Study of Lenzilumab and Axicabtagene Ciloleucel in Participants With Relapsed or Refractory Large B-Cell Lymphoma

Not Recruiting

Trial ID: NCT04314843

Purpose

The primary objectives of this study are: Phase 1: To evaluate the safety of sequenced therapy with lenzilumab and axicabtagene ciloleucel in participants with relapsed or refractory large B-cell lymphoma and identify the most appropriate dose of lenzilumab for Phase 2. Phase 2: To evaluate the incidence of neurologic events with sequenced therapy given at the recommended Phase 2 dose (RP2D) of lenzilumab in participants with relapsed or refractory large B-cell lymphoma.

Official Title

A Phase 1/2 Open-label, Multicenter Study of Lenzilumab and Axicabtagene Ciloleucel in Subjects With Relapsed or Refractory Large B-cell Lymphoma (ZUMA-19)

Stanford Investigator(s)

Parveen Shiraz, MD
Parveen Shiraz, MD

Instructor, Medicine - Blood & Marrow Transplantation

Eligibility


Key Inclusion Criteria:

   - Individuals with large B-cell lymphoma, including Diffuse large B-cell lymphoma
   (DLBCL) not otherwise specified, Primary mediastinal large B-cell lymphoma (PMBCL),
   High-grade B-cell lymphoma (HGBL), and DLBCL arising from Follicular lymphoma (FL)

   - Individuals must have relapsed disease after 2 or more lines of systemic therapy, or
   chemorefractory disease defined as the following:

      - No response to first-line therapy, including the following:

         - Progressive disease (PD) as best response to first therapy

         - Stable disease (SD) as best response after ≥ 4 cycles of first-line therapy
         (eg, 4 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine,
         prednisone (R-CHOP)), with SD duration no longer than 6 months from the last
         dose of therapy

      - No response to ≥ 2 lines of therapy, including the following:

         - PD as best response to most recent therapy

         - SD as best response after ≥ 2 cycles of last line of therapy

   - Individuals must have received adequate prior therapy including at a minimum:

      - Anti-CD20 monoclonal antibody unless investigator determines that tumor is CD20
      negative, and

      - An anthracycline-containing chemotherapy regimen

   - At least 1 measurable lesion according to the International Working Group Lugano
   Classification. Lesions that have been previously irradiated will be considered
   measurable only if progression has been documented following completion of radiation
   therapy.

   - Magnetic resonance imaging of the brain showing no evidence of central nervous system
   (CNS) lymphoma

   - Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

   - Individuals with a known medical history of tuberculosis or a risk for tuberculosis
   exposure require negative tuberculosis testing by either tuberculin skin test or
   interferon gamma release assay.

   - Adequate bone marrow function as evidenced by:

      - Absolute neutrophil count ≥ 1000/μL

      - Platelets ≥ 75,000/μL

      - Absolute lymphocyte count ≥ 100/μL

   - Adequate renal, hepatic, cardiac, and pulmonary function as evidenced by:

      - Creatinine clearance (Cockcroft-Gault) ≥ 60 mL/min

      - Serum alanine aminotransferase or aspartate aminotransferase ≤ 2.5 upper limit of
      normal

      - Total bilirubin ≤ 1.5 mg/dL, except in individuals with Gilbert's Syndrome

      - Cardiac ejection fraction ≥ 50% with no evidence of clinically significant
      pericardial effusion as determined by echocardiogram (ECHO), and no clinically
      significant electrocardiogram (ECG) findings

      - No clinically significant pleural effusion

      - Baseline oxygen saturation > 92% on room air

Key Exclusion Criteria:

   - History of Richter's transformation of chronic lymphocytic leukemia

   - Autologous stem cell transplant (SCT) within 6 weeks of planned axicabtagene
   ciloleucel infusion

   - History of allogeneic stem cell transplantation

   - Prior CD19 targeted therapy or prior CAR T cell therapy

   - History of pulmonary alveolar proteinosis (PAP)

   - History of severe, immediate hypersensitivity reaction attributed to aminoglycosides

   - Known history of human immunodeficiency virus (HIV) infection, hepatitis B (HBsAg
   positive) or hepatitis C (HCV) (anti-HCV positive) infection. A history of hepatitis B
   or hepatitis C infection is permitted if the viral load is undetectable per
   quantitative polymerase chain reaction (PCR) and/or nucleic acid testing.

   - Individuals with detectable Cerebrospinal fluid (CSF) malignant cells, or brain
   metastases, or with a history of CNS lymphoma, CSF malignant cells or brain metastases

   - History or presence of CNS disorder such as seizure disorder, cerebrovascular
   ischemia/hemorrhage, dementia, cerebellar disease, or any autoimmune disease with CNS
   involvement

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Intervention(s):

drug: Cyclophosphamide

drug: Fludarabine

biological: Lenzilumab

biological: Axicabtagene Ciloleucel

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Linnea Bjornlund Nichols
1 650-724-9050

New Trial Alerts