1008PD - ZUMA-4 preliminary results: phase 1 study of KTE-C19 chimeric antigen receptor T cell therapy in pediatric and adolescent patients (pts) with relap...

Date 11 September 2017
Event ESMO 2017 Congress
Session Haematological malignancies
Topics Cancer in Adolescents
Leukaemia
Haematologic Malignancies
Presenter Daniel Lee
Citation Annals of Oncology (2017) 28 (suppl_5): v355-v371. 10.1093/annonc/mdx373
Authors D.W. Lee1, A.S. Wayne2, V. Huynh3, R. Handgretinger4, R. Pieters5, G. Michele6, A. Baruchel7, T. Feuchtinger8, Y. Bertrand9, M. Hemiston10, P.A. Brown11, J. Rossi12, Y. Jiang13, L. Navale13, S. Stout14, J. Aycock14, A. Mardiros12, J. Wiezorek14, R. Jain14
  • 1Pediatric Stem Cell Transplant Division Of Pediatric Hematology/oncology, University of Virginia, 22908 - Charlottesville/US
  • 2Children's Center For Cancer And Blood Diseases, Children's Hospital Los Angeles, Usc-norris Comprehensive Cancer Center, Keck School Of Medicine, University of Southern California, Los Angeles/US
  • 3Department Of Epidemiology And Chao Family Comprehensive Cancer Center/ Hyundai Cancer Institute, Children's Hospital of Orange County, Orange/US
  • 4Universität Children's Hospital, Eberhard Karls Universität Tübingen, Tübingen/DE
  • 5Pediatric Oncology, Princess Maxima Center for Pediatric Oncology, Utrecht/NL
  • 6Hôpital De La Timone, Centre Hospitalier, Universitaire, Marseille Universite, Marseille/FR
  • 7Pediatric Hematology Hôpital Robert Debré, CHU Paris, Paris/FR
  • 8Dr. Von Hauner University Children’s Hospital, Ludwig-Maximilians-University Munich, Munich/DE
  • 9Department Of Pediatric Hematology And Immunology, Centre Hospitalier Universitaire, Lyon/FR
  • 10Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco/US
  • 11Pediatric Leukemia Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore/US
  • 12Translational Sciences, Kite Pharma, Santa Monica/US
  • 13Biostatistics, Kite Pharma, Santa Monica/US
  • 14Clinical Development, Kite Pharma, Santa Monica/US

Abstract

Background

ALL is the most common childhood malignancy; up to 20% of pts relapse after initial therapy, and have poor clinical outcomes (Hoffman and Gore. Front Oncol 2014). Promising results were observed with KTE-C19, an anti-CD19 chimeric antigen receptor (CAR) T cell therapy, in B cell malignancies (Locke at al. AACR 2017, #9986). We present preliminary ZUMA-4 phase 1 results.

Methods

Pts aged 2-21 y with R/R ALL and adequate organ function received the planned dose of 1 or 2 × 106 CAR T cells/kg after low-dose conditioning chemotherapy (cyclophosphamide/fludarabine, CyFlu). Pts enrolled after the study’s dose-limiting toxicities (DLTs) portion receive tocilizumab ≤36 h after CAR T cell infusion. Phase 1 primary endpoint is the incidence of DLTs. Secondary endpoints include efficacy and biomarker assessments.

Results

As of Dec 31, 2016, 4 of 5 enrolled pts have been treated; median follow-up, 5.3 mo (1.9-8.6). All pts had ≥2 prior lines of therapy and 1 pt had prior stem cell transplant (SCT). All pts received bridging chemotherapy due to high disease burden (baseline blasts, 41-99%) prior to KTE-C19. KTE-C19 was successfully manufactured in a centralized 6-7 d process across a range of baseline absolute lymphocyte counts (0.5–17.1 × 109/L) and CD4:CD8 ratios (0.1-0.7). KTE-C19 could not be manufactured for 1 pt who progressed with WBC >150,000/µL at apheresis and

Conclusions

KTE-C19 after low-dose CyFlu was tolerable and appears safe for further analysis in pediatric and adolescent pts with R/R ALL. KTE-C19 can induce deep remissions in heavily pre-treated pts with high disease burden. Based on these results, ZUMA-4 continues to enroll (NCT02625480).

Clinical trial identification

NCT02625480

Legal entity responsible for the study

Kite Pharma

Funding

Kite Pharma

Disclosure

D.W. Lee: Honoraria from Juno. A.S. Wayne: Pfizer: Consultancy, Honoraria, advisory board; Kite Pharma: Research Funding, Honoraria, Advisory Board; NIH: Patents; MedImmune: Research Funding; Spectrum Pharmaceuticals: Research Funding; Spectrum: Honoraria, advisory board. R. Handgretinger: Patents and Royalties: Milteny Biotech. J. Rossi, Y. Jiang, L. Navale, S. Stout, J. Aycock: Employment/Stock Ownership: Kite Pharma. A. Mardiros: Employment/Stock Ownership: Kite Pharma; Patents: Mustang Bio. J. Wiezorek: Leadership/Employment/Stock Ownership: Kite Pharma. R. Jain: Patent/Employment/Stock Ownership: Kite Pharma. All other authors have declared no conflicts of interest.