Abstract 29P
Background
Epstein-Barr virus-driven post-transplant lymphoproliferative disease (EBV+ PTLD) is a rare and potentially life-threatening disease in the setting of immunosuppression following solid organ (SOT) or allogeneic hematopoietic cell transplant (HCT). Treatment of relapsed/refractory EBV+ PLTD is inadequate and has poor overall survival, highlighting a clear unmet medical need. Challenges with current therapies include limited efficacy, potential for graft rejection, or graft-vs-host disease (GvHD), and high mortality.
Methods
Tabelecleucel is an off-the-shelf, allogeneic EBV-specific T cell therapy. Here we describe the design of an ongoing multicenter study of tabelecleucel for subjects with EBV+ PTLD after failure of rituximab (R) + chemotherapy (CT) which has recently opened for enrolment in Europe. ALLELE is evaluating the benefit/risk of tabelecleucel in SOT patients following treatment with R or R plus CT (N=33) and in HCT patients following treatment with R (n=33) (NCT03394365). Key inclusion criteria: biopsy-proven EBV+PTLD and failure of R + CT. Tabelecleucel is selected for each patient from an inventory based on an EBV HLA-restricting allele and a second shared allele. During each treatment cycle, tabelecleucel is administered intravenously at a dose of 2x106 cells/kg on days 1, 8, 15, followed by observation through day 35. Responses per radiographic and clinical assessment are evaluated at the end of each cycle using modified Lugano criteria. Patients receive additional treatment cycles until they meet end of treatment criteria. A restriction switch (tabelecleucel with different HLA-restriction) is permitted for patients with stable or progressive disease.
Results
After ending treatment, subjects are assessed quarterly up to 24 months for disease status, and biannually thereafter, up to 5 years, for survival status.
Conclusions
The primary endpoint of the study is overall response rate (ORR), assessed by independent review, following the administration of tabelecleucel.
Clinical trial identification
NCT03394365.
Legal entity responsible for the study
The authors.
Funding
Atara Biotherapeutics.
Disclosure
N. Worel: Advisory/Consultancy, travel support: Celgene BMS; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Sanofi Genzyme; Speaker Bureau/Expert testimony: Novartis; Speaker Bureau/Expert testimony: Kite Gilead; Speaker Bureau/Expert testimony, travel support: Therakos Mallinckrodt. J.A. Perez-Simon: Advisory/Consultancy, Research grant/Funding (self): Novartis; Advisory/Consultancy: Kite; Advisory/Consultancy: Janssen; Advisory/Consultancy: Amgen; Advisory/Consultancy, Research grant/Funding (self): Celgene BMS; Advisory/Consultancy, Research grant/Funding (self): Takeda. P. Barba: Honoraria (self): Amgen; Honoraria (self): Celgene; Honoraria (self): Gilead; Honoraria (self): Jazz Pharamceuticals; Honoraria (self): Novartis; Honoraria (self): Pfizer. D. Dierickx: Advisory/Consultancy: Takeda; Advisory/Consultancy: Atara; Research grant/Funding (self): Roche. M. Hiremath: Honoraria (institution), employee and stockholder of Atara Biotherapeutics: Atara Biotherapeutics. W. Ye: Honoraria (institution), employee and stockholder of Atara Biotherapeutics: Atara Biotherapeutics. L. Gamelin: Honoraria (institution), employee and stockholder of Atara Biotherapeutics: Atara Biotherapeutics. W.H. Navarro: Honoraria (institution), employee and stockholder of Atara Biotherapeutics: Atara Biotherapeutics. S. Choquet: Speaker Bureau/Expert testimony: Atara; Speaker Bureau/Expert testimony: Roche; Speaker Bureau/Expert testimony: Sandoz; Speaker Bureau/Expert testimony: Biogaran; Speaker Bureau/Expert testimony: Accord Healthcare.