Immunobridging/Maintenance Therapy Versus Non-bridging Therapy in CAR-T Therapy for Low-risk R/R B-NHL

NCT ID: NCT06695013

Last Updated: 2025-01-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

144 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-20

Study Completion Date

2027-03-20

Brief Summary

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This study aims to explore whether adding immunotherapy bridging treatment for low-risk refractory/relapsed B-NHL can demonstrate better outcomes, in order to find the most effective treatment plan for low-risk patients.

Detailed Description

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In the immunotherapy bridging treatment group, zanubrutinib ± radiotherapy will be used as the bridging treatment regimen, while those without bridging treatment will not receive bridging medications. Both groups will determine subsequent maintenance treatment based on efficacy at D28. Patients achieving complete response (CR) will not receive maintenance therapy, while those with partial response (PR) will be given oral zanubrutinib + PD-1 inhibitor for 2 years. Patients with stable disease (SD) or disease progression (PD) will not be included in this study.

Conditions

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B-NHL CART Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Immunotherapy bridging treatment

Zanubrutinib ± radiotherapy was used as the bridging therapy in the immunobridging treatment group, a Follow-up maintenance treatment was determined according to the efficacy of D28 in the two groups. Patients with complete response (CR) were given no maintenance treatment, while patients with partial response (PR) were given Zanubrutinib orally plus PD-1 inhibitor for 2 years. Patients with stable SD or progressive PD were excluded from this study

Group Type EXPERIMENTAL

zanubrutinib

Intervention Type DRUG

zanubrutinib 160 mg BID orally

CAR-T

Intervention Type DRUG

CAR-T Cell therapy

Bridging radiotherapy

Intervention Type RADIATION

For patients in the experimental group, the decision regarding radiotherapy will depend on whether the specific lesions are suitable.

Tislelizumab

Intervention Type DRUG

200mg IV Q3-4W

no bridging treatment

The control group will not receive bridging treatment. Maintenance treatment will be consistent with the experimental group.

Group Type ACTIVE_COMPARATOR

zanubrutinib

Intervention Type DRUG

zanubrutinib 160 mg BID orally

CAR-T

Intervention Type DRUG

CAR-T Cell therapy

Tislelizumab

Intervention Type DRUG

200mg IV Q3-4W

Interventions

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zanubrutinib

zanubrutinib 160 mg BID orally

Intervention Type DRUG

CAR-T

CAR-T Cell therapy

Intervention Type DRUG

Bridging radiotherapy

For patients in the experimental group, the decision regarding radiotherapy will depend on whether the specific lesions are suitable.

Intervention Type RADIATION

Tislelizumab

200mg IV Q3-4W

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Age 18 or older, regardless of gender.
2. Histologically confirmed B-cell non-Hodgkin lymphoma, according to Lugano diagnostic criteria.
3. At least first-line treatment for relapsed or refractory patients, including chemotherapy regimens containing anthracyclines and anti-CD20 monoclonal antibody therapy; patients must meet definitions of refractory and recurrent.
4. No prior CD19 CAR T cell therapy.
5. Adequate organ function to assess tolerance to CAR-T therapy.
6. Sufficient vascular access for leukapheresis.
7. Ability to provide written informed consent and understand the study requirements and evaluation schedule.
8. Fertile patients must agree to use highly effective contraception during the study and for 120 days post-treatment.

Exclusion Criteria

Patients with any of the following conditions will not be included in the study:

1. History of allogeneic hematopoietic stem cell transplantation.
2. History of epilepsy, cerebrovascular ischemia/bleeding, dementia, cerebellar disease, or any autoimmune disease involving the central nervous system.
3. Any other malignancies within the past 2 years, except for cured cervical carcinoma in situ, non-melanoma skin cancer, and superficial bladder tumors (Ta, Tis, and T1).
4. Severe cardiovascular disease: NYHA grade II or above myocardial ischemia or myocardial infarction, poorly controlled arrhythmias; NYHA grade III to IV heart failure or left ventricular ejection fraction (LVEF) \< 50%.
5. Allergy to any investigational drug or excipient.
6. Active viral hepatitis requiring treatment, including chronic HBV carriers with HBV DNA ≥ 500 IU/mL and positive HCV RNA.
7. Active autoimmune disease or known history of allogeneic organ transplantation; long-term heavy use of immunosuppressants or other factors affecting study therapy.
8. Active infection.
9. History of uncontrolled systemic disease, such as diabetes or hypertension.
10. Known HIV infection.
11. Underlying medical condition or substance abuse that may interfere with drug administration or affect result interpretation, or increase treatment risk.
12. End-organ damage from autoimmune disease within the past 2 years or systemic use of immunosuppressive drugs.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ruijin Hospital

OTHER

Sponsor Role lead

Responsible Party

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Zhao Weili

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ruijin

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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zhao wei li, doctor Degree

Role: CONTACT

+862164370045 ext. Ext.610707

yan zi xun, doctor degree

Role: CONTACT

+862164370045 ext. Ext.610707

Other Identifiers

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CLMB study

Identifier Type: -

Identifier Source: org_study_id

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