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NCT02445248: JULIET

Study of Efficacy and Safety of CTL019 in Adult DLBCL Patients

Completed Phase 2 Results posted Last updated 18 April 2024
What this trial tests

Phase 2 trial testing Tisagenlecleucel in Diffuse Large B-cell Lymphoma (DLBCL) in 115 participants. Completed in 22 December 2022.

Timeline
29 July 2015
Primary endpoint
22 December 2022
22 December 2022

Quick facts

Lead sponsorNovartis Pharmaceuticals
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment115
Start date29 July 2015
Primary completion22 December 2022
Estimated completion22 December 2022
Sites26 locations across France, Italy, Japan, Netherlands, Austria, Germany, Norway, Canada

Drugs / interventions tested

Conditions studied

Sponsor

Novartis Pharmaceuticals — full company profile →

Who can join

18 and older, any sex, with Diffuse Large B-cell Lymphoma (DLBCL). Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Overall Response Rate (ORR) Per Independent Review Committee (IRC) in Main Cohort Primary · 60 months

ORR, which includes complete response (CR) and partial response (PR) in the Main cohort as determined by IRC assessment. ORR is the percentage of participants with a best overall disease response of CR or PR, where the best overall disease response is defined as the best disease response recorded from CTL019 infusion until progressive disease or start of new anticancer therapy (including ASCT), whichever comes first. Response was assessed according to Evaluation Criteria in diffuse large B cell lymphoma studies (based on Cheson Response criteria and the Lugano Classification (2014))

GroupValue95% CI
Tisagenlecleucel - Main Cohort54.544.2 – 64.6
Overall Response Rate (ORR) Per Independent Review Committee (IRC) in Cohort A & in All Patients Secondary · 5 years

ORR, which includes complete response (CR) and partial response (PR) in the Main cohort as determined by IRC assessment. ORR is the percentage of participants with a best overall disease response of CR or PR, where the best overall disease response is defined as the best disease response recorded from CTL019 infusion until progressive disease or start of new anticancer therapy (including ASCT), whichever comes first.

GroupValue95% CI
Tisagenlecleucel - Cohort A43.819.8 – 70.1
Tisagenlecleucel - All Patients53.043.5 – 62.4
Time to Response (TTR) as Assessed by Independent Review Committee (Main Cohort & All Patients) Secondary · up to approx. 3.3 months

TTR is the time between date of CTL019 infusion until first documented response (CR or PR).

GroupValue95% CI
Tisagenlecleucel - Main Cohort1.00.9 – 1.0
Tisagenlecleucel - All Patients1.00.9 – 1.0
Duration of Overall Response (DOR) Per IRC Secondary · up to approx. 60.1 months

DOR is the time from achievement of CR or PR, whichever occurs first, to relapse or death due to diffuse large B-cell lymphoma (DLBCL).

GroupValue95% CI
Tisagenlecleucel - Main CohortNA10.0 – NA
Tisagenlecleucel - Cohort ANA1.2 – NA
Tisagenlecleucel - All PatientsNA10.0 – NA
Event Free Survival (EFS) Per Independent Review Committee Secondary · up to approx. 61 months

EFS is the time from date of CTL019 infusion to the date of first documented disease progression or relapse, new treatment for lymphoma or death due to any cause.

GroupValue95% CI
Tisagenlecleucel - Main Cohort2.82.2 – 3.5
Tisagenlecleucel - Cohort A2.11.0 – 3.1
Tisagenlecleucel - All Patients2.82.1 – 3.1
Progression Free Survival (PFS) Per Independent Review Committee Secondary · up to approx. 61 months

PFS is the time from date of CTL019 infusion to the date of first documented disease progression or death due to any cause.

GroupValue95% CI
Tisagenlecleucel - Main Cohort3.02.4 – 6.2
Tisagenlecleucel - Cohort A2.91.0 – NA
Tisagenlecleucel - All Patients2.92.3 – 5.2
Overall Survival (OS) Per Independent Review Committee Secondary · 60 months

OS is the time from date of CTL019 infusion to the date of death due to any cause.

GroupValue95% CI
Tisagenlecleucel - Main Cohort12.57.2 – 34.2
Tisagenlecleucel - Cohort A5.93.1 – 19.2
Tisagenlecleucel - All Patients11.16.6 – 23.9
Pharmacokinetics (Pk): Cmax Secondary · 60 months

Cmax is the maximum (peak) observed in peripheral blood or other body fluid drug concentration after single dose administration. Cmax, based on the transgene level data by qPCR, was summarized by Month 3 response, per Independent Review Committee assessment. The reported Cmax is the summary of maximum level observed based on the data from each patient and based on all the data that's been collected for up to 60 months in a patient.

