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Study of Brexucabtagene Autoleucel in Adults With Rare B-cell Malignancies (ZUMA-25)

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ClinicalTrials.gov Identifier: NCT05537766
Recruitment Status : Recruiting
First Posted : September 13, 2022
Last Update Posted : April 12, 2024
Sponsor:
Information provided by (Responsible Party):
Gilead Sciences ( Kite, A Gilead Company )

Brief Summary:
Master protocol: The goal of this master clinical study is to test how well the study drug, brexucabtagene autoleucel, works in participants with rare B-cell malignancies: relapsed/refractory Waldenstrom macroglobulinemia (r/r WM) (Substudy A - no longer recruiting), relapsed/refractory Richter transformation (r/r RT) (Substudy B), relapsed/refractory Burkitt lymphoma (r/r BL) (Substudy C and relapsed/refractory hairy cell leukemia (r/r HCL) (Substudy D - no longer recruiting).

Condition or disease Intervention/treatment Phase
Relapsed/Refractory Waldenstrom Macroglobulinemia Relapsed/Refractory Richter Transformation Relapsed/Refractory Burkitt Lymphoma Relapsed/Refractory Hairy Cell Leukemia Biological: Brexucabtagene Autoleucel Drug: Cyclophosphamide Drug: Fludarabine Phase 2

Detailed Description:

Master protocol: The primary objective of this study is to evaluate the efficacy of brexucabtagene autoleucel in two rare B-cell malignancies. This study will use a basket study design with separate, indication-specific substudies, to investigate r/r RT and r/r BL.

After completing the treatment period, all participants will be followed in the post-treatment follow-up period. Thereafter, participants will transition to a separate long-term follow-up study (KT-US-982-5968) to continue follow-up out to 15 years.

Substudies A and D have been early terminated by the sponsor.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 90 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 2, Open-Label, Multicenter, Basket Study Evaluating the Efficacy of Brexucabtagene Autoleucel in Adults With Rare B-cell Malignancies (ZUMA-25)
Actual Study Start Date : November 1, 2022
Estimated Primary Completion Date : March 2025
Estimated Study Completion Date : March 2025


Arm Intervention/treatment
Experimental: Substudy A (Relapsed/Refractory Waldenstrom Macroglobulinemia): Brexucabtagene Autoleucel

Participants will receive fludarabine 30 mg/m^2/day and cyclophosphamide 500 mg/m^2/day lymphodepletion chemotherapy for 3 days followed by a single infusion of brexucabtagene autoleucel at target dose of 2 × 10^6 anti-CD19 chimeric antigen receptor (CAR) T cells/kg.

This arm is no longer recruiting.

Biological: Brexucabtagene Autoleucel
Administered intravenously
Other Name: KTE-X19

Drug: Cyclophosphamide
Administered intravenously

Drug: Fludarabine
Administered intravenously

Experimental: Substudy B (Relapsed/Refractory Richter Transformation): Brexucabtagene Autoleucel

Participants will receive fludarabine 30 mg/m^2/day and cyclophosphamide 500 mg/m^2/day lymphodepletion chemotherapy for 3 days followed by a single infusion of brexucabtagene autoleucel at target dose of 2×10^6 anti-CD19 CAR T cells/kg.

This arm is no longer recruiting.

Biological: Brexucabtagene Autoleucel
Administered intravenously
Other Name: KTE-X19

Drug: Cyclophosphamide
Administered intravenously

Drug: Fludarabine
Administered intravenously

Experimental: Substudy C (Relapsed/Refractory Burkitt Lymphoma): Brexucabtagene Autoleucel
Participants will receive fludarabine 30 mg/m^2/day and cyclophosphamide 500 mg/m^2/day lymphodepletion chemotherapy for 3 days followed by a single infusion of brexucabtagene autoleucel at a target dose of 2x10^6 anti-CD19 CAR T cells/kg.
Biological: Brexucabtagene Autoleucel
Administered intravenously
Other Name: KTE-X19

Drug: Cyclophosphamide
Administered intravenously

Drug: Fludarabine
Administered intravenously

Experimental: Substudy D (Relapsed/Refractory hairy cell leukemia): Brexucabtagene Autoleucel

Participants will receive fludarabine 30 mg/m^2/day and cyclophosphamide 500 mg/m^2/day lymphodepletion chemotherapy for 3 days followed by a single infusion of brexucabtagene autoleucel at a target dose of 2 × 10^6 anti-CD19 CAR T cells/kg.

