Actively Recruiting
Optimizing lymphoDepletion to Improve Outcomes In Patients Receiving Cell Therapy With Yescarta
Led by University Health Network, Toronto · Updated on 2025-12-08
40
Participants Needed
1
Research Sites
215 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
This is a Phase 1b study of participants with Diffuse Large B Cell Lymphoma (DLBCL). The purpose of this study is to identify an optimized lymphodenpletion (LD) regimen by evaluating standard and intermediate doses of Fludarabine (Flu) / Cyclophosphamide (Cy) with or without a fixed dose of total lymphoid irradiation (TLI) in the setting of standard of care CAR T cell therapy.
CONDITIONS
Official Title
Optimizing lymphoDepletion to Improve Outcomes In Patients Receiving Cell Therapy With Yescarta
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age 18 years or older at the time of consent
- Life expectancy of at least 12 weeks
- Biopsy-confirmed relapsed or refractory large B cell lymphoma, including DLBCL, transformed follicular lymphoma, or primary mediastinal B cell lymphoma
- Measurable disease by imaging with at least one lesion greater than 1.5 cm that is FDG avid
- At least 2 weeks or 5 half-lives have passed since any prior systemic cancer therapy
- Eligible for standard of care CAR T cell therapy after two or more systemic therapy lines, including anti-CD20 antibody and anthracycline chemotherapy
- No active central nervous system disease
- Stable enough to undergo CAR T-cell therapy with good performance status (ECOG 0 or 1)
- No prior adoptive T-cell immunotherapy
- Not HIV positive
- No prior allogeneic stem cell transplant
- Adequate bone marrow, kidney, liver, lung, and heart function
- Negative pregnancy test for females of childbearing potential
- Male participants agree to use condoms during and for 6 months after treatment
- Must have an apheresis product accepted for manufacturing
You will not qualify if you...
- Tumor bulk of 10 cm or more after bridging therapy
- History of other cancers unless disease-free for at least 3 years (except certain skin and in situ cancers)
- History of Richter's transformation of chronic lymphocytic leukemia
- Prior allogeneic stem cell transplant
- Received fewer than two therapy lines for large B cell lymphoma
- Prior CD19 targeted therapy
- Use of high-dose corticosteroids or certain other therapies within specified timeframes before leukapheresis
- Prior chimeric antigen receptor or genetically modified T-cell therapy
- Uncontrolled infections requiring IV antibiotics
- Known HIV, active hepatitis B or C infection unless undetectable viral load after treatment
- Active tuberculosis
- Presence of indwelling lines or drains except certain central venous catheters
- Detectable cancer cells in cerebrospinal fluid or active CNS involvement
- Significant non-cancerous CNS disorders or autoimmune disease affecting CNS
- Cardiac lymphoma involvement or recent serious heart conditions
- Need for urgent therapy due to tumor effects like obstruction
- Autoimmune disease requiring systemic immunosuppression in last 2 years
- History of certain lung diseases or active pneumonitis on chest scan
- Recent symptomatic blood clots
- Any condition interfering with safety or efficacy assessment
- Severe allergic reactions to tocilizumab or study agents
- Recent live vaccine use
- Pregnant or breastfeeding women
- Unwillingness to practice birth control during and 6 months after treatment
- Unlikely to complete study visits or comply with requirements
AI-Screening
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Trial Site Locations
Total: 1 location
1
Princess Margaret Cancer Centre
Toronto, Ontario, Canada
Actively Recruiting
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NON_RANDOMIZED
Model
SEQUENTIAL
Primary Purpose
TREATMENT
Number of Arms
4
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