Study of LYL314 in Aggressive Large B-Cell Lymphoma
a study on Lymphoma Non-Hodgkin Lymphoma
Summary
- Eligibility
- for people ages 18 years and up (full criteria)
- Location
- at UC Irvine UCLA
- Dates
- study startedcompletion around
- Principal Investigator
- by Sarah M. Larson, MD (ucla)

Description
Summary
This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of LYL314, a dual-targeting chimeric antigen receptor (CAR) targeting cluster of differentiation (CD)19 and CD20 in participants with aggressive large B-cell lymphoma.
Official Title
A Phase 1/2 Multi-Center Study Evaluating the Safety and Efficacy of LYL314, a CD19/CD20 Dual-Targeting Chimeric Antigen Receptor T-Cell Therapy in Participants With Aggressive B-Cell Non-Hodgkin Lymphoma
Details
This is a Phase 1/2, multi-center, open-label study evaluating the safety and efficacy of LYL314, 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: Participants who have not received a prior CAR T-cell product (CAR T naïve) and have received at least two or more prior lines of treatment (third-line or later).
Cohort 2: Participants who have received a prior CAR T-cell product (CAR T experienced) and have received at least two or more prior lines of treatment including one CAR T-cell therapy.
Cohort 3: Participants with refractory disease or relapse within one year of first-line therapy (second-line).
Cohort 4: Participants who have received prior T-cell engager (TCE) therapy and have received at least two or more prior lines of treatment including one TCE therapy.
Cohort 5: Participants receiving first-line treatment for high-risk large B-cell lymphoma who remain with disease on positron emission tomography scanning (PET-positive) after 2 to 3 cycles of standard-of-care chemoimmunotherapy (high-risk first-line).
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 LYL314.
LYL314 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 LYL314 treatment.
Keywords
Relapsed Non-Hodgkin Lymphoma, Refractory Non-Hodgkin Lymphoma, Non-Hodgkin Lymphoma, Large B-cell Lymphoma, CAR T-cell, CD19/20, CD19, CD20, NHL, Diffuse Large B-cell lymphoma, DLBCL, Transformed follicular lymphoma, TFL, Primary mediastinal B-cell lymphoma, PMBCL, High-grade B-cell lymphoma, HGBL, follicular lymphoma Grade 3B, large cell follicular lymphoma, Aggressive B-cell NHL, Refractory Aggressive B-Cell Lymphoma, Refractory B-Cell Non-Hodgkin Lymphoma, Lymphoma, Non-Hodgkin, Lymphoma, Lymphoma, Large B-Cell, Diffuse, Cyclophosphamide, Fludarabine, Lymphoma, Follicular, Lymphoma, B-cell, Immunosuppressive Agents, Immunologic Factors, Disease Attributes, Immune System Diseases, Recurrence, PiNACLE, B-Cell Lymphoma, Aggression, LYL314
Eligibility
You can join if…
Open to people ages 18 years and up
- Age 18 years or older at time of informed consent
- Willing and able to provide written informed consent
- Histologically confirmed aggressive NHL, including the following types defined by the World Health Organization (WHO 2017):
- DLBCL
- DLBCL arising from follicular lymphoma (transformed FL, tFL)
- Primary mediastinal (thymic) large B-cell lymphoma (PMBCL)
- High-grade large B-cell lymphoma with or without MYC and BCL2 and/or BCL6 rearrangement (HGBL)
- Grade 3B follicular lymphoma/Large cell follicular lymphoma (FL3B)
- Received at least two prior lines of therapy for Cohorts 1, 2, and 4 and one prior line of therapy for Cohort 3. Prior therapy must have included:
- Anti-CD20 monoclonal antibody, and
- An anthracycline containing chemotherapy regimen
Participants with tFL must have received at least one of their prior lines of therapy after transformation to DLBCL
4b. Cohort 5 (High-risk first-line) participants must have high-risk large B-cell lymphoma
- Relapsed or refractory disease, defined by the following:
- Disease progression after last regimen (including salvage therapy after autologous stem cell transplantation [ASCT]). In participants who have only received front-line therapy, progression should be ≤ 12 months of first-line therapy (applicable for Cohort 3)
- In patients who received one line of therapy, refractory disease is defined as failure to achieve at least a PR after at least 4 cycles of therapy (applicable for Cohort 3)
- In patients who received two or more lines of therapy (Cohorts 1, 2, and 4), refractory disease is defined as failure to achieve a CR to last line of therapy (including CAR T and/or salvage therapy).
