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    Summary
    EudraCT Number:2015-005010-30
    Sponsor's Protocol Code Number:KTE-C19-104
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2022-07-11
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2015-005010-30
    A.3Full title of the trial
    A Phase 1/2 Multi-Center Study Evaluating the Safety and Efficacy of KTE-X19 in Pediatric and Adolescent Subjects with Relapsed/Refractory B-precursor Acute Lymphoblastic Leukemia or Relapsed/Refractory B-Cell Non-Hodgkin Lymphoma (ZUMA-4)

    P/142/2020
    Estudio de fase 1/2 multicéntrico para evaluar la seguridad y eficacia de KTE-X19 en sujetos pediátricos y adolescentes con leucemia linfoblástica aguda de precursores de linfocitos B recidivante/refractaria o linfoma no Hodgkin de linfocitos B recidivante/refractario (ZUMA-4)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Study Evaluating the Safety and Efficacy of KTE-X19 in pediatric and adolescent Subjects with Relapsed/Refractory B-precursor Acute Lymphoblastic Leukemia or Relapsed/Refractory Non-Hodgkin Lymphoma
    Un estudio para evaluar la seguridad y eficacia de KTE-X19 en sujetos pediátricos y adolescentes con leucemia linfoblástica aguda de precursores de linfocitos B recidivante/refractaria o linfoma no Hodgkin recidivante/refractario
    A.3.2Name or abbreviated title of the trial where available
    ZUMA-4
    ZUMA-4
    A.4.1Sponsor's protocol code numberKTE-C19-104
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02625480
    A.5.4Other Identifiers
    Name:IND NumberNumber:016675
    A.7Trial is part of a Paediatric Investigation Plan Yes
    A.8EMA Decision number of Paediatric Investigation PlanP/132/2020
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorKite Pharma, Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportKite Pharma, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationKite Pharma, Inc.
    B.5.2Functional name of contact pointRegulatory Affairs
    B.5.3 Address:
    B.5.3.1Street Address2400 Broadway
    B.5.3.2Town/ citySanta Monica
    B.5.3.3Post codeCA 90404
    B.5.3.4CountryUnited States
    B.5.6E-mailregulatory@kitepharma.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Tecartus
    D.2.1.1.2Name of the Marketing Authorisation holderKite Pharma EU B.V.
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/15/1571; EU/3/15/1553; EU/3/14/1393
    D.3 Description of the IMP
    D.3.1Product nameKTE-X19
    D.3.2Product code KTE-X19
    D.3.4Pharmaceutical form Dispersion for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNKTE-X19
    D.3.9.2Current sponsor codeKTE-X19
    D.3.9.3Other descriptive nameautologous peripheral blood T cells CD4 and CD8 selected, and CD3 and CD28 activated transduced with retroviral vector encoding an anti-CD19 CD28/CD3-zeta chimeric antigen receptor and cultured
    D.3.9.4EV Substance CodeSUB193905
    D.3.10 Strength
    D.3.10.1Concentration unit Other
    D.3.10.2Concentration typeup to
    D.3.10.3Concentration number200000000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Yes
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product Yes
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Yes
    D.3.11.3.5.1CAT classification and reference numberGene therapy medicinal product. Doc. Ref. EMA/386920/2019
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms Yes
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/15/1571; EU/3/15/1553; EU/3/14/1393
    D.3 Description of the IMP
    D.3.1Product nameKTE-X19
    D.3.2Product code KTE-X19
    D.3.4Pharmaceutical form Dispersion for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNKTE-X19
    D.3.9.2Current sponsor codeKTE-X19
    D.3.9.3Other descriptive nameautologous peripheral blood T cells CD4 and CD8 selected, and CD3 and CD28 activated transduced with retroviral vector encoding an anti-CD19 CD28/CD3-zeta chimeric antigen receptor and cultured
    D.3.9.4EV Substance CodeSUB193905
    D.3.10 Strength
    D.3.10.1Concentration unit Other
    D.3.10.2Concentration typeup to
    D.3.10.3Concentration number100000000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Yes
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product Yes
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Yes
    D.3.11.3.5.1CAT classification and reference numberGene therapy medicinal product. Doc. Ref. EMA/386920/2019
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms Yes
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/15/1571; EU/3/15/1553; EU/3/14/1393
    D.3 Description of the IMP
    D.3.1Product nameKTE-X19
    D.3.2Product code KTE-X19
    D.3.4Pharmaceutical form Dispersion for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNKTE-X19
    D.3.9.2Current sponsor codeKTE-X19
    D.3.9.3Other descriptive nameautologous peripheral blood T cells CD4 and CD8 selected, and CD3 and CD28 activated transduced with retroviral vector encoding an anti-CD19 CD28/CD3-zeta chimeric antigen receptor and cultured
    D.3.9.4EV Substance CodeSUB193905
    D.3.10 Strength
    D.3.10.1Concentration unit Other
    D.3.10.2Concentration typeup to
    D.3.10.3Concentration number50000000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Yes
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product Yes
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Yes
    D.3.11.3.5.1CAT classification and reference numberGene therapy medicinal product. Doc. Ref. EMA/386920/2019
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms Yes
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Relapsed/Refractory B-precursor Acute Lymphoblastic Leukemia (r/r ALL)
    Relapsed/Refractory B-cell non-Hodgkin lymphoma (r/r NHL)
    Leucemia linfoblástica aguda (LLA) de precursores de linfocitos B recidivante o refractaria (r/r)
    Linfoma no Hodgkin (LNH) de linfocitos B recidivante o refractario (r/r).
    E.1.1.1Medical condition in easily understood language
    Cancers of white blood cells
    Cáncer de los glóbulos blancos
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10000844
    E.1.2Term Acute lymphoblastic leukaemia
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10012818
    E.1.2Term Diffuse large B-cell lymphoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10006595
    E.1.2Term Burkitt's lymphoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10036710
    E.1.2Term Primary mediastinal large B-cell lymphoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective of phase 1 is to evaluate the safety of KTE-X19.

