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    Clinical Trial Results:
    A Phase II, single arm, multicenter, open-label trial to determine the safety and efficacy of tisagenlecleucel in pediatric patients with relapsed or refractory mature B-cell non-Hodgkin lymphoma (BIANCA) Due to EudraCT system limitations, which EMA is aware of, data using 999 as data points in this record are not an accurate representation of the clinical trial results. Please use https://www.novctrd. com/CtrdWeb/home.nov for complete trial results

    Summary
    EudraCT number
    2017-005019-15
    Trial protocol
    ES   FR   DE   SE   DK   NO   AT   GB   NL   FI   IT  
    Global end of trial date
    26 Apr 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    10 Nov 2023
    First version publication date
    10 Nov 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CCTL019C2202
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03610724
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma, AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma, AG, 41 613241111, novartis.email@novartis.com
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma, AG, 41 613241111, novartis.email@novartis.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-001654-PIP02-17
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    26 Apr 2023
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    26 Apr 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective was to evaluate the efficacy of tisagenlecleucel therapy as measured by ORR and determined by local investigator assessments in subjects with aggressive r/r B-cell NHL.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    15 Feb 2019
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 2
    Country: Number of subjects enrolled
    Austria: 1
    Country: Number of subjects enrolled
    Canada: 2
    Country: Number of subjects enrolled
    Denmark: 1
    Country: Number of subjects enrolled
    Finland: 1
    Country: Number of subjects enrolled
    France: 4
    Country: Number of subjects enrolled
    Germany: 1
    Country: Number of subjects enrolled
    Italy: 1
    Country: Number of subjects enrolled
    Japan: 4
    Country: Number of subjects enrolled
    Netherlands: 2
    Country: Number of subjects enrolled
    Norway: 2
    Country: Number of subjects enrolled
    Spain: 1
    Country: Number of subjects enrolled
    United Kingdom: 4
    Country: Number of subjects enrolled
    United States: 7
    Worldwide total number of subjects
    33
    EEA total number of subjects
    14
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    11
    Adolescents (12-17 years)
    18
    Adults (18-64 years)
    4
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    This study was conducted in twenty-four centers across 14 countries. Although 34 participants met the eligibility criteria and apheresis was accepted by the manufacturing facility, only 33 were infused in the study.

    Pre-assignment
    Screening details
    Consent, Screening, Pre-treatment, Treatment and Follow-up. In the Pretreatment phase, the subject may have undergone optional bridging therapy or lymphodepleting chemotherapy. Full Analysis Set: 33 Efficacy Analysis Set (EAS): 28; 4 patients with Complete Response prior to infusion & 1 without a scan prior to infusion excluded from EAS.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Tisagenlecleucel
    Arm description
    These participants were infused once with CAR-positive viable T cells.
    Arm type
    Experimental

    Investigational medicinal product name
    Tisagenlecleucel
    Investigational medicinal product code
    CTL019
    Other name
    Pharmaceutical forms
    Blood fraction modifier
    Routes of administration
    Intravenous use
    Dosage and administration details
    Tisagenlecleucel was administered once as an intravenous infusion, at a dose of either 0.2 to 5 x 106 CAR-positive viable T cells per kg body weight for subjects ≤ 50 kg or 0.1 to 2.5 x 108 CARpositive viable T cells for subjects > 50 kg

    Investigational medicinal product name
    lymphodepleting chemotherapy
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    lymphodepletion with recommended Fludarabine (30 mg/m2 IV daily for 4 days) and cyclophosphamide (500 mg/m2 IV daily for 2 days starting with the first dose of fludarabine) (unless contra-indicated for subject)

    Investigational medicinal product name
    Bridging Therapy
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Pre-treatment phase could also include bridging therapy of investigator’s choice

    Number of subjects in period 1
    Tisagenlecleucel
    Started
    33
    Met Eligibilty criteria and were infused
    33
    Met Eligibilty criteria, not infused*
    1
    Completed treatment & primary f/u phase
    14
    Discont. treatment & primary f/u phase
    19
    Completed
    14
    Not completed
    19
         Adverse event, serious fatal
    17
         Physician decision
    1
         Lost to follow-up
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Tisagenlecleucel
    Reporting group description
    These participants were infused once with CAR-positive viable T cells.

