This study is a single-arm, open-label clinical investigation to evaluate the tolerance, safety and preliminary efficacy of CAR-T (U96) in the treatment of relapsed/refractory B-cell tumors. The study will be conducted in two disease types, acute B-lymphoblastic leukemia and B-cell lymphoma, with a dose escalation plan using the "3+3" method. Each dose group is planned to enroll 3 to 6 patients, with a total of approximately 30 to 48 patients to be enrolled in the entire study. After signing the informed consent form, patients will undergo screening tests. If they meet the inclusion and exclusion criteria, they will be enrolled in the study. After receiving U96 treatment, patients will be followed up. It is recommended that they stay in the hospital for at least 14 days after administration. Safety and efficacy follow-ups will be conducted at 28 days and 3, 6, 12, 18, and 24 months after treatment. The follow-up period after treatment will last for 2 years, with a long-term follow-up of 15 years to assess the efficacy and safety until the end of the study or the patient withdraws from the study. For patients who have received U96 treatment, even if they withdraw from the study early, the investigators should still conduct long-term safety follow-ups according to the protocol to evaluate the long-term safety of the product.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
U96(CD7-targeted lentiviral vector for in vivo production of IL-6 knockdown CD19 CAR)
The First Affiliated Hospital of Soochow University
Suzhou, Jiangsu, China
RECRUITINGDose-limiting toxicity (DLT)
Description: DLT refers to any of the following conditions occurring within 28 days after cell reinfusion that are related to cell infusion: ① Hematologic DLT: Grade 4 toxicity (excluding lymphopenia) not caused by the underlying disease and taking more than 30 days to resolve to ≤ Grade 2. ② Non-hematologic DLT: Any toxicity ≥ Grade 4 that is possibly related to CAR-T therapy, or Grade 3 toxicity that requires ≥7 days to resolve to ≤ Grade 2 or to return to baseline.
Time frame: Within 28 days after U96 infusion
Adverse Event (AE)
Description: Record the types, occurrence frequency and severity of adverse events (AEs) related to CAR-T, with specific definitions determined according to CTCAE v5.0.The CRS and ICANS ratings do not use CTCAE but adopt the evaluation criteria in the ASTCT standards.
Time frame: 2 years
Objective Response Rate (ORR)
The acute B lymphocytic leukemia group is defined as the proportion of patients who achieved complete remission (CR), complete remission with incomplete hematological recovery (CRh), and complete remission with incomplete bone marrow recovery (CRi); the B-cell lymphoma group is defined as the complete remission rate (CR) and partial remission (PR) as determined by the investigators.
Time frame: 28 days and within 3 months after infusion of U96
MRD-negative rate (for B-ALL)
The proportion of B-ALL patients with negative MRD in the bone marrow when the therapeutic effect reaches remission. B-ALL patients have residual leukemia cells in the bone marrow detected by flow cytometry below 10-⁴ and/or negative qualitative or quantitative detection of bone marrow fusion genes (if any).MRD is detected by CD19 flow cytometry immunophenotyping (bone marrow).
Time frame: 28 days and within 3 months after infusion of U96
Duration of Response (DOR)
It refers to the time from the evaluation of CR/CRh/CRi in patients with acute B-cell leukemia, or from the time when patients with B-cell lymphoma first reach response (CR or PR) to disease recurrence/disease progression/death due to disease.Subjects who have not experienced disease progression or death by the time of the final data collection will be censored at the time of their last valid tumor assessment. Common reasons for censoring include, but are not limited to: ①Loss to follow-up; ②Withdrawal from the study; ③Initiation of a new anticancer therapy.
Time frame: 2 years
Best Overall Response (BOR)
The Best Overall Response is defined as the proportion of patients who achieve the best response (CR or CRi) after study treatment.The review period extends from the start of infusion of U96 until the initiation of subsequent anti-cancer therapy, disease progression, withdrawal of consent, death, or study closure, whichever comes first.
Time frame: 2 years
Overall Survival (OS)
Defined as the time from the date of cell infusion to the date of death from any cause. For subjects who are still alive at the time of analysis, OS will be censored on the date of last known contact.
Time frame: 2 years
Progression-Free Survival (PFS)
The duration from the start of the treatment to the onset of disease progression or death for patients with B-cell lymphoma. For patients who did not experience disease progression or death by the analysis cutoff date, the last tumor evaluation time was used for censored processing.
Time frame: 2 years
Relapse-Free Survival (RFS)
Defined as the time from the start of study treatment to the date of first documented relapse in patients with B-cell acute lymphoblastic leukemia (B-ALL).
Time frame: 2 years
Event-Free Survival (EFS)
Defined as the time from the date of cell infusion to the occurrence of any of the following events (whichever comes first): ①Death from any cause after achieving remission ②Disease relapse or progression ③Treatment failure, defined as either lack of efficacy or discontinuation of the clinical trial due to: -Death -Adverse events -Lack of efficacy or disease progression -Initiation of new antitumor therapy
Time frame: 2 years
Pharmacokinetics-AUC(0-28)
The area under the curve from 0 to 28 days for the reinfusion.
Time frame: 2 years
Pharmacokinetics-Cmax
The peak concentration of the drug in the peripheral blood sample.
Time frame: 2 years
Pharmacokinetics-Tmax
The time at which the peak concentration of the drug is reached in the peripheral
Time frame: 2 years
IL-6
Changes in the levels of IL-6
Time frame: Within 28 days after U96 infusion
Ferritin
Changes in the levels of Ferritin
Time frame: Within 28 days after U96 infusion
C-reactive protein(CRP)
Changes in the levels of CRP
Time frame: Within 28 days after U96 infusion
Pharmacokinetics-Proportion of B cells.
Change from baseline in peripheral blood B cell ratio
Time frame: Within 28 days after U96 infusion
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