On June 16, 2023 Tessa Therapeutics Ltd. (Tessa), a clinical-stage cell therapy company developing next-generation cancer treatments for hematological malignancies and solid tumors, reported encouraging safety and efficacy data from a combination study of its autologous CD30 CAR-T therapy (TT11) with Bristol Myers Squibb’s nivolumab at the 17th International Conference on Malignant Lymphoma taking place from June 13-17, 2023, at Lugano, Switzerland (Press release, Tessa Therapeutics, JUN 16, 2023, https://www.tessacell.com/2023/06/16/tessa-therapeutics-announces-positive-results-from-cd30-car-t-combination-study-with-nivolumab-in-2nd-line-hodgkin-lymphoma/ [SID1234632752]).
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TT11 is an autologous CD30 chimeric antigen receptor T-cell (CAR-T) therapy that harvests the patient’s own T-cells and modifies them to target cancer cells expressing the CD30 protein, a well-validated lymphoma target. TT11 is currently being investigated in combination with Nivolumab in Phase 1B (ACTION) study targeting R/R classical Hodgkin Lymphoma (cHL) patients after frontline therapy failure (NCT05352828).
ACTION is a single arm multi-centre Phase 1b study. Study protocol involves patients being treated with 2 cycles of Nivolumab, followed by a single infusion of CD30.CAR-T preceded by lymphodepletion (LD) chemotherapy. An additional 2 cycles of Nivolumab are then given, followed by response assessment by PET/CT per Lugano 2014 criteria. Patients without progressive disease may undergo either autologous stem cell transplant (ASCT) or continue Nivolumab up to 6 additional cycles per physician and patient preference.
A total of 15 patients were enrolled of which 13 were treated with Nivolumab + CD30 CAR-T therapy. 10 patients reached End of Treatment (Post-Nivo Cycle 4) and were evaluable for response. Of the 10 patients 9 responded to the treatment with complete disappearance of tumor observed by PET/CT in 7 patients and partial reduction in tumor size observed in 2 patients. One patient had stable disease. Of note, no patients proceeded to receive autologous stem cell transplant (ASCT) as of the data cut off. All 10 patients reaching EOT (Post-Nivo Cycle 4) proceeded to additional Nivo cycles.
The therapy was well tolerated with no grade 3 or higher Cytokine Release Syndrome (CRS) and no neurotoxicity. Two patients experienced grade 1 CRS, which resolved without use of steroid or tocilizumab.
CD30.CAR-T expansion and persistence was observed post infusion. CAR-T cells continued to persist until data cut-off for the results (day 77 post infusion) with peak expansion observed in peripheral blood at 8 days post infusion.
"CD30 CAR-T therapy in combination with Nivolumab has demonstrated promising anti-tumor efficacy with a very good safety profile in r/r cHL patients after primary treatment." Said Sairah Ahmed, M.D., lead presentation author, and Associate Professor, The University of Texas MD Anderson Cancer Center. "The results are quite encouraging and warrant further development of this combination therapy among r/r cHL patients."
Circulating tumor ctDNA-MRD (minimum residual disease) was assessed with PhasED-Seq (Foresight Diagnostics) in 3 patients with complete responses at End of Treatment (EOT). All 3 patients (100%) had undetectable ctDNA-MRD demonstrating deep molecular response. Additional patient samples are currently under assessment.
"We are very encouraged by the exciting results demonstrated by the ACTION study. These results offer the potential to re-define Hodgkin lymphoma treatment paradigm, offering a second line treatment alternative free of transplant and high dose chemotherapy to patients who fail frontline therapy." Said Thomas Willemsen, President and CEO, Tessa Therapeutics. He added "The well tolerated safety profile is especially meaningful for older patients with poor tolerability and young adolescents with risk of long-term sequelae from current standard of care."