    Reporting group values
    Tisagenlecleucel Total
    Number of subjects
    33 33
    Age categorical
    Units: Subjects
        Children (2-11 years)
    11 11
        Adolescents (12-17 years)
    18 18
        Adults (18-64 years)
    4 4
    Age Continuous
    Units: years
        median (standard deviation)
    12.8 ( 4.98 ) -
    Sex: Female, Male
    Units: Participants
        Female
    10 10
        Male
    23 23
    Race/Ethnicity, Customized
    Units: Subjects
        White
    28 28
        Black or African American
    1 1
        Asian
    2 2
        Missing
    2 2

    End points

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    End points reporting groups
    Reporting group title
    Tisagenlecleucel
    Reporting group description
    These participants were infused once with CAR-positive viable T cells.

    Primary: Overall response rate (ORR) as determined by local investigator

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    End point title
    Overall response rate (ORR) as determined by local investigator [1]
    End point description
    The overall response rate (ORR) is defined as the percentage of subjects with a best overall disease response of complete response (CR) or partial response (PR), where the best overall disease response is defined as the best disease response recorded from tisagenlecleucel infusion until progressive disease or start of new anticancer therapy, whichever comes first.
    End point type
    Primary
    End point timeframe
    any time post-tisagenlecleucel infusion until progressive disease, start of new anticancer therapy, discontinuation or end of study (2 years after last patient first visit), up to 4 years
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was done.
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    28
    Units: Percentage of participants
        number (confidence interval 95%)
    32.1 (15.9 to 52.4)
    No statistical analyses for this end point

    Secondary: Event free survival (EFS)

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    End point title
    Event free survival (EFS)
    End point description
    Event free survival (EFS) is defined as the time from date of first tisagenlecleucel infusion to the earliest date of death from any cause, disease progression as determined by local investigator assessments, or starting new anticancer therapy for underlying cancer, excluding hematopoietic stem cell transplant (HSCT).
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    28
    Units: months
        median (confidence interval 95%)
    2.1 (1.1 to 2.8)
    No statistical analyses for this end point

    Secondary: Duration of response (DOR)

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    End point title
    Duration of response (DOR)
    End point description
    Duration of response (DOR) is defined as the time from the date of first documented disease response (CR or PR) as determined by local investigator assessments to the date of first documented progression or death due to underlying cancer.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    9
    Units: months
        median (confidence interval 95%)
    9 (1.0 to 999)
    No statistical analyses for this end point

    Secondary: Progression free survival (PFS)

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    End point title
    Progression free survival (PFS)
    End point description
    Progression free survival (PFS) is defined as the time from the date of first tisagenlecleucel infusion to the date of first documented disease progression as determined by local investigator assessments or death due to any cause.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    28
    Units: months
        median (confidence interval 95%)
    2.5 (1.1 to 2.9)
    No statistical analyses for this end point

    Secondary: Relapse free survival (RFS)

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    End point title
    Relapse free survival (RFS)
    End point description
    Relapse free survival (RFS) is defined as the time from the date of first documented disease response (CR or PR) as determined by local investigator assessments to the date of first documented disease progression or death due to any cause.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    9
    Units: months
        median (confidence interval 95%)
    9 (1.0 to 999)
    No statistical analyses for this end point

    Secondary: Overall survival (OS)

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    End point title
    Overall survival (OS)
    End point description
    Overall survival (OS) is defined as the time from date of first tisagenlecleucel infusion to the date of death due to any cause.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    28
    Units: months
        median (confidence interval 95%)
    10.4 (3.4 to 999)
    No statistical analyses for this end point

    Secondary: Cellular kinetics parameter: Tlast

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    End point title
    Cellular kinetics parameter: Tlast
    End point description
    The time of last observed quantifiable transgene level in peripheral blood. Pharmacokinetics of tisagenlecleucel were based on chimeric antigen receptor (CAR) transgene levels in peripheral blood as detected by qPCR, unless otherwise noted.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    30
    Units: days
        median (full range (min-max))
    40.0 (13.0 to 1090)
    No statistical analyses for this end point