    The primary objective of Phase 2
    ALL Cohort: The primary objective is to evaluate the efficacy of KTE-X19, as measured by the overall complete remission rate defined as complete remission (CR) and complete remission with incomplete hematologic recovery (CRi) in pediatric and adolescent subjects with r/r B-precursor ALL.

    NHL Cohort: The primary objective is to estimate the efficacy as measured by the objective response rate (ORR) defined as a complete response or a partial response (CR+PR) in pediatric subjects with r/r NHL.
    El objetivo principal de la fase 1 es evaluar la seguridad de KTE-X19.

    Los objetivos principales de la fase 2 son los siguientes:
    Cohorte de LLA: evaluar la eficacia de KTE-X19 medida por la tasa de remisión completa global definida como remisión completa (RC) y remisión completa con recuperación hematológica incompleta (RCi) en sujetos pediátricos y adolescentes con LLA r/r.
    Cohorte de LNH: calcular la eficacia de KTE-X19 medida por la tasa de respuesta objetiva (TRO) definida como una respuesta completa o una respuesta parcial (RC + RP) en sujetos pediátricos con LNH r/r.
    E.2.2Secondary objectives of the trial
    Secondary objectives will include assessing the safety and tolerability of KTE-X19, additional efficacy endpoints, and (for Phase 2 only) changes in PRO scores.
    Los objetivos secundarios incluirán la evaluación de la seguridad y tolerabilidad de KTE-X19, los criterios de valoración de eficacia adicionales y los resultados comunicados por el paciente (solo en la fase 2).
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    ALL Cohort

    101. Relapsed or refractory B-precursor ALL defined as one of the following:
    - Primary refractory disease
    -Any relapse within 18 months after first diagnosis
    - Relapsed or refractory disease after 2 or more lines of systemic therapy
    - Relapsed or refractory disease after allogeneic transplant provided subject is at least 100 days from stem cell transplant at the time of enrollment and off of immunosuppressive medications for at least 4 weeks prior to enrollment

    102. Disease burden defined as at least 1 of the following:
    -Morphological disease in the bone marrow (>5% blasts)
    -MRD positive (threshold 10-4 by flow or PCR)

    103. Subjects with Ph+ disease are eligible if they are intolerant to tyrosine kinase inhibitor (TKI) therapy, or if they have relapsed/refractory disease despite treatment with at least 2 different TKIs

    104. Age ≤ 21 years and weight ≥ 6 kg.
    Note: Subjects with a weight of ≥ 6 kg to < 10kg will only be included once a pediatric formulation becomes available.


    111. In subjects previously treated with blinatumomab, CD19 tumor expression on blasts obtained from bone marrow or peripheral blood must be documented after completion of the most recent prior line of therapy and blasts must be ≥ 90% CD19 positive.