GroupValue95% CI
Tisagenlecleucel - Main Cohort: CR/PR5570± 271.3
Tisagenlecleucel - Main Cohort: SD/PD/UNK4690± 481.1
Tisagenlecleucel - Cohort A: CR/PR14300± 67.5
Tisagenlecleucel - Cohort A: SD/PD/UNK6950± 109.3
Pharmacokinetics (Pk): Tmax Secondary · 60 months

Tmax is the time to reach maximum (peak) peripheral blood or other body fluid drug concentration after single dose administration (days). Tmax, based on the transgene level data by qPCR, was summarized by Month 3 response, per Independent Review Committee assessment. The time frame of 60 months refers to the duration for which the data were reviewed to identify the time of Cmax for this measure.

GroupValue95% CI
Tisagenlecleucel - Main Cohort: CR/PR9.845.78 – 27.7
Tisagenlecleucel - Main Cohort: SD/PD/UNK8.950.994 – 26.7
Tisagenlecleucel - Cohort A: CR/PR6.955.94 – 8.96
Tisagenlecleucel - Cohort A: SD/PD/UNK6.936.67 – 10.9
Pharmacokinetics (Pk): AUC0-28d and AUC0-84d Secondary · 0 - 28 days after infusion for AUC0-28d, 0 - 84 days after infusion for AUC0-84d

The AUC from time zero to day 28 and 84 or other disease assessment days, in peripheral blood. AUC0-28d and AUC0-84d, based on the transgene level data by qPCR, were summarized by Month 3 response, per Independent Review Committee assessment.

AUC0-28d
GroupValue95% CI
Tisagenlecleucel - CR/PR58000± 182.1
Tisagenlecleucel - Main Cohort: SD/PD/UNK49900± 388.5
Tisagenlecleucel - Cohort A: CR/PR141000± 78.2
Tisagenlecleucel - Cohort A: SD/PD/UNK63700± 134.2
AUC0-84d
GroupValue95% CI
Tisagenlecleucel - CR/PR102000± 171.7
Tisagenlecleucel - Main Cohort: SD/PD/UNK92900± 165.4
Tisagenlecleucel - Cohort A: CR/PR206000± 76.7
Tisagenlecleucel - Cohort A: SD/PD/UNK142000± 61.3
Pharmacokinetics (Pk): T1/2 Secondary · 60 months

T1/2 is the half-life associated with the disposition phase slopes (alpha, beta, gamma etc.) of a semi logarithmic concentration-time curve in peripheral blood. T1/2, based on the transgene level data by qPCR, was summarized by Month 3 response, per Independent Review Committee assessment. This time frame of 60 months reflects the maximum duration up to which the transgene levels were collected to measure the half life.

GroupValue95% CI
Tisagenlecleucel - Main Cohort: CR/PR167± 355.3
Tisagenlecleucel - Main Cohort: SD/PD/UNK10.9± 205.4
Tisagenlecleucel - Cohort A: CR/PR59.4± 30402.1
Tisagenlecleucel - Cohort A: SD/PD/UNK15.6± 163.5
Pharmacokinetics (Pk): Clast Secondary · 60 months

Clast is the last observed quantifiable concentration in peripheral blood. Clast, based on the transgene level data by qPCR, was summarized by Month 3 response, per Independent Review Committee assessment. This time frame reflects maximum duration of 60 months up to which the transgene levels were collected.

GroupValue95% CI
Tisagenlecleucel - Main Cohort: CR/PR181± 114.4
Tisagenlecleucel - Main Cohort: SD/PD/UNK332± 430.9
Tisagenlecleucel - Cohort A: CR/PR272± 30.6
Tisagenlecleucel - Cohort A: SD/PD/UNK386± 540.9

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse Events (AEs) were collected during the post-infusion period (starting at the day of 1st infusion until the end of the study), up to maximum duration of 61 months for each patient. Deaths were collected at all points post-infusion until the patient completed the study duration (60 months) or further safety follow-up under the study protocol. Therefore on-treatment deaths include post-infusion deaths until Last patient Last Visit (LPLV).. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Tisagenlecleucel - All Patients
Serious: 84/115 (73%)
Deaths: 76/115

Serious adverse events (106 terms)

ReactionSystemTisagenlecleucel - All Pat…
Cytokine release syndromeImmune system disorders
Febrile neutropeniaBlood and lymphatic system disorders
PyrexiaGeneral disorders
PneumoniaInfections and infestations
FatigueGeneral disorders
Myelodysplastic syndromeNeoplasms benign, malignant and unspecified (incl cysts and polyps)
EncephalopathyNervous system disorders
Acute kidney injuryRenal and urinary disorders
PancytopeniaBlood and lymphatic system disorders
Multiple organ dysfunction syndromeGeneral disorders
Clostridium difficile infectionInfections and infestations
SepsisInfections and infestations
Neutrophil count decreasedInvestigations
Prostate cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Confusional statePsychiatric disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
Bone marrow failureBlood and lymphatic system disorders
NeutropeniaBlood and lymphatic system disorders
Gastrointestinal haemorrhageGastrointestinal disorders
InfectionInfections and infestations
InfluenzaInfections and infestations
Pneumocystis jirovecii pneumoniaInfections and infestations
Respiratory tract infectionInfections and infestations
Staphylococcal infectionInfections and infestations
Platelet count decreasedInvestigations
Other adverse events (58 terms — click to expand)

