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Ampi202018printswap1up 1..76 HEMATOLOGIC MALIGNANCIES—LYMPHOMA AND CHRONIC LYMPHOCYTIC LEUKEMIA 8000 Oral Abstract Session, Fri, 8:00 AM-11:00 AM Is autologous transplantation (autoHCT) in relapsed diffuse large B-cell lymphoma (DLBCL) patients achieving only a PET/CT positive partial remission (PR) appropriate in the CAR-T cell era? Nirav Niranjan Shah, Kwang Woo Ahn, Carlos Litovich, Timothy Fenske, Mehdi Hamadani; Medical College of Wisconsin, Milwaukee, WI; Division of Biostatistics, Institution for Health and Society, Medical College of Wisconsin, Milwaukee, WI; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI; Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI Background: In relapsed, chemosensitive DLBCL patients (pts), autoHCT consolidation is a standard therapy option. With the approval of anti-CD19 CAR T-cells in 2017, relapsed DLBCL pts with residual PET/CT avid disease after salvage therapies are increasingly being offered CAR T-cells in lieu of autoHCT. According to Center for International Blood and Marrow Transplant Research (CIBMTR) data in 2018, the number of autoHCT for DLBCL in the U.S. decreased by ~45% from prior years, likely due to application of CAR T-cells for both chemorefractory DLBCL and chemosensitive DLBCL pts not achieving a complete remission. Using the CIBMTR database, we report outcomes of autoHCT in relapsed chemosensitive DLBCL pts achieving only a PET/CT+ PR prior to HCT. Methods: 249 relapsed DLBCL pts undergoing an autoHCT from 2003-13 with a PET/CT+ PR prior to transplant were identified. The study cohort was divided into two groups: (a) early chemo-immunotherapy failure (ECF) defined as pts with primary refractory disease (PRefD) or relapse within 12 months of diagnosis, (b) late chemoimmunotherapy failure (LCF) defined as pts relapsing $12 months. Primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS) and relapse. Results: 182 pts had ECF and 67 pts had LCF. The median age of ECF pts was 57 years versus (vs) 63 years for LCF (p , 0.01). ECF pts more frequently had stage III-IV at diagnosis (74% vs 54%, p = , 0.01). 79% of ECF pts had PRefD. The most common conditioning regimen was BEAM in both cohorts. The adjusted 5-year probabilities for PFS and OS (ECF vs LCF) was not different between the 2 cohorts: 41% vs 41% (p = 0.93) and 51% vs 63% (p = 0.09), respectively. Cumulative incidence of relapse at 5 years in similar order was 48% vs 57%, p = 0.27. On multivariate analysis compared to the LCF, pts with ECF had an increased risk of death (HR = 1.61, 95%CI 1.05-2.46, p = 0.03) but no increased risk in PFS or relapse. Conclusions: Using the CIBMTR registry, we report outcomes of relapsed DLBCL pts in a PR with residual PET/CT avid disease at time of autoHCT. While OS favored LCF pts, the adjusted 5-year PFS (41%) was comparable in both cohorts. This 5 year PFS is comparable to results reported in historical trials of auto-HCT for DLBCL. With no randomized data demonstrating superiority of CAR T-cell therapy in chemosensitive PR patients, these findings strongly support that autoHCT should remain the current standard of care for this patient population. Research Sponsor: None. © 2020 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information. HEMATOLOGIC MALIGNANCIES—LYMPHOMA AND CHRONIC LYMPHOCYTIC LEUKEMIA 8001 Oral Abstract Session, Fri, 8:00 AM-11:00 AM Phase I Alexander study of AUTO3, the first CD19/22 dual targeting CAR T cell therapy, with pembrolizumab in patients with relapsed/refractory (r/r) DLBCL. Wendy Osborne, Maria Marzolini, Eleni Tholouli, Aravind Ramakrishnan, Carlos R. Bachier, Peter A McSweeney, David Irvine, Michael Zhang, Muhammad Ali Al-Hajj, Martin Pule, Simon Thomas, Maud Jonnaert, Vijay Gopal Reddy Peddareddigari, Nushmia Z. Khokhar, Robert W. Chen, Kirit Ardeshna; Newcastle, Newcastle, United Kingdom; UCL, London, United Kingdom; Manchester Royal Infirmary, Manchester, United Kingdom; SCRI Austin St. Davids, Austin, TX; Texas Transplant Physician Group PLLC, San Antonio, TX; Colorado Blood Cancer Institute, Denver, CO; Glasgow Queen Elizabeth Uni- versity, Glasgow, United Kingdom; Autolus Therapeutics, London, United Kingdom; GlaxoSmithKline, Collegeville, PA; Janssen Pharmaceuticals, Collegeville, PA; City of Hope Medical Center, Duarte, CA; University College London Hospital, London, United Kingdom Background: CD19 directed CAR T cells are effective in patients with r/r DLBCL, however relapses due to CD19 loss or PDL1 upregulation are common. In this study, we evaluate the safety and efficacy of AUTO3, a CAR T targeting CD19/22 with limited duration of PD-1 blockade. Methods: We constructed a bicistronic retroviral vector encoding both an anti-CD19 (OX40 co-stim) and an anti-CD22 (41BB co- stim) CAR with humanized