    NHL Cohort

    301. Histologically confirmed aggressive B cell NHL:
    - DLBCL not otherwise specified
    - Primary mediastinal large B-cell lymphoma (including Mediastinal gray zone lymphoma)
    - Burkitt lymphoma, Burkitt-like lymphoma and Unclassified B-cell lymphoma intermediate between DLBCL and Burkitt lymphoma

    302. Relapsed or refractory disease defined as 1 or more of the following:
    - Primary refractory disease
    - Relapsed or refractory disease after 2 or more lines of systemic therapy
    - Relapsed or refractory disease after autologous /allogeneic SCT provided subject is at least 100 days from SCT at the time of enrollment and off of immunosuppressive medications for at least 4 weeks prior to enrollment

    303. Subjects must have received adequate prior therapy including at a minimum all of the following:
    - Anti-CD20 monoclonal antibody, unless the investigator determines that the tumor is CD20 negative
    - An anthracycline-containing chemotherapy regimen

    304. At least 1 measurable lesion according to the revised International Pediatric Non-Hodgkin Lymphoma Staging System {Rosolen 2015}. Lesions that have been previously irradiated will be considered measurable only if progression has been
    documented following completion of radiation therapy.

    305. Magnetic resonance imaging (MRI) of the brain showing no evidence of CNS lymphoma

    308. Age <18 years old and weight > or = 6kg
    Note: Subjects with a weight of ≥ 6 kg to < 10kg will only be included once a pediatric formulation becomes available.

    Both Cohort
    105. and 309. Lansky (age < 16 years at the time of assent/consent) or Karnofsky (age > or = 16 years at the time of assent/consent) performance status > or = 80 at screening

    106. and 310. ANC > or = 500/uL unless, in the opinion of the PI, cytopenia is due to underlying leukemia and is potentially reversible with leukemia therapy

    107. and 311. Platelet count > or = 50,000/uL unless, in the opinion of the PI, cytopenia is due to underlying leukemia and is potentially reversible with leukemia therapy

    108. and 312. Absolute lymphocyte count > or = 100/µL

    109. and 313. Adequate renal, hepatic, pulmonary and cardiac function

    110. and 314. Females of childbearing potential must have a negative serum or urine pregnancy test
    Cohorte de LLA

    101. LLA de precursores B recidivante o refractaria definida como una de las siguientes:
    - Enfermedad refractaria primaria
    -Cualquier recidiva dentro de los 18 meses posteriores al primer diagnóstico
    - Enfermedad recidivante o refractaria después de 2 o más líneas de terapia sistémica
    - Enfermedad recidivante o refractaria después de un alotrasplante proporcionado al sujeto tiene al menos 100 días desde el trasplante de células madre en el momento de
    inclusion y no recive medicamentos inmunosupresores desde al menos 4 semanas antes de la inclusión

    102. Carga de enfermedad definida como al menos uno de los siguientes:
    -Enfermedad morfológica en la médula ósea (> 5% de blastos)
    -MRD positivo (umbral 10-4 por flujo o PCR)

    103. Los sujetos con enfermedad Ph + son elegibles si son intolerantes a la terapia con inhibidores de la tirosina quinasa (TKI), o si han recibibo tratamiento para la
    enfermedad recidivante / refractaria con al menos 2TKI diferentes

    104. Edad ≤ 21 años y peso ≥ 6 kg.
    Nota: Solo se incluirán sujetos con un peso de ≥ 6 kg a <10 kg una vez que esté disponible una formulación pediátrica.

    111. En sujetos tratados previamente con blinatumomab, la expresión del tumor CD19 en blastos obtenidos de médula ósea o sangre periférica debe documentarse después de completar la línea anterior más reciente de la terapia y los blastos deben ser ≥ 90% CD19 positivos.

    Cohorte de LNH

    301. LNH de células B agresivo confirmado histológicamente:
    - DLBCL no especificado de otra manera
    - Linfoma mediastínico primario de células B grandes (incluido el linfoma mediastínico de la zona gris)
    - Linfoma de Burkitt, linfoma tipo Burkitt y linfoma de células B no clasificado intermedio entre LDCBG y linfoma de Burkitt

    302. Enfermedad recidivante o refractaria definida como 1 o más de las siguientes:
    - Enfermedad refractaria primaria
    - Enfermedad recidivante o refractaria después de 2 o más líneas de terapia sistémica
    - Enfermedad recidivante o refractaria después de SCT autólogo / alogénico, siempre que el sujeto esté al menos 100 días desde el SCT en el momento de la inscripción y sin medicamentos inmunosupresores durante al menos 4 semanas antes de la inclusión

    303. Los sujetos deben haber recibido una terapia previa adecuada que incluya como mínimo todo lo siguiente:
    - Anticuerpo monoclonal anti-CD20, a menos que el investigador determine que el tumor es CD20 negativo
    - Un régimen de quimioterapia que contiene antraciclina

    304. Al menos 1 lesión medible de acuerdo con el Sistema de estadificación del linfoma no Hodgkin pediátrico internacional revisado {Rosolen 2015}. Las lesiones que hayan sido irradiadas previamente se considerarán medibles solo si la progresión ha sido documentada tras la finalización de la radioterapia.