ReactionSystemTisagenlecleucel - All Pat…
AnaemiaBlood and lymphatic system disorders
Cytokine release syndromeImmune system disorders
White blood cell count decreasedInvestigations
Neutrophil count decreasedInvestigations
Platelet count decreasedInvestigations
DiarrhoeaGastrointestinal disorders
PyrexiaGeneral disorders
NauseaGastrointestinal disorders
FatigueGeneral disorders
HypotensionVascular disorders
HypokalaemiaMetabolism and nutrition disorders
HeadacheNervous system disorders
NeutropeniaBlood and lymphatic system disorders
ConstipationGastrointestinal disorders
HypomagnesaemiaMetabolism and nutrition disorders
HypophosphataemiaMetabolism and nutrition disorders
CoughRespiratory, thoracic and mediastinal disorders
Oedema peripheralGeneral disorders
ArthralgiaMusculoskeletal and connective tissue disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
ThrombocytopeniaBlood and lymphatic system disorders
Upper respiratory tract infectionInfections and infestations
Decreased appetiteMetabolism and nutrition disorders
ChillsGeneral disorders
Weight decreasedInvestigations
DizzinessNervous system disorders
TachycardiaCardiac disorders
Blood creatinine increasedInvestigations
Febrile neutropeniaBlood and lymphatic system disorders
AnxietyPsychiatric disorders
HypogammaglobulinaemiaImmune system disorders
Urinary tract infectionInfections and infestations
Pain in extremityMusculoskeletal and connective tissue disorders
Abdominal painGastrointestinal disorders
VomitingGastrointestinal disorders
Influenza like illnessGeneral disorders
NasopharyngitisInfections and infestations
HyponatraemiaMetabolism and nutrition disorders
AstheniaGeneral disorders
PneumoniaInfections and infestations

Most-reported serious reactions: Cytokine release syndrome, Febrile neutropenia, Pyrexia, Pneumonia, Fatigue, Myelodysplastic syndrome, Encephalopathy, Acute kidney injury.

Data from ClinicalTrials.gov NCT02445248 adverse events section.

Sponsor's own description

This is a multi-center, phase II study to determine the efficacy and safety of CTL019 in adult patients with relapsed or refractory DLBCL.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Tisagenlecleucel in Adult Relapsed or Refractory Diffuse Large B-Cell Lymphoma.
    Schuster SJ, Bishop MR, Tam CS, Waller EK, et al · · 2019 · cited 3115× · PMID 30501490 · DOI 10.1056/nejmoa1804980
  2. Engineered T cells: the promise and challenges of cancer immunotherapy.
    Fesnak AD, June CH, Levine BL. · · 2016 · cited 812× · PMID 27550819 · DOI 10.1038/nrc.2016.97
  3. Long-term clinical outcomes of tisagenlecleucel in patients with relapsed or refractory aggressive B-cell lymphomas (JULIET): a multicentre, open-label, single-arm, phase 2 study.
    Schuster SJ, Tam CS, Borchmann P, Worel N, et al · · 2021 · cited 429× · PMID 34516954 · DOI 10.1016/s1470-2045(21)00375-2
  4. Chimeric antigen receptor T-cell therapies for lymphoma.
    Brudno JN, Kochenderfer JN. · · 2018 · cited 390× · PMID 28857075 · DOI 10.1038/nrclinonc.2017.128
  5. Cornerstones of CRISPR-Cas in drug discovery and therapy.
    Fellmann C, Gowen BG, Lin PC, Doudna JA, et al · · 2017 · cited 340× · PMID 28008168 · DOI 10.1038/nrd.2016.238
  6. Grading of cytokine release syndrome associated with the CAR T cell therapy tisagenlecleucel.
    Porter D, Frey N, Wood PA, Weng Y, et al · · 2018 · cited 266× · PMID 29499750 · DOI 10.1186/s13045-018-0571-y
  7. Chimeric antigen receptor (CAR) T therapies for the treatment of hematologic malignancies: clinical perspective and significance.
    Boyiadzis MM, Dhodapkar MV, Brentjens RJ, Kochenderfer JN, et al · · 2018 · cited 199× · PMID 30514386 · DOI 10.1186/s40425-018-0460-5
  8. Current status and perspective of CAR-T and CAR-NK cell therapy trials in Germany.
    Albinger N, Hartmann J, Ullrich E. · · 2021 · cited 171× · PMID 33753909 · DOI 10.1038/s41434-021-00246-w

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Other trials of Tisagenlecleucel

Trials testing the same drug.

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Trials by the same sponsor.

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Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT02445248.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing