E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Relapsed/Refractory Chronic Lymphocytic Leukemia |
Leucemia linfocitica cronica refrattaria/recidiva |
|
E.1.1.1 | Medical condition in easily understood language |
Cancers of white blood cells |
Neoplasie dei globuli bianchi |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10008977 |
E.1.2 | Term | Chronic lymphocytic leukemia recurrent |
E.1.2 | System Organ Class | 100000004864 |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10008978 |
E.1.2 | Term | Chronic lymphocytic leukemia refractory |
E.1.2 | System Organ Class | 100000004864 |
|
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Phase 1: Evaluate the safety of KTE-X19
Phase 2: Evaluate the efficacy of KTE-X19 as measured by the objective response rate (ORR) per independent review |
Obiettivo primario della fase 1: valutare la sicurezza di KTE-C19 in soggetti con LLC r/r. Obiettivo primario della fase 2: valutare l’efficacia di KTE-C19 misurata in base al tasso di risposta obiettiva (ORR) secondo la revisione indipendente in soggetti con LLC r/r trattati con KTE-C19. |
|
E.2.2 | Secondary objectives of the trial |
Characterize the safety profile and assess additional efficacy endpoints |
Caratterizzare il profilo di sicurezza e valutare ulteriori endpoint di efficacia |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Documentation of relapsed or refractory CLL; subjects must have received at least 2 prior lines of treatment, one of which must include a BTK inhibitor 2. An indication for treatment per IWCLL 2018 criteria and radiographically measurable disease (at least 1 lesion > 1.5cm in diameter) 3. Adequate hematologic function 4. Adequate renal, hepatic, cardiac and pulmonary function 5. Age 18 or older 6. ECOG performance status of 0 or 1 7. Females of childbearing potential must have a negative serum or urine pregnancy test 8. At least 2 weeks or 5 half-lives, whichever is shorter, must have elapsed since any prior systemic therapy or BTKi (ibrutinib or acalabrutinib) at the time the subject is planned for leukapheresis, except for systemic inhibitory/stimulatory immune checkpoint therapy. At least 3 half-lives must have elapsed from any prior systemic inhibitory/stimulatory immune checkpoint molecule therapy at the time the subject is planned for leukapheresis (eg, ipilimumab, nivolumab, pembrolizumab, atezolizumab, OX40 agonists, 4-1BB agonists) |
1. Documentation of relapsed or refractory CLL; subjects must have received at least 2 prior lines of treatment, one of which must include a BTK inhibitor 2. An indication for treatment per IWCLL 2018 criteria and radiographically measurable disease (at least 1 lesion > 1.5cm in diameter) 3. Adequate hematologic function 4. Adequate renal, hepatic, cardiac and pulmonary function 5. Age 18 or older 6. ECOG performance status of 0 or 1 7. Females of childbearing potential must have a negative serum or urine pregnancy test 8. At least 2 weeks or 5 half-lives, whichever is shorter, must have elapsed since any prior systemic therapy or BTKi (ibrutinib or acalabrutinib) at the time the subject is planned for leukapheresis, except for systemic inhibitory/stimulatory immune checkpoint therapy. At least 3 half-lives must have elapsed from any prior systemic inhibitory/stimulatory immune checkpoint molecule therapy at the time the subject is planned for leukapheresis (eg, ipilimumab, nivolumab, pembrolizumab, atezolizumab, OX40 agonists, 4-1BB agonists) |
|
E.4 | Principal exclusion criteria |
- A history of treatment including any of the following: a. Prior CD19 directed therapy b. Treatment with alemtuzumab within 6 months before enrollment c. Prior allogeneic hematopoietic stem cell transplant or donor lymphocyte infusion within 6 months prior to enrollment d. Live vaccine administration within 4 weeks before enrollment e. Systemic immunosuppression or systemic treatment for any autoimmune disease not related to CLL in the 2 years before enrollment - Acute GVHD grade II-IV by Glucksberg criteria or severity B-D by IBMTR index - History of autoimmune disease resulting in end-organ injury unless attributable to CLL (eg, ITP, AIHA) - Diagnosis of Richter’s transformation or a history of malignancy other than non-melanoma skin cancer or carcinoma in situ (eg, skin, cervix, bladder, breast), superficial bladder cancer, asymptomatic localized low grade prostate cancer for which watch-and-wait approach is standard of care, or any other cancer that has been in remission for > 3 years prior to enrollment - History of severe hypersensitivity reaction attributed to aminoglycosides or any of the agents required for treatment in this study - CNS disease - History of concomitant genetic syndrome associated with bone marrow failure such as Fanconi anemia, Kostmann syndrome, Shwachman-Diamond syndrome - History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other clinically significant cardiac disease within 12 months before enrolment - History of symptomatic deep vein thrombosis or pulmonary embolism within 6 months before enrollment - Primary immunodeficiency - Known infection with HIV; chronic active hepatitis B; active hepatitis C. A history of hepatitis B or C is permitted if the viral load is undetectable by quantitative PCR or a comparable testing method. - Presence of active fungal, bacterial, viral infection or any infection requiring antimicrobial treatment for management. Simple UTI and uncomplicated bacterial pharyngitis are permitted if responding to active treatment and after consultation with the Kite Medical Monitor - Presence of any indwelling line or drain (eg, percutaneous nephrostomy tube, indwelling Foley catheter, biliary drain, pleural/peritoneal/pericardial catheter). Ommaya reservoirs and dedicated central venous access catheters such as Port-a-Cath or Hickman catheters are permitted - Any medical condition likely to interfere with assessment of safety or efficacy of study treatment |
