CAP-100 for Subjects With Relapsed/Refractory Chronic Lymphocytic Leukemia

Trial statusRecruiting
Trial phasePhase 1
Trial typeInterventional
Biological sexAll
Age18+
SponsorCatapult Therapeutics

About this trial

Introduction of immuno-chemotherapy in the treatment options of CLL and SLL changed the treatment paradigm of these diseases. Presently, first-line therapies for CLL/SLL include targeted therapies (e.g. ibrutinib, acalabrutinib) or combined immuno-chemotherapy regimens (e.g., fludarabine, cyclophosphamide, and rituximab for patients aged \<65 years without del17p/TP53 mutations or bendamustine and rituximab for patients ≥65 years who have additional comorbidities).

Despite the gradual introduction of targeted therapies, new treatment strategies efficacious for patients ineligible for/unresponsive to these therapies are still required. These new strategies should ideally overcome disease relapse and circumvent compound-specific safety challenges. Emerging treatment options include new compounds aimed for both untreated and relapsed/refractory CLL, and combination therapies of existing compounds that extend single-agent efficacy in specific high-risk patient populations.

CAP-100 is expected to prevent the migration of leukemia cells to and their survival in lymphoid niches as well as to eliminate CCR7-positive leukemia cells via ADCC, resulting in measurable clinical responses.

The present trial is the first-in-human trial of CAP-100 and is divided into two phases. The aim of the Phase Ia (dose escalation) is to define the Recommended Phase 2 Dose (RP2D) versus the Maximum Tolerated Dose (MTD) of CAP-100 in subjects with CLL.

Phase Ib of the trial (expansion phase) will evaluate the safety and preliminary clinical benefit of CAP-100 monotherapy at RP2D (response rate, lymph node size reduction, assessment of minimal residual disease \[MRD\]) to support the design of future trials investigating CAP-100 either as monotherapy or in a combination setting with approved treatments for CLL.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age ≥ 18 years.

Able to understand and sign a written informed consent document.

Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2.

Relapsed or refractory to at least two (2) prior standard systemic treatment regimen for CLL or SLL (USA).

Disqualifiers

Allogeneic stem-cell transplantation within 6 months of trial entry.

Monoclonal antibody for anti-cancer therapy within 4 weeks of trial entry.

Side effects due to prior therapy not recovered to ≤Grade 1.

Oral targeted inhibitors (Bruton's tyrosine kinase [BTK]-inhibitors, B-cell lymphoma 2 [BCL-2] inhibitors, phosphoinositide 3-kinase [PI3K] inhibitors) within five times their half-life.

Trial design

Design model

Sequential

Treatments tested in this trial

  • CAP-100

    Drug

    CAP-100 (humanized antibody against C-C-chemokine receptor 7 \[CCR\]7)

Treatment groups

18 Participants
are divided into 2 treatment groups
Group A: Experimental: Phase Ia - Dose escalationExperimental treatment 1 intervention
Group B: Experimental: Phase Ib - Dose expansionExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Incidence of treatment emergent adverse effects at increasing doses of CAP-100 (safety and tolerability)

The incidence of Grade 3 and Grade 4 AEs related to CAP-100 administration according to the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0 for non-hematological AEs. The incidence and severity of hematological AEs related to CAP-100 treatment according to CLL international working group criteria (iwCLL, Hallek et al, 2018).

Time frame
28 Days
2

Incidence of treatment emergent adverse effects of CAP-100 at RP2D in an expanded cohort (safety and tolerability)

The incidence of Grade 3 and Grade 4 AEs related to CAP-100 administration according to the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0 for non-hematological AEs. The incidence and severity of hematological AEs related to CAP-100 treatment according to CLL international working group criteria (iwCLL, Hallek et al, 2018).

Time frame
28 Days
3

Preliminary clinical benefit of CAP-100 monotherapy at RP2D

Overall response rate (ORR) after 3 cycles of CAP-100 treatment according to iwCLL criteria

Time frame
3 Cycles (84 Days)

Secondary outcomes

Other outcomes

Sponsors and contacts

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