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A Phase 3 Study of Tabelecleucel for Participants With Epstein-Barr Virus-Associated Post-Transplant Lymphoproliferative Disease After Failure With Rituximab or Rituximab and Chemotherapy

NCT03394365 · Pierre Fabre Medicament
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Official title
Multicenter, Open-Label, Phase 3 Study of Tabelecleucel for Solid Organ or Allogeneic Hematopoietic Cell Transplant Subjects With Epstein-Barr Virus-Associated Post-Transplant Lymphoproliferative Disease After Failure of Rituximab or Rituximab and Chemotherapy
About this study
This is a multicenter, open-label, phase 3 study to assess the efficacy and safety of tabelecleucel for the treatment of EBV+ PTLD in the setting of SOT-R and SOT-R+C (Cohort \[C\]-SOT) or HCT after failure of rituximab (C-HCT). SOT-R further included participants: 1. who did not receive chemotherapy and did not have a documented medical reason not to receive chemotherapy (SOT-Ro) or 2. who were considered chemotherapy ineligible/inappropriate (SOT-R-Ci) Combined population (SOT-R-Ci, SOT-R+C, and HCT) and (SOT-R-Ci and SOT-R+C) who received commercial product, or a product manufactured using a comparable process version (PV) were also used for analysis of outcomes. Enrollment will be preceded by confirmation of availability of partially human leukocyte antigen (HLA) matched and restricted tabelecleucel for the participant. Study procedures and product administration will be the same for each cohort. Tabelecleucel will be administered in cycles lasting 5 weeks (35 days). During each cycle, participants will receive intravenous tabelecleucel at a dose of 2 × 10\^6 cells/kg on Days 1, 8, and 15, followed by observation through Day 35. Treatment will continue until maximal response, unacceptable toxicity, initiation of non protocol therapy, or failure of tabelecleucel with up to 2 different HLA restrictions (C-SOT) or up to 4 different HLA restrictions (C-HCT). The study includes a total of 5 years of follow-up for disease and survival status for participants enrolled before or after 09 October 2023 to reach the initial sample size of 33 participants in both cohorts. For all other participants enrolled after 09 October 2023 and after the initial sample of 33 participants in both cohorts has been reached in both cohorts, the follow-up will be every 3 months, up to 12 months, as assessed on anniversary of Cycle 1 Day 1. For responders, the follow-up will be 12 months from the date of initial response.
Eligibility criteria
Inclusion Criteria: 1. Prior SOT of kidney, liver, heart, lung, pancreas, small bowel, or any combination of these (C-SOT); or prior allogeneic HCT (C-HCT). 2. A diagnosis of locally assessed, biopsy-proven EBV+ PTLD. 3. Availability of appropriate partially HLA-matched and restricted tabelecleucel has been confirmed by the sponsor. 4. Measurable, 18F-deoxyglucose (FDG)-avid (Deauville score ≥ 3) systemic disease using Lugano Classification response criteria by positron emission tomography (PET)-diagnostic computed tomography (CT), except when contraindicated or mandated by local practice, then magnetic resonance imaging (MRI) may be used. For participants with treated central nervous system (CNS) disease, a head CT and/or brain/spinal MRI as clinically appropriate will be required to follow CNS disease response per Lugano Classification response criteria. 