Evaluating a new cell therapy for B-Cell Lymphoma

A Single-Arm, Open-Label Clinical Study on the Efficacy and Safety of U01 (ssCART-19) in the Treatment of Relapsed or Refractory B-Cell Lymphoma

This study is testing a new cell therapy for people with hard-to-treat B-cell lymphoma to see if it is safe and effective at reducing side effects compared to traditional treatments.

Quick facts

• Phase: Phase1; Phase2
• Study type: Interventional
• Enrollment: 50 (estimated)
• Ages: 2 Years to 75 Years
• Sex: All
• Sponsor: Shanghai Tongji Hospital, Tongji University School of Medicine (Academic / other)
• Drugs / interventions: CAR-T, chemotherapy, CAR T
• Locations: 1 site (Shanghai, Shanghai Municipality)
• Trial ID: NCT06987916 on ClinicalTrials.gov

What this trial studies

This open-label phase 1 and 2 study assesses the safety and efficacy of U01(ssCART-19) cell therapy in patients with refractory or recurrent diffuse large B-cell lymphoma (DLBCL). The therapy utilizes modified CAR T-cells that incorporate small hairpin RNA technology to silence the IL-6 gene, aiming to reduce the risk of cytokine release syndrome and neurotoxicity associated with traditional CAR T-cell therapies. Participants will be monitored for both safety and treatment outcomes as they receive this innovative therapy.

Who should consider this trial

Good fit: Ideal candidates include individuals aged 2 to 75 with a confirmed diagnosis of B-cell lymphoma who have not responded to previous treatments.

Not a fit: Patients who have not undergone prior treatment or those with CD20-negative tumors may not benefit from this study.

Why it matters

Potential benefit: If successful, this therapy could provide a safer and more effective treatment option for patients with relapsed or refractory B-cell lymphoma.

How similar studies have performed: Other studies utilizing modified CAR T-cell therapies have shown promise, but this specific approach targeting IL-6 is novel.

Eligibility criteria

Inclusion Criteria:

1. Participants must voluntarily sign the informed consent form (ICF) and demonstrate good compliance.
2. Participants must meet the following requirements:

   1. Age ≥2 years and ≤75 years at the time of signing the ICF (both sexes eligible). For minors (\<18 years), the legal guardian must sign after full disclosure; minors with decision-making capacity must co-sign with their guardians.
   2. Confirmed diagnosis of B-cell lymphoma according to the NCCN Clinical Practice Guidelines for B-Cell Lymphomas (3rd Edition, 2024) .
   3. Prior treatment requirements :

   Failure to achieve partial response (PR) after first-line therapy, or relapse within 12 months post-first-line therapy; Relapsed/refractory B-cell lymphoma after second-line therapy (one standard chemotherapy regimen + one salvage regimen).

   Prior treatments must include CD20 monoclonal antibody (unless CD20-negative tumor confirmed by the investigator) and anthracycline-based regimens .

   Additionally, meet one of the following:

   i. Ineligible for autologous stem cell transplantation (ASCT); ii. Refusal of ASCT; iii. Post-ASCT relapse. d) Refractory/relapsed status at screening: Relapse: Disease progression (PD) after achieving PR or complete response (CR);

   Refractory:

   i. No response to last-line therapy (PD during/after treatment, or stable disease \[SD\] lasting \<6 months); ii. Post-ASCT relapse/PD (biopsy-confirmed), including relapse/PD within 12 months post-ASCT with SD/PD after salvage therapy2.
3. CD19 positivity confirmed by immunohistochemistry (IHC) of tumor tissue (preferably within 6 months).
4. At least one measurable lesion assessed by the Lugano Lymphoma Response Criteria (Cheson 2014) .
5. ECOG performance status score 0-3 .
6. Adequate bone marrow reserve at screening:

   Absolute lymphocyte count (ALC) ≥0.3×10⁹/L ; Platelet count (PLT) ≥30×10⁹/L .
7. Adequate organ function:

   AST/ALT ≤3×ULN (≤5×ULN if due to tumor infiltration); Total bilirubin ≤2×ULN (≤3×ULN for Gilbert syndrome with direct bilirubin ≤1.5×ULN); Serum creatinine ≤1.5×ULN or creatinine clearance ≥60 mL/min (Cockcroft-Gault formula); Oxygen saturation \>91% on room air (dyspnea grade ≤1); Left ventricular ejection fraction (LVEF) ≥50% ; INR ≤1.5×ULN and APTT ≤1.5×ULN .
8. Negative pregnancy test (blood/urine) within 7 days before CAR-T infusion for women of childbearing potential. All participants must agree to use effective contraception during the study and for ≥1 year post-treatment.
9. Adequate venous access for leukapheresis or blood collection, with no contraindications to leukapheresis.
10. Expected survival ≥3 months .

Exclusion Criteria:

1. Concurrent malignancies , except for:

   Malignancies with disease-free survival (DFS) \>3 years ; Carcinoma in situ ;
2. Active viral infections :

   Hepatitis B : Positive for HBe-Ab and/or HBc-Ab with HBV-DNA \> lower limit of quantitation (LLOQ) ; Hepatitis C : Positive HCV-Ab with HCV-RNA \> LLOQ ; Positive Treponema pallidum antibody (TP-Ab); Positive HIV antibody ;
3. Uncontrolled infections (bacterial, fungal, viral, mycoplasmal, or others) as determined by the investigator;
4. Clinically significant CNS diseases (current or history), including:

   Epilepsy, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disorders, or CNS-related autoimmune diseases , deemed uncontrolled by the investigator;
5. Cardiovascular exclusion criteria :

   Cardiac angioplasty/stent placement within 12 months prior to signing ICF ; NYHA Class II-IV congestive heart failure , myocardial infarction, unstable angina, or other clinically significant cardiac history; QTe interval ≥480 ms (Fridericia correction) or LVEF \<50% at screening;
6. Primary immunodeficiency ;
7. Severe immediate hypersensitivity to any study drug;
8. Live vaccine administration within 6 weeks prior to screening ;
9. Pregnancy or lactation ;
10. Active autoimmune diseases ;
11. Participation in another interventional clinical trial within 30 days prior to ICF signing ;
12. Other conditions deemed ineligible by the investigator.

Where this trial is running

Shanghai, Shanghai Municipality

• Shanghai Tongji Hospital ( Tongji Hospital of Tongji University) — Shanghai, Shanghai Municipality, China (Recruiting)

Study contacts

• Principal investigator: Wenjun Zhang, Doctor — Tongji hospital of tongji university (Shanghai tongji hospital)
• Study coordinator: Wenjun Zhang, Doctor

Conditions B Cell Lymphoma; ssCART-19; Relapsed or Refractory B-Cell Lymphma; IL-6