Status:

COMPLETED

Anakinra for the Prevention of Cytokine Release Syndrome and Neurotoxicity in Patients With B-Cell Non-Hodgkin Lymphoma Receiving CD19-Targeted CAR-T Cell Therapy

Lead Sponsor:

Fred Hutchinson Cancer Center

Collaborating Sponsors:

Swedish Orphan Biovitrum

Conditions:

B-Cell Non-Hodgkin Lymphoma

Eligibility:

All Genders

18+ years

Phase:

PHASE2

Brief Summary

This phase II trial studies how well anakinra works in decreasing the occurrence of cytokine release syndrome (CRS) and damage to the nerves (neurotoxicity) in patients with B-cell non-Hodgkin lymphom...

Detailed Description

OUTLINE: Patients receive anakinra intravenously (IV) \[previously subcutaneously (SC) for some patients\] over 10-30 minutes daily on days 0-13 and lisocabtagene maraleucel via infusion on day 0. Pa...

Eligibility Criteria

Inclusion

  • Subjects must be 18 years of age or older
  • Karnofsky performance status of \>= 60%
  • Patients with B-cell non-Hodgkin lymphoma (B-NHL) and eligible for treatment with liso-cel. Patients treated with non-conforming (out-of-specification) liso-cell may remain on study.
  • Negative serum pregnancy test within 2 weeks of enrollment for women of childbearing potential, defined as those who have not been surgically sterilized or who have not been free of menses for at least 1 year
  • Fertile male and female subjects must be willing to use an effective contraceptive method before, during, and for at least 4 months after the last dose of anakinra
  • Ability to understand and provide informed consent

Exclusion

  • Subjects requiring ongoing daily corticosteroid therapy at a dose of \> 15 mg of prednisone per day (or equivalent). Pulsed corticosteroid use for disease control is acceptable
  • Active autoimmune disease requiring immunosuppressive therapy is excluded unless discussed with the principal investigator (PI)
  • Known hypersensitivity to Escherichia € coli-derived proteins, anakinra, or to any component of the product
  • Major organ dysfunction defined as:
  • Serum creatinine \> 2.5 mg/dL
  • Significant hepatic dysfunction (Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) \> 5x upper limit of normal; bilirubin \> 3.0 mg/dL) unless due to malignancy or Gilbert's syndrome in the opinion of the PI or designee
  • Subjects with clinically significant pulmonary dysfunction, as determined by medical history and physical exam should undergo pulmonary function testing. Those with a forced expiratory volume in 1 second (FEV1) of \< 50% of predicted or diffusion capacity of the lung for carbon monoxide (DLCO) (corrected) \< 40% will be excluded
  • Significant cardiovascular abnormalities as defined by any one of the following: New York Heart Association (NYHA) class III or IV congestive heart failure, clinically significant hypotension, uncontrolled symptomatic coronary artery disease, or a documented ejection fraction of \< 35%
  • Uncontrolled serious and active infection

Key Trial Info

Start Date :

December 27 2021

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

December 23 2024

Estimated Enrollment :

27 Patients enrolled

Trial Details

Trial ID

NCT04359784

Start Date

December 27 2021

End Date

December 23 2024

Last Update

October 23 2025

Active Locations (1)

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1

Fred Hutch/University of Washington Cancer Consortium

Seattle, Washington, United States, 98109