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RECRUITINGPhase 1 / Phase 2INTERVENTIONAL

Study of CTO1681 for the Prevention and Treatment of CRS in DLBCL Patients Receiving CAR T-Cell Therapy

Phase 1B/2A Study of CTO1681 for the Prevention and Treatment of Cytokine Release Syndrome in Patients With Diffuse Large B-Cell Lymphoma Receiving Chimeric Antigen Receptor T-Cell Therapy

Important: This information is not medical advice. Talk to your doctor about whether a clinical trial is right for you.

About This Trial

This is an interventional study to evaluate the use of CTO1681 in preventing or reducing CAR T-cell-induced toxicities like cytokine release syndrome (CRS). This study will enroll adult patients with DLBCL who are scheduled to receive CD19-directed CAR T-cell therapy. The first phase of the study will be open label with dose escalation. Participants will start taking CTO1681 just prior to receiving their CAR T-cell therapy and continue to take the study drug three times daily for a total of 15 days.

Who May Be Eligible (Plain English)

Who May Qualify: 1. Age 18 years or older. 2. Undergone leukapheresis and is scheduled to receive protocol-specified commercially available CD19-directed CAR T-cell therapy (axicabtagene ciloleucel or lisocabtagene maraleucel) for DLBCL without corticosteroid prophylaxis for CRS and/or ICANS. Patients eligible for study must have relapsed or refractory DLBCL after at least one prior line of systemic therapy. 3. Met all inclusion criteria for CAR T-cell therapy per institutional guidelines. 4. your organs (liver, kidneys, etc.) are working well enough based on blood tests defined as: 1. Estimated Creatinine Clearance per Cockroft Gault formula ≥ 60 mL/min. 2. Serum alanine aminotransferase/aspartate aminotransferase ≤ 2.5 × ULN. 3. Total bilirubin ≤ 1.5 × ULN. 4. Left ventricular ejection fraction ≥ 40% on echocardiogram or multigated acquisition and no clinically significant pericardial effusion. 5. platelet count at least 50,000/mm3. 6. Absolute neutrophil count \> 1000/μL. 7. Absolute lymphocyte count \> 100/μL. 5. Documented measurable lymphoma disease adequate to judge by Lugano Criteria. 6. Eastern Cooperative Oncology Group performance status 0 to 1. 7. Female participants of childbearing potential and all male participants must agree to use Investigator-approved methods of birth control while on study drug and for 30 days thereafter. 8. Patients who are willing to provide written willing to sign a consent form before the predose procedures, or patients who have a legal representative capable of providing willing to sign a consent form on their behalf. Who Should NOT Join This Trial: 1. Any cytotoxic chemotherapy within 14 days prior to leukapheresis. 2. Clinically significant malabsorption syndromes and swallowing difficulties which are inadequately controlled with medication (eg, odynophagia, dysphagia, gastroesophageal reflux disease) as per Investigator assessment. 3. Grade 2 or greater electrolyte imbalance, per CTCAE v5.0: ...See full criteria on ClinicalTrials.gov Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language
Inclusion Criteria: 1. Age 18 years or older. 2. Undergone leukapheresis and is scheduled to receive protocol-specified commercially available CD19-directed CAR T-cell therapy (axicabtagene ciloleucel or lisocabtagene maraleucel) for DLBCL without corticosteroid prophylaxis for CRS and/or ICANS. Patients eligible for study must have relapsed or refractory DLBCL after at least one prior line of systemic therapy. 3. Met all inclusion criteria for CAR T-cell therapy per institutional guidelines. 4. Adequate organ function defined as: 1. Estimated Creatinine Clearance per Cockroft Gault formula ≥ 60 mL/min. 2. Serum alanine aminotransferase/aspartate aminotransferase ≤ 2.5 × ULN. 3. Total bilirubin ≤ 1.5 × ULN. 4. Left ventricular ejection fraction ≥ 40% on echocardiogram or multigated acquisition and no clinically significant pericardial effusion. 5. Platelets ≥ 50,000/mm3. 6. Absolute neutrophil count \> 1000/μL. 7. Absolute lymphocyte count \> 100/μL. 5. Documented measurable lymphoma disease adequate to judge by Lugano Criteria. 6. Eastern Cooperative Oncology Group performance status 0 to 1. 7. Female participants of childbearing potential and all male participants must agree to use Investigator-approved methods of birth control while on study drug and for 30 days thereafter. 8. Patients who are willing to provide written informed consent before the predose procedures, or patients who have a legal representative capable of providing informed consent on their behalf. Exclusion Criteria: 1. Any cytotoxic chemotherapy within 14 days prior to leukapheresis. 2. Clinically significant malabsorption syndromes and swallowing difficulties which are inadequately controlled with medication (eg, odynophagia, dysphagia, gastroesophageal reflux disease) as per Investigator assessment. 3. Grade 2 or greater electrolyte imbalance, per CTCAE v5.0: 1. Potassium \< 3.0 or \> 5.5 mmol/L 2. Sodium \< 130 or \> 150 mmol/L 3. Calcium \< 8.0 or \> 11.5 mg/dL 4. Magnesium \< 0.5 or \> 1.23 mmol/L 4. Clinically significant ECG abnormality at Screening or Baseline (Day -1), including but not limited to, a confirmed QTcF value \> 470 msec. Patients to be excluded included those with QTcF readings that are borderline or difficult to interpret because of a condition such as bundle branch block, or in those where the end of the T wave is difficult to measure. This also includes any Grade 2 or greater conduction block disorder, atrial, or ventricular arrythmia. 5. History of clinically significant arrhythmia and/or requiring anticoagulation/antiplatelet treatment at therapeutic dose. 6. Any clinically significant (ie, active) cardiovascular disease, including cerebral vascular accident/stroke (\< 6 months before enrollment), myocardial infarction (\< 6 months before enrollment) or unstable angina, and congestive heart failure ≥ New York Heart Association Classification Class III. 7. Uncontrolled thromboembolic events or recent severe hemorrhage within the last 6 months. 8. Known history of any bleeding disorder. 9. Requirement for ongoing therapeutic doses of anticoagulant therapy, antiplatelet or fibrinolytic agents (low molecular weight heparin prophylaxis is allowed). 10. Baseline systolic blood pressure \<100 mmHg. 11. History of autoimmune disease/ graft versus host disease requiring immunosuppressive therapy within the last 2 years. However, physiologic steroids (prednisone equivalent) may be given at a dose of 5 mg or less. 12. Patients who, in the opinion of the Investigator, would be unlikely to comply with study procedures or are otherwise unsuitable for enrollment.

Treatments Being Tested

DRUG

CTO1681 10 μg

Administered 3 times daily for 15 days (initial cohort).

DRUG

CTO1681 20 μg

Administered 3 times daily for 15 days (successive cohort).

DRUG

CTO1681 30 μg

Administered 3 times daily for 15 days (successive cohort).

Locations (6)

University of California, Irvine - Chao Family Comprehensive Cancer Center
Orange, California, United States
Georgia Cancer Center at Augusta University
Augusta, Georgia, United States
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
Duke Cancer Institute
Durham, North Carolina, United States
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
Fred Hutchinson Cancer Center
Seattle, Washington, United States