5. Treatment failure of rituximab or interchangeable commercially available biosimilar monotherapy (C-SOT-R or C-HCT) or rituximab plus any concurrent or sequentially administered chemotherapy regimen (C-SOT-R+C) for treatment of PTLD. 6. Males and females of any age. 7. Eastern Cooperative Oncology Group performance status ≤ 3 for participants aged ≥ 16 years; Lansky score ≥ 20 for participants \< 16 years. 8. For C-HCT only: If allogeneic HCT was performed as treatment for an acute lymphoid or myeloid malignancy, the underlying primary disease for which the participant underwent transplant must be in morphologic remission. 9. Adequate organ function. 1. Absolute neutrophil count ≥ 1000/μL, (C-SOT) or ≥ 500/μL (C-HCT), with or without cytokine support. 2. Platelet count ≥ 50,000/μL, with or without transfusion or cytokine support. For C-HCT, platelet count \< 50,000/μL but ≥ 20,000/μL, with or without transfusion support, is permissible if the participant has not had grade ≥ 2 bleeding in the prior 4 weeks (where grading of the bleeding is determined per the National Cancer Institute's Common Terminology Criteria for Adverse Events \[CTCAE\], version 5.0). 3. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin each \< 5 × the upper limit of normal; however, ALT, AST, and total bilirubin each ≤ 10 × upper limit of normal is acceptable if the elevation is considered by the investigator to be due to EBV and/or PTLD involvement of the liver as long as there is no known evidence of significant liver dysfunction. 10. Participant or participant's representative is willing and able to provide written informed consent. Exclusion Criteria: 1. Currently active Burkitt, T-cell, NK/T-cell lymphoma/LPD, Hodgkin, plasmablastic, transformed lymphoma, active hemophagocytic lymphohistiocytosis, or other malignancies requiring systemic therapy. 2. Daily steroids of \> 0.5 mg/kg prednisone or glucocorticoid equivalent, ongoing methotrexate, or extracorporeal photopheresis. 3. Untreated CNS PTLD or CNS PTLD for which the participant is actively receiving CNS-directed chemotherapy (systemic or intrathecal) or radiotherapy at enrollment. NOTE: Participants with previously treated CNS PTLD may enroll if CNS-directed therapy is complete. 4. Suspected or confirmed grade ≥ 2 graft-versus-host disease (GvHD) per the Center for International Blood and Marrow Transplant Research consensus grading system at enrollment. 5. Ongoing or recent use of a checkpoint inhibitor agent (eg, ipilimumab, pembrolizumab, nivolumab) within 3 drug half-lives from the most recent dose to enrollment. 6. For C-HCT: active adenovirus viremia. 7. Need for vasopressor or ventilatory support. 8. Antithymocyte globulin or similar anti-T cell antibody therapy ≤ 4 weeks prior to enrollment. 9. Treatment with Epstein-Barr virus cytotoxic T lymphocytes or chimeric antigen receptor T cells directed against B cells within 8 weeks of enrollment (C-SOT or C-HCT), or unselected donor lymphocyte infusion within 8 weeks of enrollment (C-HCT only). 10. Female who is breastfeeding or pregnant or female of childbearing potential or male with a female partner of childbearing potential unwilling to use a highly effective method of contraception. 11. Inability to comply with study-related procedures. 12. Any medical condition or organ system dysfunction that in the investigator';s opinion, could compromise the participant's safety or ability to complete the study.