    305. Imágenes por resonancia magnética (IRM) del cerebro que no muestren signos de linfoma del SNC

    308. Edad <18 años y peso ≥ 6 kg
    Nota: Los sujetos con un peso de ≥ 6 kg a <10 kg solo se incluirán una vez que esté disponible una formulación pediátrica.

    Ambas cohorte
    105. y 309. Lansky (edad <16 años en el momento del asentimiento / consentimiento) o Karnofsky (edad> o = 16 años en el momento del asentimiento / consentimiento) performance status > o = 80 en la selección

    106. y 310. ANC> o = 500 / ul a menos que, en opinión del IP, la citopenia se deba a una leucemia subyacente y sea potencialmente reversible con el tratamiento de la leucemia

    107. y 311. Recuento de plaquetas> o = 50.000 / uL a menos que, en opinión del IP, la citopenia se deba a una leucemia subyacente y sea potencialmente reversible con el tratamiento contra la leucemia.

    108. y 312. Recuento absoluto de linfocitos> o = 100 / µL

    109. y 313. Función renal, hepática, pulmonar y cardíaca adecuada

    110. y 314. Las mujeres en edad fértil deben tener una prueba de embarazo en suero u orina negativa
    E.4Principal exclusion criteria
    ALL Cohort

    201. Diagnosis of Burkitt’s leukemia/lymphoma according to WHO classification or chronic myelogenous leukemia lymphoid blast crisis

    202. History of malignancy other than nonmelanoma skin cancer or carcinoma in situ (e.g. cervix, bladder, breast) unless disease free for at least 3 years

    205. History of concomitant genetic syndrome associated with bone marrow failure such as Fanconi anemia, Kostmann syndrome, or Shwachman-Diamond syndrome

    206. History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other clinically significant cardiac disease within 12 months of enrollment

    NHL Cohort

    401. History of malignancy other than nonmelanoma skin cancer, carcinoma in situ (eg, cervix, breast), or FL unless disease free for at least 3 years

    402. Autologous SCT within 100 days of planned KTE-X19 infusion

    403. Prior CD19 targeted therapy other than blinatumomab (subjects who received KTE-X19 in this study are eligible for re-treatment)

    404. Prior CAR therapy or other genetically modified T-cell therapy

    409. Acute GVHD grade II-IV by Glucksberg criteria or severity B-D by IBMTR index; acute or chronic GVHD requiring systemic treatment within 4 weeks prior to enrollment.


    Both Cohort

    204. and 410. CNS involvement and abnormalities:
    a. Any CNS tumor mass by imaging and/or parameningeal mass (cranial and/or spinal).
    b. Presence of CNS-3 disease, defined as WBC ≥5/µL in CSF with presence of lymphoblasts with or without neurologic symptoms.
    c. Presence of CNS 2 disease defined as WBC <5/µL in CSF with presence of lymphoblasts and with neurologic symptoms (see note below for further clarification).
    Note: Neurologic symptoms may include but are not limited to cranial nerve palsy (if not explained by extracranial tumor) and clinical cord compression.
    [Subjects with CNS-1 (no detectable lymphoblasts in the CSF) and those with CNS 2 without clinically evident neurological changes are eligible to participate in the study].
    d. History or presence of any CNS disorder such as cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or any autoimmune disease with CNS involvement, posterior reversible encephalopathy syndrome (PRES), or cerebral edema with confirmed structural defects by appropriate imaging. History of stroke or transient ischemic attack within 12 months before enrollment. Patients with seizure disorders requiring active anti-convulsive medication.

