Session: 704. Cellular Immunotherapies: Early Phase and Investigational Therapies: Poster I
Methods: MB-106 is being evaluated in a Phase 1/2, open label, multicenter study utilizing a 3+3 dose-escalation design in R/R B-cell NHL patients with confirmed CD20 expression. Prior treatment with CD19-targeted CAR-T therapy is permitted. Following lymphodepletion (cyclophosphamide 300 mg/m2/day and fludarabine 30 mg/m2/day for 3 days), MB-106 is administered to patients with indolent B-cell NHL at one of two dose levels (DL): DL1, 3.3×106; and DL2, 1.0×107 cells/kg. MB-106 is infused in the outpatient setting if allowed by the institution, except for the first patient in each dose level cohort (overnight observation). Dose-limiting toxicities (DLT) are monitored through day 28. The treatment response is assessed on day 28 and on subsequent visits, and best overall response is reported here. CAR-T persistence is assessed by both flow cytometry and qPCR in peripheral blood mononuclear cells.
Results: Three patients with indolent NHL (2 FL, 1 Waldenström macroglobulinemia [WM]) received MB-106 at DL1. In addition, one patient with hairy cell leukemia variant (HCL-v) received non-conforming material (drug product that failed to meet release criteria) at DL1, following FDA authorization. These four patients were heavily pre-treated with a median of 5.5 prior lines of treatment. High-risk features included progression of disease within 24 months of first-line treatment (POD24, n=1), prior autologous stem cell transplant (n=1) and prior CD19-targeted CAR-T therapy (n=1). No DLTs were observed at DL1. Three patients experienced Grade 1 cytokine release syndrome. There have been no occurrences of immune effector cell-associated neurotoxicity syndrome (ICANS). The 2 FL patients achieved CR by both PET-CT and bone marrow biopsy, one of whom had been previously treated with CD19-targeted CAR-T. The WM patient, who had nine prior treatments, including autologous stem cell transplant, and high disease burden, achieved very good partial response, with complete metabolic response by PET-CT, morphologic clearance of lymphoma in bone marrow, and resolution of the IgM paraprotein. The patient with HCL-v, who had been transfusion dependent, continues to have stable disease with decreased disease in the bone marrow, and achieved complete transfusion independence which is ongoing at 6 months. All patients displayed MB-106 expansion with peak levels between 7-14 days post-infusion. Persistence of CAR T-cells is ongoing at 6 months.
Conclusion: Treatment with MB-106, a third generation CD20 targeting CAR-T, resulted in responses, including CRs, and CAR-T persistence in patients with R/R indolent NHL and was associated with favorable safety profile with no occurrence of Grade 3 or Grade 4 cytokine release syndrome and no ICANS of any grade. CRs have been observed in patients previously treated with CD19-targeted CAR-T in both this multicenter trial and the original single institution trial. Dosing is ongoing in the final dosing level (1.0×107 cells/kg) to establish the recommended Phase 2 dose for a planned pivotal trial in WM. It is anticipated that the complete data set from the Phase 1 indolent NHL arm will be presented.
Disclosures: Shadman: Eli Lilly: Consultancy; BeiGene: Consultancy, Research Funding; Fate Therapeutics: Consultancy; Janssen: Consultancy; Bristol Myers Squibb: Consultancy, Research Funding; MorphoSys/Incyte: Consultancy, Research Funding; Kite, a Gilead Company: Consultancy; AstraZeneca: Consultancy, Research Funding; Pharmacyclics: Consultancy, Research Funding; Mustang Bio: Consultancy, Research Funding; Genmab: Consultancy, Research Funding; ADC therapeutics: Consultancy; Vincerx: Research Funding; Genentech: Consultancy, Research Funding; AbbVie: Consultancy, Research Funding; MEI Pharma: Consultancy; Regeneron: Consultancy; TG Therapeutics: Research Funding. Caimi: SOBI: Honoraria; Novartis: Consultancy; Lilly Oncology: Consultancy; BMS: Consultancy; Genentech: Consultancy; ADC Therapeutics: Consultancy; Kite Pharma: Honoraria. O'Brien: Pharmacyclics: Consultancy, Research Funding; Regeneron: Research Funding; Pfizer: Consultancy, Research Funding; Johnson & Johnson: Consultancy; Janssen: Consultancy; Lilly: Consultancy, Research Funding; Beigene: Consultancy, Research Funding; Astrazeneca: Consultancy; Abbvie: Consultancy. Reagan: Kite, a Gilead Company: Consultancy, Other: speaker; Genentech: Research Funding; Caribou biosciences: Consultancy; Seagen: Research Funding. Dezube: Mustang Bio: Current Employment, Current equity holder in publicly-traded company. Navaratnarajah: Mustang Bio: Current Employment. Gaur: Mustang Bio: Current Employment. Petrossian: Mustang Bio: Current Employment. Till: Proteios Technology: Consultancy, Current holder of stock options in a privately-held company; Mustang Bio: Consultancy, Patents & Royalties, Research Funding; BMS/Juno Therapeutics: Research Funding. Abramson: Kymera: Consultancy; Lilly: Consultancy; Merck: Research Funding; MorphoSys: Consultancy; Mustang Bio: Consultancy, Research Funding; Ono Pharma: Consultancy; Regeneron: Consultancy, Honoraria; Seagen Inc.: Research Funding; Takeda: Consultancy; Cellectar Biosciences: Consultancy; Kite Pharma: Consultancy; Janssen: Consultancy, Honoraria; Interius: Consultancy; Incyte: Consultancy; Genmab: Consultancy; Genentech: Consultancy; Epizyme: Consultancy; Century Therapeutics: Consultancy; Celgene: Consultancy; Novartis: Consultancy; EMD Serono: Consultancy; Alimera Sciences: Consultancy; Karyopharm Therapeutics: Consultancy; C4 Therapeutics: Consultancy; Bluebird Bio: Consultancy; AI Therapeutics: Research Funding; Caribou Biosciences: Consultancy; BMS: Consultancy, Honoraria, Research Funding; BeiGene: Consultancy; AstraZeneca: Consultancy, Honoraria; AbbVie: Consultancy.
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