This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of LYL314, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma.
This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of LYL314, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma. Five cohorts of participants will be enrolled: Cohort 1: Participants who have not received a prior CAR T-cell product (CAR T naïve) and have received at least two or more prior lines of treatment (third-line or later). Cohort 2: Participants who have received a prior CAR T-cell product (CAR T experienced) and have received at least two or more prior lines of treatment including one CAR T-cell therapy. Cohort 3: Participants with refractory disease or relapse within one year of first-line therapy (second-line). Cohort 4: Participants who have received prior T-cell engager (TCE) therapy and have received at least two or more prior lines of treatment including one TCE therapy. Cohort 5: Participants receiving first-line treatment for high-risk large B-cell lymphoma who remain with disease on positron emission tomography scanning (PET-positive) after 2 to 3 cycles of standard-of-care chemoimmunotherapy (high-risk first-line). Up to approximately 150 participants (across all cohorts) will be enrolled in the dose finding Phase 1 part of the study. The Phase 2 pivotal study (PiNACLE) will expand enrollment of Cohort 1 to approximately 120 participants to further evaluate the safety and efficacy of LYL314. LYL314 treatment consists of a single administration of CAR transduced autologous T-cells administered intravenously after a conditioning chemotherapy regimen consisting of fludarabine and cyclophosphamide, administered over 3 days. Individual participants will remain in the active post-treatment follow-up (PTFU) period for approximately 2 years. Participants will continue in long-term follow-up (LTFU) for 15 years from LYL314 treatment.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
270
CAR T-cell therapy
Conditioning chemotherapy
Conditioning chemotherapy
Phase 1: Evaluate the safety and tolerability of a single dose of LYL314 administered as a single agent
Incidence of dose-limiting toxicities (DLTs) and other treatment-emergent adverse events (TEAEs)
Time frame: Baseline to Month 24
Phase 2: Estimate the efficacy of LYL314, as measured by ORR
ORR based on Independent Review Committee (IRC) assessment per Lugano criteria
Time frame: Baseline to Month 24
Phase 1: Evaluate the efficacy of LYL314
Overall response rate (ORR), Complete response rate (CRR), duration of response (DOR), duration of complete response (DOCR), progression free survival (PFS) based on Investigator assessment until a pivotal trial (Phase 2) portion is initiated at which time all scans will be reviewed by an IRC assessment (Cohort 1) per Lugano criteria
Time frame: Baseline to Month 24
Phase 1: Evaluate the feasibility of treatment with LYL314
Proportion of enrolled participants who receive the target dose of LYL314
Time frame: Baseline to Month 24
Phase 1: Evaluate the pharmacokinetics of LYL314 when administered as a single agent
Maximum concentration (Cmax), area under the curve from time 0 to Day 28 (AUC0-28) and persistence of LYL314
Time frame: Baseline to Month 24
Phase 2: Estimate the efficacy of LYL314
ORR based on Investigator assessment per Lugano criteria
Time frame: Baseline to Month 24
Phase 2: Estimate the efficacy of LYL314
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University of California-Irvine Medical Center
Irvine, California, United States
RECRUITINGCedars-Sinai Medical Center
Los Angeles, California, United States
RECRUITINGUniversity of California, Los Angeles (UCLA) Medical Center
Los Angeles, California, United States
RECRUITINGScripps Clinic
San Diego, California, United States
RECRUITINGColorado Blood Cancer Institute
Denver, Colorado, United States
RECRUITINGAugusta University Medical Center
Augusta, Georgia, United States
RECRUITINGIndiana Blood and Marrow Transplantation
Indianapolis, Indiana, United States
RECRUITINGUniversity of Iowa
Iowa City, Iowa, United States
RECRUITINGUniversity of Louisville Brown Cancer Center
Louisville, Kentucky, United States
RECRUITINGLouisiana State University Health Sciences Center
Shreveport, Louisiana, United States
RECRUITING...and 16 more locations
DOR based on IRC assessment and investigator assessment per Lugano criteria
Time frame: Baseline to Month 24
Phase 2: Estimate the efficacy of LYL314
Time to response (TTR) based on IRC assessment and investigator assessment per Lugano criteria
Time frame: Baseline to Month 24
Phase 2: Estimate the efficacy of LYL314
PFS based on IRC assessment and investigator assessment per Lugano criteria
Time frame: Baseline to Month 24
Phase 2: Estimate the efficacy of LYL314
Overall Survival (OS)
Time frame: Baseline to Month 72
Phase 2: Evaluate the safety and tolerability of a single dose of LYL314 administered as a single agent
Incidence and severity of TEAEs
Time frame: Baseline to Month 24
Phase 2: Evaluate the pharmacokinetics of LYL314 when administered as a single agent
Maximum concentration (Cmax), area under the curve from time 0 to Day 28 (AUC0-28) and persistence of LYL314
Time frame: Baseline to Month 24