- At least 1 measurable lesion (per Lugano classification). Lesions that have been previously irradiated will be considered measurable only if progression has been documented following completion of radiation therapy
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 or ECOG 0 to 2 (Cohort 5)
- Absolute neutrophil count (ANC) ≥ 1000/uL
- Platelet count ≥ 50,000/uL
- Absolute lymphocyte count (ALC) ≥ 200/uL
Other protocol-defined criteria apply.
You CAN'T join if...
- History of malignancy other than non-melanoma skin cancer or carcinoma in situ (e.g., cervix, bladder, breast) unless disease-free for at least 3 years. Participants who have received therapy for a prior malignancy within the prior 3 years, e.g., in the adjuvant setting, are not excluded
- Active central nervous system (CNS) involvement by malignancy on magnetic resonance imaging (MRI) or by lumbar puncture. Participants with prior evidence of brain metastasis treated at least 8 weeks prior to enrollment will not be excluded for participation if CNS disease is deemed stable at the time of study enrollment
- History of cardiac lymphoma involvement or Epstein-Barr virus (EBV)+ lymphoma
- Ongoing or impending oncologic emergency (e.g., tumor mass effect, tumor lysis syndrome, known vascular invasion)
- Received the following therapies in the specified time frame prior to enrollment/leukapheresis
- Any systemic therapy within 2 weeks
- Any systemic inhibitory/stimulatory immune checkpoint molecule therapy within 3 half-lives prior to enrollment (e.g., ipilimumab, nivolumab, pembrolizumab, atezolizumab, OX40 agonists, 4-1BB agonists)
- Fludarabine within 12 weeks
- Alemtuzumab, bendamustine or antithymocyte globuline (ATG) within 6 months
- Any T cell engager/bispecific antibody therapy such as CD20/CD3 or CD19/CD3 bispecific antibodies within 4 weeks
- Any experimental therapy within 4 weeks or 5 half-lives (whichever is shorter)
- Received radiation therapy within 3 weeks prior to enrollment/leukapheresis
- Experiencing non-hematologic toxicities due to prior therapy. Exceptions include: stable and recovered to grade ≤ 1 or non-clinically significant toxicities such as (1) alopecia, (2) toxicities where Grade 2 is solely defined by participant receiving hormone replacement therapy for endocrinopathies resulting from previous checkpoint inhibitor therapy, (3) Grade 2 lymphopenia, and (4) hearing loss or Grade 2 neuropathy associated with prior treatment with taxanes or platinating agents
- History of allogeneic stem cell or solid organ transplantation
- Receipt of autologous stem cell transplantation within 6 weeks prior to enrollment/leukapheresis
- History of prior genetically modified cell therapy 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). For all other CAR T cell therapy treatments, discussion with the Sponsor's Medical Monitor is required
- Primary immunodeficiency
- History of autoimmune disease (e.g., Crohn's disease, rheumatoid arthritis, systemic lupus) resulting in end organ injury or requiring systemic immunosuppression/systemic disease modifying agents within the last 2 years. Participants who have other autoimmune condition(s) considered to be associated with underlying malignancy may be enrolled in the study after discussion with and approval of the Medical Monitor.
Other protocol-defined criteria apply.
Locations
- University of California-Irvine Medical Center
accepting new patients
Irvine California 92697 United States - University of California, Los Angeles (UCLA) Medical Center
accepting new patients
Los Angeles California 90095 United States - Scripps Clinic
accepting new patients
San Diego California 92037 United States - Cedars-Sinai Medical Center
accepting new patients
Los Angeles California 90048 United States
Lead Scientist at University of California Health
- Sarah M. Larson, MD (ucla)
HS Associate Clinical Professor, Medicine. Authored (or co-authored) 21 research publications
Details
- Status
- accepting new patients
- Start Date
- Completion Date
- (estimated)
- Sponsor
- Lyell Immunopharma, Inc.
- ID
- NCT05826535
- Phase
- Phase 1/2 research study
- Study Type
- Interventional
- Participants
- Expecting 270 study participants
- Last Updated