Study design
Enrollment target: 115 participants
Allocation: non_randomized
Masking: none
Age groups: child, adult, older_adult
Timeline
Starts: 2017-12-29
Estimated completion: 2030-08
Last updated: 2026-02-20
Interventions
Biological: tabelecleucel
Primary outcomes
  • Objective Response Rate (ORR) in the Analysis Cohorts C-SOT, C-HCT, and Combined Population (C-SOT-R+C, C-SOT-R-Ci, and C-HCT) Who Received Commercial Product, or a Product Manufactured Using a Comparable PV (2 years)
Sponsor
Pierre Fabre Medicament · industry
Contacts & investigators
ContactClaire Fabre · contact · claire.fabre@pierre-fabre.com · 6 42 04 84 76
ContactMarie Bosredon · contact · marie.bosredon@pierre-fabre.com · 7 84 14 59 82
InvestigatorAnke Friedetzky · study_director, Pierre Fabre Laboratories
All locations (71)
City of Hope (Adults and Pediatrics)Completed
Duarte, California, United States
University of California San Diego Moores Cancer Center (Adults only)Completed
La Jolla, California, United States
Loma Linda University Medical Center (Adults only)Recruiting
Loma Linda, California, United States
Children's Hospital Los Angeles, Div. of Research Immunology/BMT (Adults and Pediatrics)Recruiting
Los Angeles, California, United States
UCLA Medical Center (Adults and Pediatrics)Completed
Los Angeles, California, United States
University of California Davis Comprehensive Cancer Center (Adults only)Completed
Sacramento, California, United States
Yale University (Adults and Pediatrics)Completed
New Haven, Connecticut, United States
MedStar Georgetown University Hospital (Adults and Pediatrics)Recruiting
Washington D.C., District of Columbia, United States
University of Florida (Adults and Pediatrics)Completed
Gainesville, Florida, United States
University of Miami/Jackson Memorial Hospital (Adults only)Recruiting
Miami, Florida, United States
Winship Cancer Institute (Adults only)Completed
Atlanta, Georgia, United States
Arthur M. Blank Hospital (Pediatrics)Recruiting
Atlanta, Georgia, United States
Ann & Robert H. Lurie Children's Hospital of Chicago (Adults and Pediatrics)Recruiting
Chicago, Illinois, United States
University of Chicago Medical Center - Duchossois Center for Advanced Medicine (Adults only)Completed
Chicago, Illinois, United States
Loyola University Medical Center (Adults and Pediatrics)Recruiting
Maywood, Illinois, United States
University of Maryland School of Medicine (Adults only)Completed
Baltimore, Maryland, United States
Dana Farber Cancer Institute, Brigham and Women's Hospital (Adults and Pediatrics)Recruiting
Boston, Massachusetts, United States
Washington University School of Medicine (Adults only)Recruiting
St Louis, Missouri, United States
Weill Cornell Medicine (Adults only)Completed
New York, New York, United States
Columbia University Medical Center (Adults and Pediatrics)Completed
New York, New York, United States
Memorial Sloan Kettering Cancer Center (Adults and Pediatrics)Completed
New York, New York, United States
Montefiore Medical Center (Adults only)Completed
The Bronx, New York, United States
Montefiore Medical Center (Pediatrics only)Completed
The Bronx, New York, United States
University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center (Adults and Pediatrics)Completed
Chapel Hill, North Carolina, United States
Carolinas Medical Center/Levine Children's Hospital (Adults and Pediatrics)Recruiting
Charlotte, North Carolina, United States
Duke Cancer Institute (Adults and Pediatrics)Recruiting
Durham, North Carolina, United States
Cleveland Clinic Foundation (Adults and Pediatrics)Recruiting
Cleveland, Ohio, United States
Nationwide Children's Hospital (Pediatrics only)Completed
Columbus, Ohio, United States
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (Adults and Pediatrics)Recruiting
Columbus, Ohio, United States
Oregon Health and Science University Physicians Pavilion (Adults and Pediatrics)Recruiting
Portland, Oregon, United States
Hospital of the University of Pennsylvania (Adults only)Recruiting
Philadelphia, Pennsylvania, United States
The Children's Hospital of Philadelphia Oncology Division, Blood & Marrow Transplant Section (Pediatrics)Recruiting
