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History of Changes for Study: NCT03876769
Study of Efficacy and Safety of Tisagenlecleucel in HR B-ALL EOC MRD Positive Patients (CASSIOPEIA)
Latest version (submitted May 2, 2024) on ClinicalTrials.gov
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Study Record Versions
Version A B Submitted Date Changes
1 March 12, 2019 None (earliest Version on record)
2 March 26, 2019 Recruitment Status, Study Status and Contacts/Locations
3 April 14, 2019 Study Status and Contacts/Locations
4 May 6, 2019 Study Status and Contacts/Locations
5 May 14, 2019 Recruitment Status, Study Status and Contacts/Locations
6 June 26, 2019 Recruitment Status, Study Status, Contacts/Locations and IPDSharing
7 June 28, 2019 Contacts/Locations and Study Status
8 July 8, 2019 Study Status and Contacts/Locations
9 July 18, 2019 Contacts/Locations and Study Status
10 August 5, 2019 Study Status and Contacts/Locations
11 September 2, 2019 Study Status and Contacts/Locations
12 September 23, 2019 Contacts/Locations and Study Status
13 October 4, 2019 Study Status and Contacts/Locations
14 October 16, 2019 Contacts/Locations and Study Status
15 October 31, 2019 Contacts/Locations, Study Status and Study Identification
16 November 4, 2019 Contacts/Locations and Study Status
17 November 25, 2019 Contacts/Locations and Study Status
18 November 27, 2019 Contacts/Locations and Study Status
19 January 9, 2020 Contacts/Locations and Study Status
20 January 24, 2020 Contacts/Locations and Study Status
21 February 6, 2020 Contacts/Locations and Study Status
22 April 14, 2020 Study Status, Contacts/Locations, Eligibility and Study Description
23 April 17, 2020 Contacts/Locations and Study Status
24 June 5, 2020 Contacts/Locations and Study Status
25 June 11, 2020 Study Status and Contacts/Locations
26 June 17, 2020 Contacts/Locations and Study Status
27 July 17, 2020 Study Status and Contacts/Locations
28 July 27, 2020 Study Status and Contacts/Locations
29 August 19, 2020 Study Status and Contacts/Locations
30 August 27, 2020 Contacts/Locations and Study Status
31 September 15, 2020 Study Status and Contacts/Locations
32 September 25, 2020 Contacts/Locations and Study Status
33 October 18, 2020 Contacts/Locations and Study Status
34 October 23, 2020 Contacts/Locations and Study Status
35 November 11, 2020 Study Status and Contacts/Locations
36 November 24, 2020 Contacts/Locations and Study Status
37 December 3, 2020 Contacts/Locations and Study Status
38 December 15, 2020 Contacts/Locations and Study Status
39 December 22, 2020 Contacts/Locations and Study Status
40 January 14, 2021 Contacts/Locations and Study Status
41 January 24, 2021 Contacts/Locations and Study Status
42 February 10, 2021 Study Status and Contacts/Locations
43 April 5, 2021 Recruitment Status, Study Status and Contacts/Locations
44 May 26, 2021 Recruitment Status, Study Status and Contacts/Locations
45 July 29, 2021 Contacts/Locations and Study Status
46 September 2, 2021 Study Status and Contacts/Locations
47 September 21, 2021 Contacts/Locations and Study Status
48 September 29, 2021 Study Status and Contacts/Locations
49 October 4, 2021 Study Status and Contacts/Locations
50 October 11, 2021 Contacts/Locations and Study Status
51 November 5, 2021 Contacts/Locations and Study Status
52 January 10, 2022 Contacts/Locations and Study Status
53 February 18, 2022 Contacts/Locations and Study Status
54 March 31, 2022 Study Status and Contacts/Locations
55 April 25, 2022 Contacts/Locations and Study Status
56 April 28, 2022 Contacts/Locations and Study Status
57 May 23, 2022 Contacts/Locations and Study Status
58 May 25, 2022 Contacts/Locations and Study Status
59 October 1, 2022 Study Status and Contacts/Locations
60 October 31, 2022 Contacts/Locations and Study Status
61 February 15, 2023 Contacts/Locations and Study Status
62 April 6, 2023 Contacts/Locations and Study Status
63 July 11, 2023 Contacts/Locations, Outcome Measures, Study Status, Study Design and Study Description
64 July 14, 2023 Study Status and Contacts/Locations
65 September 11, 2023 Contacts/Locations and Study Status
66 January 1, 2024 Study Status and Contacts/Locations
67 February 14, 2024 Contacts/Locations and Study Status
68 March 12, 2024 Contacts/Locations and Study Status
69 March 21, 2024 Contacts/Locations and Study Status
70 March 22, 2024 Contacts/Locations and Study Status
71 May 2, 2024 Contacts/Locations and Study Status
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Study NCT03876769
Submitted Date:  March 12, 2019 (v1)

