A Phase 3 Study of Tabelecleucel for Participants With Epstein-Barr Virus-Associated Post-Transplant Lymphoproliferative Disease After Failure With Rituximab or Rituximab and Chemotherapy
tabelecleucel: Tabelecleucel is being investigated as an off-the-shelf, allogeneic T-cell immunotherapy for the treatment of EBV+ malignancies and diseases.
Study summary
The purpose of this study is to determine the clinical benefit and characterize the safety profile of tabelecleucel for the treatment of Epstein-Barr virus-associated post-transplant lymphoproliferative disease (EBV+ PTLD) in the setting of (1) solid organ transplant (SOT) after failure of rituximab (SOT-R) and rituximab plus chemotherapy (SOT-R+C) or (2) allogeneic hematopoietic cell transplant (HCT) after failure of rituximab.
Eligibility
Sex
ALL
Min age
—
Max age
—
Healthy volunteers
No
Inclusion Criteria:
1. Prior SOT of kidney, liver, heart, lung, pancreas, small bowel, or any combination of these (C-SOT); or prior allogeneic HCT (C-HCT).
2. A diagnosis of locally assessed, biopsy-proven EBV+ PTLD.
3. Availability of appropriate partially HLA-matched and restricted tabelecleucel has been confirmed by the sponsor.
4. Measurable, 18F-deoxyglucose (FDG)-avid (Deauville score ≥ 3) systemic disease using Lugano Classification response criteria by positron emission tomography (PET)-diagnostic computed tomography (CT), except when contraindicated or mandated by local practice, then magnetic resonance imaging (MRI) may be used. For participants with treated central nervous system (CNS) disease, a head CT and/or brain/spinal MRI as clinically appropriate will be required to follow CNS disease response per Lugano Classification response criteria.
5. Treatment failure of rituximab or interchangeable commercially available biosimilar monotherapy (C-SOT-R or C-HCT) or rituximab plus any concurrent or sequentially administered chemotherapy regimen (C-SOT-R+C) for treatment of PTLD.
6. Males and females of any age.
7. Eastern Cooperative Oncology Group performance status ≤ 3 for participants aged ≥ 16 years; Lansky score ≥ 20 for participants \< 16 years.
8. For C-HCT only: If allogeneic HCT was performed as treatment for an acute lymphoid or myeloid malignancy, the underlying primary disease for which the participant underwent transplant must be in morphologic remission.
9. Adequate organ function.
1. Absolute neutrophil count ≥ 1000/μL, (C-SOT) or ≥ 500/μL (C-HCT), with or without cytokine support.
2. Platelet count ≥ 50,000/μL, with or without transfusion or cytokine support. For C-HCT, platelet count \< 50,000/μL but ≥ 20,000/μL, with or without transfusion support, is permissible if the participant has not had grade ≥ 2 bleeding in the prior 4 weeks (where grading of the bleeding is determined per the National Cancer Institute's Common Terminology Criteria for Adverse Events \[CTCAE\], version 5.0).
3. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin each \< 5 × the upper limit of normal; however, ALT, AST, and total bilirubin each ≤ 10 × upper limit of normal is acceptable if the elevation is considered by the investigator to be due to EBV and/or PTLD involvement of the liver as long as there is no known evidence of significant liver dysfunction.
10. Participant or participant's representative is willing and able to provide written informed consent.
Exclusion Criteria:
1. Currently active Burkitt, T-cell, NK/T-cell lymphoma/LPD, Hodgkin, plasmablastic, transformed lymphoma, active hemophagocytic lymphohistiocytosis, or other malignancies requiring systemic therapy.
2. Daily steroids of \> 0.5 mg/kg prednisone or glucocorticoid equivalent, ongoing methotrexate, or extracorporeal photopheresis.
3. Untreated CNS PTLD or CNS PTLD for which the participant is actively receiving CNS-directed chemotherapy (systemic or intrathecal) or radiotherapy at enrollment. NOTE: Participants with previously treated CNS PTLD may enroll if CNS-directed therapy is complete.
4. Suspected or confirmed grade ≥ 2 graft-versus-host disease (GvHD) per the Center for International Blood and Marrow Transplant Research consensus grading system at enrollment.
5. Ongoing or recent use of a checkpoint inhibitor agent (eg, ipilimumab, pembrolizumab, nivolumab) within 3 drug half-lives from the most recent dose to enrollment.
6. For C-HCT: active adenovirus viremia.
7. Need for vasopressor or ventilatory support.
8. Antithymocyte globulin or similar anti-T cell antibody therapy ≤ 4 weeks prior to enrollment.
9. Treatment with Epstein-Barr virus cytotoxic T lymphocytes or chimeric antigen receptor T cells directed against B cells within 8 weeks of enrollment (C-SOT or C-HCT), or unselected donor lymphocyte infusion within 8 weeks of enrollment (C-HCT only).
