• WU-CART-007, an allogeneic anti-CD7 chimeric antigen receptor T cell, established a manageable safety profile at the RP2D of 900 × 106 cells.

  • WU-CART-007 at the RP2D had a composite complete remission rate of 72.7% in heavily pretreated patients with relapsed/refractory T-ALL/LBL.

Abstract

Relapsed/refractory T-cell acute lymphoblastic leukemia (ALL; T-ALL)/lymphoma (LBL) represent a significant unmet medical need. WU-CART-007 is a CD7-targeting, allogeneic, fratricide-resistant chimeric antigen receptor T-cell product generated from healthy donor T cells. WU-CART-007 was evaluated in a phase 1/2 study with a 3+3 dose-escalation design followed by cohort expansion in relapsed/refractory T-ALL/LBL. Patients received 1 infusion of WU-CART-007 after standard or enhanced lymphodepleting chemotherapy. The primary objectives, to characterize safety and assess the composite complete remission rate, were met. Of 28 patients enrolled, 13 received the recommended phase 2 dose (RP2D) of 900 × 106 cells of WU-CART-007 with enhanced lymphodepletion. The most common treatment-related adverse event was cytokine release syndrome (88.5%; 19.2% grade 3-4). Two grade 1 immune effector cell–associated neurotoxicity syndrome events (7.7%) and 1 grade 2 acute graft-versus-host disease event occurred (3.8%). One grade 2 immune effector cell–associated hemophagocytic lymphohistiocytosis–like syndrome was observed. Among the 11 patients evaluable for response at the RP2D who received enhanced lymphodepleting chemotherapy, the overall response rate was 90.9%, and the composite complete remission rate was 72.7%. WU-CART-007 at the RP2D demonstrated a high response rate in patients with relapsed/refractory T-ALL/LBL and has the potential to provide a new treatment option. This trial was registered at www.ClinicalTrials.gov as #NCT04984356.