Open or close this module Study Identification
Unique Protocol ID: CCTL019G2201J
Brief Title: Study of Efficacy and Safety of Tisagenlecleucel in HR B-ALL EOC MRD Positive Patients (CASSIOPEIA)
Official Title: A Phase II Trial of Tisagenlecleucel in First-line High-risk (HR) Pediatric and Young Adult Patients With B-cell Acute Lymphoblastic Leukemia (B-ALL) Who Are Minimal Residual Disease (MRD) Positive at the End of Consolidation (EOC) Therapy
Secondary IDs:
Open or close this module Study Status
Record Verification: March 2019
Overall Status: Not yet recruiting
Study Start: March 22, 2019
Primary Completion: November 26, 2026 [Anticipated]
Study Completion: May 20, 2027 [Anticipated]
First Submitted: November 12, 2018
First Submitted that
Met QC Criteria:
March 12, 2019
First Posted: March 15, 2019 [Actual]
Last Update Submitted that
Met QC Criteria:
March 12, 2019
Last Update Posted: March 15, 2019 [Actual]
Open or close this module Sponsor/Collaborators
Sponsor: Novartis Pharmaceuticals
Responsible Party: Sponsor
Collaborators: Children's Oncology Group
Open or close this module Oversight
U.S. FDA-regulated Drug: Yes
U.S. FDA-regulated Device: No
Data Monitoring: Yes
Open or close this module Study Description
Brief Summary: This is a single arm, open-label, multi-center, phase II study to determine the efficacy and safety of tisagenlecleucel in de novo HR pediatric and young adult B-ALL patients who received first-line treatment and are EOC MRD positive. The study will have the following sequential phases: screening, pre-treatment, treatment & follow-up, and survival. After tisagenlecleucel infusion, efficacy will be assessed at Day 29, then every 3 months for the first year, every 6 months for the second year, then yearly until the end of the study. Safety will be assessed throughout the study. The study is expected to end in approximately 8 years after first patient first treatment (FPFT). A post-study long term follow-up for lentiviral vector safety will continue under a separate protocol per health authority guidelines.
Detailed Description:
Open or close this module Conditions
Conditions: B-Cell Acute Lymphoblastic Leukemia
Keywords: CTL019
Kymriah
B-Cell Acute Lymphoblastic Leukemia
ALL
tisagenlecleucel
HR B-ALL EOC MRD
Minimal Residual Disease (MRD)
Positive at the End of Consolidation (EOC)
Open or close this module Study Design
Study Type: Interventional
Primary Purpose: Treatment
Study Phase: Phase 2
Interventional Study Model: Single Group Assignment
Number of Arms: 1
Masking: None (Open Label)
Allocation: N/A
Enrollment: 140 [Anticipated]
Open or close this module Arms and Interventions
Arms Assigned Interventions
Experimental: Single dose of CTL019

Based on the subject's weight one of two possible dose ranges will be prepared for the subject:

Subjects ≤ 50 kg: 0.2 to 5.0 x 10(6) CAR-positive viable T cells per kg body weight

