This phase I/II trial studies the side effects and best dose of allogeneic iC9/CAR.19/IL15-transduced cord blood (CB) natural killer (NK) cells (umbilical cord blood immune cells) when given together with chemotherapy, and to see how well they work in treating participants with CD19 positive acute lymphoblastic leukemia, chronic lymphocytic leukemia, or non-Hodgkin lymphoma that has come back or does not respond to treatment. iC9/CAR.19/IL15-transduced CB-NK cells are genetically changed immune cells that may help improve the disease. Drugs used in chemotherapy, such as fludarabine and cyclophosphamide work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving iC9/CAR.19/IL15-transduced CB-NK cells and chemotherapy may work better in treating participants with acute lymphoblastic leukemia, chronic lymphocytic leukemia, or non-Hodgkin lymphoma.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT03056339.
PRIMARY OBJECTIVE:
I. To determine the safety and relative efficacy of chimeric antigen receptors (CAR).CD19-CD28-zeta-2A-iCasp9-IL15-transduced cord blood natural killer (CB-NK) cells in patients with relapsed/refractory CD19 positive (+) B lymphoid malignancies.
SECONDARY OBJECTIVES:
I. To assess the overall response rate (complete and partial response rates).
II. To quantify persistence of infused allogeneic donor CAR-transduced CB-derived NK cells in the recipient.
III. To conduct comprehensive immune reconstitution studies.
OUTLINE: This is a phase I, dose-escalation study of allogeneic iC9/CAR.19/IL15-transduced CB-NK cells followed by a phase II study.
PREPARATIVE REGIMEN: Participants receive fludarabine intravenously (IV) over 1 hour and cyclophosphamide IV over 3 hours in the absence of disease progression or unacceptable toxicity.
INFUSION: Participants receive allogeneic iC9/CAR.19/IL15-transduced CB-NK cells IV on day 0.
POST-INFUSION: After receiving allogeneic iC9/CAR.19/IL15-transduced CB-NK cells, participants with graft versus host disease (GVHD), cytokine release syndrome (CRS), or neurotoxicity receive rimiducid IV.
After completion of study treatment, participants are followed for up to 15 years.
Lead OrganizationM D Anderson Cancer Center
Principal InvestigatorLoretta J. Nastoupil