    Secondary: Cellular kinetics parameter: Tmax

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    End point title
    Cellular kinetics parameter: Tmax
    End point description
    The time to reach maximum (peak) transgene level (days) in peripheral blood or other body fluid after single dose administration. Pharmacokinetics of tisagenlecleucel were based on chimeric antigen receptor (CAR) transgene levels in peripheral blood as detected by qPCR, unless otherwise noted.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    31
    Units: days
        median (full range (min-max))
    12.7 (1.90 to 21.9)
    No statistical analyses for this end point

    Secondary: Levels of pre-existing and treatment induced humoral immunogenicity and cellular immunogenicity against tisagenlecleucel cellular kinetics, safety and efficacy

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    End point title
    Levels of pre-existing and treatment induced humoral immunogenicity and cellular immunogenicity against tisagenlecleucel cellular kinetics, safety and efficacy
    End point description
    The humoral immunogenicity assay measures the antibody titers specific to tisagenlecleucel prior to and following infusion by flow cytometry. A subject was only defined as positive for tisagenlecleucel treatment-induced or -boosted anti-mCAR19 antibodies when the anti-mCAR19 antibody median fluorescence intensity at any time post-infusion was at least 2.28-fold higher (for samples analyzed on or prior to 05-May-2021) or 2.38-fold higher (for samples analyzed on or after 06-May-2021) than pre-infusion levels for participants whose baseline status was positive (boosted) or if the baseline status was negative but any post-baseline interpretation was positive (induced).
    End point type
    Secondary
    End point timeframe
    Until disease progression or through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    33
    Units: Percentage of participants
    number (not applicable)
        anti-tisagenlecleucel antibodies (+ve) at baseline
    87.9
        anti-tisa antibodies (+ve) anytime post-baseline
    97.0
    No statistical analyses for this end point

    Secondary: Cellular kinetics parameter: Clast

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    End point title
    Cellular kinetics parameter: Clast
    End point description
    The last observed quantifiable transgene level in peripheral blood. Pharmacokinetics of tisagenlecleucel were based on chimeric antigen receptor (CAR) transgene levels in peripheral blood as detected by qPCR, unless otherwise noted.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    30
    Units: copies/μg
        geometric mean (geometric coefficient of variation)
    344 ( 350.4 )
    No statistical analyses for this end point

    Secondary: Cellular kinetics parameter: AUC0-28d

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    End point title
    Cellular kinetics parameter: AUC0-28d
    End point description
    Area Under the Concentration-time Curve (AUs) from the time course of transgene levels in peripheral blood following tisagenlecleucel infusion (days*copies/μg), from day of infusion to day 28. D28 refers to the timepoint for definition of responder populations. Pharmacokinetics of tisagenlecleucel were based on chimeric antigen receptor (CAR) transgene levels in peripheral blood as detected by qPCR, unless otherwise noted.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    27
    Units: copies/μg*days
        geometric mean (geometric coefficient of variation)
    53500 ( 154.9 )
    No statistical analyses for this end point

    Secondary: Cellular kinetics parameter: Cmax

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    End point title
    Cellular kinetics parameter: Cmax
    End point description
    The maximum (peak) transgene level (copies/μg) observed in peripheral blood or other body fluid after single dose administration as measured by qPCR. Pharmacokinetics of tisagenlecleucel were based on chimeric antigen receptor (CAR) transgene levels in peripheral blood as detected by qPCR, unless otherwise noted. Pharmacokinetics of tisagenlecleucel were based on chimeric antigen receptor (CAR) transgene levels in peripheral blood as detected by qPCR, unless otherwise noted.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    31
    Units: copies/μg
        geometric mean (geometric coefficient of variation)
    5140 ( 238.9 )
    No statistical analyses for this end point

    Secondary: Percentage of participants who proceeded to stem cell transplant (SCT) after tisagenlecleucel infusion

