Clinical trial · Interventional
Blinatumomab Expanded T-cells (BET) in Indolent Non-Hodgkin Lymphomas/Chronic Lymphocytic Leukemia
Immune Reconstitution With Blinatumomab Expanded T-cells (BET) After First-line Treatment With Fludarabine-Cyclophosphamide-Rituximab or Bendamustine-Rituximab in CD20+ Indolent Non-Hodgkin Lymphomas/Chronic Lymphocytic Leukemia: a Phase I Study
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Non-Hodgkin CD20 + Indolent Lymphoma (iNHL) and Chronic Lymphatic Leukemia (CLL) are the most frequent neoplasms of B lymphocytes. They include various histologies (follicular NHL, marginal zone NHL and Lymphocytic NHL/ CLL) characterized by a chronic course and prolonged survival, but while patients with a limited disease could be cured, those with advanced disease or relapsed after localized radiation therapy are generally considered untreatable through standard treatments. The options for first-line therapy include the use of the FCR scheme, based on Fludarabine, Cyclophosphamide and Rituximab or the BR, with Bendamustine and Rituximab. Despite good results, treatment with these two regimens (FCR or BR) is associated with severe immunosuppression which worsens the immunological dysfunction already present at diagnosis in several patients. It has been shown previously that the adoptive transfer of ex vivo anti-CD3/CD28 co-stimulated autologous T cells can successfully accelerate a robust early recovery of T cells after autologous transplantation in multiple myeloma. These CD3/CD28 expanded T cells cannot however be used in NHLi and CLL due to the presence of contaminating tumor cells in the preparation. Polyclonal T cells can also be expanded in vitro in presence of Blinatumomab and recombinant human IL2 (rhIL2) and have been called BET (Blinatumomab-expanded T cells). They are a product of Advanced Therapeutic Medicinal Product (ATMP) composed of polyclonal CD8 and CD4 T cells that are still functional and devoid of contaminating CD19+ neoplastic cells. Based on these data, it was hypothesized that infusion of BET in patients with iNHL/CLL, after the first treatment line (with FCR or BR), could induce adequate immunological recovery.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Indolent Non-Hodgkin Lymphomas/Chronic Lymphocytic Leukemia | — | UNRESOLVED | — |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Blinatumomab Expanded T-cells (BET) | Biological | — | UNRESOLVED |
Design
Arms and outcomes
Arms (1)
- type
- EXPERIMENTAL
- label
- Indolent NHL or CLL patients
- description
- Adults diagnosed with indolent non-Hodgkin lymphomas (iNHL) or chronic lymphocytic leukemia (CLL) in need of first line treatment consisting of either FCR or BR as per investigator assessment
- interventionNames
- Biological: Blinatumomab Expanded T-cells (BET)
Primary outcomes (1)
- measure
- Number of grade 3 or 4 adverse events (AE) possibly related to therapy
- timeFrame
- The period of observation is during 14 days after BET infusion
- description
- Description and grading of all adverse events will be based on the NCI -CTCAE v4.03 and MedDra code (current version).
Secondary outcomes (4)
- measure
- Number of Adverse event (AE) and laboratory abnormalities.
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: * 1\. Male or female patients 18 years or older 2. Confirmed diagnosis of the following CD20+ iNHL or CLL according to (World Health Organization ) WHO criteria: * Follicular NHL * Marginal zone NHL (splenic, extranodal or nodal) * Lymphocytic lymphoma/CLL without del(17p) or TP53 mutations 3. No previous chemotherapy. Previous radiotherapy for localized disease is admitted 4. Requirement for treatment: * For CLL, active disease is defined as meeting at least one of the International Workshop on CLL guidelines (Hallek et al., 2008) * For iNHL, active disease is defined as meeting at least one of the Groupe d'Etudes des Lymphomes Folliculaires (GELF) criteria (Brice et al., 1997) 5. Indication to treatment with either fludarabine, cyclophosphamide and rituximab or bendamustine and rituximab 6. Presence of peripheral blood clone ≥10% of total lymphocytes (with absolute lymphocyte count \>800 x106/L) at study entrance 7. Written informed consent prior to any study procedures being performed Additional inclusion criteria to be met at study entry (i.e. before BET infusion): 8\. Achieving at least a partial response after three chemo-immunotherapy cycles 9. Absence of any serious therapy-related complications that might affect interpretation of the results of the study or render the subject at high risk from treatment complications 10. Production of adequate BET numbers (counted on CD3+ cells: ≥0.5 x 109) 11. For female patients: 1. being postmenopausal for at least 1 year before the screening visit, OR 2. being surgically sterile, OR 3. if they are of childbearing potential, must agree to practice highly effective method of contraception and one additional effective (barrier) method from the time of signing the informed consent until the end of study. Highly effective method of contraception includes: (i) combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation: oral, intravaginal, transdermal; (ii) progestogen-only hormonal contraception associated with inhibition of ovulation: oral, injectable, implantable (intrauterine device (IUD), intrauterine hormone-releasing system (IUS), bilateral tubal occlusion, vasectomized partner, sexual abstinence) OR 4. must agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject from the time of signing the informed consent until the end of study. \[Periodic abstinence (eg, calendar, ovulation, symptothermal, postovulation methods), withdrawal, spermicides only, and lactational amenorrhea are not acceptable methods of contraception. Female and male condoms should not be used together.