Recruiting
Phase 3
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
Condition(s) studied
Epstein-Barr Virus+ Associated Post-transplant Lymphoproliferative Disease (EBV+ PTLD)Solid Organ Transplant ComplicationsLymphoproliferative DisordersAllogeneic Hematopoietic Cell TransplantStem Cell Transplant Complications
Investigational drug(s) / intervention(s)
tabelecleucel
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
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.
More Pierre Fabre Medicament trials in the UK