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DRUG:

rapcabtagene autoleucel (YTB323)

i
Other names: YTB323, YTB-323, YTB 323
Associations
Company:
Novartis
Drug class:
CD19-targeted CAR-T immunotherapy
Related drugs:
Associations
26d
Phase 2 Study of Rapcabtagene Autoleucel in Myositis (clinicaltrials.gov)
P2, N=123, Not yet recruiting, Novartis Pharmaceuticals
New P2 trial
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rapcabtagene autoleucel (YTB323)
1m
New P2 trial
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Rituxan (rituximab) • rapcabtagene autoleucel (YTB323)
2ms
CYTB323A12101: Phase I/II Study of Rapcabtagene Autoleucel in CLL, 3L+ DLBCL, r/r ALL and 1L HR LBCL (clinicaltrials.gov)
P1/2, N=225, Recruiting, Novartis Pharmaceuticals | Trial completion date: Jun 2027 --> May 2028
Trial completion date
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BCL2 (B-cell CLL/lymphoma 2) • BCL6 (B-cell CLL/lymphoma 6)
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CD19 positive • BCL6 rearrangement • BCL2 rearrangement
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Imbruvica (ibrutinib) • rapcabtagene autoleucel (YTB323)
2ms
New P1/2 trial
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rapcabtagene autoleucel (YTB323)
3ms
New P2 trial
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rapcabtagene autoleucel (YTB323)
1year
Express Delivery of Next-Generation CAR T Cells with Preserved Naive and Stemness Phenotypes for the Treatment of Aggressive Lymphomas. (PubMed, Cancer Discov)
In this issue of Cancer Discovery, Dickinson and colleagues present clinical data from a first-in-human study of YTB323, a novel autologous CD19-directed chimeric antigen receptor T-cell therapy generated on the T-Charge platform with preserved naive state and stemness phenotypes. Their cell doses are up to 25-fold lower than with tisagenlecleucel. See related article by Dickinson et al., p. 1982 (10).
Journal • CAR T-Cell Therapy
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Kymriah (tisagenlecleucel-T) • rapcabtagene autoleucel (YTB323)
1year
Updated Results From a Rapcabtagene Autoleucel (YTB323) Phase I Study Demonstrate Durable Efficacy and a Manageable Safety Profile in Patients With Relapsed or Refractory Diffuse Large B‑Cell Lymphoma (R/R DLBCL) (SOHO 2023)
Rapcabtagene autoleucel, a next-generation, autologous CD19- directed CAR T-cell therapy, preserved T-cell stemness, demonstrated promising durable efficacy with manageable safety. DL2 (12.5x106) CAR+ viable T cells is recommended for phase II/III studies.
Clinical • P1 data
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CD8 (cluster of differentiation 8) • CD4 (CD4 Molecule)
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rapcabtagene autoleucel (YTB323)
over1year
A Novel Autologous CAR-T Therapy, YTB323, with Preserved T-Cell Stemness Shows Enhanced CAR T-Cell Efficacy in Preclinical and Early Clinical Development. (PubMed, Cancer Discov)
Clinically, at doses 25-fold lower than tisagenlecleucel, YTB323 showed 1) promising overall safety (CRS [any-grade, 35%; grade ≥3, 6%], neurotoxicity [any-grade, 25%; grade ≥3, 6%]); 2) ORR of 75% and 80% for DL1 and DL2, respectively; 3) comparable CAR T-cell expansion; and 4) preservation of T-cell phenotype. Current data support continued development of YTB323 for r/r DLBCL.