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    End point title
    Percentage of participants who proceeded to stem cell transplant (SCT) after tisagenlecleucel infusion
    End point description
    These participants proceeded to transplant any time post-tisagenlecleucel therapy until end of study (EOS).
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    33
    Units: Percentage of participants
        number (not applicable)
    21.2
    No statistical analyses for this end point

    Secondary: Maximum Positive Predictive Value (PPV)

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    End point title
    Maximum Positive Predictive Value (PPV)
    End point description
    Retrospective assessment of potential cytokine release syndrome (CRS) predictive models considering also data from other CTL019 trials. The Positive Predictive Value (PVV) is the percentage of participants who actually had severe CRS out of all the cases where the prediction model predicts that severe CRS will occur. The maximum PPV is the highest value attained across all potential CRS predictive models.
    End point type
    Secondary
    End point timeframe
    Through study completion, up to 4 years
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    33
    Units: Percentage of participants
        number (not applicable)
    36.0
    No statistical analyses for this end point

    Post-hoc: All Collected Deaths

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    End point title
    All Collected Deaths
    End point description
    On-treatment deaths were collected during the pos-infusion period starting at the day of first infusion until the end of the study, up to 48 months. All deaths is the sum of pre-infusion and post-infusion deaths. Note: 33 patients were infused with tisagenlecleucel. The one death prior to infusion is an additional patient who was enrolled but not infused and is not part of the 33 infused patients.
    End point type
    Post-hoc
    End point timeframe
    Pre-treatment deaths: from enrollment to pre-infusion; On-treatment deaths: post-infusion up to 48 months
    End point values
    Tisagenlecleucel
    Number of subjects analysed
    33
    Units: Participants
        On-treatment deaths incl post-infusion deaths
    17
        Deaths prior to infusion
    1
        All Deaths
    18
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    AEs: collected during the post-infusion period, starting at the day of 1st infusion until the end of the study, up to max. duration of 48 months for each patient. Deaths: collected at all points post-infusion until patients completed the study (LPLV).
    Adverse event reporting additional description
    Any sign or symptom that occurs during the post-infusion period (starting at the day of first infusion of CTL019 until the end of the study) and safety follow-up. Deaths in the post treatment survival follow-up are not considered Adverse Events while still included in the All-Cause Mortality table.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.0
    Reporting groups
    Reporting group title
    Tisagenlecleucel - All patients
    Reporting group description
    These participants were infused once with CAR-positive viable T cells.

