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B-Cell LeukemiaPhase 1NCT06208735

CLIC-2201 for the Treatment of Relapsed/Refractory B Cell Malignancies

A Phase 1 study testing CLIC-2201 in people with B-Cell Leukemia and Non-Hodgkin's Lymphoma, run by British Columbia Cancer Agency at 7 sites in Canada.

Recruiting

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

Sites and contacts
Official record
Search all trials

Trial summary

This is a phase I dose-finding trial of an autologous CD22 targeting chimeric antigen receptor (CAR)-T cell product, called CLIC-2201, for participants with relapsed/refractory B cell malignancies. Read more about this study

Who is it for?
Ages 1 year and older
What is being tested?
CLIC-2201
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
7 sitesCanada
Study dates
2 Jan 2025to 1 Aug 2028
Phase
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 1 year and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Participants must meet the following criteria to be enrolled on the trial:
  • Participants in the cohort A must be 18 years of age or older of age at time of informed consent.
  • Participants must provide written informed consent.
  • Participants must have a relapsed or refractory B cell lymphoma, including one of the following:
  • diffuse large B-cell lymphoma (DLBCL) not otherwise specified (NOS),
  • high grade B cell lymphoma NOS,
Show all 36Show fewer
  • high grade B cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements,
  • primary mediastinal large B-cell lymphoma (PMBCL),
  • aggressive B cell lymphoma transformed from an indolent lymphoma,
  • mantle cell lymphoma (MCL),
  • Participants must have refractory or relapsed disease, defined as one of the following:
  • Relapse or refractory disease after at least 2 lines of therapy, OR
  • Any relapse after autologous or allogeneic hematopoietic cell transplantation (HCT), OR
  • Any relapse after CAR-T cell therapy.
  • Participants must have adequate organ function at enrolment, defined as:
  • Left ventricular ejection fraction (LVEF) ≥ 45%, and no current evidence of significant cardiac dysfunction.
  • Creatinine clearance using Cockcroft-Gault of > 30 mL/min, AND
  • ALP/ALT < 5X upper limit of normal (ULN), conjugated bilirubin < 2X ULN, and no evidence or history of liver cirrhosis.
  • Participants must have Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2 or Karnofsky Score ≥50%.
  • Females of child-bearing potential and sexually active males must agree to use a highly effective contraception method (see section 5.4) through to at least one year following administration of the CLIC-2201 product.
  • Participants with accessible disease, must be willing to undergo a tumour biopsy at enrolment. For participants with a recent (within 3 months) tumor biopsy, access to the archival biopsy is acceptable.
  • Participants in the cohort B must be between 1-39 years of age at the time of consent.
  • For participants who are under the age of consent as defined by REB requirements, parent or legal guardian of the participant must provide the informed consent and the participant's assent/consent must be obtained (if applicable).
  • Participants must have a relapsed or refractory B cell acute lymphoblastic leukemia (B-ALL).
  • Participants must have refractory or relapsed disease, defined as one of the following:
  • Relapse or refractory disease after at least 2 lines of therapy, OR
  • Any relapse after autologous or allogeneic hematopoietic cell transplantation (HCT), OR
  • Any relapse after CAR-T cell therapy.
  • Participants in cohort B and/or those who have received CD22 targeted therapy must have documentation of CD22 tumour expression within the 6 months prior to study screening, and after any prior CD22 directed therapy (if applicable).
  • Participants must have adequate organ function at enrolment, defined as:
  • Left ventricular ejection fraction (LVEF) ≥ 45%, and no current evidence of significant cardiac dysfunction.
  • Creatinine clearance using Cockcroft-Gault or Schwartz equation of > 30 mL/min, AND
  • ALP/ALT < 5X upper limit of normal (ULN), conjugated bilirubin < 2X ULN, and no evidence or history of liver cirrhosis.
  • Participants must have a Karnofsky or Lansky Score ≥50%.
  • Participants of reproductive age must agree to use a highly effective contraception method through to at least one year following administration of the CLIC-2201 product.
  • Participants must be willing to undergo a bone marrow biopsy at enrolment.