OR

Subjects > 50 kg: 0.1 to 2.5 x 10(8) CAR-positive viable T cells

Biological: CTL019

Based on the subject's weight, one of two possible dose ranges will be prepared for the subject:

Subjects ≤ 50 kg: 0.2 to 5.0 x 10(6) CAR-positive viable T cells per kg body weight

OR

Subjects > 50 kg: 0.1 to 2.5 x 10(8) CAR-positive viable T cells

Open or close this module Outcome Measures
Primary Outcome Measures:
1. Disease Free Survival (DFS) rate
[ Time Frame: 5 years after tisagenlecleucel infusion ]

DFS is defined as the time from the date of tisagenlecleucel infusion to the date of the first documented morphological relapse, occurrence of secondary malignancy or death due to any cause.
Secondary Outcome Measures:
1. Percentage of participants who are disease free without allogeneic stem cell transplant (SCT)
[ Time Frame: 12 months after last infusion ]

Minimal Residual Disease (MRD) negative remission (complete remission (CR) or Complete remission with incomplete blood count recovery CRi)) at Month 12 without SCT after tisagenlecleucel infusion.
2. Overall Survival
[ Time Frame: 8 years ]

Time from tisagenlecleucel infusion to the death due to any cause
3. Percentage of participants achieving MRD negative CR or CRi at Month 3
[ Time Frame: 3 months after the tisagenlecleucel infusion. ]

MRD negative status as determined by central laboratory using multi-parameter flow cytometry
4. Percentage of participants with in CR or CRi with persistent B-cell aplasia over time post tisagenlecleucel infusion
[ Time Frame: 8 years ]

Absolute lymphocyte CD19 count of >50/uL
5. Percentage of participants who have tisagenlecleucel product successfully manufactured over the total number of subjects enrolled for the age ≥1 year and < 3 years
[ Time Frame: 8 years ]

Success in manufacturing of tisagenlecleucel dose for patients who are ≥1 year and <3 years as respective time points.
6. Pediatric Quality of Life (PedsQL)
[ Time Frame: 5 years ]

Patient reported outcome to assess quality of life in patients aged 8 and above. The 23 items PedQL (Pediatrics Quality of Life Inventory) measure core dimensions of health as delineated by the World Health Organization, as well as role (school) functioning.

Items measured include 1) Physical Functioning (8 items), 2) Emotional Functioning (5 items), 3) Social Functioning (5 items), and 4) School Functioning (5 items).

Each item is measured on a 5 point Likert scale with 0 indicating "never" and 4 indicating "almost always".

The Likert scores are reversed scored and linearly transform to a 0-100 scale with 0=100, 1-75, 2=50, 5=25, and 4=0. A higher score indicates better health-related quality of life (HRQoL).

7. European Quality of Life 5 dimensions (EQ-5D-3L & EQ-5D-Y))
[ Time Frame: 5 years ]

Patient reported outcome to assess health status in patients aged 8 and above. The EQ-5D (European Quality of Life -5 Dimensions) measures a wide range of health conditions and treatments; it is composed of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and a visual analogue scale (EQ-visual analogue scale [EQ-VAS]) that records the patient's self-rated overall health state.

Respondents rate each of these 5 dimensions from "no problem", "some problem," or "extreme problem".

The EQ-VAS records the respondents' self-related health on a vertical, visual analogue scale. The range for EQ-VAS is from 0 (=the worst health you can imagine) to 100 (=the best health you can imagine).

