A first-in-human phase 1, multicenter, open-label study of CB-012, a next-generation CRISPR-edited allogeneic anti-CLL-1 CAR-T cell therapy for adults with relapsed/refractory acute myeloid leukemia (AMpLify).

Authors

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Naval Guastad Daver

The University of Texas MD Anderson Cancer Institute, Houston, TX

Naval Guastad Daver , Abhishek Maiti , David Andrew Sallman , Gail J. Roboz , Melhem M. Solh , Filippo Milano , Stephen Anthony Strickland , Alireza Eghtedar , Steven Brian Kanner , Guy Ledergor , Donna Marcy , Elizabeth Garner , Brian J. Francica , McKay Shaw , Kalin Bird , Jennifer Rattan , Enrique Zudaire , Socorro Portella , Pankit Vachhani , Jae H. Park

Organizations

The University of Texas MD Anderson Cancer Institute, Houston, TX, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, Weill Cornell Medicine and NewYork-Presbyterian Hospital, New York, NY, The Bone Marrow and Transplant Group of Georgia, Atlanta, GA, Fred Hutchinson Cancer Center, Seattle, WA, SCRI at TriStar Centennial, Nashville, TN, The Colorado Blood Cancer Institute, Denver, CO, Caribou Biosciences, Inc., Berkeley, CA, University of Alabama at Birmingham, Birmingham, AL, Memorial Sloan Kettering Cancer Center, New York, NY

Research Funding

Caribou Biosciences, Inc.

Background: CAR-T cell therapies have shown significant clinical benefit in treating adults with many hematologic malignancies. In acute myeloid leukemia (AML), a challenge in the development of CAR-T cell therapies has been the limitation of suitable target antigens since many are also expressed on hematopoietic stem cells (HSCs). The target antigen C-type lectin-like molecule-1 (CLL-1) has emerged as an attractive therapeutic target due to its expression on AML mature blasts and leukemic stem cells and its absence on HSCs. CB-012 is an allogeneic CAR-T cell therapy that targets CLL-1. CB-012 is derived from healthy donor T cells by using Cas12a CRISPR hybrid RNA-DNA (chRDNA) technology to introduce 5 genome edits: (1) TRAC gene knockout (KO), which eliminates T cell receptor expression to reduce the risk of graft-versus-host disease, (2) site-directed insertion of a fully human anti-CLL-1 CAR into the TRAC locus, (3) KO of PD-1 to enhance antitumor activity by reducing T cell exhaustion, (4) β2-microgobulin (B2M) gene KO, which eliminates HLA class I presentation to mitigate host T cell-mediated rejection, and (5) site-directed insertion of a B2M–HLA-E-peptide fusion into the B2M locus to reduce NK cell-mediated rejection. In murine xenograft models of AML, CB-012 significantly reduced the tumor burden and increased the survival of mice bearing CLL-1+PD-L1+ tumors. Methods: CB-012 is being evaluated in a multicenter, Phase 1 clinical trial in patients with relapsed/refractory (r/r) AML. A 3+3 dose escalation design is being utilized with the primary objectives to determine the safety and tolerability of CB-012 and the recommended Phase 2 dose (RP2D). An expansion phase will follow dose escalation at the recommended dose(s) for expansion. Additional objectives include preliminary antitumor activity and pharmacokinetics. Key inclusion criteria include nonproliferative disease defined as ≤25% blasts in the bone marrow and peripheral blood, ECOG performance status ≤1, and adequate organ function. After receiving lymphodepletion therapy with cyclophosphamide (750 mg/m2/d) and fludarabine (30 mg/m2/d) administered concurrently for 3 days followed by a 2-day break, patients receive a single-dose infusion of CB-012 and are followed for safety and efficacy. The dose escalation portion of the study is actively enrolling patients. The AMpLify trial is registered at clinicaltrials.gov (NCT06128044). Clinical trial information: NCT06128044.

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Abstract Details

Meeting

2024 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Leukemia, Myelodysplastic Syndromes, and Allotransplant

Track

Hematologic Malignancies

Sub Track

Acute Leukemia

Clinical Trial Registration Number

NCT06128044

Citation

J Clin Oncol 42, 2024 (suppl 16; abstr TPS6586)

DOI

10.1200/JCO.2024.42.16_suppl.TPS6586

Abstract #

TPS6586

Poster Bd #

144b

Abstract Disclosures