This is a Phase I/II multicentre, open-label trial designed to evaluate the efficacy, safety, tolerability, timing of administration and pharmacokinetics (PK) of a novel chimeric antigen receptor (CAR) T-cell engager, ALETA-001, administered by intravenous (IV) infusion as a single agent every 2 weeks in participants with B-cell malignancies post CD19 CAR T-cell therapy. This first in human study is divided into 2 parts: a safety lead-in phase (Phase I) and a dose expansion phase (Phase II). Different dose levels of ALETA-001 and timing of administration will be evaluated in Phase I in order to define a recommended dosing level and time of administration for Phase II. Phase II will further evaluate the safety, PK and therapeutic activity of ALETA-001.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
84
ALETA-001 will be administered intravenously (IV) every two weeks.
University Hospital Birmingham NHS Foundation Trust
Birmingham, United Kingdom
RECRUITINGCambridge University Hospitals
Cambridge, United Kingdom
RECRUITINGSt James's University Hospital
Leeds, United Kingdom
RECRUITINGUniversity Hospital London Hospital
London, United Kingdom
RECRUITINGManchester Royal Infirmary
Manchester, United Kingdom
RECRUITINGThe Christie Hospital
Manchester, United Kingdom
RECRUITINGRoyal Marsden Hospital
Sutton, United Kingdom
NOT_YET_RECRUITINGDose level of ALETA-001 and timing of administration for use in Dose Expansion (Safety Lead-in Phase).
Determine a dose level that is deemed tolerable and timing of administration based on available safety and pharmacodynamic data.
Time frame: Day 1 to Day 28.
Number of Participants who experience dose limiting toxicities (DLTs).
DLTs will be assessed up to Day 28 and are defined as toxicities that meet pre-defined severity criteria and assessed as having a suspected relationship to study drug, and unrelated to disease, disease progression, intercurrent illness, or concomitant medications that occurs within the 28 days of the first dose of ALETA-001.
Time frame: Up to Day 28.
Number of Participants who experience Grade 3, 4 or 5 related adverse event (AEs).
Related AEs are those considered by the investigator to be possibly, probably or highly probably related to ALETA-001. Events of cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity (ICANS) are graded according to the American Society for Transplantation and Cellular Therapy grading criteria. All other AEs are graded according to the Common Terminology Criteria for AEs (CTCAE) Version 5.0.
Time frame: Safety data will be collected from the time of informed consent until 95 days after the last dose of ALETA-001. The average time from consent to the end of follow up will be presented.
Best Overall Response (Dose Expansion Phase).
Best Overall Response according to Lugano criteria (Cheson, Journal of Clinical Oncology, 2014), the number of participants taking part in the Dose Expansion Phase with best overall response of complete response (CR), partial response (PR), no response or stable disease (SD/NR), and progressive disease (PD).
Time frame: Radiological assessment from within 28 days before starting ALETA-001 and up to 12 months after.
Progression-Free Survival (PFS) (Dose Expansion Phase).
Median PFS measured from first dose of ALETA-001 to date of progression according to Lugano criteria or date of death without a previous progression recorded.
Time frame: From date of first dose of ALETA-001 up to 12 months.
Time to Progression (TTP) (Dose Expansion Phase).
Median TTP measured from first dose of ALETA-001 to date of progression according to Lugano criteria. Participants who die without recorded progression will be censored.
Time frame: From date of first dose of ALETA-001 up to 12 months.
Overall Survival (OS) (Dose Expansion Phase).
Median OS measured from first dose of ALETA-001 to date of death due to any cause or to the date of censoring at the last time the participant was known to be alive.
Time frame: Follow-up until end of trial, estimated to be up to 48 months.
Best Overall Response (Safety Lead-in Phase).
Best Overall Response according to Lugano criteria, the number of participants taking part in the Safety Lead-in Phase with best overall response of complete response (CR), partial response (PR), no response or stable disease (SD), and progressive disease (PD).
Time frame: Radiological assessment from within 28 days before starting ALETA-001 and up to 12 months after.
Progression-Free Survival (PFS) (Safety Lead-in Phase).
Median PFS measured from first dose of ALETA-001 to date of progression according to Lugano criteria or date of death without a previous progression recorded.
Time frame: From date of first dose of ALETA-001 up to 12 months.
Time to Progression (TTP) (Safety Lead-in Phase).
Median TTP measured from first dose of ALETA-001 to date of progression according to Lugano criteria. Participants who die without recorded progression will be censored.
Time frame: From date of first dose of ALETA-001 up to 12 months.
Overall Survival (OS) (Safety Lead-in Phase).
Median OS measured from first dose of ALETA-001 to date of death due to any cause or to the date of censoring at the last time the participant was known to be alive.
Time frame: Follow-up until end of trial, estimated to be up to 48 months.
Maximum observed serum concentration (Cmax) of ALETA-001.
Measurement of Cmax of ALETA-001 as appropriate.
Time frame: Day 1 to Day 7.
Terminal elimination half-life (t1/2) of ALETA-001.
Measurement of t1/2 of ALETA-001 as appropriate.
Time frame: Day 1 to Day 7.
Area under the concentration-time curve (AUC) of ALETA-001.
Measurement of AUC of ALETA-001 as appropriate.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Day 1 to Day 7.
Volume of distribution (Vss) of ALETA-001.
Measurement of Vss of ALETA-001 as appropriate.
Time frame: Day 1 (before first ALETA-001 infusion) to Day 7.
Clearance (CL) of ALETA-001.
Measurement of CL of ALETA-001 as appropriate.
Time frame: Day 1 to Day 7.