A multicenter, open-label expanded access protocol for the treatment of subjects withrelapsed/refractory large B-cell lymphoma.Subjects who received an infusion of axicabtagene ciloleucel will complete the remainderof the 15 year follow-up assessments in a separate long-term follow-up study,KT-US-982-5968
Biological: Axicabtagene Ciloleucel
Axicabtagene Ciloleucel and A conditioning chemotherapy regimen of fludarabine and
cyclophosphamide will be administered followed by a single infusion of CAR transduced
autologous T cells administered intravenously.
Other Name: Yescarta®
Inclusion Criteria:
1. Histologically confirmed large B-cell lymphoma, including the following types:
1. DLBCL, not otherwise specified
2. Primary mediastinal large B-cell lymphoma
3. High-grade B-cell lymphoma
4. DLBCL arising from follicular lymphoma (transformed follicular lymphoma, or
TFL)
2. Relapsed or refractory disease, defined as one or more of the following:
1. No response to first-line therapy (primary refractory disease); subjects who
are intolerant to first-line therapy chemotherapy are excluded OR
2. No response or relapse to second or greater lines of therapy OR
3. Relapsed after ASCT
3. Subjects must have received adequate prior therapy including at a minimum:
1. anti-CD20 monoclonal antibody unless investigator determines that tumor is CD20
negative, and
2. an anthracycline containing chemotherapy regimen;
4. No evidence, suspicion, and/or history of central nervous system (CNS) involvement
of lymphoma
5. Age 18 or older
6. Eastern cooperative oncology group (ECOG) performance status of 0 or 1
7. Absolute neutrophil count ANC ≥1000/μL
8. Platelet count ≥75,000/μL
9. Absolute lymphocyte count ≥100/μL
10. Adequate renal, hepatic, pulmonary and cardiac function defined as:
1. Creatinine clearance (as estimated by Cockcroft Gault) ≥ 60 mL/min
2. Serum alanine aminotransferase/aspartate aminotransferase (ALT/AST) ≤2.5 upper
limit of normal (ULN)
3. Total bilirubin ≤1.5 mg/dL, except in subjects with Gilbert's syndrome.
4. Cardiac ejection fraction ≥ 50% and no evidence of pericardial effusion within
180 days provide the subject did not receive an anthracycline based treatment
or experience a cardiac event or change in performance status
5. No clinically significant pleural effusion
6. Baseline oxygen saturation >92% on room air
11. Cohort 2 inclusion criteria: Subjects whose commercial manufacture of axicabtagene
ciloleucel did not meet commercial release specification(s)
Exclusion Criteria:
1. History of malignancy other than nonmelanoma skin cancer or carcinoma in situ (e.g.
cervix, bladder, breast) or follicular lymphoma unless disease free for at least 3
years
2. History of allogeneic stem cell transplantation (SCT)
3. Prior CD19 targeted therapy
4. Prior chimeric antigen receptor therapy or other genetically modified T-cell therapy
5. History of severe, immediate hypersensitivity reaction attributed to aminoglycosides
6. Presence or suspicion of fungal, bacterial, viral, or other infection that is
uncontrolled or requiring intravenous (IV) antimicrobials for management. Simple
urinary tract infection (UTI) and uncomplicated bacterial pharyngitis are permitted
if responding to active treatment and after consultation with the Kite Pharma
Medical Monitor
7. History of human immunodeficiency virus (HIV) infection or acute or chronic active
hepatitis B or hepatitis C infection. Subjects with a history of hepatitis infection
must have cleared their infection as determined by standard serological and genetic
testing per current Infectious Diseases Society of America (IDSA) guidelines
8. History or presence of primary CNS lymphoma and/or CNS disorder such as seizure
disorder, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, or any
autoimmune disease with CNS involvement
9. Cohort 2 exclusion criteria: Any medical condition that, deemed by the investigator,
may interfere with assessment of safety or efficacy of study treatment
City of Hope
Duarte, California, United States
Stanford Cancer Institute
Stanford, California, United States
University of Miami Hospital and Clinics
Miami, Florida, United States
H. Lee Moffitt Cancer and Research Institute
Tampa, Florida, United States
University of Chicago Medical Center
Chicago, Illinois, United States
The University of Kansas Hospital Investigational Drug Services
Westwood, Kansas, United States
Dana-Farber Cancer Institute
Boston, Massachusetts, United States
Mayo Clinic
Rochester, Minnesota, United States
University of Nebraska Medical Center
Omaha, Nebraska, United States
Roswell Park Cancer Institute
Buffalo, New York, United States
Memorial Sloan Kettering Cancer Center
New York, New York, United States
Cleveland Clinic
Cleveland, Ohio, United States
James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive Cancer Center
Columbus, Ohio, United States
The University of Texas MD Anderson Cancer Center
Houston, Texas, United States
University of Washington Medical Center
Seattle, Washington, United States
Kite Study Director, Study Director
Kite, A Gilead Company