New treatment for patients with relapsed or refractory chronic lymphocytic leukemia

An Open Label Phase Ia/b Dose Escalation Followed by Dose Expansion Safety and Tolerability Trial of CAP-100, a Humanized C-C-chemokine Receptor 7 Antibody, Administered as Monotherapy in Subjects With r/r Chronic Lymphocytic Leukemia

This study is testing a new treatment called CAP-100 for people with chronic lymphocytic leukemia who haven't had success with other therapies.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 18 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Catapult Therapeutics (Industry-sponsored)
• Drugs / interventions: chimeric antigen receptor, rituximab, ibrutinib, acalabrutinib, chemotherapy, cyclophosphamide, fludarabine
• Locations: 4 sites (Boston, Massachusetts and 3 other locations)
• Trial ID: NCT04704323 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the efficacy of CAP-100, a novel immuno-chemotherapy treatment, for patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic leukemia (SLL). The study aims to provide an alternative for patients who have not responded to at least two prior standard treatments. Participants will be monitored for safety and effectiveness as they receive CAP-100, which is designed to overcome challenges associated with existing therapies. The trial is conducted at prominent cancer treatment centers in the United States and Spain.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older who have relapsed or refractory CLL or SLL after at least two prior treatments.

Not a fit: Patients who have not received prior systemic therapy or those with a life expectancy of less than 16 weeks may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could offer a new option for patients with limited alternatives, potentially improving their outcomes.

How similar studies have performed: While there have been advancements in CLL treatments, the specific approach of CAP-100 is novel and has not been extensively tested in prior studies.

Eligibility criteria

Inclusion Criteria:

1. Age ≥ 18 years.
2. Able to understand and sign a written informed consent document.
3. Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2.
4. Relapsed or refractory to at least two (2) prior standard systemic treatment regimen for CLL or SLL (USA).

   Relapsed or refractory to at least two (2) prior standard systemic treatment regimen for CLL or SLL and without available therapies known to provide clinical benefit (until new amendment implemented, Spain).
5. Prior CLL or SLL systemic therapy must have been discontinued for a duration of at least five times its half-life (palliative low dose steroids are allowed to bridge the time to CAP-100; major surgery or irradiation for CLL must have been completed \> 4 weeks prior to the first trial dose of medication). Prior chimeric antigen receptor (CAR)-T cell therapy is allowed.
6. Life expectancy \> 16 weeks.
7. Subjects must have met the diagnostic criteria for CLL according to the iwCLL 2018 guidelines (Hallek et al, 2018) or for SLL (NCCN guidelines, 2020) at some point during their disease course.
8. Subjects must meet iwCLL 2018 guideline criteria (Hallek et al, 2018) for active disease.
9. Platelet count ≥ 50,000/ μL, unless decrease is attributable to bone marrow infiltration of CLL.
10. Adequate liver function as indicated by aspartate transaminase (AST)/ alanine transaminase (ALT) ≤ 2.5 times upper limit of normal (ULN), unless directly attributable to the subject's tumor (in this case, acceptable levels are ≤ 5 x ULN).
11. Renal function as defined by creatinine clearance (CrCl)≥ 45 mL/min/1.73m2 (by CKD-EPI formula).
12. Women of childbearing potential and male subjects who have partners capable of reproduction must agree to use an effective contraceptive method during the course of the trial and for 4 months following the completion of their last treatment. Women of childbearing potential must have a negative serum β-subunit of hCG gonadotropin (β-hCG) pregnancy test result within 7 days of first trial dose. Female subjects who are surgically sterilized or who are \> 45 years old and have not experienced menses for \> 2 years may have β-hCG pregnancy test waived.

Exclusion Criteria:

1. Allogeneic stem-cell transplantation within 6 months of trial entry.
2. Monoclonal antibody for anti-cancer therapy within 4 weeks of trial entry.
3. Side effects due to prior therapy not recovered to ≤Grade 1.
4. Oral targeted inhibitors (Bruton's tyrosine kinase \[BTK\]-inhibitors, B-cell lymphoma 2 \[BCL-2\] inhibitors, phosphoinositide 3-kinase \[PI3K\] inhibitors) within five times their half-life.
5. Active viral, bacterial or systemic fungal infection requiring treatment.
6. Subjects who are known to be human immunodeficiency virus (HIV)-positive.
7. Subjects with active known central nervous system (CNS) lymphoma.
8. Pregnant or lactating women.
9. History of previous cancer \< 2 years before the trial, except controlled disease using systemic therapy with curative intent, surgical therapy with curative intent or skin cancer, cancer in situ, and prostate cancer on the "watch and wait" approach.
10. Uncontrolled intercurrent illness including, but not limited to, New York Heart Association Class (NYHA) III and IV congestive heart failure, myocardial infraction within the previous 6 months, ejection fraction (EF) \< 40%, life-threatening arrhythmias, or unstable angina brain metastasis or psychiatric illness that would limit compliance with trial requirement.
11. Subjects with known hypersensitivity to any excipient contained in the drug formulation.
12. Subjects with a history of documented human anti-globulin antibodies.
13. Active autoimmune disease, motor neuropathy considered of autoimmune origin, and other CNS autoimmune disease.

Where this trial is running

Boston, Massachusetts and 3 other locations

• Dana-Farber Cancer Institute — Boston, Massachusetts, United States (Recruiting)
• Duke University — Durham, North Carolina, United States (Recruiting)
• Hospital Universitario de La Princesa — Madrid, Spain (Recruiting)
• Hospital Universitario Marqués de Valdecilla — Santander, Spain (Recruiting)

Study contacts

• Study coordinator: Marlies Van Hoef, MD, PhD, MBA

Conditions Lymphocytic Leukemia, Chronic; SLL