Jeff Aycock

Abstract CT019: Primary results from ZUMA-1: a pivotal trial of axicabtagene ciloleucel (axicel; KTE-C19) in patients with refractory aggressive non-Hodgkin lymphoma (NHL)

Introduction: Outcomes for pts with refractory aggressive NHL are poor with current therapies (Crump, ASCO 2016). Results from the interim analysis of (n=62) of ZUMA-1, the 1st multicenter trial of an anti-CD19 chimeric antigen receptor (CAR) T cell, axi-cel, in refractory aggressive NHL, showed an objective response rate (ORR) of 79% (complete response [CR] 52%; Blood 2016;128:LBA-6). Here we present results from the primary analysis of ZUMA-1. Methods: Pts received a target dose of 2 × 106 anti-CD19 CAR T cells/kg after lowdose conditioning with cy/flu. Eligible pts (≥18 y) had diffuse large B cell lymphoma (DLBCL), primary mediastinal B cell lymphoma (PMBCL) or transformed follicular lymphoma (TFL); an ECOG performance status (PS) 0-1; and refractory disease (progressive or stable disease as best response to last prior therapy, or relapsed ≤12 m of autologous stem cell transplant [ASCT]). The primary endpoint for this analysis was ORR in the combined DLBCL, PMBCL, and TFL population. Key secondary endpoints were duration of response (DOR), overall survival (OS), and frequency of adverse events (AEs). The primary analysis was triggered when 92 pts had at least 6 m of follow-up. Results: As of January 27, 2017, 111 pts from 22 institutions were enrolled; 101 pts (91%) received axi-cel. Median age was 58 y (range, 23-76), 67% male, 85% stage IIIIV, 47% IPI 3-4, 77% refractory to ≥2nd line of therapy, and 21% relapsed ≤12 m of ASCT. Axi-cel was successfully manufactured in 110/111 (99%) pts with an average turnaround time from apheresis to the clinical site of 17 d. With an ORR of 82% (n = 92; P Conclusions: Axi-cel significantly improved ORR in patients with refractory aggressive NHL. The CR rate was 7-fold higher compared to historical controls (Crump, ASCO 2016) and nearly half the patients have an ongoing response. Axi-cel demonstrated significant clinical benefit with a manageable safety profile in pts lacking curative treatment options.[F.L.L. and S.S.N. contributed equally to this study.] Funding source: Kite Pharma and in part by funding from the Leukemia & Lymphoma Society (LLS) Therapy Acceleration Program treatment options. Citation Format: Frederick L. Locke, Sattva S. Neelapu, Nancy L. Bartlett, Lazaros J. Lekakis, David Miklos, Caron A. Jacobson, Ira Braunschweig, Olalekan Oluwole, Tanya Siddiqi, Yi Lin, John Timmerman, Jonathan W. Friedberg, Adrian Bot, John Rossi, Lynn Navale, Yizhou Jiang, Jeff Aycock, Meg Elias, Jeff Wiezorek, William Y. Go. Primary results from ZUMA-1: a pivotal trial of axicabtagene ciloleucel (axicel; KTE-C19) in patients with refractory aggressive non-Hodgkin lymphoma (NHL) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr CT019. doi:10.1158/1538-7445.AM2017-CT019

Abstract 2308: Manufacturing and characterization of KTE-C19 in a multicenter trial of subjects with refractory aggressive non-Hodgkin's lymphoma (NHL) (ZUMA-1): Table 1.

Introduction: KTE-C19 is an autologous anti-CD19 CAR T cell product that is being studied in a phase 2 multicenter trial (ZUMA-1, NCT02348216). We developed a robust and efficient manufacturing process to support this trial, and compared the characteristics of the starting lymphocytes to resultant CAR T cells. Methods: After apheresis and PBMC enrichment, cells were activated with anti-CD3 antibody and cultured in serum free medium. T cells were transduced with a retroviral vector encoding the CAR gene, expanded to achieve a target dose and cryopreserved. The product CAR T cells and the starting PBMCs were evaluated by flow cytometry. Results: 7 subjects were dosed in the phase 1 portion of the trial. KTE-C19 was successfully manufactured at a dose of 2 × 10 6 /kg (minimum 1 × 10 6 /kg) for all subjects. All lots contained mainly CD3+ T cells (median 97%; 94-99%). While there was inter-subject variability in PBMC and CAR T cell product characteristics, the CD8/CD4 T cell ratios in PBMC and corresponding CAR product were similar (Table 1). T cells in PBMC from patients with NHL contained a majority of effector memory (36%) and effector T cells (27%), however, T cells in KTE-C19 contained a majority of central memory (37%) and effector memory (42%) CAR+ T cells. These CAR T cells were active and objective responses occurred in 5/7 patients. Conclusions: A KTE-C19 dose was successfully produced for all subjects. The optimized manufacturing process generated clinically active CAR T cells with a less differentiated phenotype than T cells in the starting PBMC population. Less differentiated cells likely confer preferred product characteristics based on preclinical studies. This manufacturing process is robust and well suited for multicenter clinical trials. Citation Format: Marc Better, Vijay Chiruvolu, James Oliver, Maryam Sorkhabi, Jeff S. Aycock, Emily Lowe, Edmund Chang, Arianne Perez, Lynn Navale, John M. Rossi, Adrian Bot. Manufacturing and characterization of KTE-C19 in a multicenter trial of subjects with refractory aggressive non-Hodgkin9s lymphoma (NHL) (ZUMA-1). [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2308.