10. Female who is breastfeeding or pregnant or female of childbearing potential or male with a female partner of childbearing potential unwilling to use a highly effective method of contraception.
11. Inability to comply with study-related procedures.
12. Any medical condition or organ system dysfunction that in the investigator';s opinion, could compromise the participant's safety or ability to complete the study.
Primary outcome measure(s)
Objective Response Rate (ORR) in the Analysis Cohorts C-SOT, C-HCT, and Combined Population (C-SOT-R+C, C-SOT-R-Ci, and C-HCT) Who Received Commercial Product, or a Product Manufactured Using a Comparable PV — 2 years
Trial sites (71)
Facility
City
Region
Status
City of Hope (Adults and Pediatrics)
Duarte
California
Completed
University of California San Diego Moores Cancer Center (Adults only)
La Jolla
California
Completed
Loma Linda University Medical Center (Adults only)
Loma Linda
California
Recruiting
Children's Hospital Los Angeles, Div. of Research Immunology/BMT (Adults and Pediatrics)
Los Angeles
California
Recruiting
UCLA Medical Center (Adults and Pediatrics)
Los Angeles
California
Completed
University of California Davis Comprehensive Cancer Center (Adults only)
Sacramento
California
Completed
Yale University (Adults and Pediatrics)
New Haven
Connecticut
Completed
MedStar Georgetown University Hospital (Adults and Pediatrics)
Washington D.C.
District of Columbia
Recruiting
University of Florida (Adults and Pediatrics)
Gainesville
Florida
Completed
University of Miami/Jackson Memorial Hospital (Adults only)
Miami
Florida
Recruiting
Winship Cancer Institute (Adults only)
Atlanta
Georgia
Completed
Arthur M Blank Hospital - Children's Healthcare of Atlanta
Atlanta
Georgia
Recruiting
Ann & Robert H. Lurie Children's Hospital of Chicago (Adults and Pediatrics)
Chicago
Illinois
Recruiting
University of Chicago Medical Center - Duchossois Center for Advanced Medicine (Adults only)
Chicago
Illinois
Completed
Loyola University Medical Center (Adults and Pediatrics)
Maywood
Illinois
Recruiting
University of Maryland School of Medicine (Adults only)
Baltimore
Maryland
Completed
Dana Farber Cancer Institute, Brigham and Women's Hospital (Adults and Pediatrics)
Boston
Massachusetts
Recruiting
Washington University School of Medicine (Adults only)
St Louis
Missouri
Recruiting
Weill Cornell Medicine (Adults only)
New York
New York
Completed
Columbia University Medical Center (Adults and Pediatrics)
New York
New York
Completed
Memorial Sloan Kettering Cancer Center (Adults and Pediatrics)
New York
New York
Completed
Montefiore Medical Center (Adults only)
The Bronx
New York
Completed
Montefiore Medical Center (Pediatrics only)
The Bronx
New York
Completed
University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center (Adults and Pediatrics)
Chapel Hill
North Carolina
Completed
Carolinas Medical Center/Levine Children's Hospital (Adults and Pediatrics)
Charlotte
North Carolina
Recruiting
Duke Cancer Institute (Adults and Pediatrics)
Durham
North Carolina
Recruiting
Cleveland Clinic Foundation (Adults and Pediatrics)
Cleveland
Ohio
Recruiting
Nationwide Children's Hospital (Pediatrics only)
Columbus
Ohio
Completed
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (Adults and Pediatrics)
Columbus
Ohio
Recruiting
Oregon Health and Science University Physicians Pavilion (Adults and Pediatrics)
Portland
Oregon
Recruiting
Hospital of the University of Pennsylvania (Adults only)
Philadelphia
Pennsylvania
Recruiting
The Children's Hospital of Philadelphia Oncology Division, Blood & Marrow Transplant Section (Pediatrics)
Philadelphia
Pennsylvania
Recruiting
University of Pittsburgh Medical Center (Adults only)
Pittsburgh
Pennsylvania
Completed
Medical University of South Carolina (Adults and Pediatrics)
Charleston
South Carolina
Completed
Saint Jude Children's Research Hospital (Pediatrics only)
Memphis
Tennessee
Completed
Vanderbilt University Medical Center Henry-Joyce Cancer Clinic (Adults and Pediatrics)
Nashville
Tennessee
Recruiting
Baylor Scott and White Research Institute (Adults only)
Dallas
Texas
Recruiting
University of Texas Southwestern Medical Center - Children's Medical Center (Pediatrics only)
Dallas
Texas
Recruiting
MD Anderson Cancer Center (Pediatrics and Adult)
Houston
Texas
Recruiting
Froedtert and Medical College of Wisconsin - Clinical Cancer Center (Adults only)
Milwaukee
Wisconsin
Completed
+ 31 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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