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Recurrent Diffuse Large B-Cell LymphomaEarly Phase 1NCT05800405

Evaluation of Bridging Radiation Therapy Before CAR T-Cell Infusion for the Treatment of Relapsed or Refractory Large B-Cell Lymphoma

A Early Phase 1 study testing Biospecimen Collection, Chimeric Antigen Receptor T-Cell Therapy and Computed Tomography in people with Recurrent Diffuse Large B-Cell Lymphoma and Refractory Diffuse Large B-Cell Lymphoma, run by City of Hope Medical Center at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This early phase I clinical trial evaluates bridging radiation therapy given before chimeric antigen receptor (CAR) T-cell infusion to treat large B-cell lymphoma (LBCL) that has come back (relapsed) or has not responded to previous treatment (refractory). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Biospecimen Collection, Chimeric Antigen Receptor T-Cell Therapy and Computed Tomography
Could I receive a placebo?
No, everyone receives an active treatment
How many people
9 participants
Where
1 siteUnited States
Study dates
20 Jul 2023to 4 Jan 2027
Phase
Early Phase 1
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Documented informed consent of the participant and/or legally authorized representative.
  • Assent, when appropriate, will be obtained per institutional guidelines.
  • Age: >= 18 years.
  • Eastern Cooperative Oncology Group (ECOG) =< 2 or Karnofsky Performance Status (KPS) >= 60.
  • Histologically confirmed large B-cell lymphoma.
  • Relapsed/refractory disease.
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  • Planned to undergo commercial CAR T-cell infusion within 3 months of enrollment.
  • 6 or fewer sites (treatable with a maximum of 3 isocenters) of FDG-PET avid disease, treatable with a a maximum of 3 isocenters.
  • Measurable disease e.g., at least 1.5 cm on CT/MRI or by Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1).
  • Fully recovered from the acute toxic effects (except alopecia) to =< grade 1 to prior anti-cancer therapy.
  • Women of childbearing potential (WOCBP): negative urine or serum pregnancy test (performed within 30 days prior to day 1 of protocol therapy).
  • If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.

Who cannot join

  • Prior CD19-directed therapy.
  • Radiation therapy within 21 days prior to day 1 of protocol therapy.
  • Central nervous system (CNS) disease.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to study agent.
  • Active diarrhea.
  • Clinically significant uncontrolled illness.
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  • Active infection requiring antibiotics.
  • Other active malignancy.
  • Females only: Pregnant.
  • Any other condition that would, in the investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures.
  • Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site, 1 recruiting
  • City of Hope Medical Center

    Duarte, California, 91010

    Savita V. Dandapani, 626-218-5334 ext. 82071, sdandapani@coh.org

    Savita V. Dandapani

    Recruiting

Other trials in United States

About this study

Official title: A Feasibility Study of Bridging Radiation to All Sites of FDG-Avid Disease for Commercial CAR T-Cell Infusion in Patients With Large B-Cell Lymphoma

This early phase I clinical trial evaluates bridging radiation therapy given before chimeric antigen receptor (CAR) T-cell infusion to treat large B-cell lymphoma (LBCL) that has come back (relapsed) or has not responded to previous treatment (refractory). Patients with relapsed or refractory disease have historically poor prognosis. CAR T-cell therapy is a type of treatment in which a patient's T-cells (a type of immune system cell) are changed in the laboratory so they will attack cancer cells. T-cells are taken from a patient's blood (leukapheresis). Then the gene for a special receptor that binds to a certain protein on the patient's cancer cells is added to the T-cells in the laboratory. The special receptor is called a chimeric antigen receptor (CAR). Large numbers of the CAR T-cells are grown in the laboratory and given to the patient by infusion for treatment of certain cancers. While the outcomes from CAR T-cell therapy appear favorable, in the time between leukapheresis and CAR T-cell infusion many patients have symptomatic or life-threatening disease which often requires bridging therapy. Bridging therapy aims to slow disease progression and control symptoms during this critical period prior to CAR T-cell infusion. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill cancer cells. Giving bridging radiation therapy to patients with relapsed or refractory LBCL prior to CAR T-cell infusion may improve treatment outcomes with minimal toxicity.

Read the detailed description

PRIMARY OBJECTIVE:

  1. Evaluate if bridging radiation to all sites of F-fluorodeoxyglucose (FDG)-avid disease can be feasibly administered prior to commercial CAR T-cell infusion in patients with large B-cell lymphoma (LBCL).

SECONDARY OBJECTIVES:

  1. Assess the toxicities of bridging radiation in patients with LBCL. II. Assess overall response rate, complete response rate, progression-free survival, local control, distant control, and overall survival after bridging radiation and CAR T-cell infusion in patients with LBCL.

EXPLORATORY OBJECTIVES:

  1. Bank blood for future immune profiling or other correlatives. II. Explore the association between positron emission tomography (PET)/computed tomography (CT) radiomic features and clinical outcomes.

III. Collect PET/CT imaging data using the RefleXion X1 linear accelerator imaging system.

OUTLINE:

Patients undergo leukapheresis per standard of care, undergo external beam radiation therapy, and undergo CAR T-cell infusion per standard of care on study. Patients undergo PET/CT throughout the study and may undergo magnetic resonance imaging (MRI) during screening. Patients also undergo blood sample collection throughout the study.

