Summary
This trial will compare tisagenlecleucel to standard of care in adult participants with relapsed or refractory (r/r) follicular lymphoma.
Objectives
The purpose of this phase III study is to verify the clinical benefit of tisagenlecleucel for the treatment of r/r FL by comparing the tisagenlecleucel treatment strategy to standard of care therapy in patients with r/r FL after two or more lines of systemic therapy, with progression-free survival (PFS) as the primary endpoint.
The primary objective is to demonstrate superiority of the tisagenlecleucel treatment strategy over standard of care (SOC) therapy with respect to progression-free survival (PFS) determined by blinded independent review committee (BIRC) based on the Lugano response criteria.
Participants randomized to Arm A (tisagenlecleucel treatment) will receive a single infusion of 0.6 to 6 x 10^8 CAR-positive viable T-cells.
Participants randomized to Arm B (Standard of Care) will receive R2 or R-CHOP based on investigator choice and this has to be determined prior to randomization.
Eligibility
Description
Inclusion Criteria:
- Age ≥ 18 years at the date of signing the informed consent form.
- Follicular lymphoma grade 1, 2, or 3A confirmed histologically after latest relapse (local assessment).
- Relapsed or refractory disease after a second or later line of systemic therapy including an anti-CD20 antibody and an alkylating agent.
- Disease that is both active on Positron emission tomography (PET) scan (defined as a score of 4 or 5 on the Deauville 5-point scale) and measurable on Computed tomography (CT) scan.
- ECOG performance status of 0, 1 or 2 at screening.
- Adequate hematologic, renal, hepatic and pulmonary organ function at screening.
- Must meet the institutional criteria to undergo leukapheresis (unless historical leukapheresis is available).
- Must be eligible for treatment with the selected standard of care regimen.
Exclusion Criteria:
- Follicular lymphoma grade 3B or evidence of histologic transformation.
- Prior treatment with anti-CD19 therapy, gene therapy, or adoptive T-cell therapy.
- Active CNS involvement by malignancy.
- Clinically significant active infection, presence of Human immunodeficiency virus (HIV) antibody or active hepatitis B or C.
- Active neurological autoimmune or inflammatory disorders (e.g., Guillain-Barré syndrome).
- Investigational medicinal product within the last 30 days or five half-lives (whichever is longer) prior to randomization.
- Clinically significant cardiovascular conditions such as acute coronary syndrome, significant cardiac arrhythmias, heart failure or decreased LVEF.
Other protocol defined inclusion/exclusion criteria may apply