8. Impact of tisagenlecleucel on cognitive functioning using Computerized neurocognitive assessment: Detection test
[ Time Frame: 5 years ]

Speed of performance (mean of the log10 transformed reaction times for correct responses)
9. Impact of tisagenlecleucel on cognitive functioning usingComputerized neurocognitive assessment: Identification test
[ Time Frame: 5 years ]

This test measures the speed of performance (mean of the log10 transformed reaction times for correct responses)
10. Impact of tisagenlecleucel on cognitive functioning using Computerized neurocognitive assessment: Groton Maze Learning test
[ Time Frame: 5 years ]

This test looks at the total number of errors made in attempting to learn the hidden pathways during a single session.
11. Impact of tisagenlecleucel on cognitive functioning using Computerized neurocognitive assessment: One Back test
[ Time Frame: 5 years ]

This test measures the accuracy of performance (arcsine transformation of the square root of the percentage of correct responses). The test also measures the speed of performance (mean of the log10 transformed reaction times for correct responses).
12. Impact of tisagenlecleucel on cognitive functioning usingComputerized neurocognitive assessment: One card learning test
[ Time Frame: 5 years ]

This test measures the accuracy of performance (arcsine transformation of the square root of the proportion of correct responses).
13. Percentage of participants with pre-existing antibodies
[ Time Frame: 8 years ]

Prevalence of immunogenicity
14. Percentage of participants with anti-m CAR19 antibodies post infusion with tisagenlecleucel and % of patients without measureable anti-mCAR19 antibodies
[ Time Frame: 8 years ]

Incidence of immunogenicity
15. Percentage of patients that have measureable anti-mCAR19 antibodies above patient specific cut-point (reported as a %) pre and post tisagenlecleucel infusion categorized by Day 28 response
[ Time Frame: 8 years ]

Impact of immunogenicity on clinical response
16. tisagenlecleucel transgene concentration
[ Time Frame: 8 years ]

Transgene concentration as detected by qPCR in target tissue
17. Expression of tisagenlecleucel
[ Time Frame: 8 years ]

Summary of tisagenlecleucel CAR-positive viable T cells measured by flow cytometry in target tissue
18. Persistence of CAR (reported as copies/ug) categorized by the time to B-cell recovery (recovery < 3 months, >3 months to < 6months, > 6 months)
[ Time Frame: 8 years ]

Relationship between B-cell recovery and transgene levels
19. Cmax; cellular kinetic parameter of tisagenlecleucel
[ Time Frame: 8 years ]

The maximum (peak) observed in peripheral blood or other body fluid drug concentration after single dose administration (% or copies/μg)
20. Tmax; cellular kinetic parameter of tisagenlecleucel
[ Time Frame: 8 years ]

The time to reach maximum (peak) peripheral blood or other body fluid drug concentration after single dose administration (days)
21. AUC0-29d and 84d; cellular kinetic parameter of tisagenlecleucel
[ Time Frame: 8 years ]

The AUC from time zero to day 29 and 84 or other disease assessment days, in peripheral blood (% or copies/μg x days )
22. AUC0-Tmax; cellular kinetic parameter of tisagenlecleucel
[ Time Frame: 8 years ]

The AUC from time zero to Tmax in peripheral blood (% or copies/μg x days)
23. T1/2; cellular kinetic parameter of tisagenlecleucel
[ Time Frame: 8 years ]

The half-life associated with the elimination phase slope of a semi logarithmic concentration-time curve (days) in peripheral blood
24. Clast; cellular kinetic parameter of tisagenlecleucel
[ Time Frame: 8 years ]

The last observed quantifiable concentration in peripheral blood (% or copies/μg)
25. Tlast; cellular kinetic parameter of tisagenlecleucel
[ Time Frame: 8 years ]

The time of last observed quantifiable concentration in peripheral blood (days)
26. Impact of tisagenlecleucel dose on day 29 response
[ Time Frame: 8 years ]

Clinical response summarized by quartile of administered doses
27. AUC 0 - 29d; cellular kinetic parameter of tisagenlecleucel
[ Time Frame: Day 29 ]

Impact of tisagenlecleucel exposure on day 29 response; The AUC from time zero to day 29 in peripheral blood (% or copies/μg x days )
28. Cmax: cellular kinetic parameter of tisagenlecleucel
[ Time Frame: Day 29 ]

Impact of tisagenlecleucel exposure on day 29 response; The maximum (peak) observed in peripheral blood or other body fluid drug concentration after single dose administration (% or copies/μg)
29. Tmax: cellular kinetic parameter of tisagenlecleucel
[ Time Frame: Day 29 ]