Being tested
Biospecimen Collection, Chimeric Antigen Receptor T-Cell Therapy, Computed Tomography, External Beam Radiation Therapy, Leukapheresis
Medical subject headings
Lymphoma, Large B-Cell, Diffuse

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Biospecimen CollectionProcedure or surgery

    Also called Biological Sample Collection, Biospecimen Collected, Specimen Collection

    Undergo blood sample collection

  • Chimeric Antigen Receptor T-Cell TherapyBiological

    Also called CAR T Infusion, CAR T Therapy, CAR T-cell Therapy, Chimeric Antigen Receptor T-cell Infusion

    Receive CAR-T per standard of care

  • Computed TomographyProcedure or surgery

    Also called CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography

    Undergo PET/CT

  • External Beam Radiation TherapyRadiation

    Also called Definitive Radiation Therapy, EBRT, External Beam Radiation, External Beam Radiotherapy

    Undergo radiation therapy

  • LeukapheresisProcedure or surgery

    Also called Leukocytopheresis, Therapeutic Leukopheresis

    Receive leukapheresis

  • Magnetic Resonance ImagingProcedure or surgery

    Also called Magnetic Resonance, Magnetic Resonance Imaging Scan, Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance, MR

    Undergo MRI

  • Positron Emission TomographyProcedure or surgery

    Also called Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron Emission Tomography Scan

    Undergo PET/CT

Study groups in NCT05800405
Study groupRoleWhat they receive
Treatment (leukapheresis, external beam radiation, CAR-T)ExperimentalPatients undergo leukapheresis per standard of care, undergo external beam radiation therapy, and undergo CAR T-cell infusion per standard of care on study. Patients undergo PET/CT throughout the study and may undergo MRI during screening. Patients also undergo blood sample collection throughout the study.
Receives: Procedure: Biospecimen Collection; Biological: Chimeric Antigen Receptor T-Cell Therapy; Procedure: Computed Tomography; Radiation: External Beam Radiation Therapy; Procedure: Leukapheresis; Procedure: Magnetic Resonance Imaging; Procedure: Positron Emission Tomography

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of participants completing planned radiation therapy

    Will be assessed by the proportion of participants completing planned radiation therapy without any grade 3 or higher radiation-attributable (possibly, probably, or definitely) adverse events (AEs), along with its associated 95% Clopper Pearson exact binomial confidence interval (CI). All participants who start protocol radiation therapy are evaluable.

    Measured: From the first fraction of radiation until approximately 1 month after infusion of chimeric antigen receptor (CAR) T-cell therapy

Secondary outcomes (7)
  1. Incidence of AEs

    Will be assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v)5.0 except in the case of cytokine release syndrome and neurotoxicity, which will be graded by American Society for Transplantation and Cellular Therapy Consensus Grading and not NCI CTCAE v5.0. All participants who receive any fraction of protocol radiation are evaluable.

    Measured: Up to 1 year

  2. Objective response rate

    Will be defined as the proportion of participants that achieve a best response of either complete response (CR) or partial response after CAR T-cell infusion and prior to disease progression and/or start of other anti-lymphoma therapy, along with its associated 95% Clopper Pearson exact binomial CI. Only participants who receive CAR T-cell infusion post protocol radiation are evaluable.

    Measured: Up to 1 year

  3. Complete response rate

    Will be defined as the proportion of participants that achieve a best response of CR after CAR T-cell infusion and prior to disease progression and/or start of other anti-lymphoma therapy, along with its associated 95% Clopper Pearson exact binomial CI. Only participants who receive CAR T-cell infusion post protocol radiation are evaluable.

    Measured: Up to 1 year

  4. Progression free survival

    Will be assessed only in participants who receive CAR T-cell infusion post protocol radiation are evaluable for this endpoint. Will be estimated for patients who received radiation and CAR T-cells using the Kaplan Meier method along with the Greenwood estimator of standard error; 95% confidence interval will be constructed based on log-log transformation.

    Measured: Time from CAR T-cell infusion to time of disease relapse/progression or death due to any cause, whichever occurs first, assessed up to 1 year

  5. Overall survival

    Will be assessed only in participants who receive CAR T-cell infusion post protocol radiation are evaluable. Will be estimated for patients who received radiation and CAR T-cells using the Kaplan Meier method along with the Greenwood estimator of standard error; 95% confidence interval will be constructed based on log-log transformation.

    Measured: Time from CAR T-cell infusion to time of death due to any cause, assessed up to 1 year

  6. Local control

    Will be defined as the 80% isodose line. Only participants who receive CAR T-cell infusion post protocol radiation are evaluable. Will be analyzed by competing risk method where death without any progression will also be treated as a competing risk event.

    Measured: Time from CAR T-cell infusion to time of disease relapse/progression within the radiation field, assessed up to 1 year

  7. Distant control

    Will be defined as the 80% isodose line. Only participants who receive CAR T-cell infusion post protocol radiation are evaluable. Will be analyzed by competing risk method where death without any progression will also be treated as a competing risk event.

    Measured: Time from CAR T-cell infusion to time of disease relapse/progression outside the radiation field, assessed up to 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Apr 2023
  2. Study start20 Jul 2023
  3. Primary completion4 Jan 2027 (estimated)
  4. Study completion4 Jan 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Early Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
9 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05800405
Sponsor's protocol ID
22141
Other IDs
NCI-2023-02190, 22141, P30CA033572
Status last verified
Feb 2026
First submitted
24 Mar 2023
Last updated
4 Feb 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Early Phase 1 study testing Biospecimen Collection, Chimeric Antigen Receptor T-Cell Therapy and Computed Tomography in people with Recurrent Diffuse Large B-Cell Lymphoma and Refractory Diffuse Large B-Cell Lymphoma, run by City of Hope Medical Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 4 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of participants completing planned radiation therapy (time frame: From the first fraction of radiation until approximately 1 month after infusion of chimeric antigen receptor (CAR) T-cell therapy). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Feb 2026.

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