TrialPath
Recruiting

A Study to Investigate Ronde-cel Versus Investigator's Choice CD19 CAR T-Cell Therapy

NCT07188558 · Lyell Immunopharma, Inc.
In plain English

Click the button to translate this study into plain language — what it is, who qualifies, and what participation looks like.

Official title
A Phase 3 Randomized Controlled Trial of Rondecabtagene Autoleucel , an Autologous, Dual-targeting CD19/CD20 CAR T-Cell Product Candidate, Vs. Investigator's Choice of CD19 CAR T-Cell Therapy in Patients With Relapsed or Refractory Large B-Cell Lymphoma in the Second-line Setting
About this study
PiNACLE-H2H is a Phase 3 randomized controlled trial comparing the efficacy and safety of rondecabtagene autoleucel (ronde-cel, formerly known as LYL314) against the currently approved cluster of differentiation (CD)19 chimeric antigen receptor (CAR) T-cell therapies (axicabtagene ciloleucel \[axi-cel\] or lisocabtagene maraleucel \[liso-cel\]), in patients with aggressive LBCL that has relapsed or is refractory to first-line anti-CD20 antibody and anthracycline-containing chemotherapy. Patients will be randomized (1:1) before leukapheresis to receive either: * Ronde-cel; or * Investigator's choice of axi-cel or liso-cel Most patients who receive currently approved CD19-directed CAR T-cell therapies, including axi-cel and liso-cel, still experience progressive disease, often due to mechanisms such as CD19 antigen loss or T-cell exhaustion. Ronde-cel is a novel, autologous, dual-targeting CD19/CD20 CAR T-cell product candidate enriched for CD62L-positive naïve and central memory T cells, which are associated with enhanced proliferation capacity and persistence. Ronde-cel is an "OR"-gated CAR construct that can fully activate upon recognition of either CD19 or CD20, aiming to improve durability of response despite antigen heterogeneity. Approximately 400 participants will be enrolled. CAR T-cell therapy in both arms will be administered as a single intravenous infusion following fludarabine and cyclophosphamide lymphodepletion. Participants will be followed for 3 years for safety and efficacy, with long-term follow-up extending to 15 years.
Eligibility criteria
Key Inclusion Criteria: 1. CAR T cell naïve and eligible to receive a CD19 CART-cell therapy 2. Histologically confirmed large B-cell lymphoma, including the following types defined by (WHO 2022) or International Consensus Classification (2022) * Diffuse large B-cell lymphoma (DLBCL) * Transformations of indolent B-cell lymphomas (excluding Richter's transformation) * DLBCL/High-grade B-cell lymphoma (HGBCL) with MYC and BCL2 rearrangements * High-grade B-cell lymphoma (HGBCL) not otherwise specified (HGBCL NOS) * Primary mediastinal large B-cell lymphoma (PMBCL) * Grade 3B follicular lymphoma/large cell follicular lymphoma (FL3B) 3. Relapsed or refractory disease after anti-CD20 antibody and anthracycline-containing first-line chemoimmunotherapy 4. Measurable disease by presence of \[18F\]-fluorodeoxyglucose PET/CT positive lesion during Screening per Lugano Criteria 5. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 6. Adequate hematological, renal, hepatic, pulmonary, and cardiac function Key Exclusion Criteria: 1. Patients ineligible to receive CD19 CAR T-cell therapy 2. Primary CNS lymphoma 3. Patients with primary cutaneous LBCL, human herpes virus-8 positive lymphoma, Burkitt lymphoma, T cell histiocyte-rich lymphoma, or transformation from chronic lymphocytic leukemia/small lymphocytic lymphoma (Richter's transformation) 4. Patients with prior history of malignancy, other than aggressive relapsed or refractory LBCL, unless the patient has been free of the disease for ≥ 2 years 5. Patients with uncontrolled systemic fungal, bacterial, viral, or other infection (including tuberculosis) despite appropriate antibiotics or other treatment 6. Active autoimmune disease requiring ongoing systemic immunosuppressive therapy. Note: Other protocol defined Inclusion/Exclusion criteria may apply
