GoFast CAR T-Cell Therapy for Recurrent Refractory B-Cell Lymphoma

Official title

Exploratory Clinical Study of GoFast CAR T-Cell Platform Targeting CD19 CAR T-Cell Therapy for Recurrent Refractory B-Cell Lymphoma

Overview

This is an investigator-initiated, prospective, open-label exploratory clinical study designed to evaluate the safety and preliminary efficacy of GoFast CD19 CAR T-cell therapy in adult patients with recurrent or refractory B-cell lymphoma. Eligible patients will undergo screening, baseline assessment, peripheral blood or leukapheresis collection, lymphodepleting chemotherapy, and intravenous infusion of GoFast CD19 CAR T cells. The study plans to enroll 9 participants using a sequential dose-escalation design. The primary outcome is objective response rate, and secondary outcomes include complete remission rate, overall survival, progression-related survival outcomes, duration of response, MRD negativity, and adverse events.

Detailed description

This study will enroll adult patients with recurrent or refractory B-cell lymphoma who are CD19-positive and meet the protocol-defined eligibility criteria. After signing informed consent, participants will undergo screening assessments, including medical history, physical examination, performance status assessment, laboratory tests, infection screening, imaging evaluation, and assessment of feasibility for CAR T-cell preparation.

Eligible participants will undergo peripheral blood or leukapheresis collection for preparation of autologous GoFast CD19 CAR T cells. Before CAR T-cell infusion, participants will receive lymphodepleting chemotherapy with fludarabine 30 mg/m2 and cyclophosphamide 300 mg/m2 from Day -5 to Day -3. After completion of lymphodepletion, GoFast CD19 CAR T cells will be administered by intravenous infusion according to the assigned dose cohort.

The study uses a dose-escalation design with three planned dose cohorts: 0.3 × 10\^6 cells/kg, 0.6 × 10\^6 cells/kg, and 1.2 × 10\^6 cells/kg. Each participant will receive a fixed dose according to the assigned cohort. Dose escalation will proceed only after review of safety data from the previous cohort and confirmation that no dose-limiting toxicity or other unacceptable safety signal has occurred.

Participants will be closely monitored after CAR T-cell infusion for adverse events, including cytokine release syndrome, neurotoxicity, tumor lysis syndrome, cytopenia, infection, organ dysfunction, and laboratory abnormalities. CAR T-cell expansion, lymphocyte subsets, cytokines, blood routine tests, biochemical tests, coagulation function, and organ function will be evaluated at protocol-defined time points.

Tumor response will be assessed using imaging and clinical evaluation at predefined follow-up visits, including Day 28 and Week 12 after CAR T-cell infusion. Participants with complete or partial response will continue follow-up for up to 1 year after enrollment. The primary endpoint is objective response rate. Secondary endpoints include complete remission rate, overall survival, time to progression, disease-free survival, duration of response, event-free survival, MRD negativity rate, and the incidence and severity of adverse events.

Interventions

• Biological GoFast CD19 CAR T Cells
  GoFast CD19 CAR T cells are autologous CD19-targeted chimeric antigen receptor T cells prepared using the GoFast CAR T-cell platform. Participants will receive lymphodepleting chemotherapy with fludarabine 30 mg/m2 and cyclophosphamide 300 mg/m2 from Day -5 to Day -3, followed by intravenous infusion of GoFast CD19 CAR T cells according to the assigned dose cohort: 0.3 × 10\^6 cells/kg, 0.6 × 10\^6 cells/kg, or 1.2 × 10\^6 cells/kg.

Primary outcome measures

• Objective Response Rate [Time frame: Up to 12 weeks after CAR T-cell infusion]

Secondary outcome measures (10)

• Complete Remission Rate [Time frame: Up to 12 weeks after CAR T-cell infusion]
• Overall Survival [Time frame: Up to 52 weeks after enrollment]
• Time to Progression [Time frame: Up to 52 weeks after enrollment]
• Disease-Free Survival [Time frame: Up to 52 weeks after enrollment]
• Duration of Response [Time frame: Up to 52 weeks after enrollment]
• Event-Free Survival [Time frame: Up to 52 weeks after enrollment]
• MRD Negativity Rate [Time frame: Up to 12 weeks after CAR T-cell infusion]
• Incidence and Severity of Adverse Events Assessed by CTCAE v4.03 [Time frame: From informed consent to 52 weeks after enrollment]
• Incidence and Severity of Cytokine Release Syndrome Assessed by ASTCT Consensus Criteria [Time frame: Up to 28 days after CAR T-cell infusion]
• Incidence and Severity of Immune Effector Cell-Associated Neurotoxicity Syndrome Assessed by ASTCT Criteria [Time frame: Up to 28 days after CAR T-cell infusion]

Eligibility criteria

Inclusion criteria

• Age 18 years or older.
• Histologically or cytologically confirmed primary refractory or relapsed/progressive large B-cell lymphoma.
• Expected survival of more than 3 months.
• CD19-positive B-cell lymphoma confirmed by flow cytometry or immunohistochemistry.
• ECOG performance status of 0 to 2 or KPS score greater than 80.
• Adequate venous access for leukapheresis or peripheral blood collection, with no contraindication to blood cell separation.
• White blood cell count ≥ 1 × 10\^9/L and lymphocyte count ≥ 0.3 × 10\^9/L.
• INR < 1.7 or prothrombin time prolonged by less than 4 seconds above the normal value.
• ALT and AST ≤ 2.5 × upper limit of normal.
• Total bilirubin ≤ 2.0 mg/dL, equivalent to 34.2 μmol/L.
• Able to understand and voluntarily sign the written informed consent form.

Exclusion criteria

• Pregnant or breastfeeding women.
• Active hepatitis B virus or hepatitis C virus infection.
• HIV/AIDS infection.
• Any uncontrolled active infection.
• Systemic corticosteroid use within 2 weeks before signing informed consent, except inhaled corticosteroids.
• Active cardiac disease requiring treatment or poorly controlled hypertension.
• Unstable or active ulcer disease or gastrointestinal bleeding.
• History of organ transplantation or currently awaiting organ transplantation.
• Central nervous system involvement by lymphoma.
• Current participation in another clinical trial.
• Any other condition that, in the investigator's judgment, makes the participant unsuitable for this clinical study.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Sequential

Masking

Open label

Primary purpose

Treatment

Study locations

China · 1 center

• Chinese PLA General Hospital — Beijing

Identifiers

NCT: NCT07670260 · GoFast CD19CAR-T

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