Study of Rondecabtagene Autoleucel in Aggressive Large B-Cell Lymphoma

Purpose

This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of rondecabtagene autoleucel (ronde-cel) also known as LYL314, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma.

Conditions

  • Relapsed Non-Hodgkin Lymphoma
  • Refractory Non-Hodgkin Lymphoma
  • Non-Hodgkin Lymphoma
  • Large B-cell Lymphoma

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  1. Age 18 years or older 2. Willing and able to provide written informed consent 3. Histologically confirmed LBCL, including the following types defined by the World Health Organization (WHO 2022) or International Consensus Classification (2022) 4. Received at least two prior lines of therapy for Cohorts 1, 2, and 4 and one prior line of therapy for Cohort 3 5. Relapsed or refractory disease. 6. At least 1 measurable lesion (per Lugano classification) 7. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 or ECOG 0 to 2 (Cohort 5) 8. Absolute neutrophil count (ANC) ≥ 1000/µL 9. Platelet count ≥ 50,000/µL 10. Absolute lymphocyte count (ALC) ≥ 200/µL Other protocol-defined criteria apply.

Exclusion Criteria

  1. History of malignancy other than non-melanoma skin cancer or carcinoma in situ unless disease-free for at least 3 years 2. Active central nervous system involvement 3. History of cardiac lymphoma involvement or Epstein-Barr virus (EBV)+ lymphoma 4. Ongoing or impending oncologic emergency 5. Recent systemic anti-cancer therapy or radiation 6. Ongoing non-hematologic toxicities due to prior therapy 7. History of allogeneic stem cell or solid organ transplantation 8. Autologous stem cell transplantation within 6 weeks 9. History of prior genetically modified cell therapy (Cohorts 1, 3, 4, 5) or no other than a product targeting CD19 with an FMC63-based CAR (e.g., axicabtagene ciloleucel (axi-cel), tisagenlecleucel (tisa-cel), or lisocabtagene maraleucel (liso-cel) (Cohort 2). 10. Primary immunodeficiency 11. History of autoimmune disease resulting in end organ injury or requiring recent therapy Other protocol-defined criteria apply.

Study Design

Phase
Phase 1/Phase 2
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Sequential Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Ph1, 3rd or later line, 3L+ have not received prior CAR T (Cohort 1)
  • Drug: Rondecabtagene autoleucel (ronde-cel)
    CAR T-cell therapy
  • Drug: Fludarabine
    Conditioning chemotherapy
  • Drug: Cyclophosphamide
    Conditioning chemotherapy
Experimental
Ph1 CAR T experienced, 3L+ received at least two or more prior lines of treatment (Cohort 2)
  • Drug: Rondecabtagene autoleucel (ronde-cel)
    CAR T-cell therapy
  • Drug: Fludarabine
    Conditioning chemotherapy
  • Drug: Cyclophosphamide
    Conditioning chemotherapy
Experimental
Ph1, 2L Refractory/relapse within 1 year of 1st-line therapy & no prior CAR T (Cohort 3)
  • Drug: Rondecabtagene autoleucel (ronde-cel)
    CAR T-cell therapy
  • Drug: Fludarabine
    Conditioning chemotherapy
  • Drug: Cyclophosphamide
    Conditioning chemotherapy
Experimental
Ph1 (T-cell engager experienced, 3L+) received at least 2 prior lines including 1 TCE (Cohort 4)
  • Drug: Rondecabtagene autoleucel (ronde-cel)
    CAR T-cell therapy
  • Drug: Fludarabine
    Conditioning chemotherapy
  • Drug: Cyclophosphamide
    Conditioning chemotherapy
Experimental
Ph1 high risk 1st line, PET-positive after 2-3 cycles chemoimmunotherapy, no prior CAR T (Cohort 5)
  • Drug: Rondecabtagene autoleucel (ronde-cel)
    CAR T-cell therapy
  • Drug: Fludarabine
    Conditioning chemotherapy
  • Drug: Cyclophosphamide
    Conditioning chemotherapy
Experimental
Ph2, 3rd or later line, have not received prior CAR T (Cohort 1)
Single dose determined during Phase 1.
  • Drug: Rondecabtagene autoleucel (ronde-cel)
    CAR T-cell therapy
  • Drug: Fludarabine
    Conditioning chemotherapy
  • Drug: Cyclophosphamide
    Conditioning chemotherapy