Preclinical • Journal • CAR T-Cell Therapy
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Kymriah (tisagenlecleucel-T) • rapcabtagene autoleucel (YTB323)
over1year
CYTB323A12101: Phase I/II Study of Rapcabtagene Autoleucel in CLL, 3L+ DLBCL, ALL and 1L HR LBCL (clinicaltrials.gov)
P1/2, N=225, Recruiting, Novartis Pharmaceuticals | Phase classification: P1 --> P1/2
Phase classification
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BCL2 (B-cell CLL/lymphoma 2) • BCL6 (B-cell CLL/lymphoma 6)
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CD19 positive • BCL6 rearrangement • BCL2 rearrangement
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Imbruvica (ibrutinib) • rapcabtagene autoleucel (YTB323)
over1year
CYTB323A12101: Phase I/II Study of Rapcabtagene Autoleucel in CLL, 3L+ DLBCL, ALL and 1L HR LBCL (clinicaltrials.gov)
P1, N=225, Recruiting, Novartis Pharmaceuticals | N=110 --> 225 | Trial completion date: Oct 2025 --> Jun 2027 | Trial primary completion date: Oct 2025 --> Jun 2027
Enrollment change • Trial completion date • Trial primary completion date • CAR T-Cell Therapy
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BCL2 (B-cell CLL/lymphoma 2) • BCL6 (B-cell CLL/lymphoma 6)
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CD19 positive • BCL6 rearrangement • BCL2 rearrangement
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Imbruvica (ibrutinib) • rapcabtagene autoleucel (YTB323)
almost2years
Rapcabtagene Autoleucel (YTB323), an Innovative CD19-Directed CAR-T Cell Therapy, Demonstrates Durable Efficacy and a Manageable Safety Profile in Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma (r/r DLBCL): Phase I Study Update (TCT-ASTCT-CIBMTR 2023)
Rapcabtagene autoleucel showed remarkable in vivo expansion at DL2 by qPCR (geometric mean Cmax 26,500 copies/μg DNA) that was at the higher end of tisagenlecleucel expansion at a 25-fold lower dose, with no further increases in expansion at higher doses (Fig 2). Rapcabtagene autoleucel is a next-generation, autologous CD19-directed CAR-T cell therapy that preserves T-cell stemness, translating into durable efficacy and a manageable safety profile. DL2 (12.5×10 6 ) CAR+ viable T cells is the recommended dose for Phase II/III studies.
Clinical • P1 data • Late-breaking abstract • CAR T-Cell Therapy
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MYC (V-myc avian myelocytomatosis viral oncogene homolog) • BCL2 (B-cell CLL/lymphoma 2) • CD19 (CD19 Molecule) • CD8 (cluster of differentiation 8) • BCL6 (B-cell CLL/lymphoma 6) • CD4 (CD4 Molecule)
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Kymriah (tisagenlecleucel-T) • rapcabtagene autoleucel (YTB323)
2years
YTB323 (Rapcabtagene Autoleucel) Demonstrates Durable Efficacy and a Manageable Safety Profile in Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma: Phase I Study Update (ASH 2022)
CRS was managed with tocilizumab, corticosteroids, and vasopressors in 7 (70%), 3 (30%), and 1 (10%) pts at DL2, respectively, and 1 DL3 pt (50%) received tocilizumab...ICANS management was based on dexamethasone, methylprednisolone, and anakinra in 2 (67%), 1 (33%), and 1 (33%) pts at DL2, respectively, and 1 DL4 pt (50%) received dexamethasone...At a 25-fold lower dose, rapcabtagene autoleucel expansion at DL2 was comparable by qPCR to tisagenlecleucel expansion in JULIET... Rapcabtagene autoleucel is a potent new CD19-directed CAR-T cell tx with distinct cellular kinetics, durable efficacy, and a manageable safety profile. DL2 (12.5×106) CAR+ viable T cells is the recommended dose for Phase III studies, based on the CR rate, favorable safety profile, and cellular kinetics. Updated results with expanded cellular kinetics and biomarker analyses will be presented at the meeting.