binders. The cell product was manufactured in a semi-automated and closed process using CliniMACS Prodigy. Patients ($ 18 years) with r/r DLBCL (NOS) or transformed (tDLBCL); ECOG ,2, adequate organ function are eligible. Lymphodepletion was Flu/Cy prior to AUTO3. Bridging therapy was allowed. The three dose levels explored are 50, 150, and 450 x 10^6 CAR T cells. Patients received AUTO3 alone, or with 3 doses of pembrolizumab (pem) 200 mg q 3 wks starting on D14 (regimen A), or with a single dose of pem 200 mg on D-1 (regimen B). The primary endpoint is frequency of DLTs and grade (G) 3-5 adverse events (AE) and secondary endpoints included ORR, CRR, and biomarkers. Results: As of Jan 21, 2020, 28 patients underwent leukapheresis, 27 successfully manufactured, 1 being manufactured, and 19 patients treated with AUTO3. The median age was 57 (28 - 71) and median number of prior therapies was 3 (2 - 10). 89% had refractory disease, 74% were DLBCL NOS, and 26% were tDLBCL. Dose escalation from 50 to 450 x 106 cells with pem regimen A and B have been completed without DLTs. G . 3 treatment emergent AEs that occurred . 15% were neutropenia (89%), thrombocytopenia (58%), anemia (47%), febrile neutropenia (16%), and hypophosphataemia (16%). Across all dose levels, there were 0% sCRS with primary infusion and 5% severe neurotoxicity (sNT) (1/19), which resolved. There were no cases of sCRS and no neurotoxicity of any grade at . 50 x 106 cells. Eighteen patients were evaluable for efficacy. Among the 11 treated at dose . 50 x 106, the ORR and CRR were 64% and 55%, and all CRs are ongoing (1-12 mth). Two out of 3 patients achieved CR at 450 x 106 cells on pem regimen B. Additional patients and longer follow up, as well as biomarkers, will be presented. Conclusions: AUTO3 at . 50 x 106 CAR T cells with pembrolizumab induces CRs without severe CRS or neurotoxicities of any grade. Clinical trial infor- mation: NCT03287817. Research Sponsor: Autolus Therapeutics. © 2020 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information. HEMATOLOGIC MALIGNANCIES—LYMPHOMA AND CHRONIC LYMPHOCYTIC LEUKEMIA 8002 Oral Abstract Session, Fri, 8:00 AM-11:00 AM First-in-human data of ALLO-501 and ALLO-647 in relapsed/refractory large cell or fol- licular lymphoma (R/R LBCL/FL): ALPHA study. Sattva Swarup Neelapu, Javier Munoz, Frederick Lundry Locke, David Bernard Miklos, Robert Brown, Jennifer T. McDevitt, Armen Mardiros, Eren Demirhan, Cyril Konto, Michael Timothy Tees; The University of Texas MD Anderson Cancer Center, Department of Lymphoma/Myeloma, Houston, TX; Banner MD Anderson Cancer Center, Gilbert, AZ; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Stanford University School of Medicine, Stanford, CA; Allogene Therapeutics, South San Francisco, CA; Colorado Blood Cancer Institute/Sarah Cannon Research Institute, Denver, CO Background: Allogeneic (off the shelf) chimeric antigen receptor (CAR) T cell therapy addresses the logistical challenges and variable product quality of autologous CAR T therapy. ALLO-501 is a genetically modified anti-CD19 CAR T cell product in which the TCR alpha constant gene is disrupted to reduce the risk of graft-versus-host disease (GvHD) and the CD52 gene is disrupted to permit the use of ALLO-647, an anti-CD52 mAb, for selective and prolonged host lymphodepletion. Methods: This is an open-label, Phase 1 trial (NCT03939026) in adults with R/R LBCL/FL who have received $ 2 prior lines of therapy; prior anti-CD19 cell therapy is allowed. Patients (pts) receive fludarabine (flu) 90 mg/m2, cyclophosphamide (cy) 900 mg/m2, and ALLO-647 39 or 90 mg followed by ALLO- 501 at 1 of 3 dose levels (DL) in a 3+3 design: 40, 120, and 360 3 106 CAR+ T cells. Results: As of 20 January 2020, 12 pts were enrolled: 9 received ALLO-501 at 3 DLs (4, 4 & 1 pts in DL1, DL2 and DL3 respectively), 1 pt discontinued due to kidney injury prior to lymphodepletion and 2 are starting treatment. Of the 9 treated pts aged 42 to 70 years: 5 had LBCL, 2 were female, 3 had primary refractory disease, and 3 had prior autologous stem cell transplants. The median number of prior lines of therapies was 3 (range 2 to 4). All treated pts received 39 mg of ALLO-647. No DLTs or GvHD have been observed to date. Most common Grade (Gr) $ 3 adverse events were neutropenia (55.6%), leukopenia (33.3%) and anemia (22.2%). Two pts (22.2%) developed cytokine release syndrome (1 Gr1 and 1 Gr2) that resolved within 72 hrs without steroids or tocilizumab. One pt developed Gr1 neurotoxicity that resolved without treatment. Infections included upper respiratory tract infection (Gr2), CMV (Gr3) and EBV viremia (Gr1), all reported in a single pt and resolved. One pt had a Gr2 infusion reaction to ALLO-647 which resolved with antihistamines.
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