This arm is no longer recruiting.

Biological: Brexucabtagene Autoleucel
Administered intravenously
Other Name: KTE-X19

Drug: Cyclophosphamide
Administered intravenously

Drug: Fludarabine
Administered intravenously




Primary Outcome Measures :
  1. Substudy A: Combined Rate of Complete Response (CR) and Very Good Partial Response (VGPR) Determined by Central Assessment per the Sixth International Workshop in Waldenstrom Macroglobulinemia (WM) [ Time Frame: Up to 5 years ]
    Combined rate is defined as the proportion of participants who achieve either CR or VGPR.

  2. Substudy B: Objective Response Rate (ORR) Determined by Central Assessment per the Lugano Classification [ Time Frame: Up to 2 years ]
    ORR is defined as the proportion of participants who achieve a best response of either CR or partial response (PR).

  3. Substudy C: ORR Determined by Central Assessment per the Lugano Classification [ Time Frame: Up to 2 years ]
    ORR is defined as the proportion of participants who achieve a best response of either CR or PR.

  4. Substudy D: ORR Determined by Central Assessment per the Response Criteria Described by Grever and Colleagues [ Time Frame: Up to 5 years ]
    ORR is defined as the proportion of participants who achieve either CR or PR.


Secondary Outcome Measures :
  1. All Substudies (Substudies A, B, C and D): Complete Response (CR) Rate Determined by Central Assessment [ Time Frame: Up to 2 years for substudies B and C; Up to 5 years for substudies A and D ]
    CR rate is defined as proportion of participants who achieve CR.

  2. All Substudies (Substudies A, B, C and D): Duration of Response (DOR) [ Time Frame: Up to 2 years for substudies B and C; Up to 5 years for substudies A and D ]
    DOR is defined as time from first objective response to disease progression per indication specific response criteria or death from any cause.

  3. All Substudies (Substudies A, B, C and D): Overall Survival (OS) [ Time Frame: Up to 2 years for substudies B and C; Up to 5 years for substudies A and D ]
    OS is defined as the time from enrollment or brexucabtagene autoleucel infusion to death from any cause.

  4. All Substudies (Substudies A, B, C and D): Progression Free Survival (PFS) [ Time Frame: Up to 2 years for substudies B and C; Up to 5 years for substudies A and D ]
    PFS is defined as the time from enrollment or brexucabtagene autoleucel infusion to disease progression per indication specific response criteria or death from any cause.

  5. All Substudies (Substudies A, B, C and D): Time to Next Treatment (TTNT) [ Time Frame: Up to 2 years for substudies B and C; Up to 5 years for substudies A and D ]
    TTNT defined as the time from enrollment or brexucabtagene autoleucel infusion to the initiation of subsequent anticancer treatment.

  6. All Substudies (Substudies A, B, C and D): Time to First Response [ Time Frame: Up to 2 years for substudies B and C; Up to 5 years for substudies A and D ]
    Time to first response is defined as the time from enrollment or brexucabtagene autoleucel infusion to first objective response.

  7. All Substudies (Substudies A, B, C and D): Time to Best Response [ Time Frame: Up to 2 years for substudies B and C; Up to 5 years for substudies A and D ]
    Time to best response is defined as the time from enrollment or brexucabtagene autoleucel infusion to best objective response.

  8. All Substudies (Substudies A, B, C and D): Percentage of Participants Experiencing Treatment-emergent Adverse Events (TEAEs) [ Time Frame: First infusion date up to 2 years plus 30 days for substudies B and C; First infusion date up to 5 years plus 30 days for substudies A and D ]
  9. All Substudies (Substudies A, B, C and D): Percentage of Participants Experiencing Clinically Significant Changes in Safety Laboratory Values [ Time Frame: First infusion date up to 2 years plus 30 days for substudies B and C; First infusion date up to 5 years plus 30 days for substudies A and D ]
  10. All Substudies (Substudies A, B, C and D): Percentage of Participants Experiencing Adverse Events (AEs) Defined as Dose Limiting Toxicities (DLTs) [ Time Frame: First infusion date of brexucabtagene autoleucel up to 28 days ]
    Dose-limiting toxicity is defined as protocol-defined brexucabtagene autoleucel-related events with onset within the first 28 days following brexucabtagene autoleucel infusion.