    208. and 416. Any medical condition likely to interfere with assessment of the safety or efficacy of study treatment

    209. and 414. Primary immunodeficiency

    210. and 407. History of HIV infection or acute /chronic active hepatitis B or C infection. Subjects with a history of hepatitis infection must have cleared their infection as determined by standard serological and genetic testing per current Infectious Diseases Society of America guidelines or applicable country guidelines
    Cohorte de LLA

    201. Diagnóstico de leucemia / linfoma de Burkitt según la clasificación de la OMS o crisis blástica linfoide de leucemia mielógena crónica

    202. Historial de malignidad diferente al cáncer de piel no melanoma o carcinoma in situ (por ejemplo, cuello uterino, vejiga, mama) a menos que haya estado libre de enfermedad durante al menos 3 años

    205. Antecedentes de síndrome genético concomitante asociado con insuficiencia de la médula ósea, como anemia de Fanconi, síndrome de Kostmann o síndrome de Shwachman-Diamond

    206. Antecedentes de infarto de miocardio, angioplastia cardíaca o colocación de stents, angina inestable u otra enfermedad cardíaca clínicamente significativa dentro de los 12 meses posteriores a la inclusión

    Cohorte LNH

    401. Historia de malignidad diferente al cáncer de piel no melanoma, carcinoma in situ (p. Ej., Cuello uterino, mama) o FL, a menos que haya estado libre de enfermedad durante al menos 3 años

    402. SCT autólogo dentro de los 100 días de la infusión planificada de KTE-X19

    403. Terapia dirigida anterior a CD19 distinta de blinatumomab (los sujetos que recibieron KTE-X19 en este estudio son elegibles para un nuevo tratamiento)

    404. Terapia previa con CAR u otra terapia con células T modificadas genéticamente

    409. GVHD aguda grado II-IV según los criterios de Glucksberg o gravedad B-D según el índice IBMTR; EICH aguda o crónica que requiera tratamiento sistémico en las 4 semanas anteriores a la inscripción.


    Ambos cohortes

    204. y 410. Afectación y anomalías del SNC:
    a. Cualquier masa tumoral del SNC por imagen y / o masa parameníngea (craneal y / o espinal).
    b. Presencia de enfermedad del SNC-3, definida como WBC ≥5 / µL en LCR con presencia de linfoblastos con o sin síntomas neurológicos.
    C. Presencia de enfermedad del SNC 2 definida como WBC <5 / µL en LCR con presencia de linfoblastos y con síntomas neurológicos (ver nota a continuación para mayor aclaración).
    Nota: Los síntomas neurológicos pueden incluir, entre otros, parálisis de pares craneales (si no se explica por un tumor extracraneal) y compresión clínica del cordón.
    [Los sujetos con SNC-1 (sin linfoblastos detectables en el LCR) y aquellos con SNC 2 sin cambios neurológicos clínicamente evidentes son elegibles para participar en el estudio].
    d. Antecedentes o presencia de cualquier trastorno del SNC, como isquemia / hemorragia cerebrovascular, demencia, enfermedad cerebelosa o cualquier enfermedad autoinmune con afectación del SNC, síndrome de encefalopatía posterior reversible (SEPR) o edema cerebral con defectos estructurales confirmados mediante imágenes apropiadas. Antecedentes de accidente cerebrovascular o ataque isquémico transitorio en los 12 meses anteriores a la inscripción. Pacientes con trastornos convulsivos que requieran medicación anticonvulsiva activa.

    208. y 416. Cualquier condición médica que pueda interferir con la evaluación de la seguridad o eficacia del tratamiento del estudio.