Who cannot join

  • Any uncontrolled or serious active infection at the time of enrolment.
  • Active autoimmune disease requiring immunosuppressive therapy within 4 weeks of enrolment.
  • Live vaccine ≤6 weeks prior to enrolment
  • Active Graft Versus Host Disease (GVHD) requiring systemic immunosuppressive therapy within 4 weeks of enrolment.
  • Diagnosis of primary central nervous system lymphoma (PCNSL)
  • Treatment with any of the following in the specified time period before leukapheresis:
Show all 23Show fewer
  • Allogeneic HCT within 3 months,
  • Autologous HCT within 3 months,
  • CD19 CAR-T cell infusion within 3 months,
  • Donor lymphocyte infusion (DLI) within 3 months,
  • Bendamustine within the last 6 months,
  • Any investigational agent within 30 days or 5 half-lives (whichever is shorter),
  • Systemic administration of therapeutic dose corticosteroids (>20 mg/day prednisone or equivalent for adults and ≥ 12 mg/m2/day for paediatric participants) within 7 days prior to leukapheresis.
  • Immunosuppressive therapies (i.e., calcineurin inhibitors, methotrexate, mycophenolate, rapamycin) within 4 weeks, unless used as treatment for the B cell malignancy.
  • Oral chemotherapy agents (i.e., venetoclax) within 5 half-lives. An exception to this is that bruton tyrosine kinase (BTK) inhibitors like ibrutinib can be continued in participants with mantle cell lymphoma throughout the trial period.
  • Other concurrent malignancy or a prior malignancy treated within the past 2 years, except carcinoma in situ of the skin or cervix treated with curative intent and with no evidence of active disease.
  • Concomitant genetic syndrome associated with bone marrow failure such as Fanconi anemia, Kostmann syndrome, Shwachman syndrome or any other known bone marrow failure or immunodeficiency syndrome.
  • Active (confirmed by PCR) hepatitis B or hepatitis C at time of screening confirmed by PCR.
  • Any Human Immunodeficiency Virus (HIV) infection at time of screening.
  • Hypersensitivity to fludarabine or cyclophosphamide.
  • Any allergy to gentamycin or its derivatives
  • Participants who do not meet the minimum weight requirement for the planned dose level.
  • Pregnant or nursing participants.

Trial locations and contacts

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

7 sites in 1 country

Canada7 sites, 7 recruiting
  • Arthur J.E. Child Comprehensive Cancer Centre

    Calgary, Alberta, T2N 5G2

    Karm Alhasan, karm.alhasan2@cancercarealberta.ca

    Robert Puckrin, MD

    Recruiting
  • Alberta Children's Hospital

    Calgary, Alberta, T3B 6A8

    Sherry Qian, sherry.qian@albertahealthservices.ca

    Victor Lewis, MD

    Recruiting
  • The Ottawa Hospital - General Campus

    Ottawa, Ontario, K1H 8L6

    Vanessa Lopez, vlopez@ohri.ca

    Natasha Kekre, MD

    Recruiting
  • Princess Margaret Cancer Centre

    Toronto, Ontario

    Hannah Sendzik, hannah.sendzik@uhn.ca

    John Kuruvilla, MD

    Recruiting
  • The Hospital for Sick Children

    Toronto, Ontario

    Erilda Kapllani, erilda.kapllani@sickkids.ca

    Joerg Krueger, MD

    Recruiting
  • Vancouver General Hospital

    Vancouver, British Columbia, V5Z 1M9

    Madeleine Cannings, madeleine.cannings@bccancer.bc.ca

    Hannah Cherniawsky, MD

    Recruiting
  • BC Children's Hospital

    Vancouver, British Columbia

    Nima Molavi, nima.molavi@cw.bc.ca

    Amanda Li, MD

    Recruiting

Other trials in Canada

About this study

Official title: CLIC-02: A Phase I Trial of CLIC-2201 for the Treatment of Relapsed/Refractory B Cell Malignancies

This is a phase I dose-finding trial of an autologous CD22 targeting chimeric antigen receptor (CAR)-T cell product, called CLIC-2201, for participants with relapsed/refractory B cell malignancies. In the proposed trial, eligible enrolled participants will undergo leukapheresis for autologous T cell collection to enable CLIC-2201 manufacturing, followed by lymphodepletion with cyclophosphamide and fludarabine, then intravenous infusion of the autologous CLIC-2201 product. The trial will use the 3+3 design to escalate or de-escalate the dose level of CLIC-2201 administered. Participants will be monitored for safety and tolerability up to day 365 following CLIC-2201 infusion.

