A Study Evaluating KTE-C19 for Children and Adolescents with Relapsed/Refractory B-Precursor Acute Lymphoblastic Leukemia

Overview

  • Study type

    Interventional
  • Study phase

    I/II
  • Study IDs

  • Describes the nature of a clinical study. Types include:

    • Observational study — observes people and measures outcomes without affecting results.
    • Interventional study (clinical trial) — studies new tests, treatments, drugs, surgical procedures or devices.
    • Medical records research — uses historical information collected from medical records of large groups of people to study how diseases progress and which treatments and surgeries work best.
  • During the early phases (phases 1 and 2), researchers assess safety, side effects, optimal dosages and risks/benefits. In the later phase (phase 3), researchers study whether the treatment works better than the current standard therapy. They also compare the safety of the new treatment with that of current treatments. Phase 3 trials include large numbers of people to make sure that the result is valid. There are also less common very early (phase 0) and later (phase 4) phases. Phase 0 trials are small trials that help researchers decide if a new agent should be tested in a phase 1 trial. Phase 4 trials look at long-term safety and effectiveness, after a new treatment has been approved and is on the market.

  • Site IRB
    • Rochester, Minnesota: 16-005582
    NCT ID: NCT02625480
    Sponsor Protocol Number: KTE-C19-104

About this study

The purpose of this study is to determine the safety and effectiveness of KTE-C19, an anti-CD19 antigen T cell therapy, for the treatment of children or adolescents who have B-precursor type acute lymphoblastic leukemia that has returned or is resistant to treatment.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. If you need assistance understanding the eligibility criteria, please contact the study team.

See eligibility criteria

Inclusion Criteria

  • Relapsed or refractory B-precursor ALL defined as one of the following
    • Primary refractory disease
    • Relapsed or refractory disease after first or later salvage therapy
    • Relapsed or refractory disease after allogeneic transplant provided subject is at least 100 days from stem cell transplant at the time of enrollment
  • Morphological disease in the bone marrow with ≥ 5% blasts
    • Ph+ disease is eligible if intolerant to tyrosine kinase inhibitor (TKI) therapy, or if has relapsed/refractory disease despite treatment with at least 2 different TKIs
  • Ages 2 to 21 at the time of Assent or Consent per IRB guidelines
  • Performance status ≥ 80 at screening using Lansky for age < 16 years at the time of assent/consent, or Karnofsky for age ≥ 16 years at the time of assent/consent
  • Adequate renal, hepatic, pulmonary and cardiac function defined as
    • Creatinine clearance ≥ 60 cc/min
    • Serum ALT/AST ≤ 2.5 x ULN
    • Total bilirubin ≤ 1.5 x ULN
    • Cardiac ejection fraction ≥ 50% and no clinically significant ECG findings
    • Baseline oxygen saturation > 92% on room air

Exclusion Criteria

  • Diagnosis of Burkitt's leukemia/lymphoma according to WHO classification or chronic myelogenous leukemia lymphoid blast crisis
  • History of malignancy other than non-melanoma skin cancer or carcinoma in situ (e.g. cervix, bladder, breast) unless disease free for at least 3 years
  • Presence of CNS-3 disease and CNS-2 disease with neurological changes
  • History of concomitant genetic syndrome such as
    • Fanconi anemia
    • Kostmann syndrome
    • Shwachman-Diamond syndrome 
    • Any other known bone marrow failure syndrome
  • History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other clinically significant cardiac disease within 12 months of enrollment
  • History of symptomatic deep vein thrombosis or pulmonary embolism within 6 months of enrollment
  • Primary immunodeficiency
  • Known infection with HIV, hepatitis B (HBsAg positive) or hepatitis C virus (anti-HCV positive)
  • Presence of fungal, bacterial, viral, or other infection that is uncontrolled or requiring IV antimicrobials for management
  • Prior medication
    • Prior CD19 directed therapy, including CAR+ T cell, BiTE, and antibody drug conjugate (ADC), with the exception of subjects who received KTE-C19 in this study and are eligible for re-treatment
    • Treatment with alemtuzumab within 6 months prior to leukapheresis, or treatment with clofarabine or cladribine within 3 months prior to leukapheresis
    • Donor lymphocyte infusion (DLI) within 28 days prior to enrollment
    • Any drug used for GVHD within 4 weeks prior to enrollment
  • 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
  • Live vaccine ≤ 6 weeks prior to start of conditioning regimen
  • Pregnancy or breastfeeding, because of potentially dangerous effects of the preparative chemotherapy on the fetus or infant
  • Either gender of child-bearing potential not willing to practice birth control from the time of consent through 6 months after the completion of KTE-C19
    • Females who have undergone surgical sterilization are not considered to be of childbearing potential

Participating Mayo Clinic locations

Study statuses change often. Please contact us for help.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Richard Bram, M.D., Ph.D.

Contact us for the latest status

Contact information:

Cancer Center Clinical Trials Referral Office

855-776-0015

Additional contact information

Cancer-related trials contact form

Phone: 855-776-0015 (toll-free)

International patient clinical studies questions