiting Toxicities (DLTs)
Dose limiting toxicity (DLT) is an AE that meets the following criteria and occurs within 28 days of JWCAR029 infusion.AE is graded according to CTCAE version 5.0, CRS is graded according to the American Society for Transplantation and Cellular Therapy (ASTCT) 2019 consensus CRS grading criteria, and neurotoxicity is graded according to the ASTCT 2019 consensus ICANS grading criteria.
Time frame: Day 28 after JWCAR029 infusion
The occurrence of adverse events
These adverse events would be measured by assessment scale method according to NCI CTC AE v5.0 classification standard
Time frame: After JWCAR029 infusion for 2 year
Overall remission Rate
Overall remission rates assessed by investigators at 1, 2, and 3 months after JWCAR029 infusion,Include complete remission (CR) and complete morphological remission without complete recovery of blood counts (CRi),and the results of the efficacy assessment at each time point
Time frame: After JWCAR029 infusion for 2 year
MRD negative rate
Investigator assessed response rate for microscopic residual disease (MRD) at 1 , 2 and 3 months after completion of infusion, including the percentage of patients achieving MRD negativity (MRD level \<10\^-4) among all infused patients
Time frame: After JWCAR029 infusion for 2 year
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