The primary objective is to evaluate the safety and tolerability of CLIC-2201 and estimate the maximum tolerated dose (MTD) of CLIC-2201 in B-cell malignancies.

Read more

The secondary objectives are to evaluate the (i) feasibility; (ii) anti-tumour activity of CLIC-2201; (iii) and characterize the pharmacokinetic (PK) profile of CLIC-2201.

Exploratory objectives will include: i) characterizing the cellular and humoral immune responses against CLIC-2201 up to 1 year following infusion of CLIC-2201; (ii) characterizing the phenotype and gene expression profile of CLIC-2201 cells; (iii) evaluating immune and tumour cells at baseline and relapse for biomarkers of response or toxicity; (iv) evaluating serum cytokines, circulating tumour DNA (ctDNA) and B cell aplasia as biomarkers of clinical outcomes; and (v) assessing the quality of life.

Read the detailed description

This is a Phase I, first-in-human, open-label multicenter trial of CLIC-2201 CAR-T cells for participants with relapsed/refractory B cell malignancies.

This trial will be conducted in two cohorts (cohort A, including 12 adult participants with B-NHL and cohort B, including 12 paediatric/young adult participants with B-ALL).

Consented participants will undergo a series of tests to confirm eligibility. Following eligibility confirmation, participants will undergo leukapheresis, which enables CLIC-2201 manufacturing. Leukapheresis is a procedure where white blood cells are collected from the blood. The collected cells will be shipped fresh to the Conconi Family Immunotherapy Laboratory (CFIL) in Victoria, BC, where manufacturing will take place.

At the CFIL lab, the autologous T cells will be selected, activated, and transduced with lentivirus to deliver the sdCD22 CAR transgene and then expanded over a period of 8 days in an automated, closed process on the CliniMACS Prodigy.

Participants will undergo lymphodepleting chemotherapy consisting of fludarabine (40 mg/m^2 daily x 3 days) and cyclophosphamide (500 mg/m^2 daily x 2 days) on trial days -4 and -3. The chemotherapy will deplete the exciting immune cells and give a chance to the infused CAR-T cells to expand and grow in the body.

Infusion of the autologous CLIC-2201 will follow at least 48 hours after but within seven days of completion of the last dose of fludarabine.

The standard 3+3 design will be used for CLIC-2201 administration to guide dosing and determination of the maximum tolerated dose (MTD). At each dose level, a decision will be made by the study team to escalate (E), stay at the current dose (S), de-escalate (D), or remove that dose level from further enrollment on trial (R) based on the number of dose-limiting toxicities (DLTs) evaluable participants who experience a DLT at that level.

There is no evidence that dosing of CAR-T cells/kg is different between paediatric and adult populations; however, most CAR-T cell products for B-ALL typically used a lower dose than for B-NHL. Therefore, in this trial, each dose level will be evaluated in adults before enrolling pediatric participants at that dose level.

Participants in each cohort will be enrolled and treated in groups of n=3. The first 3 participants (group 1) will be treated at DL1. The first participant at this dose level will be staggered for a minimum of 28 days to allow for the full assessment of DLTs. After this, the other two participants enrolled at this level will be monitored for a minimum 14-day period. The staggered intervals pattern will be repeated for each dose level.

If none of the three participants in group 1 experiences a DLT, another group of three participants will be treated at the next higher dose level (DL2).

If >=2/3 participants experience a DLT, the dose will be de-escalated to DL-1, with de-escalation to DL-1 potentially occurring if both first 2 participants experience a DLT.

If 1/3 participants experience a DLT, an additional group of 3 more participants will be treated at the same dose level.

The dose escalation will continue until the maximum dose level (DL3) is reached without significant DLTs, or when at least 2/6 participants experience DLTs at a certain dose level (i.e., 33% of patients with a DLT at that dose level). The MTD will then be defined as the dose level just below this toxic dose level.

To receive the CLIC-2201 infusion, participants will be admitted to the in-patient unit, and they will remain at the hospital for a minimum of 7 days to be monitored closely for any complication, infection, and side effects. The participants will be discharged to the appropriate outpatient clinic if they are deemed medically stable after this time.