    209. y 414. Inmunodeficiencia primaria

    210. y 407. Historia de infección por VIH o infección por hepatitis B o C activa aguda / crónica. Los sujetos con antecedentes de infección por hepatitis deben haber sanado su infección según lo determinado por las pruebas serológicas y genéticas estándar según las pautas actuales de la Sociedad de Enfermedades Infecciosas de América o las pautas correspondientes del país
    E.5 End points
    E.5.1Primary end point(s)
    Phase 1: Incidence of adverse events (AEs) defined as dose-limiting toxicities (DLTs).
    Phase 2:
    ALL Cohort: Overall complete remission rate (CR + CRi) per independent review. All subjects who do not meet the criteria for CR or CRi by the analysis data cutoff date will be considered non-responders for the overall complete remission rate evaluation.
    NHL Cohort: ORR per investigator assessment
    Fase 1: Incidencia de acontecimientos adversos (AA) definidos como toxicidades limitantes de la dosis (TLDs)
    Fase 2:
     Cohorte de LLA: Tasa de remisión completa global (RC + RCi) mediante revisión independiente . Todos los sujetos que no cumplan con los criterios de RC o RCi en la fecha de corte de los datos de análisis se considerarán no respondedores para la evaluación de la tasa de remisión completa general.
     Cohorte de LNH: TRO mediante evaluación del investigador.
    E.5.1.1Timepoint(s) of evaluation of this end point
    The primary analysis will occur when the overall study enrollment is complete and all treated subject in the mITT set have had the opportunity to complete the month 6 disease assessment.
    El análisis principal se producirá cuando la inclusión general al estudio se complete y todos los sujetos tratados en el conjunto de mITT hayan tenido la oportunidad de completar la evaluación de la enfermedad del mes 6.
    E.5.2Secondary end point(s)
    - Overall complete remission rate (CR + CRi) per investigator assessment
    - Duration of Remission (DOR) in the ALL and NHL cohort
    - Minimal Residual Disease (MRD) negative rate in ALL cohort
    - Allogeneic SCT rate
    - Overall survival (OS) in the ALL and NHL cohort
    - Relapsed-free Survival (RFS) in ALL cohort
    - Incidence of AEs and Common Terminology Criteria for Adverse Events (CTCAE) grade changes in safety laboratory values in the ALL and NHL cohort
    - Incidence of anti-KTE-X19 antibodies in the ALL and NHL cohort
    - Progression free survival in the NHL cohort
    - Tasa de remisión completa global (RC + RCi) mediante evaluación del investigador
    - Duración de la remisión (DR) en las cohortes LLA y LNH
    - Tasa de enfermedad mínima residual (EMR) negativa en la cohorte LLA.
    - Tasa de TCM alogénico
    - Supervivencia global (SG) en las cohortes LLA y LNH
    - Supervivencia libre de recidiva (SLR) en la cohorte LLA
    - Incidencia de AA y cambios de grado conforme a los criterios terminológicos comunes de acontecimientos adversos (CTCAE) en los valores de laboratorio de seguridad en las cohortes LLA y LNH
    - Incidencia de anticuerpos anti-KTE-X19 en la sangre en las cohortes LLA y LNH
    - Supervivencia libre de progresión en la cohorte LNH
    E.5.2.1Timepoint(s) of evaluation of this end point
    All subjects will be followed in the long term follow-up (LTFU) period for survival and disease status if applicable. Subjects will begin the long term follow-up period after they have completed the Month 3 visit of the post treatment assessment period (whether they have responded to treatment or went straight to the month 3 visit due to disease progression)
    - Every 3 months (± 2 weeks) through Month 18
    - Every 6 months (± 1 month) between Month 24 - Month 60
    - Beginning with year 6, Month 72 (± 3 months), subjects will return to the clinic 1 time annually up to 15 years after the last subject receives their KTE X19 infusion.
    Todos los sujetos serán seguidos en el período de seguimiento a largo plazo (LTFU) para la supervivencia y el estado de la enfermedad, si corresponde. Los sujetos comenzarán el período de seguimiento a largo plazo después de haber completado la visita del mes 3 del período de evaluación posterior al tratamiento (ya sea que hayan respondido al tratamiento o hayan pasado directamente a la visita del mes 3 debido a la progresión de la enfermedad)
    - Cada 3 meses (± 2 semanas) hasta el mes 18
    - Cada 6 meses (± 1 mes) entre el mes 24 y el mes 60
    - A partir del año 6, mes 72 (± 3 meses), los sujetos regresarán a la clínica 1 vez al año hasta 15 años después de que el último sujeto reciba su infusión de KTE X19.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    Phase I to assess safety, Phase II to assess efficacy of KTE-X19
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised Information not present in EudraCT
    E.8.1.2Open Yes
    E.8.1.3Single blind Information not present in EudraCT
    E.8.1.4Double blind Information not present in EudraCT
    E.8.1.5Parallel group Information not present in EudraCT
    E.8.1.6Cross over Information not present in EudraCT
    E.8.1.7Other Information not present in EudraCT
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Information not present in EudraCT
    E.8.2.3Other Information not present in EudraCT
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned1
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA14
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Canada
    United States
    France
    Poland
    Sweden
    Netherlands
    Spain
    Czechia
    Germany
    Italy
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    Defined as when the last subject is assessed or received an intervention for evaluation in the study, including survival assessments
    Definido como cuando el último paciente es evaluado o recibió una intervención para la evaluación en el estudio, incluidas evaluaciones de supervivencia.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years21
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years23
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    F.1.1Number of subjects for this age range: 116
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) Yes
    F.1.1.5.1Number of subjects for this age range: 42
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 41
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 33
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    Children.
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state1
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 18
    F.4.2.2In the whole clinical trial 116
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    None.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2021-03-08
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-02-26
    P. End of Trial
    P.End of Trial StatusOngoing
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