Philadelphia, Pennsylvania, United States
University of Pittsburgh Medical Center (Adults only)Completed
Pittsburgh, Pennsylvania, United States
Medical University of South Carolina (Adults and Pediatrics)Active Not Recruiting
Charleston, South Carolina, United States
Saint Jude Children's Research Hospital (Pediatrics only)Completed
Memphis, Tennessee, United States
Vanderbilt University Medical Center Henry-Joyce Cancer Clinic (Adults and Pediatrics)Recruiting
Nashville, Tennessee, United States
Baylor Scott and White Research Institute (Adults only)Recruiting
Dallas, Texas, United States
University of Texas Southwestern Medical Center - Children's Medical Center (Pediatrics only)Recruiting
Dallas, Texas, United States
MD Anderson Cancer Center (Pediatrics and Adult)Recruiting
Houston, Texas, United States
Froedtert and Medical College of Wisconsin - Clinical Cancer Center (Adults only)Completed
Milwaukee, Wisconsin, United States
The Children's Hospital at Westmead (Pediatrics only)Recruiting
Westmead, New South Wales, Australia
Westmead Hospital (Adults only)Recruiting
Westmead, New South Wales, Australia
The Prince Charles Hospital (Adults only)Recruiting
Chermside, Queensland, Australia
Royal Adelaide Hospital (Adults only)Recruiting
Adelaide, South Australia, Australia
The Royal Children's Hospital Melbourne (Pediatrics only)Recruiting
Melbourne, Victoria, Australia
Fiona Stanley Hospital (Adults only)Recruiting
Murdoch, Western Australia, Australia
Medizinische Universitat Wien (Adults only)Active Not Recruiting
Vienna, Austria, Austria
Centre Hospitalier Universitaire de Liège Site Sart Tilman (Adults and Pediatrics)Completed
Liège, Brussels Capital, Belgium
Universitair Ziekenhuis Leuven (Adults and Pediatrics)Active Not Recruiting
Leuven, Flemish Brabant, Belgium
Alberta Children's Hospital (Adults and Pediatrics)Recruiting
Calgary, Alberta, Canada
Sick Kids (Pediatrics only)Recruiting
Toronto, Ontario, Canada
Princess Margaret Cancer Centre (Adults only)Recruiting
Toronto, Ontario, Canada
Centre Hospitalier Universitaire de Bordeaux (Adults only)Completed
Pessac, Aquitaine, France
Centre Hospitalier Régional Universitaire de Lille (Adults and Pediatrics)Completed
Lille, Hauts-de-France, France
Hôpital Necker-Enfants Malades (Pediatrics only)Completed
Paris, Île-de-France Region, France
Hôpital Saint Antoine (Adults only)Completed
Paris, Île-de-France Region, France
Hôpital Universitaire Pitié Salpêtrière (Adults only)Completed
Paris, Île-de-France Region, France
Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (Adults only)Completed
Milan, Milano, Italy
Fondazione IRCCS Policlinico San Matteo (Adults and Pediatrics)Completed
Pavia, Pavia, Italy
Fondazione Policlinico Universitario Agostino Gemelli (Adults only)Completed
Roma, Roma, Italy
Ospedale Pediatrico Bambino Gesu (Pediatrics only)Completed
Roma, Roma, Italy
Azienda Ospedaliera - Universitaria Città della Salute e della Scienza di Torino (Adults only)Completed
Torino, Torino, Italy
Hospital Duran i Reynals (Adults and Pediatrics)Recruiting
Badalona, BARCELONA, Spain
Hospital Universitari Vall d'Hebrón - Institut de Recerca (Adults and Pediatrics)Suspended
Barcelona, Barcelona, Spain
Hospital Universitario Marqués de Valdecilla (Adults and Pediatrics)Recruiting
Santander, Cantabria, Spain
Hospital General Universitario Gregorio Marañón (Adults and Pediatrics)Recruiting
Madrid, Madrid, Spain
University Hospital Virgen del Rocio (Adults and Pediatrics)Recruiting
Seville, Spain, Spain
Hospital Universitario La Fe (Adults and Pediatrics)Recruiting
Valencia, Valencia, Spain
University Hospitals Birmingham NHS Foundation Trust (Adults only)Recruiting
Birmingham, England, United Kingdom
King's College Hospital NHS Foundation Trust (Adults only)Completed
London, England, United Kingdom
Imperial College Healthcare NHS Trust (Adults only)Recruiting
London, England, United Kingdom
A Phase 3 Study of Tabelecleucel for Participants With Epstein-Barr Virus-Associated Post-Transplant Lymphoproliferative Disease After Failure With Rituximab or Rituximab and Chemotherapy · TrialPath