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NCT05826535PHASE1, PHASE2Recruiting

Study of Rondecabtagene Autoleucel in Aggressive Large B-Cell Lymphoma

Lyell Immunopharma, Inc.

Start Date

5/9/2023

Completion Date

6/30/2031

Summary

This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of rondecabtagene autoleucel (ronde-cel) also known as LYL314, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma.

Detailed Description

This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of ronde-cel, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma. Five cohorts of participants will be enrolled: Cohort 1: (3rd or later line, 3L+) Participants who have received least two prior lines of treatment Cohort 2: (CAR T-cell experienced, 3L+): Participants who have received at least two prior lines of treatment including one prior CAR T. Cohort 3: (second line, 2L) Participants with refractory disease or relapse within one year of first-line therapy (second-line). Cohort 4: (TCE-experienced, 3L+) Participants have received prior T-cell engager therapy and have received at least two prior lines of treatment including one TCE therapy and have not received prior CAR T. Cohort 5: (high-risk 1st line) Participants receiving first-line treatment who remain with disease on positron emission tomography scanning (PET-positive) after 2 to 3 cycles of standard-of-care chemoimmunotherapy and have not received prior CAR T. Up to approximately 150 participants (across all cohorts) will be enrolled in the dose finding Phase 1 part of the study. The Phase 2 pivotal study (PiNACLE) will expand enrollment of Cohort 1 to approximately 120 participants to further evaluate the safety and efficacy of ronde-cel. Ronde-cel treatment consists of a single administration of CAR transduced autologous T-cells administered intravenously after a conditioning chemotherapy regimen consisting of fludarabine and cyclophosphamide, administered over 3 days. Individual participants will remain in the active post-treatment follow-up (PTFU) period for approximately 2 years. Participants will continue in long-term follow-up (LTFU) for 15 years from ronde-cel treatment.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: 1. Age 18 years or older 2. Willing and able to provide written informed consent 3. Histologically confirmed LBCL, including the following types defined by the World Health Organization (WHO 2022) or International Consensus Classification (2022) 4. Received at least two prior lines of therapy for Cohorts 1, 2, and 4 and one prior line of therapy for Cohort 3 5. Relapsed or refractory disease. 6. At least 1 measurable lesion (per Lugano classification) 7. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 or ECOG 0 to 2 (Cohort 5) 8. Absolute neutrophil count (ANC) ≥ 1000/µL 9. Platelet count ≥ 50,000/µL 10. Absolute lymphocyte count (ALC) ≥ 200/µL Other protocol-defined criteria apply. Exclusion Criteria: 1. History of malignancy other than non-melanoma skin cancer or carcinoma in situ unless disease-free for at least 3 years 2. Active central nervous system involvement 3. History of cardiac lymphoma involvement or Epstein-Barr virus (EBV)+ lymphoma 4. Ongoing or impending oncologic emergency 5. Recent systemic anti-cancer therapy or radiation 6. Ongoing non-hematologic toxicities due to prior therapy 7. History of allogeneic stem cell or solid organ transplantation 8. Autologous stem cell transplantation within 6 weeks 9. History of prior genetically modified cell therapy (Cohorts 1, 3, 4, 5) or no other than a product targeting CD19 with an FMC63-based CAR (e.g., axicabtagene ciloleucel (axi-cel), tisagenlecleucel (tisa-cel), or lisocabtagene maraleucel (liso-cel) (Cohort 2). 10. Primary immunodeficiency 11. History of autoimmune disease resulting in end organ injury or requiring recent therapy Other protocol-defined criteria apply.

Interventions

DRUG

Rondecabtagene autoleucel (ronde-cel)

DRUG

Fludarabine

DRUG

Cyclophosphamide

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Conditions

Relapsed Non-Hodgkin LymphomaRefractory Non-Hodgkin LymphomaNon-Hodgkin LymphomaLarge B-cell Lymphoma

Locations

University of California-Irvine Medical Center

Irvine, California 92697

United States

Cedars-Sinai Medical Center

Los Angeles, California 90048

United States

University of California, Los Angeles (UCLA) Medical Center

Los Angeles, California 90095

United States

Scripps Clinic

San Diego, California 92037

United States

Colorado Blood Cancer Institute

Denver, Colorado 80218

United States

Medstar Georgetown University Hospital

Washington D.C., District of Columbia 20007

United States

Augusta University Medical Center

Augusta, Georgia 30912

United States

Indiana Blood and Marrow Transplantation

Indianapolis, Indiana 46237

United States

University of Iowa

Iowa City, Iowa 52242

United States

University of Louisville Brown Cancer Center

Louisville, Kentucky 40202

United States

Louisiana State University Health Sciences Center

Shreveport, Louisiana 71130

United States

Corewell Health

Grand Rapids, Michigan 49503

United States

University of Nebraska Medical Center

Omaha, Nebraska 68198

United States

John Theurer Cancer Center Hackensack University Medical Center

Hackensack, New Jersey 07601

United States

University of New Mexico Comprehensive Cancer Center

Albuquerque, New Mexico 87131

United States

Roswell Park Comprehensive Cancer Center

Buffalo, New York 14263

United States

David H. Koch Center for Cancer Care at Memorial Sloan Kettering Cancer Center

New York, New York 10021

United States

Montefiore Medical Center

The Bronx, New York 10461

United States

Atrium Health Wake Forest Baptist

Winston-Salem, North Carolina 27157

United States

University of Cincinnati (UC) Physicians Company, LLC

Cincinnati, Ohio 45267

United States

Cleveland Clinic

Cleveland, Ohio 44195

United States

Lehigh Valley Topper Cancer Center Institute

Allentown, Pennsylvania 18103

United States

Thomas Jefferson University

Philadelphia, Pennsylvania 19107

United States

West Penn Hospital

Pittsburgh, Pennsylvania 15224

United States

Vanderbilt University Medical Center

Nashville, Tennessee 37212

United States

Baylor University Medical Center

Dallas, Texas 75246

United States

Texas Transplant Institute

San Antonio, Texas 78229

United States

Huntsman Cancer Institute

Salt Lake City, Utah 84112

United States

Intermountain Healthcare

Salt Lake City, Utah 84143

United States

Virginia Oncology Associates

Norfolk, Virginia 24502

United States

Virginia Commonwealth University-Massey Cancer Center

Richmond, Virginia 23298

United States

Medical College of Wisconsin

Milwaukee, Wisconsin 53226

United States

Royal Perth Hospital

Perth, Western Australia 6000

Australia

The Alfred Hospital

Melbourne, 3004

Australia