- A history of treatment including any of the following: a. Prior CD19 directed therapy b. Treatment with alemtuzumab within 6 months before enrollment c. Prior allogeneic hematopoietic stem cell transplant or donor lymphocyte infusion within 6 months prior to enrollment d. Live vaccine administration within 4 weeks before enrollment e. Systemic immunosuppression or systemic treatment for any autoimmune disease not related to CLL in the 2 years before enrollment - Acute GVHD grade II-IV by Glucksberg criteria or severity B-D by IBMTR index - History of autoimmune disease resulting in end-organ injury unless attributable to CLL (eg, ITP, AIHA) - Diagnosis of Richter's transformation or a history of malignancy. Exceptions include: non-melanoma skin cancer or carcinoma in situ (eg, skin, cervix, bladder, breast), superficial bladder cancer, asymptomatic localized low grade prostate cancer for which watch-and-wait approach is standard of care, or any other cancer that has been in remission for > 3 years prior to enrollment - History of severe hypersensitivity reaction attributed to aminoglycosides or any of the agents required for treatment in this study - CNS disease - History of concomitant genetic syndrome associated with bone marrow failure such as Fanconi anemia, Kostmann syndrome, Shwachman-Diamond syndrome - History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other clinically significant cardiac disease within 12 months before enrolment - History of symptomatic deep vein thrombosis or pulmonary embolism requiring systemic anticoagulation within 6 months before enrollment - Primary immunodeficiency - History of human immunodeficiency virus (HIV) infection or acute or chronic active hepatitis B or C infection. Subjects with history of hepatitis infection must have cleared their infection as determined by standard serological and genetic testing per current Infectious Disease Society of America (IDSA) guidelines or applicable country guidelines. - Presence of active fungal, bacterial, viral infection or any infection requiring antimicrobial treatment for management. Simple UTI and uncomplicated bacterial pharyngitis are permitted if responding to active treatment and after consultation with the Kite Medical Monitor - Presence of any indwelling line or drain (eg, percutaneous nephrostomy tube, indwelling Foley catheter, biliary drain, pleural/peritoneal/pericardial catheter). Ommaya reservoirs and dedicated central venous access catheters such as Port-a-Cath or Hickman catheters are permitted - Any medical condition likely to interfere with assessment of safety or efficacy of study treatment |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Phase 1: Incidence of DLTs in subjects treated with KTE-X19
Phase 2: Objective response rate (CR/CRi/PR) per independent review as defined by IWCLL 2018 criteria |
Fase 1: incidenza di tossicità dose-limitanti (DLT) nei soggetti trattati con KTE-C19 Fase 2: tasso di risposta obiettiva (CR/CRi/PR) definito in base ai criteri 2018 del Workshop internazionale sulla leucemia linfocitica cronica (IWCLL) secondo la revisione indipendente |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Phase 1: onset within the first 28 days following KTE-X19 infusion Phase 2: Disease assessment at D28, W8, M3, M6, then every 3 months till M24 |
Phase 1: onset within the first 28 days following KTE-X19 infusion Phase 2: Disease assessment at D28, W8, M3, M6, then every 3 months till M24 |
|
E.5.2 | Secondary end point(s) |
Complete response (CR/CRi) rate ORR per investigator review Minimum Residual Disease (MRD) Negative Rate CR/CRi with MRD- (CR/MRD-) rate Duration of response (DOR), Progression-free survival (PFS) Overall survival (OS) Incidence of AEs and clinically significant changes in laboratory values Changes in EQ-5D and FACT-Leu Levels of anti-CD19 CAR T-cells in blood |
Complete response (CR/CRi) rate, ORR per investigator review Minimum Residual Disease (MRD) Negative Rate CR/CRi with MRD- (CR/MRD-) rate Duration of response (DOR) Progression-free survival (PFS) Overall survival (OS) Incidence of AEs and clinically significant changes in laboratory values Changes in EQ-5D and FACT-Leu Levels of anti-CD19 CAR T-cells in blood |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Disease Assessment at D28, W8, M3, M6, then every 3 months till M24, then every 6 months till M60, them annually through Year 15 Blood draw at leukapheresis, M3, and every 3 months up to M12 if applicable Safety: onset on or after the KTE-X19 infusion, through the study |
Disease Assessment at D28, W8, M3, M6, then every 3 months till M24, then every 6 months till M60, them annually through Year 15 Blood draw at leukapheresis, M3, and every 3 months up to M12 if applicable Safety: onset on or after the KTE-X19 infusion, through the study |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Dose escalation |
Dose escalation |
|
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 12 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
United States |
France |
Germany |
Italy |
Spain |
United Kingdom |
|
E.8.7 | Trial 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
|
LVLS; All enrolled subjects will be followed in the long-term follow-up period for safety, survival and disease status, if applicable, for up to 15 years after KTE-X19 Infusion. |
LVLS; All enrolled subjects will be followed in the long-term follow-up period for safety, survival and disease status, if applicable, for up to 15 years after KTE-X19 Infusion. |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 17 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 17 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |