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NCT03590574 · REGISTRY CONDITION SEARCH

Phase I/II Study Evaluating AUTO4 in Patients With T Cell Receptor Beta Constant (TRBC)1 Positive T Cell Lymphoma

Found through the registry condition index, not selected as a treatment recommendation. This discovery collection was restricted to studies with posted results.

Phase
PHASE1, PHASE2
Status at capture
TERMINATED
Registry last update
2026-03-16

The purpose of this study is to test the safety and efficacy of AUTO4 a chimeric antigen receptor (CAR) T cell treatment targeting TRBC1 in patients with relapsed or refractory TRBC1 positive selected T-Non-Hodgkin Lymphoma (NHL).

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

Who could take part
eligibility Criteria
Inclusion Criteria: 1. Male or female, aged ≥ 18 years. 2. Willing and able to give written, informed consent to be screened for TRBC1 positive T-NHL and to enter the main study. 3. Confirmed diagnosis of selected T-NHL, including: 1. Peripheral T cell lymphoma not otherwise specified, or 2. Angioimmunoblastic T cell lymphoma, or 3. Anaplastic large cell lymphoma 4. Confirmed TRBC1 positive tumour. 5. Relapsed or refractory disease and have had ≥1 prior lines of therapy. 6. Positron emission tomography (PET)-positive measurable disease per Lugano classification. 7. Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1. 8. Adequate bone marrow function without the requirement for ongoing blood products. 9. Adequate renal, hepatic, pulmonary, and cardiac function. 10. For females of childbearing potential (defined as \< 2 years after last menstruation or not surgically sterile), a negative serum or urine pregnancy test must be documented at screening, prior to pre-conditioning and confirmed before receiving the first dose of study treatment. For females who are not postmenopausal (\< 24 months of amenorrhea) or who are not surgically sterile (absence of ovaries and/or uterus), a highly effective method of contraception together with a barrier method must be used from the start of the pre-conditioning stage and for at least 12 months after the last dose of AUTO4 (study treatment). They must agree not to donate eggs (ova, oocytes) for the purposes of assisted reproduction during the study and for 12 months after receiving the last dose of study drug 11. For males, it must be agreed that 2 acceptable methods of contraception are used. 12. No contra-indications for leukapheresis, or the pre-conditioning regimen. Exclusion Criteria: Patients meeting any of the following exclusion criteria must not be enrolled into the study: 1. Patients with T cell leukaemia. 2. Females who are pregnant or lactating. 3. Prior treatment with investigational gene therapy or approved gene therapy or genetically engineered cell therapy product or allogeneic stem cell transplant. 4. Known history or presence of clinically relevant central nervous system (CNS) pathology. Patients with a known history or prior diagnosis of optic neuritis or other immunologic or inflammatory disease affecting the CNS. 5. Current or history of CNS involvement by malignancy. 6. Clinically significant, uncontrolled heart disease. 7. Patients with evidence of uncontrolled hypertension or with a history of hypertension crisis or hypertensive encephalopathy. 8. Patients with a history (within 3 months) or evidence of deep vein thrombosis or pulmonary embolism requiring ongoing therapeutic anticoagulation at the time of pre-conditioning. 9. Patients with active gastrointestinal bleeding. 10. Active infectious bacterial, viral disease or fungal disease (hepatitis B virus, hepatitis C virus, human immunodeficiency virus, human T cell lymphotropic virus or syphilis) requiring treatment. 11. Active autoimmune disease requiring immunosuppression. 12. History of other neoplasms unless disease free for at least 2 years (adequately treated carcinoma in situ, curatively treated non-melanoma skin cancer, breast or prostate cancer on hormonal therapy are allowed). 13. Prior treatment with programmed cell death protein 1, programmed death ligand 1, or cytotoxic T lymphocyte-associated protein 4 targeted therapy, or tumour necrosis factor (TNF) receptor superfamily agonists including cluster of differentiation (CD)134 (OX40), CD27, CD137 (41BB), and CD357 (glucocorticoid induced TNF receptor family related protein) within 6 weeks prior to AUTO4 infusion. 14. Research participants receiving any other investigational agents, or concurrent biological, chemotherapy, or radiation therapy. 15. Use of rituximab (or rituximab biosimilar) within the last 6 months prior to AUTO4 infusion. 16. Patients, who in the opinion of the Investigator, may not be able to understand or comply with the safety monitoring requirements of the study.
healthy Volunteers
false
minimum Age
18 Years
sex
ALL
std Ages
  1. ADULT
  2. OLDER_ADULT
Treatment arms and interventions
arm Groups
  1. description
    Relapsed or refractory T cell non-Hodgkin Lymphoma patients
    intervention Names
    1. Biological: AUTO4
    label
    AUTO4
    type
    EXPERIMENTAL
interventions
  1. arm Group Labels
    1. AUTO4
    description
    AUTO4 (Ritux-QBEND/10-Ritux-CD8 sort-suicide gene generated as a marker/suicide gene for T cells \[RQR8\]/anti-T cell receptor beta constant \[aTRBC\]1 CAR T cells). Following pre-conditioning with chemotherapy (cyclophosphamide and fludarabine), patients will be treated with doses from 25 to 900 x 10\^6 RQR8/anti-TRBC1 CAR T cells in Phase I. Following dose determination patients will be treated with the selected doses of RQR8/aTRBC1 CAR T cells (AUTO4) in Phase II.
    name
    AUTO4
    type
    BIOLOGICAL
Study design
allocation
NA
intervention Model
SINGLE_GROUP
masking Info
masking
NONE
primary Purpose
TREATMENT
Enrollment
count
20
type
ACTUAL
Registered outcome plans (not posted results)
primary Outcomes
  1. description
    To assess the safety and tolerability of AUTO4 administration. The incidence of Grade 3-5 toxicities occurring within 60 days of AUTO4 infusion.
    measure
    The Numbers of Patients With Grade 3 to 5 Toxicity Occurring Within 60 Days of AUTO4 Infusion.
    time Frame
    60 days of AUTO4 infusion
  2. description
    To identify the recommended Phase II dose and maximum tolerated dose (MTD), if an MTD exists, of AUTO4 by monitoring the frequency of DLT of AUTO4 within 28 days of AUTO4 infusion.
    measure
    Frequency of Dose-limiting Toxicity (DLT) of AUTO4 Within 28 Days of AUTO4 Infusion.
    time Frame
    28 days of AUTO4 infusion
secondary Outcomes
  1. description
    All AEs/SAEs were recorded from admission for pre-conditioning chemotherapy (Day -6 relative to AUTO4). Due to the long period between consent and AUTO4 treatment, any AEs/SAEs related to bridging chemotherapy not associated with study procedures did not require reporting as study AEs/SAEs. Any significant events were added to the patient's medical history. All AEs/SAEs related to study procedures (leukapheresis, bone marrow assessments) were reported.
    measure
    Frequency and Severity of All Adverse Events (AEs) and Serious Adverse Events (SAEs).
    time Frame
    24 months post treatment
  2. description
    Incidence and severity of opportunistic infections following AUTO4 infusion.
    measure
    To Assess the Overall Safety and Tolerability of AUTO4.
    time Frame
    24 months post treatment
  3. description
    Feasibility of product generation was examined by assessing the number of AUTO4 successfully manufactured as a fraction of the number of patients undergoing leukapheresis (all patients enrolled).
    measure
    Feasibility of Generating AUTO4: Number of Patients Whose Cells Achieve Successful AUTO4 Manufacture as a Proportion of the Number of Patients Undergoing Leukapheresis.
    time Frame
    Up to 8 weeks post leukapheresis
  4. description
    Participants achieving CR per Lugano criteria based on independent central radiology review. The Lugano classification of response by 18F (Fluorine isotope 18)-2-fluoro-2-deoxy-D-glucose fluorodeoxyglucose (FDG) positron emission tomography (PET)-computed tomography (CT): 1. no uptake or no residual uptake (when used interim) 2. slight uptake, but below blood pool (mediastinum) 3. uptake above mediastinal, but below or equal to uptake in the liver 4. uptake slightly to moderately higher than liver 5. markedly increased uptake or any new lesion (on response evaluation) Non-progressive disease * complete metabolic response - score of 1, 2 or 3 in nodal or extranodal sites with or without a residual mass * partial metabolic response - score of 4 or 5 with reduced uptake compared with baseline and residual mass(es) of any size * stable disease or no metabolic response - score of 4 or 5 with no obvious change in FDG uptake Progressive disease score 4 or 5 in any lesion
    measure
    Determine the Complete Response (CR) Rate Following Treatment With AUTO4.
    time Frame
    Up to 24 months
  5. description
    DOR was defined as the time from the first observed CR or partial response (PR) to documented disease progression or death due to any cause, for patients who were considered as responders. Patients who received protocol specified anti-cancer treatment post AUTO4 infusion were ignored in the main analysis. Patients who proceeded to stem cell transplantation (SCT) after AUTO4 infusion were censored at the time of SCT (including the conditioning regimen for SCT). Patients who received new non-protocol anticancer therapies other than SCT were censored at the date of last adequate assessment prior to the new therapy. Patients who experienced event after missing two or more scheduled disease assessments were censored at the date of last adequate assessment prior to the event. Data for DOR were pooled for analysis because the number of patients was \<5 for all of the groups and the intended model cannot be built with such a small sample size.
    measure
    Evaluate Duration of Response (DOR) Following Treatment With AUTO4.
    time Frame
    Up to 24 months
  6. description
