Session: 704. Cellular Immunotherapies: Early Phase and Investigational Therapies: Poster II
Hematology Disease Topics & Pathways:
Research, clinical trials, Biological therapies, Clinical Research, Plasma Cell Disorders, Chimeric Antigen Receptor (CAR)-T Cell Therapies, Diseases, Therapies, Lymphoid Malignancies
The primary objective is to assess the safety and maximum tolerated dose (MTD) of P-BCMA-ALLO1 based on dose limiting toxicity (DLT) in RRMM patients with measurable disease who have received a proteasome inhibitor (PI), immunomodulatory agent (IMiD) and anti-CD38 monoclonal antibody therapy. Key secondary objective will assess the anti-myeloma effect of P-BCMA-ALLO1. Exploratory objectives will assess CAR-T related cytokines, serum BCMA levels and cellular kinetics.
The trial utilizes a standard 3 + 3 dose escalation design to test seven planned dose levels of intravenous P-BCMA-ALLO1 ranging from 0.0625 × 106 to 15 × 106 cells/kg (NCT04960579). Multiple lymphodepletion (LD) strategies and cyclic administration of P-BCMA-ALLO1 are being investigated. Repeat P-BCMA-ALLO1 administration is allowed for patients who do not achieve at least a partial response with the first dose after 4 weeks of follow up. We are currently dosing patients in arm S (Cyclophosphamide (Cy) 300 mg/m2 + Fludarabine (Flu) 30 mg/m2 X 3 days), arm P1 (Cy 500 mg/m2 + Flu 30 mg/m2 X 3 days), arm P2 (Cy 1,000 mg/m2 + Flu 30 mg/m2 X 3 days) and arm C (multiple P-BCMA-ALLO1 doses following Cy 300 mg/m2 + Flu 30 mg/m2 X 3 days).
The median patient age was 73 (33, 85) years, 61% were female, and median time since MM diagnosis was 6.27 (1.48,18.95) years. Eight (35%) patients had high risk disease by cytogenetic criteria. The enrolled patients were heavily pretreated, having received median 7 (2,16) prior lines of therapy, with 30% having undergone prior BCMA targeting therapy.
As of 10 Jul 2023, 24 patients received P-BCMA-ALLO1 at 4 dose levels. Twenty-two were treated in arm S, 1 each in arms P1 and P2. One patient received 0.25 X 106 cells/kg (cohort -1, arm S), 7 received 0.75 X 106 cells/kg (cohort 1, arm S), 12 received 2 X 106 cells/kg (cohort 2, 10 in arm S, 1 in arm P1 and 1 in arm P2), and 4 received 6 X 106 cells/kg (cohort 3). One of the cohort 2 patients received a second P-BCMA-ALLO1 infusion at the cohort 2 dose level following disease progression. The median time from enrollment to start of LD chemotherapy was 2 (1-8) days and from enrollment to CAR-T infusion was 7 (6-13) days. No patient needed bridging therapy between enrollment and the start of LD.
Twenty-two (all in arm S) of the 24 treated patients completed DLT evaluation by data cutoff. None of the patients treated thus far had DLTs. Most common treatment emergent adverse events (TEAEs) were anemia (36%), neutropenia (36%), constipation (36%) and leukopenia (32%). Most common ≥ grade (G) 3 TEAEs were neutropenia (36%), leukopenia (32%) and anemia (23%). Most of the AEs were considered unrelated to P-BCMA-ALLO1. Three (14%) patients developed grade 1 Cytokine Release Syndrome (CRS). One (4%) patient experienced grade 1 Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS), which resolved with one dose of corticosteroids. None of the patients experienced GvHD by the last follow up.
P-BCMA-ALLO1 is a non-viral transposon-generated allogeneic “off-the-shelf” CAR-T that is rapidly available for administration and well tolerated in a heavily pretreated RRMM patient population with minimal CRS/ICANS risk. Updated results including safety, preliminary efficacy, and selected biomarkers will be presented at the American Society of Hematology 2023 meeting.
Disclosures: Dholaria: Poseida: Research Funding; Atara: Research Funding; Angiocrine: Research Funding; Allovir: Research Funding; NCI: Research Funding; MEI: Research Funding; Wugen: Research Funding; Takeda: Research Funding; ADC therapeutics: Consultancy, Honoraria; Arivan: Consultancy; Gilead: Research Funding; Orca Bio: Research Funding; Adicet: Research Funding; Molecular Templates: Research Funding; Poseida: Research Funding; BMS: Research Funding; Janssen: Consultancy, Honoraria, Research Funding; AstraZeneca: Research Funding; Pluri Biotech: Consultancy; Boxer Capital: Consultancy; Ellipsis pharma: Consultancy; Lumanity: Consultancy; gamida cel: Consultancy; Pfizer: Research Funding; BEAM therapeutics: Consultancy. McArthur: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. McCaigue: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. DePrimo: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. Martin: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. Haag: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. Zhang: Poseida Therapeutics: Current Employment. Namini: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. Christie: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. Belani: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. Cranert: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. Coronella: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company. Shedlock: Poseida Therapeutics: Current Employment, Current equity holder in publicly-traded company, Current holder of stock options in a privately-held company, Patents & Royalties: Poseida Therapeutic Patents Co-inventor. Costello: Takeda: Consultancy, Research Funding; Regeneron: Honoraria; Poseida, Ionis, Harpoon Therapeutics: Research Funding; Pfizer: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Janssen: Consultancy, Research Funding.
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