Study design
Enrollment target: 400 participants
Allocation: randomized
Masking: none
Age groups: adult, older_adult
Timeline
Starts: 2026-01-12
Estimated completion: 2032-01
Last updated: 2026-08-04
Interventions
Biological: rondecabtagene autoleucelBiological: axicabtagene ciloleucelBiological: lisocabtagene maraleucel
Primary outcomes
  • Event free survival (36 months)
Sponsor
Lyell Immunopharma, Inc. · industry
Contacts & investigators
ContactDavid Shook, MD · contact · clinicaltrials@lyell.com · 000-000-0000
ContactMary Lessig, MS · contact · clinicaltrials@lyell.com · 000-000-0000
All locations (36)
Banner MD Anderson Cancer CenterRecruiting
Gilbert, Arizona, United States
Honor HealthRecruiting
Scottsdale, Arizona, United States
Mayo Clinic ArizonaRecruiting
Scottsdale, Arizona, United States
University of ArkansasNot Yet Recruiting
Little Rock, Arkansas, United States
Cedars-Sinai Medical CenterRecruiting
Los Angeles, California, United States
University of California, Los Angeles (UCLA)Recruiting
Los Angeles, California, United States
University of California, IrvineRecruiting
Orange, California, United States
University of ColoradoRecruiting
Aurora, Colorado, United States
Colorado Blood Cancer InstituteRecruiting
Denver, Colorado, United States
MedStar Georgetown University HospitalNot Yet Recruiting
Washington D.C., District of Columbia, United States
Mayo Clinic FloridaRecruiting
Jacksonville, Florida, United States
AdventHealthNot Yet Recruiting
Orlando, Florida, United States
Moffitt Cancer CenterRecruiting
Tampa, Florida, United States
Northside HospitalRecruiting
Atlanta, Georgia, United States
NorthwesternNot Yet Recruiting
Chicago, Illinois, United States
University of ChicagoRecruiting
Chicago, Illinois, United States
University of IowaNot Yet Recruiting
Iowa City, Iowa, United States
University of Kansas Cancer CenterRecruiting
Westwood, Kansas, United States
University of Louisville HealthRecruiting
Louisville, Kentucky, United States
Mayo Clinic RochesterRecruiting
Rochester, Minnesota, United States
University of Nebraska Medical Center (UNMC)Recruiting
Omaha, Nebraska, United States
HackensackRecruiting
Hackensack, New Jersey, United States
Roswell Park Comprehensive Cancer CenterRecruiting
Buffalo, New York, United States
Duke Cancer InstituteRecruiting
Durham, North Carolina, United States
Atrium Health Wake Forest Baptist Comprehensive Cancer CenterNot Yet Recruiting
Winston-Salem, North Carolina, United States
Oncology Hematology Care Clinical TrialsRecruiting
Cincinnati, Ohio, United States
University of CincinnatiRecruiting
Cincinnati, Ohio, United States
Cleveland Clinical Taussig Cancer CenterNot Yet Recruiting
Cleveland, Ohio, United States
Allegheny Health NetworkNot Yet Recruiting
Pittsburgh, Pennsylvania, United States
SCRI Oncology PartnersRecruiting
Nashville, Tennessee, United States
St. David's South Austin Medical CenterRecruiting
Austin, Texas, United States
University of Texas Southwestern Medical CenterNot Yet Recruiting
Fort Worth, Texas, United States
MD Anderson Cancer CenterRecruiting
Houston, Texas, United States
Texas Transplant InstituteRecruiting
San Antonio, Texas, United States
Intermountain HealthcareRecruiting
Salt Lake City, Utah, United States
Virginia Oncology AssociatesRecruiting
Norfolk, Virginia, United States
A Study to Investigate Ronde-cel Versus Investigator's Choice CD19 CAR T-Cell Therapy · TrialPath