  11. All Substudies (Substudies A, B, C and D): Percentage of Participants With Positive Anti-brexucabtagene autoleucel Antibodies [ Time Frame: First infusion date Up to 2 years for substudies B and C; First infusion date Up to 5 years for substudies A and D ]
  12. All Substudies (Substudies A, B, C and D): Percentage of Participants With Replication-competent Retrovirus (RCR) in Peripheral Blood Mononuclear Cells (PBMCs) [ Time Frame: Baseline, Month 12 ]
  13. All Substudies (Substudies A, B, C and D): Change From Baseline in the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire-30 (EORTC QLQ-C30) Score [ Time Frame: Baseline, up to 24 months ]
    The EORTC-QLQ-C30 is a multi-item questionnaire measuring the following content five (5) multi-item functional scales, six (6) multi-item symptom scales, one (1) global health status scale, and one (1) global health-related quality of life (HRQoL) each scale is measured from 0 to 100 after a linear transformation. Higher scores for functioning scales and for the Global Health Status or Global HRQoL scales indicate a higher level of functioning and a better HRQoL respectively, whereas higher scores in symptom scales represent a higher level of symptoms.

  14. All Substudies (Substudies A, B, C and D): Changes From Baseline in the European Quality of Life Five Dimensions Five Levels Questionnaire (EQ-5D-5L) Score [ Time Frame: Baseline, Up to 24 months ]
    The EQ-5D-5L questionnaire is a generic measure of health status that provides a simple descriptive profile and a single index value. The EQ-5D-5L comprises 2 components: a questionnaire covering 5 dimensions and a tariff of values based upon direct valuations of health states using a visual analog scale (VAS). Rating gets recorded on a vertical VAS in which the endpoints are labeled best imaginable health state is 100 (on the top) and worst imaginable health state is 0 (on the bottom). Higher scores of EQ VAS indicate better health.

  15. Substudy A: ORR Determined by Central Assessment [ Time Frame: Up to 5 years ]
    ORR is defined as the proportion of participants who achieve a best response of CR, VGPR, or PR.

  16. Substudy A: Combined CR and VGPR Rate Determined by Investigator Assessment [ Time Frame: Up to 5 years ]
    Combined rate is defined as the proportion of participants who achieve either CR or VGPR.

  17. Substudy A: PR Rate Determined by Central Assessment [ Time Frame: Up to 5 years ]
    PR rate is defined as proportion of participants who achieve PR.

  18. Substudy A: VGPR Rate Determined by Central Assessment [ Time Frame: Up to 5 years ]
    VGPR rate is defined as proportion of participants who achieve VGPR.

  19. Substudy B: ORR Determined by Investigator Assessment per the Lugano Classification [ Time Frame: Up to 2 years ]
    ORR is defined as the proportion of participants who achieve a best response of either CR or PR.

  20. Substudy B: ORR Determined by Central Assessment per the Lugano Classification [ Time Frame: Up to 2 years ]
    ORR is defined as the proportion of participants who achieve a best response of either CR or PR, in subgroups by clonal relationship to the underlying CLL. Clonality will be assessed by central assessment.

  21. Substudy B: ORR Determined by Investigator per International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2018 Criteria [ Time Frame: Up to 2 years ]
    ORR is defined as the proportion of participants who achieve a best response of either CR, complete response with incomplete marrow recovery (CRi) or PR.

  22. Substudy C: ORR Determined by Investigator Assessment per the Lugano Classification [ Time Frame: Up to 2 years ]
    ORR is defined as the proportion of participants who achieve a best response of either CR or PR.

  23. Substudy D: ORR Determined by Investigator Assessment [ Time Frame: Up to 5 years ]
    ORR is defined as the proportion of participants who achieve either CR or PR.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

All Substudies:

  • Presence of toxicities due to prior therapy must be stable and recovered to Grade 1 or lower.
  • Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
  • Adequate hematologic and end-organ function.
  • Individuals of childbearing potential who engage in heterosexual intercourse must agree to use specified method(s) of contraception.