    Serious adverse events
    Tisagenlecleucel - All patients
    Total subjects affected by serious adverse events
         subjects affected / exposed
    24 / 33 (72.73%)
         number of deaths (all causes)
    17
         number of deaths resulting from adverse events
    0
    Vascular disorders
    Hypertension
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Condition aggravated
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Disease progression
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pyrexia
         subjects affected / exposed
    7 / 33 (21.21%)
         occurrences causally related to treatment / all
    4 / 7
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Cytokine release syndrome
         subjects affected / exposed
    8 / 33 (24.24%)
         occurrences causally related to treatment / all
    8 / 8
         deaths causally related to treatment / all
    0 / 0
    Haemophagocytic lymphohistiocytosis
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pneumothorax
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Respiratory distress
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Ejection fraction decreased
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Cardiac arrest
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tachycardia
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Seizure
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Peripheral sensorimotor neuropathy
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Motor dysfunction
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Aphasia
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Depressed level of consciousness
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 1
    Disturbance in attention
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hemiparesis
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Memory impairment
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Vision blurred
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Dental caries
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Proctitis
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Aspergillus infection
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pseudomonas infection
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Candida infection
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Urinary tract infection
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Vascular device infection
         subjects affected / exposed
    1 / 33 (3.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Tisagenlecleucel - All patients
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    33 / 33 (100.00%)
    Vascular disorders
    Hypotension
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Haematoma
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Hypertension
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    General disorders and administration site conditions
    Catheter site pain
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    Chills
         subjects affected / exposed
    4 / 33 (12.12%)
         occurrences all number
    4
    Fatigue
         subjects affected / exposed
    5 / 33 (15.15%)
         occurrences all number
    5
    Generalised oedema
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Oedema peripheral
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Pain
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Pyrexia
         subjects affected / exposed
    14 / 33 (42.42%)
         occurrences all number
    25
    Immune system disorders
    Cytokine release syndrome
         subjects affected / exposed
    16 / 33 (48.48%)
         occurrences all number
    19
    Drug hypersensitivity
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Hypogammaglobulinaemia
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    4
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    5 / 33 (15.15%)
         occurrences all number
    5
    Epistaxis
         subjects affected / exposed
    4 / 33 (12.12%)
         occurrences all number
    4
    Pleural effusion
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Tachypnoea
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Depression
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Insomnia
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    5 / 33 (15.15%)
         occurrences all number
    8
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    3
    Blood bilirubin increased
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    3
    Blood creatinine increased
         subjects affected / exposed
    5 / 33 (15.15%)
         occurrences all number
    6
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    Lymphocyte count decreased
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    4
    Neutrophil count decreased
         subjects affected / exposed
    10 / 33 (30.30%)
         occurrences all number
    19
    Platelet count decreased
         subjects affected / exposed
    9 / 33 (27.27%)
         occurrences all number
    9
    SARS-CoV-2 test positive
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Serum ferritin increased
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Weight decreased
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    4
    White blood cell count decreased
         subjects affected / exposed
    8 / 33 (24.24%)
         occurrences all number
    8
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    Cardiac disorders
    Sinus tachycardia
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    Tachycardia
         subjects affected / exposed
    4 / 33 (12.12%)
         occurrences all number
    4
    Nervous system disorders
    Depressed level of consciousness
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Dizziness
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    3
    Headache
         subjects affected / exposed
    8 / 33 (24.24%)
         occurrences all number
    11
    Neuralgia
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Neuropathy peripheral
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Paraesthesia
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    11 / 33 (33.33%)
         occurrences all number
    18
    Bone marrow failure
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Coagulopathy
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Febrile neutropenia
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Leukopenia
         subjects affected / exposed
    5 / 33 (15.15%)
         occurrences all number
    7
    Lymphopenia
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Neutropenia
         subjects affected / exposed
    7 / 33 (21.21%)
         occurrences all number
    11
    Thrombocytopenia
         subjects affected / exposed
    4 / 33 (12.12%)
         occurrences all number
    4
    Eye disorders
    Vision blurred
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    Abdominal pain
         subjects affected / exposed
    6 / 33 (18.18%)
         occurrences all number
    9
    Abdominal pain upper
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Constipation
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    Gastrooesophageal reflux disease
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Nausea
         subjects affected / exposed
    9 / 33 (27.27%)
         occurrences all number
    13
    Small intestinal obstruction
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Stomatitis
         subjects affected / exposed
    5 / 33 (15.15%)
         occurrences all number
    6
    Vomiting
         subjects affected / exposed
    13 / 33 (39.39%)
         occurrences all number
    19
    Hepatobiliary disorders
    Cholelithiasis
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Dry skin
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Pruritus
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    Rash
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    3
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Neck pain
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Pain in extremity
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Infections and infestations
    Myelitis
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    5 / 33 (15.15%)
         occurrences all number
    6
    Hyperphosphataemia
         subjects affected / exposed
    3 / 33 (9.09%)
         occurrences all number
    3
    Hypomagnesaemia
         subjects affected / exposed
    4 / 33 (12.12%)
         occurrences all number
    4
    Hyponatraemia
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Hypophosphataemia
         subjects affected / exposed
    2 / 33 (6.06%)
         occurrences all number
    2
    Hypokalaemia
         subjects affected / exposed
    5 / 33 (15.15%)
         occurrences all number
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    14 Jan 2020
    Update of inclusion criteria to allow patients between 18 and 25 years of age; Update inclusion criteria to allow Burkitt leukemia; Addition of a data monitoring committee for safety monitoring; Removed absolute lymphocyte count and absolute CD3+ T cell requirements from inclusion criteria

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Due to EudraCT system limitations, which EMA is aware of, data using 999 as data points in this record are not an accurate representation of the clinical trial results. Please use https://www.novctrd. com/CtrdWeb/home.nov for complete trial results
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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