Participants will be seen at the outpatient clinic or daycare unit on days 10, 14, 21, 28, 60, 90, 180, 365, 547, and 730 after the CLIC-2201 infusion. They will continue with annual follow-up visits up to 15 years post-CLIC-2201 infusion.

Being tested
CLIC-2201
Keywords
Chimeric Antigen Receptor T cells, CLIC-2201, CD22, Immunotherapy, CAR-T cell
Medical subject headings
Leukemia, B-Cell, Lymphoma, Non-Hodgkin, Burkitt Lymphoma, Lymphoma, Large B-Cell, Diffuse, Lymphoma, Mantle-Cell, Lymphoma, B-Cell

What participants receive

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

  • CLIC-2201Biological

    Also called Autologous CD22 targeting CAR-T cells

    Participants will undergo (a) lymphodepletion with cyclophosphamide and fludarabine, followed by (b) infusion of autologous CLIC-2201 CAR-T cells. All treatments will be delivered intravenously.

Study groups in NCT06208735
Study groupRoleWhat they receive
CLIC-2201ExperimentalA single Intravenous infusion of CLIC-2201 will be given.
Receives: Biological: CLIC-2201

What is being measured

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

  1. Defining the maximum tolerated dose (MTD) of CLIC-2201

    The MTD will be measured by monitoring and recording the AEs experienced by the participant within the first 28 days after the infusion, including the treatment-related death as deemed by the investigator, grade 3 Cytokine Release Syndrome (CRS), Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS), and Immune Effector Cell-Associated Hemophagocytic Lymphocytosis-Like Syndrome (IEC-HS) lasting for more than seven days; grade 4 CRS, ICANS, and IEC-HS; grade 4 non-hematologic toxicity that is not deemed related to CRS, ICANS, IEC-HS (except for Grade 4 transaminases and isolated, asymptomatic laboratory electrolyte abnormalities for seven days or more).

    Measured: Within the first 28 days of CAR-T infusion

  2. Proportion of participants who experienced any grade of CRS to define the safety of CLIC-2201

    The safety will be measured by the proportion of participants who experienced any grade of CRS, ICANS, IEC-HS, any adverse events, and any severe adverse events.

    Measured: Within the first 28 days of CAR-T infusion

  3. Proportion of participants who experienced any grade of ICANs to define the safety of CLIC-2201

    The safety will be measured by the proportion of participants who experienced any grade of CRS, any grade of ICANS, any adverse events, and any severe adverse events.

    Measured: Within the first 28 days of CAR-T infusion

  4. Proportion of participants who experienced any grade of IEC-HS to define the safety of CLIC-2201

    The safety will be measured by the proportion of participants who experienced any grade of CRS, any grade of ICANS, any adverse events, and any severe adverse events.

    Measured: Within the first 28 days of CAR-T infusion

  5. Proportion of participants who experienced any grade of AEs to define the safety of CLIC-2201

    The safety will be measured by the proportion of participants who experienced any grade of CRS, any grade of ICANS, any adverse events, and any severe adverse events.

    Measured: Within the first 28 days of CAR-T infusion

  6. Proportion of participants who experienced any SAEs to define the safety of CLIC-2201

    The safety will be measured by the proportion of participants who experienced any grade of CRS, any grade of ICANS, any adverse events, and any severe adverse events.

    Measured: Within the first 28 days of CAR-T infusion

Secondary outcomes (13)
  1. Proportion of participants achieving achieving and/or maintaining Complete response (CR) or complete response with incomplete count recovery (CRi).

    This would be used to measure the anti-tumour activities of the CLIC-2201 treatment within a year after the infusion. The complete response will be assessed on days 28, 90, 180, and 365.

    Response for lymphoma participants will be defined by Lugano criteria and for B-ALL participants by CIBMTR response criteria.

    Measured: Within 730 days of CAR-T infusion

  2. Proportion of participants with an overall response [achieving a CR or partial remission (PR)]

    This would be used to measure the anti-tumour activities of the CLIC-2201 treatment within a year after the infusion.

    Measured: Within 730 days of CAR-T infusion

  3. Proportion of B-ALL participants with B with minimal residual disease (MRD) negative status by next-generation sequencing and/or high-resolution flow cytometry.