1.
Samra
B
,
Alotaibi
AS
,
Short
NJ
, et al
.
Outcome of adults with relapsed/refractory T-cell acute lymphoblastic leukemia or lymphoblastic lymphoma
.
Am J Hematol
.
2020
;
95
(
9
):
E245
-
E247
.
2.
Specchia
G
,
Pastore
D
,
Carluccio
P
, et al
.
FLAG-IDA in the treatment of refractory/relapsed adult acute lymphoblastic leukemia
.
Ann Hematol
.
2005
;
84
(
12
):
792
-
795
.
3.
Burkhardt
B
,
Hermiston
ML
.
Lymphoblastic lymphoma in children and adolescents: review of current challenges and future opportunities
.
Br J Haematol
.
2019
;
185
(
6
):
1158
-
1170
.
4.
Patel
JL
,
Smith
LM
,
Anderson
J
, et al
.
The immunophenotype of T-lymphoblastic lymphoma in children and adolescents: a Children’s Oncology Group report
.
Br J Haematol
.
2012
;
159
(
4
):
454
-
461
.
5.
Kroeze
E
,
Loeffen
JLC
,
Poort
VM
,
Meijerink
JPP
.
T-cell lymphoblastic lymphoma and leukemia: different diseases from a common premalignant progenitor?
.
Blood Adv
.
2020
;
4
(
14
):
3466
-
3473
.
6.
Basso
K
,
Mussolin
L
,
Lettieri
A
, et al
.
T-cell lymphoblastic lymphoma shows differences and similarities with T-cell acute lymphoblastic leukemia by genomic and gene expression analyses
.
Genes Chromosomes Cancer
.
2011
;
50
(
12
):
1063
-
1075
.
7.
Arber
DA
,
Orazi
A
,
Hasserjian
R
, et al
.
The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia
.
Blood
.
2016
;
127
(
20
):
2391
-
2405
.
8.
Litzow
MR
,
Ferrando
AA
.
How I treat T-cell acute lymphoblastic leukemia in adults
.
Blood
.
2015
;
126
(
7
):
833
-
841
.
9.
Marks
DI
,
Rowntree
C
.
Management of adults with T-cell lymphoblastic leukemia [published correction information appears in Blood. 2017;129(15):2204]
.
Blood
.
2017
;
129
(
9
):
1134
-
1142
.
10.
Fielding
AK
,
Richards
SM
,
Chopra
R
, et al;
Medical Research Council of the United Kingdom Adult ALL Working Party
Eastern Cooperative Oncology Group
.
Outcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL); an MRC UKALL12/ECOG 2993 study
.
Blood
.
2007
;
109
(
3
):
944
-
950
.
11.
Cohen
MH
,
Johnson
JR
,
Justice
R
,
Pazdur
R
.
FDA drug approval summary: nelarabine (Arranon) for the treatment of T-cell lymphoblastic leukemia/lymphoma
.
Oncologist
.
2008
;
13
(
6
):
709
-
714
.
12.
Khalidi
H
,
Chang
KL
,
Medeiros
LJ
, et al
.
Acute lymphoblastic leukemia. Survey of immunophenotype, French-American-British classification, frequency of myeloid antigen expression, and karyotypic abnormalities in 210 pediatric and adult cases
.
Am J Clin Pathol
.
1999
;
111
(
4
):
467
-
476
.
13.
Food and Drug Administration (FDA)
. Briefing document for the Oncologic Drugs Advisory Committee Meeting, BLA 125646, tisagenlecleucel.
Novartis Pharmaceuticals Corporation
;
2017
.
14.
Cooper
ML
,
Choi
J
,
Staser
K
, et al
.
An “off-the-shelf” fratricide-resistant CAR-T for the treatment of T cell hematologic malignancies
.
Leukemia
.
2018
;
32
(
9
):
1970
-
1983
.
15.
Chiesa
R
,
Georgiadis
C
,
Syed
F
, et al;
Base-Edited CAR T Group
.
Base-edited CAR7 T cells for relapsed T-cell acute lymphoblastic leukemia
.
N Engl J Med
.
2023
;
389
(
10
):
899
-
910
.
16.
Li
S
,
Wang
X
,
Liu
L
, et al
.
CD7 targeted “off-the-shelf” CAR-T demonstrates robust in vivo expansion and high efficacy in the treatment of patients with relapsed and refractory T cell malignancies
.
Leukemia
.
2023
;
37
(
11
):
2176
-
2186
.
17.
Lu
P
,
Liu
Y
,
Yang
J
, et al
.
Naturally selected CD7 CAR-T therapy without genetic manipulations for T-ALL/LBL: first-in-human phase 1 clinical trial
.
Blood
.
2022
;
140
(
4
):
321
-
334
.
18.
Pan
J
,
Tan
Y
,
Wang
G
, et al
.
Donor-derived CD7 chimeric antigen receptor T cells for T-cell acute lymphoblastic leukemia: first-in-human, phase I trial
.
J Clin Oncol
.
2021
;
39
(
30
):
3340
-
3351
.
19.
Hu
Y
,
Zhang
M
,
Yang
T
, et al
.
Sequential CD7 CAR T-cell therapy and allogeneic HSCT without GVHD prophylaxis
.
N Engl J Med
.
2024
;
390
(
16
):
1467
-
1480
.
20.
Maude
SL
,
Laetsch
TW
,
Buechner
J
, et al
.
Tisagenlecleucel in children and young adults with B-cell lymphoblastic leukemia
.
N Engl J Med
.
2018
;
378
(
5
):
439
-
448
.
21.
Cheson
BD
,
Fisher
RI
,
Barrinton
SF
, et al;
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 Español de Médula Ósea
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
;
32
(
27
):
3059
-
3067
.
22.
Lee
DW
,
Santomasso
BD
,
Locke
FL
, et al
.
ASTCT consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells
.
Biol Blood Marrow Transpl
.
2019
;
25
(
4
):
625
-
638
.
23.
Hines
MR
,
Knight
TE
,
McNerney
KO
, et al
.
Immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome
.
Transpl Cell Ther
.
2023
;
29
(
7
):
438.e1
-
438.e16
.
24.
U.S. Department of Health and Human Services
National Institutes of Health
National Cancer Institute
. Common Terminology Criteria for Adverse Events (CTCAE) version 5.
2017
.
25.
Burke
MJ
,
Verneris
MR
,
Le Rademacher
J
, et al
.
Transplant outcomes for children with T cell acute lymphoblastic leukemia in second remission: a report from the Center for International Blood and Marrow Transplant Research
.
Biol Blood Marrow Transpl
.
2015
;
21
(
12
):
2154
-
2159
.
26.
Oh
BLZ
,
Shimasaki
N
,
Coustan-Smith
E
, et al
.
Fratricide-resistant CD7-CAR T cells in T-ALL
.
Nat Med
.
2024
;
30
(
12
):
3687
-
3696
.
You do not currently have access to this content.
Sign in via your Institution