A CRISPR-edited allogeneic anti-CD19 CAR-T cell therapy with a PD-1 knockout (CB-010) in patients with relapsed/refractory B cell non-Hodgkin lymphoma (r/r B-NHL): Updated phase 1 results from the ANTLER trial.

Authors

Boyu Hu

Boyu Hu

Huntsman Cancer Institute, Salt Lake City, UT

Boyu Hu , Loretta J. Nastoupil , Houston Holmes , Ayad Hamdan , Abraham Kanate , Umar Farooq , Mohamad Cherry , Elizabeth Brem , Lauren C. Pinter-Brown , Daniel Arthur Ermann , Muhammad Husnain , Kenneth Micklethwaite , Syed Rizvi , Ashley Hammad , Ben Thompson , Enrique Zudaire , Socorro Portella , Mehdi Hamadani , James Essell , Susan Mary O'Brien

Organizations

Huntsman Cancer Institute, Salt Lake City, UT, The University of Texas MD Anderson Cancer Institute, Houston, TX, Texas Oncology - Baylor Sammons Cancer Center, Dallas, TX, University of California, San Diego Health, San Diego, CA, HonorHealth, Scottsdale, AZ, University of Iowa Hospitals and Clinics, Iowa City, IA, Morristown Medical Center, Morristown, NJ, University of California, Irvine, Irvine, CA, University of Arizona Cancer Center, Tucson, AZ, New South Wales Health, St Leonards, NSW, Australia, Caribou Biosciences, Inc., Berkeley, CA, Medical College of Wisconsin Cancer Center, Milwaukee, WI, Oncology Hematology Care, Inc., Cincinnati, OH

Research Funding

Caribou Biosciences, Inc.

Background: CB-010 is an allogeneic anti-CD19 CAR-T cell therapy derived from healthy donor T cells using CRISPR hybrid RNA-DNA (chRDNA) technology. This technology is used to introduce 3 genome edits: (1) knockout of TRACto eliminate TCR expression and reduce risk of GvHD, (2) insertion of a CD19-specific CAR (scFv FMC63) into theTRAC locus, and (3) knockout of PD-1 to prevent premature CAR-T cell exhaustion and potentially enhance antitumor activity. Methods: ANTLER is a Phase 1 clinical trial (NCT04637763) with a 3+3 dose escalation phase and a dose expansion phase designed to evaluate safety, tolerability, and antitumor activity of CB-010 in patients (pts) with r/r B-NHL and determine RP2D. In dose escalation, pts must have received ≥2 prior lines of chemoimmunotherapy or had primary refractory disease to 1L therapy. Pts received lymphodepletion with sequential cyclophosphamide (60 mg/kg/day x 2 days) and fludarabine (25 mg/m2/day x 5 days) followed by a single CB-010 infusion. Results: 16 pts with r/r B-NHL (10 LBCL, 3 MCL, 2 FL with POD24, 1 MZL) received CB-010 at 40 x 106 CAR-T cells (dose level 1; N=8), 80 x 106 CAR-T cells (dose level 2; N=5), or 120 x 106 CAR-T cells (dose level 3; N=3) during dose escalation. Median age was 66 years (range 55-82). Median time since first diagnosis was 2.4 years (range 0.2-16.4). Median prior lines of therapy was 2 (range 1-8). CB-010 was generally well tolerated. No GvHD was seen. CRS occurred in 7/16 (44%) pts (no CRS grade ≥3). Median time to CRS onset was 3.5 days and median duration was 3 days. ICANS occurred in 4/16 (25%) pts (13% grade ≥3). Median time to ICANS onset was 7.5 days and median duration was 2 days. The 3 most common TEAEs grade ≥3 were thrombocytopenia (11/16; 69%), neutropenia (9/16; 56%), and anemia (8/16; 50%). One grade 3 infection (antecubital cellulitis) occurred unrelated to CB-010. After a single CB-010 infusion, 15/16 (94%) pts achieved an overall response, 11/16 (69%) achieved a CR, and 7/16 (44%) achieved a CR at ≥6 months. Median time to CR was 28 days. Among LBCL pts (n=10), 9 (90%) achieved an overall response, 7 (70%) achieved a CR, and 5 (50%) achieved a CR at ≥6 months. To date,2 pts have completed the 24-month study period with ongoing CR. Peak expansion of CB-010 occurred at days 7-10 post-infusion. T and NK cells recovered rapidly in peripheral blood (<3 weeks) after lymphodepletion, and B cells remained below the limit of quantification beyond 3 months, supporting specific targeting of B cells by CB-010. Conclusions: CB-010 showed a manageable safety profile and promising efficacy for treatment of pts with r/r B-NHL, including aggressive subtypes. The dose escalation phase is complete. Enrollment of 2L LBCL pts in dose expansion is ongoing. Initial dose expansion data at the CB-010 RP2D and translational data will be presented for the first time at the meeting. Clinical trial information: NCT04637763.

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Abstract Details

Meeting

2024 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Track

Hematologic Malignancies

Sub Track

Cell Therapy, Bispecific Antibodies, and Autologous Stem Cell Transplantation for NHL, HL, or CLL

Clinical Trial Registration Number

NCT04637763

Citation

J Clin Oncol 42, 2024 (suppl 16; abstr 7025)

DOI

10.1200/JCO.2024.42.16_suppl.7025

Abstract #

7025

Poster Bd #

8

Abstract Disclosures