Clinical • P1 data • IO biomarker
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CD19 (CD19 Molecule)
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dexamethasone • Kymriah (tisagenlecleucel-T) • Actemra IV (tocilizumab) • Kineret (anakinra) • rapcabtagene autoleucel (YTB323)
over2years
PHASE I STUDY OF YTB323, A CHIMERIC ANTIGEN RECEPTOR (CAR)-T CELL THERAPY MANUFACTURED USING T-CHARGE™, IN PATIENTS WITH RELAPSED/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA (EHA 2022)
Tocilizumab and corticosteroids were used for CRS management in 4 (80%) and 2 (40%) pts at DL2, respectively...YTB323 expansion (C max and AUC 0-28d ) with 12.5×10 6 CAR+ cells (DL2) was comparable to a median tisagenlecleucel dose of 312×10 6 CAR+ cells in pts with DLBCL, a 25-fold lower median dose (Awasthi R, et al...Conclusion YTB323 is a potent new CAR-T cell tx with distinct cellular kinetics, encouraging early efficacy results across DL1 and DL2, and a manageable safety profile. Updated results will be presented at the meeting along with a recommended dose for subsequent trials.
Clinical • P1 data • IO biomarker
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CD19 (CD19 Molecule) • CD8 (cluster of differentiation 8) • CD4 (CD4 Molecule)
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Kymriah (tisagenlecleucel-T) • Actemra IV (tocilizumab) • rapcabtagene autoleucel (YTB323)
3years
Preservation of T-Cell Stemness with a Novel Expansionless CAR-T Manufacturing Process, Which Reduces Manufacturing Time to Less Than Two Days, Drives Enhanced CAR-T Cell Efficacy (ASH 2021)
T cells were enriched from healthy donor leukapheresis, followed by activation and transduction with a lentiviral vector encoding for the same CAR used for tisagenlecleucel. The novel manufacturing platform T-Charge™ used for YTB323 is simplified, shortened, and expansionless. It thereby preserves T-cell stemness, associated with improved in vivo CAR-T expansion and antitumor efficacy. Compared to approved CAR-T therapies, YTB323 has the potential to achieve higher clinical efficacy at its respective lower doses.
Clinical • CAR T-Cell Therapy
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CD19 (CD19 Molecule) • IFNG (Interferon, gamma) • IL2 (Interleukin 2) • CCR7 (Chemokine (C-C motif) receptor 7)
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Kymriah (tisagenlecleucel-T) • rapcabtagene autoleucel (YTB323)
3years
A First-in-Human Study of YTB323, a Novel, Autologous CD19-Directed CAR-T Cell Therapy Manufactured Using the Novel T-ChargeTM platform, for the Treatment of Patients (Pts) with Relapsed/Refractory (r/r) Diffuse Large B-Cell Lymphoma (DLBCL) (ASH 2021)
Tocilizumab and corticosteroids were administered for CRS management in 2 (13%) and 1 (7%) pts, respectively. YTB323 recruitment is ongoing at DL3; RP2D remains to be identified. At DL2, YTB323 showed promising efficacy and a favorable safety profile. Current data support continued development of YTB323 in r/r DLBCL pts.
Clinical • P1 data • CAR T-Cell Therapy • IO biomarker
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CD19 (CD19 Molecule) • CD8 (cluster of differentiation 8) • CD4 (CD4 Molecule)
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Actemra IV (tocilizumab) • rapcabtagene autoleucel (YTB323)
over3years
CD19-specific CAR-T Cells in CLL/SLL and DLBCL (clinicaltrials.gov)
P1, N=110, Recruiting, Novartis Pharmaceuticals | Trial completion date: Mar 2024 --> Oct 2025 | Trial primary completion date: Mar 2024 --> Oct 2025
Clinical • Trial completion date • Trial primary completion date • CAR T-Cell Therapy
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CD19 (CD19 Molecule)
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CD19 positive
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Imbruvica (ibrutinib) • rapcabtagene autoleucel (YTB323)
over4years
CD19-specific CAR-T Cells in CLL/SLL and DLBCL (clinicaltrials.gov)
P1, N=110, Recruiting, Novartis Pharmaceuticals | N=50 --> 110 | Trial completion date: Jan 2023 --> Mar 2024 | Trial primary completion date: Jan 2023 --> Mar 2024
Clinical • Enrollment change • Trial completion date • Trial primary completion date • CAR T-Cell Therapy
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CD19 (CD19 Molecule)
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CD19 positive
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Imbruvica (ibrutinib) • rapcabtagene autoleucel (YTB323)