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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

邮发代号 80-967

2019 Impact Factor: 3.421

Frontiers of Medicine  2022, Vol. 16 Issue (2): 285-294   https://doi.org/10.1007/s11684-021-0843-8
  本期目录
Phase I study of CBM.CD19 chimeric antigen receptor T cell in the treatment of refractory diffuse large B-cell lymphoma in Chinese patients
Lei Fan, Li Wang, Lei Cao, Huayuan Zhu, Wei Xu(), Jianyong Li()
Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Abstract

Anti-CD19 chimeric antigen receptor (CAR) T cell therapy has shown impressive efficacy in treating B-cell malignancies. A single-center phase I dose-escalation study was conducted to evaluate the safety and efficacy of T cells transduced with CBM.CD19 CAR, a second-generation anti-CD19 CAR bearing 4-1BB costimulatory molecule, for the treatment of patients with refractory diffuse large B-cell lymphoma (DLBCL). Ten heavily treated patients with refractory DLBCL were given CBM.CD19 CAR-T cell (C-CAR011) treatment. The overall response rate was 20% and 50% at 4 and 12 weeks after the infusion of C-CAR011, respectively, and the disease control rate was 60% at 12 weeks after infusion. Treatment-emergent adverse events occurred in all patients. The incidence of cytokine release syndrome in all grades and grade≥3 was 90% and 0, respectively, which is consistent with the safety profile of axicabtagene ciloleucel and tisagenlecleucel. Neurotoxicity or other dose-limiting toxicities was not observed in any dose cohort of C-CAR011 therapy. Antitumor efficacy was apparent across dose cohorts. Therefore, C-CAR011 is a safe and effective therapeutic option for Chinese patients with refractory DLBCL, and further large-scale clinical trials are warranted.

Key wordsCAR-T cell therapy    refractory diffuse large B-cell lymphoma    cytokine release syndrome    dose-limiting toxicity
收稿日期: 2020-07-21      出版日期: 2022-04-26
Corresponding Author(s): Wei Xu,Jianyong Li   
作者简介:

Peng Lu, Renxing Wang, and Yue Xing contributed equally to this work.

