This is an exploratory study with an open-label, single-arm, single-center design. It plans to enroll subjects with refractory/relapsed acute B-cell lymphoblastic leukemia (B-ALL), or treatment-naive or previously treated B-ALL subjects who achieved complete remission (CR) after induction chemotherapy but still have positive minimal residual disease (MRD). The primary objectives are to preliminarily evaluate the safety, tolerability, pharmacokinetics, biology, preliminary efficacy, and immunogenicity of A-319 subcutaneous injection.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
18
The maximum duration of treatment is no more than 4 cycles (one cycle is defined as: 1 week of induction + 3 weeks of treatment + 2 weeks of drug withdrawal). During the 1st week, induction doses of 0.15 μg/kg, 0.45 μg/kg, and 0.9 μg/kg will be administered subcutaneously on Days 1, 3, and 5 respectively. From Weeks 2 to 4, the corresponding treatment dose will be administered subcutaneously on Days 1, 3, and 5 of each week. Weeks 5 to 6 will be the drug withdrawal period.
Safety Analysis
Safety will be evaluated based on the incidence and severity of adverse events (AEs) and serious adverse events (SAEs).
Time frame: From the signing of the informed consent form to 30 days after the last dose
Characteristics of Dose-Limiting Toxicity (DLT)
Dose Limiting Toxicity (DLT) is defined as the occurrence of Grade 3 or higher non-hematologic toxicity (including neurotoxicity) during the first cycle (4 weeks of treatment plus 2 weeks of treatment holiday).
Time frame: During the first cycle (each cycle lasts 42 days)
Peripheral Blood Lymphocyte Count
Pharmacodynamic endpoints:Detection of CD20+, CD19+, CD3+ T cells, CD4+ T cells, and CD8+ T cells.
Time frame: No more than 4 cycles (each cycle is 42 days)
Maximum Concentration (Cmax)
Pharmacokinetic endpoints
Time frame: During the first cycle (each cycle lasts 42 days)
Mean
It will be evaluated based on the levels of cytokines (IL-2, IL-4, IL-6, IL-8, IL-10, IFNγ, TNFα, IL-1β) in peripheral blood.
Time frame: During the first cycle (each cycle lasts 42 days)
Best response rate
Hematologic Complete Remission (CR) or Hematologic Complete Remission with Incomplete Hematologic Recovery (CRi)
Time frame: No more than 4 cycles (each cycle is 42 days)
Minimal Residual Disease (MRD) Response Rate
Time frame: No more than 4 cycles (each cycle is 42 days)
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Time to Hematologic Relapse
Duration of Response, DOR
Time frame: 4 cycles (each cycle is 42 days) plus a 12-month survival follow-up period
Relapse-Free Survival (RFS)
Time frame: Within 2 years
Overall Survival (OS)
Time frame: Within 2 years
Percentage of subjects who undergo allogeneic hematopoietic stem cell transplantation (Allo-HSCT) after achieving complete remission (CR), complete remission with incomplete hematologic recovery (CRi), or minimal residual disease (MRD) negativity followi
Time frame: Within 2 years
Immunogenicity
Number and percentage of subjects who develop anti-A-319 antibodies (ADA)
Time frame: No more than 4 cycles (each cycle is 42 days)
Time to Maximum Concentration (Tmax)
Pharmacokinetic endpoints
Time frame: During the first cycle (each cycle lasts 42 days)
Area Under the Concentration-Time Curve (AUC)
Pharmacokinetic endpoints
Time frame: During the first cycle (each cycle lasts 42 days)
Mean Residence Time (MRT)
Pharmacokinetic endpoints
Time frame: During the first cycle (each cycle lasts 42 days)
Apparent Volume of Distribution (Vd)
Pharmacokinetic endpoints
Time frame: During the first cycle (each cycle lasts 42 days)
Total Clearance (CL/F)
Pharmacokinetic endpoints
Time frame: During the first cycle (each cycle lasts 42 days)
Volume of Distribution (Vz/F)
Pharmacokinetic endpoints
Time frame: During the first cycle (each cycle lasts 42 days)
Standard Deviation (SD)
Detection of biomarkers (serum cytokines): Interleukin-2 (IL-2), Interleukin-4 (IL-4), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10), Tumor Necrosis Factor-α (TNF-α), Interferon-γ (IFN-γ), and Interleukin-1β (IL-1β)
Time frame: During the first cycle (each cycle lasts 42 days)
Coefficient of Variation (CV)
Detection of biomarkers (serum cytokines): Interleukin-2 (IL-2), Interleukin-4 (IL-4), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10), Tumor Necrosis Factor-α (TNF-α), Interferon-γ (IFN-γ), and Interleukin-1β (IL-1β)
Time frame: During the first cycle (each cycle lasts 42 days)