    This would be used to measure the anti-tumour activities of the CLIC-2201 treatment within a year after the infusion. The partial remission will be assessed on days 28, 90, 180, and 365.

    Measured: Within 730 days of CAR-T infusion

  4. Overall survival rate

    This would be used to measure the the anti-tumor activities of the CLIC-2201 treatment within 6 months after the infusion.

    Measured: Up to 15 years of CAR-T infusion

  5. Progression free survival rate

    This would be used to measure the the anti-tumor activities of the CLIC-2201 treatment within 6 months after the infusion.

    Measured: Up to 15 years of CAR-T infusion

  6. The average number of CAR transgene copies per cell

    This would be used to evaluate the pharmacokinetics of the CLIC-2201 treatment.

    Measured: Up to day 730

  7. Proportion of participants who fail enrollment that were successfully screened

    This would be used to evaluate the feasibility of administering CLIC-2201 cells to participants with relapsed/refractory B Cell Malignancies.

    Measured: Enrollment

  8. Proportion of participants for whom leukapheresis failed that successfully completed trial enrollment

    This would be used to evaluate the feasibility of administering CLIC-2201 cells to participants with relapsed/refractory B Cell Malignancies.

    Measured: From date of enrollment until the date of leukapheresis, assessed up to 4 weeks

  9. Proportion of participants for whom CLIC-2201 manufacturing was unsuccessful that completed leukapheresis

    This would be used to evaluate the feasibility of administering CLIC-2201 cells to participants with relapsed/refractory B Cell Malignancies.

    Measured: Through manufacturing, an average of 8 days

  10. Proportion of participants who fail to receive CLIC-2201 infusion for whom a CLIC-2201 was successfully manufactured

    This would be used to evaluate the feasibility of administering CLIC-2201 cells to participants with relapsed/refractory B Cell Malignancies.

    Measured: Day of CLIC-2201 infusion

  11. Median time from enrollment to leukapheresis

    This would be used to evaluate the feasibility of administering CLIC-2201 cells to participants with relapsed/refractory B Cell Malignancies.

    Measured: From date of enrollment until the date of leukapheresis, assessed up to 4 weeks

  12. Median time from enrollment to CLIC-2201 infusion

    This would be used to evaluate the feasibility of administering CLIC-2201 cells to participants with relapsed/refractory B Cell Malignancies.

    Measured: From date of enrollment until the date of infusion, assessed up to 6 weeks

  13. Median time from enrollment to disease progression that prevents CLIC-2201 infusion.

    This would be used to evaluate the feasibility of administering CLIC-2201 cells to participants with relapsed/refractory B Cell Malignancies.

    Measured: From date of enrollment until the date of infusion, assessed up to 6 weeks

Timeline

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

  1. First posted17 Jan 2024
  2. Study start2 Jan 2025
  3. Primary completion1 Aug 2027 (estimated)
  4. Study completion1 Aug 2028 (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
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
This is a Phase I, first-in-human, open-label multicenter trial of CLIC-2201 CAR-T cells in participants with relapsed or refractory CD22-positive B-cell malignancies. The trial will consist of a 3+3 dose-escalation/de-escalation method in both cohorts (Cohort A: individuals who are 18 years or older and diagnosed with relapsed or refractory B-NHL and Cohort B: pediatric individuals who are 1-39 years old and diagnosed with relapsed or refractory B-ALL) to evaluate the safety and tolerability of increasing dose levels of CLIC-2201 in order to estimate the MTD.
Masking
None (open label)
Enrolment
24 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06208735
Sponsor's protocol ID
CLIC-02
Status last verified
Oct 2026
First submitted
20 Dec 2023
Last updated
14 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing CLIC-2201 in people with B-Cell Leukemia and Non-Hodgkin's Lymphoma, run by British Columbia Cancer Agency at 7 sites in Canada.

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 36 inclusion and 23 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 14 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in Canada. 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?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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?

Contact Kevin Hay, MD ((403) 210-6191, kevin.hay@bccancer.bc.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Defining the maximum tolerated dose (MTD) of CLIC-2201 (time frame: Within the first 28 days of CAR-T infusion). The study lists 6 primary outcomes in all. 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 14 Oct 2026.

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