\] For male patients, even if surgically sterilized (i.e., status postvasectomy): 1. with female partners of childbearing potential: must agree to practice barrier contraception (condom with or without spermicide) from the time of signing the informed consent until the end of study and his female partner must agree to practice method of contraception including one of the following: estrogen and progestogen containing hormonal contraception; inhibition of ovulation: oral, intravaginal, transdermal; progestogen-only hormonal contraception associated with inhibition of ovulation: oral, injectable, implantable (intrauterine device (IUD), intrauterine hormone-releasing system (IUS), bilateral tubal occlusion) from the time of signing the informed consent until the end of study. 2. must agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject from the time of signing the informed consent until the end of study. \[Periodic abstinence (eg, calendar, ovulation, symptothermal, postovulation methods), withdrawal, spermicides only, and lactational amenorrhea are not acceptable methods of contraception. Female and male condoms should not be used together.\] 3. must agree to refrain from donating sperm Exclusion Criteria: 1. ECOG (Eastern Cooperative Oncology Group) Performance Status \>2 2. Active central nervous system (CNS) disease 3. Calculated creatinine clearance (by Cockroft-Gault) of \< 50 ml/min or serum creatinine \> 1.5x ULN (Upper Limit of Normal ) 4. Concomitant or previous diagnosis of autoimmune hemolytic anemia or thrombocytopenia 5. Subjects with active, known or suspected autoimmune disease. Subjects with vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition requiring the sole hormone replacement are allowed to participate. Psoriasis requiring systemic treatment, or conditions expected to recur at the presence of an external trigger are excluded. 6. Known infection with human immunodeficiency virus (HIV) or treponema 7. Active hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infections 8. Any suspected or known active infection 9. History of other diseases, metabolic dysfunctions, physical examination findings, or clinical laboratory findings giving reasonable suspicion of a disease or condition that contraindicates use of an investigational drug or that might affect interpretation of the results of the study or render the subject at high risk from treatment complications 10. Residual CD19+ B cells in BET final cell product ≥0.5%
References
Publications (31)
- BACKGROUNDArdeshna KM, Smith P, Norton A, Hancock BW, Hoskin PJ, MacLennan KA, Marcus RE, Jelliffe A, Vaughan G, Hudson, Linch DC; British National Lymphoma Investigation. Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advanced-stage non-Hodgkin lymphoma: a randomised controlled trial. Lancet. 2003 Aug 16;362(9383):516-22. doi: 10.1016/s0140-6736(03)14110-4. PMID 12932382
- BACKGROUNDBerdeja JG, Hess A, Lucas DM, O'Donnell P, Ambinder RF, Diehl LF, Carter-Brookins D, Newton S, Flinn IW. Systemic interleukin-2 and adoptive transfer of lymphokine-activated killer cells improves antibody-dependent cellular cytotoxicity in patients with relapsed B-cell lymphoma treated with rituximab. Clin Cancer Res. 2007 Apr 15;13(8):2392-9. doi: 10.1158/1078-0432.CCR-06-1860. PMID 17438098
- BACKGROUNDBomberger C, Singh-Jairam M, Rodey G, Guerriero A, Yeager AM, Fleming WH, Holland HK, Waller EK. Lymphoid reconstitution after autologous PBSC transplantation with FACS-sorted CD34+ hematopoietic progenitors. Blood. 1998 Apr 1;91(7):2588-600. PMID 9516161
- BACKGROUNDBrice P, Bastion Y, Lepage E, Brousse N, Haioun C, Moreau P, Straetmans N, Tilly H, Tabah I, Solal-Celigny P. Comparison in low-tumor-burden follicular lymphomas between an initial no-treatment policy, prednimustine, or interferon alfa: a randomized study from the Groupe d'Etude des Lymphomes Folliculaires. Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 1997 Mar;15(3):1110-7. doi: 10.1200/JCO.1997.15.3.1110. PMID 9060552
- BACKGROUNDCheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, Lister TA; Alliance, Australasian Leukaemia and Lymphoma Group; Eastern Cooperative Oncology Group; European Mantle Cell Lymphoma Consortium; Italian Lymphoma Foundation; European Organisation for Research; Treatment of Cancer/Dutch Hemato-Oncology Group; Grupo Espanol de Medula Osea; German High-Grade Lymphoma Study Group; German Hodgkin's Study Group; Japanese Lymphorra Study Group; Lymphoma Study Association; NCIC Clinical Trials Group; Nordic Lymphoma Study Group; Southwest Oncology Group; United Kingdom National Cancer Research Institute. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014 Sep 20;32(27):3059-68. doi: 10.1200/JCO.2013.54.8800.