Recruiting Locations

University of California-Irvine Medical Center
Irvine, California 92697

Cedars-Sinai Medical Center
Los Angeles, California 90048

University of California, Los Angeles (UCLA) Medical Center
Los Angeles, California 90095

Scripps Clinic
San Diego, California 92037

Colorado Blood Cancer Institute
Denver, Colorado 80218

Augusta University Medical Center
Augusta, Georgia 30912

Indiana Blood and Marrow Transplantation
Indianapolis, Indiana 46237

University of Iowa
Iowa City, Iowa 52242

University of Louisville Brown Cancer Center
Louisville, Kentucky 40202

Louisiana State University Health Sciences Center
Shreveport, Louisiana 71130

Corewell Health
Grand Rapids, Michigan 49503

University of Nebraska Medical Center
Omaha, Nebraska 68198

University of New Mexico Comprehensive Cancer Center
Albuquerque, New Mexico 87131

Roswell Park Comprehensive Cancer Center
Buffalo, New York 14263

Montefiore Medical Center
The Bronx, New York 10461

Atrium Health Wake Forest Baptist
Winston-Salem, North Carolina 27157

University of Cincinnati (UC) Physicians Company, LLC
Cincinnati, Ohio 45267

Cleveland Clinic
Cleveland, Ohio 44195

Lehigh Valley Topper Cancer Center Institute
Allentown, Pennsylvania 18103

Thomas Jefferson University
Philadelphia, Pennsylvania 19107

West Penn Hospital
Pittsburgh, Pennsylvania 15224

Baylor University Medical Center
Dallas, Texas 75246

Texas Transplant Institute
San Antonio, Texas 78229

Huntsman Cancer Institute
Salt Lake City, Utah 84112

Intermountain Healthcare
Salt Lake City, Utah 84143

Virginia Oncology Associates
Norfolk, Virginia 24502

Virginia Commonwealth University-Massey Cancer Center
Richmond, Virginia 23298

Medical College of Wisconsin
Milwaukee, Wisconsin 53226

More Details

Status
Recruiting
Sponsor
Lyell Immunopharma, Inc.

Study Contact

Stephen Simko, MD
000-000-0000
clinicaltrials@lyell.com

Detailed Description

This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of ronde-cel, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma. Five cohorts of participants will be enrolled: Cohort 1: (3rd or later line, 3L+) Participants who have received least two prior lines of treatment Cohort 2: (CAR T-cell experienced, 3L+): Participants who have received at least two prior lines of treatment including one prior CAR T. Cohort 3: (second line, 2L) Participants with refractory disease or relapse within one year of first-line therapy (second-line). Cohort 4: (TCE-experienced, 3L+) Participants have received prior T-cell engager therapy and have received at least two prior lines of treatment including one TCE therapy and have not received prior CAR T. Cohort 5: (high-risk 1st line) Participants receiving first-line treatment who remain with disease on positron emission tomography scanning (PET-positive) after 2 to 3 cycles of standard-of-care chemoimmunotherapy and have not received prior CAR T. Up to approximately 150 participants (across all cohorts) will be enrolled in the dose finding Phase 1 part of the study. The Phase 2 pivotal study (PiNACLE) will expand enrollment of Cohort 1 to approximately 120 participants to further evaluate the safety and efficacy of ronde-cel. Ronde-cel treatment consists of a single administration of CAR transduced autologous T-cells administered intravenously after a conditioning chemotherapy regimen consisting of fludarabine and cyclophosphamide, administered over 3 days. Individual participants will remain in the active post-treatment follow-up (PTFU) period for approximately 2 years. Participants will continue in long-term follow-up (LTFU) for 15 years from ronde-cel treatment.