Impact of tisagenlecleucel exposure on day 29 response; The time to reach maximum (peak) peripheral blood or other body fluid drug concentration after single dose administration (days)
30. T1/2: cellular kinetic parameter of tisagenlecleucel
[ Time Frame: Day 29 ]

Impact of tisagenlecleucel exposure on day 29 response; The half-life associated with the elimination phase slope of a semi logarithmic concentration-time curve (days) in peripheral blood
Open or close this module Eligibility
Minimum Age: 1 Year
Maximum Age: 25 Years
Sex: All
Gender Based:
Accepts Healthy Volunteers: No
Criteria:

Inclusion Criteria:

  1. CD19 expressing B-cell Acute Lymphoblastic Leukemia
  2. De novo NCI HR B-ALL who received first-line treatment and are MRD ≥ 0.01% at EOC. EOC bone marrow MRD will be collected prior to screening and will be assessed by multi-parameter flow cytometry using central laboratory analysis.
  3. Age 1 to 25 years at the time of screening
  4. Lansky (age < 16 years) or Karnofsky (age ≥ 16 years) performance status ≥ 60%
  5. Adequate organ function during the screening period:

    A. Renal function based on age/gender B. ALT ≤ 5 times ULN for age C. AST ≤ 5 times ULN for age D. Total bilirubin < 2 mg/dL (for Gilbert's Syndrome subjects total bilirubin < 4 mg/dL)

    E. Adequate pulmonary function defined as:

    • no or mild dyspnea (≤ Grade 1)
    • oxygen saturation of > 90% on room air F. Adequate cardiac function defined as LVSF ≥ 28% confirmed by echocardiogram or LVEF ≥ 45% confirmed by echocardiogram or MUGA within 6 weeks of screening
  6. Prior induction and consolidation chemotherapy allowed: 1st line subjects: ≤ 3 blocks of standard chemotherapy for first-line B-ALL, defined as 4-drug induction, augmented Berlin-Frankfurt-Münster (BFM) consolidation, and interim maintenance with high-dose methotrexate.

Exclusion Criteria:

  1. M3 marrow at the completion of 1st line induction therapy
  2. M2 or M3 marrow or persistent extramedullary disease at the completion of first-line consolidation therapy. Patients with previous CNS disease are eligible if there is no active CNS involvement of leukemia at the time of enrollment.
  3. Philadelphia chromosome positive ALL
  4. Hypodiploid: less than 44 chromosomes and/or DNA index < 0.81, or other clear evidence of a hypodiploid clone
  5. Prior tyrosine kinase inhibitor therapy
  6. Subjects with concomitant genetic syndromes associated with bone marrow failure states: such as subjects with Fanconi anemia, Kostmann syndrome, Shwachman syndrome or any other known bone marrow failure syndrome. Subjects with Down syndrome will not be excluded.
  7. Subjects with Burkitt's lymphoma/leukemia (i.e. subjects with mature B-ALL, leukemia with B-cell [sIg positive and kappa or lambda restricted positivity] ALL, with FAB L3 morphology and /or a MYC translocation)
  8. Has had treatment with any prior anti-CD19 therapy 9. Treatment with any prior gene or engineered T cell therapy

Other protocol-defined inclusion/exclusion may apply.

Open or close this module Contacts/Locations
Central Contact Person: Novartis Pharmaceuticals
Telephone: 1-888-669-6682
Email: novartis.email@novartis.com
Central Contact Backup: Novartis Pharmaceuticals
Telephone: +41613241111
Study Officials: Novartis Pharmaceuticals
Study Director
Novartis Pharmaceuticals
Locations:
Open or close this module IPDSharing
Plan to Share IPD: Undecided

Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent expert panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.

This trial data is currently available according to the process described on www.clinicalstudydatarequest.com.

Open or close this module References
Links:
Available IPD/Information:

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U.S. National Library of Medicine | U.S. National Institutes of Health | U.S. Department of Health & Human Services