    PFS was defined as the time from the first treatment of AUTO4 to documented disease progression/relapse or death due to any cause. If a patient did not have relapse or death due to any reason prior to data cut-off, PFS was censored at the date of the last adequate assessment by default. Patients who received protocol specified anti-cancer treatment post AUTO4 infusion were ignored in the main analysis. Patients who proceeded to SCT after AUTO4 infusion were censored at the time of SCT (including the conditioning regimen for SCT). Patients who received new non-protocol anticancer therapies other than SCT were censored as the date of last adequate assessment prior to the new therapy. Patients who experienced event after missing two or more scheduled disease assessments were censored at the date of last adequate assessment prior to the event
    measure
    Evaluate Progression-free Survival (PFS) Following Treatment With AUTO4.
    time Frame
    Up to 24 months
  7. description
    OS was defined as the time from the first treatment of AUTO4 to death due to any cause. Patients who had not died prior to data cut-off or database finalization were censored at the last contact date. Patients who received SCT after AUTO4 infusion were ignored in the main analysis.
    measure
    Evaluate Overall Survival (OS) Following Treatment With AUTO4.
    time Frame
    Up to 24 months
  8. description
    Time taken for participants achieving PR or CR per Lugano criteria based on independent central radiology review. The Lugano classification of response by 18F FDG PET-CT: 1. no uptake or no residual uptake (when used interim) 2. slight uptake, but below blood pool (mediastinum) 3. uptake above mediastinal, but below or equal to uptake in the liver 4. uptake slightly to moderately higher than liver 5. markedly increased uptake or any new lesion (on response evaluation) Non-progressive disease: * Complete metabolic response - score of 1, 2, or 3 in nodal or extranodal sites with or without a residual mass * Partial metabolic response - score of 4 or 5 with reduced uptake compared with baseline and residual mass(es) of any size
    measure
    Time to Response (PR and CR)
    time Frame
    24 months post treatment
  9. description
    The time taken for participants achieving CR per Lugano criteria based on independent central radiology review. The Lugano classification of response by 18F-2-fluoro-2-deoxy-D-glucose FDG PET-CT: 1. no uptake or no residual uptake (when used interim) 2. slight uptake, but below blood pool (mediastinum) 3. uptake above mediastinal, but below or equal to uptake in the liver 4. uptake slightly to moderately higher than liver 5. markedly increased uptake or any new lesion (on response evaluation) Non-progressive disease: • Complete metabolic response - score of 1, 2, or 3 in nodal or extranodal sites with or without a residual mass
    measure
    Evaluate Time to CR Following Treatment With AUTO4.
    time Frame
    Up to 24 months
  10. description
    RQR8/aTRBC1-CAR positive T cells as determined by polymerase chain reaction at a range of time points in the peripheral blood.
    measure
    To Determine the Expansion and Persistence of AUTO4 Following Infusion.
    time Frame
    Up to 24 months
  11. description
    Enumeration of circulating T cell receptor beta constant 1 positive T cells assessed by flow cytometry at a range of time points in the peripheral blood.
    measure
    Duration of TRBC1 Positive T Cell Aplasia.
    time Frame
    Up to 24 months
Full study description
brief Summary
The purpose of this study is to test the safety and efficacy of AUTO4 a chimeric antigen receptor (CAR) T cell treatment targeting TRBC1 in patients with relapsed or refractory TRBC1 positive selected T-Non-Hodgkin Lymphoma (NHL).
detailed Description
The study will consist of 2 phases, a Phase I/dose escalation phase and a Phase II/expansion phase. Patients with relapsed or refractory TRBC1 positive selected T-NHL will be enrolled in both phases of the study. Eligible patients will undergo leukapheresis to harvest T cells, the starting material for the manufacture of the autologous CAR-T product AUTO4. Following preconditioning by a chemotherapeutic regimen, the patient will receive AUTO4 intravenously as a single dose following which they will then enter a 24-month follow-up period
Source references
references
  1. citation
    Cwynarski K, Iacoboni G, Tholouli E, Menne T, Irvine DA, Balasubramaniam N, Wood L, Shang J, Xue E, Zhang Y, Basilico S, Neves M, Raymond M, Scott I, El-Kholy M, Jha R, Dainton-Smith H, Hussain R, Day W, Ferrari M, Thomas S, Lilova K, Brugger W, Marafioti T, Lao-Sirieix P, Maciocia P, Pule M. TRBC1-CAR T cell therapy in peripheral T cell lymphoma: a phase 1/2 trial. Nat Med. 2025 Jan;31(1):137-143. doi: 10.1038/s41591-024-03326-7. Epub 2024 Nov 11.
    pmid
    39528665
    type
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Source notices and limitations
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    Preserved source evidence · Not medical advice