Substudy B:

  • Confirmed diagnosis of chronic lymphocytic leukemia (CLL) based on International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2018 criteria with histologically confirmed Richter transformation (RT) to a diffuse large B-cell lymphoma (DLBCL) subtype.
  • Relapsed or refractory disease after 1 line of therapy, defined as at least 1 of the following:

    • Refractory disease, defined as progressive disease or stable disease as best response to first-line therapy.
    • Relapsed disease, defined as complete remission to first-line therapy followed by biopsy-proven disease relapse.
  • At least 1 measurable lesion based on the Lugano Classification. Lesions that have been previously irradiated will be considered measurable only if progression has been documented following completion of radiation therapy.

Substudy C:

  • Histologically confirmed mature B-cell non-Hodgkin lymphoma (NHL) Burkitt lymphoma/leukemia.
  • Relapsed or refractory disease after first-line chemoimmunotherapy, defined as 1 of the following:

    • Refractory disease, defined as progressive disease or stable disease as best response to first-line therapy; individuals who are intolerant to first-line therapy are excluded.
    • Relapsed disease, defined as complete remission to first-line therapy followed by biopsy-proven disease relapse.
  • At least 1 measurable lesion based on the Lugano Classification. Lesions that have been previously irradiated will be considered measurable only if progression has been documented following completion of radiation therapy.

Key Exclusion Criteria:

All Substudies:

  • Prior CAR therapy or treatment with any anti-CD19 therapy.
  • HIV-positive patients, unless taking appropriate anti-HIV medications, having an undetectable viral load by quantitative polymerase chain reaction (qPCR) and a CD4 count > 200 cells/uL.
  • Presence of detectable cerebrospinal fluid malignant cells or brain metastases.
  • History of autoimmune disease (eg, Crohn's disease, rheumatoid arthritis, systemic lupus).

Substudy B:

  • Diagnosis of RT not of DLBCL subtype (including, but not limited to, Hodgkin lymphoma (HL) and prolymphocytic leukemia).
  • Prior allogeneic or autologous stem cell transplant < 3 months prior to screening and/or < 4 months prior to planned infusion of brexucabtagene autoleucel.
  • Presence of active graft-versus-host disease following prior stem cell transplant.

Substudy C:

  • Burkitt-like lymphoma with 11q aberration, high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangement, or high-grade B-cell lymphoma not otherwise specified.
  • Prior allogeneic stem cell transplant < 3 months prior to screening and/or < 4 months prior to planned infusion of brexucabtagene autoleucel.
  • Presence of active graft-versus-host disease following prior allogeneic stem cell transplant.
  • Presence of CNS involvement. Individuals with a prior history of CNS involvement are eligible if they show a negative CSF and no involvement by imaging.

Substudies A and D have been early terminated by the sponsor.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05537766


Contacts
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Contact: Medical Information 844-454-5483(1-844-454-KITE) medinfo@kitepharma.com

Locations
Show Show 27 study locations
Sponsors and Collaborators
Kite, A Gilead Company
Investigators
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Study Director: Kite Study Director Kite, A Gilead Company
Additional Information:
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Responsible Party: Kite, A Gilead Company
ClinicalTrials.gov Identifier: NCT05537766    
Other Study ID Numbers: KT-US-568-0138
2022-501259-10 ( Other Identifier: European Medicines Agency )
2022-501260-18 ( Other Identifier: European Medicines Agency )
2022-501261-46 ( Other Identifier: European Medicines Agency )
2022-501262-21 ( Other Identifier: European Medicines Agency )
First Posted: September 13, 2022    Key Record Dates
Last Update Posted: April 12, 2024
Last Verified: April 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Burkitt Lymphoma
Waldenstrom Macroglobulinemia
Leukemia, Hairy Cell
Neoplasms
Epstein-Barr Virus Infections
Herpesviridae Infections
DNA Virus Infections
Virus Diseases
Infections
Tumor Virus Infections
Lymphoma, B-Cell
Lymphoma, Non-Hodgkin
Lymphoma
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Neoplasms, Plasma Cell
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
Paraproteinemias
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Leukemia
Cyclophosphamide
Fludarabine
Brexucabtagene autoleucel