 引用本文:   
. [J]. Frontiers of Medicine, 2022, 16(2): 285-294.
Lei Fan, Li Wang, Lei Cao, Huayuan Zhu, Wei Xu, Jianyong Li. Phase I study of CBM.CD19 chimeric antigen receptor T cell in the treatment of refractory diffuse large B-cell lymphoma in Chinese patients. Front. Med., 2022, 16(2): 285-294.
 链接本文:  
https://academic.hep.com.cn/fmd/CN/10.1007/s11684-021-0843-8
https://academic.hep.com.cn/fmd/CN/Y2022/V16/I2/285
Fig.1  
Characteristic Low-dose cohort Middle-dose cohort High-dose cohort Total
(N = 3) (N = 3) (N = 4) (N = 12a)
Age (year)    
Mean±SD 50.3±5.8 28.8±3.2 52.9±11.0 44.5±13.2
Range 43.7-53.0 25.4-31.6 45.4-69.2 25.4-69.2
Gender, n (%)
Male 2 (66.7) 3 (100.0) 2 (50.0) 9 (75.0)
Female 1 (33.3) 0 2 (50.0) 3 (25.0)
Height (cm)
Mean±SD 169.0±4.4 174.3±4.9 168.5±6.1 170.5±4.93
Range 164–172 171–180 163–176 163–180
Weight (kg)
Mean±SD 69.7±9 73±7 67.9±12.2 69.6±8.3
Range 64-80 68-81 60-86 60-86
Days to pathological diagnosisb
Mean±SD -440.5±21.9 -415.0±261.6 -331.3±61.8 -386.4±124.6
Range -456 to -425 -600 to -230 -399 to -278 -600 to -230
Modified Ann Arbor stage before enrollment, n (%)
I or II 0 1 (33.3) 1 (25.0) 4 (33.35)
III or IV 3 (100.0) 2 (66.7) 3 (75.0) 8 (66.7)
Symptom A or B, n (%)
A 3 (100.0) 3 (100.0) 1 (25.0) 9 (75.0)
B 0 0 3 (75.0) 3 (25.0)
Number of prior lines of treatment, n (%)
1−2 0 0 0 1 (8.3)c
3 1 (33.3) 1 (33.3) 1 (25.0) 3 (25.0)
>3 2 (66.7) 2 (66.7) 3 (75.0) 8 (66.7)d
Best response to previous regimens, n (%)
CR 0 0 1 (25.0) 1 (8.3)
PR 0 2 (66.7) 0 2 (16.7)
SD 1 (33.3) 1 (33.3) 1 (25.0) 4 (33.3)
PD 2 (66.7) 0 2 (50.0) 5 (41.7)
Tab.1  
Factor, n (%) Low-dose cohort Middle-dose cohort High-dose cohort Total
(N = 3) (N = 3) (N = 4) (N = 10)
Patients with≥1 TEAE 3 (100%) 3 (100%) 4 (100%) 10 (100%)
Patients with≥1 TEAE (NCI CTCAE≥3) 3 (100%) 3 (100%) 4 (100%) 10 (100%)
Patients with≥1 Serious TEAE 1 (33.3%) 0 0 1 (10%)
Tab.2  
Cohort Patient Symptom description Level Use of tocilizumab Use of corticosteroids Other medication Action to study product Withdrawal
Yes/no Yes/no Yes/no Yes/no
Low-dose cohort S002 Fever/chills/elevated transaminase 1 No No Yes Not applicable No
  S003 Elevated transaminase 1 No No No Not applicable No
  S004 Fever/diarrhea 1 No No Yes Continue No
Middle-dose cohort S008 Elevated transaminase 1 No No Yes Not applicable No
  S010 Diarrhea/constipation 1 No No Yes Continue No
High-dose cohort S014 Fever 1 No No Yes Not applicable No
  S015 Fever/anorexia/vomiting/hypoxemia /elevated transaminase 2 No No Yes Continue No
  S016 Fever/elevated transaminase 1 No No Yes Not applicable No
  S018 Fever/fatigue 1 No No Yes Continue No
Tab.3  
Response Low-dose cohort Middle-dose cohort High-dose cohort Total
(N = 3) (N = 3) (N = 4) (N = 10)
Week 4, n (%)        
CR 0 0 0 0
PR 1 (33.3%) 0 1 (25.0%) 2 (20.0%)
SD 1 (33.3%) 3 (100.0%) 2 (50.0%) 6 (60.0%)
PD 1 (33.3%) 0 1 (25.0%) 2 (20.0%)
NA 0 0 0 0
ORRa 1 (33.3%) 0 1 (25.0%) 2 (20.0%)
95% CI 0.8%−90.6% 0.0%−70.8% 0.6%−80.6% 2.5%−55.6%
week 12, n (%)        
CR 2 (66.7%) 0 1 (25.0%) 3 (30.0%)
PR 0 1 (33.3%) 1 (25.0%) 2 (20.0%)
SD 0 1 (33.3%) 0 1 (10.0%)
PD 0 1 (33.3%) 1 (25.0%) 2 (20.0%)
NA 0 0 0 0
ORRa 2 (66.7%) 1 (33.3%) 2 (50.0%) 5 (50.0%)
95% CI 9.4%−99.2%) 0.8%−90.6% 6.8%−93.2% 18.7%−81.3%
DCRb 2 (66.7%) 2 (66.7%) 2 (50.0%) 6 (60.0%)
95% CI 9.4%−99.2% 9.4%−99.2% 6.8%−93.2% 26.2%−87.8%
 
Tab.4  
Fig.2  
Fig.3  
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