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International Study for Treatment of Childhood Relapsed ALL 2020

Project description

Personalising childhood leukaemia treatment

Relapse of acute lymphoblastic leukaemia (ALL) is a significant factor contributing to childhood cancer mortality. The EU-funded IntReALL 2020 project has a primary objective: to replace toxic chemotherapy with more effective and better-tolerated immunotherapeutic drugs for children dealing with relapsed B-cell precursor (BCP) ALL. This will be accomplished through randomised trials and historical controlled trials. For standard-risk patients with acute ALL, the project will randomly compare a CD22-directed antibody-drug conjugate known as inotuzumab ozogamicin (InO) with the standard-of-care (SOC) induction therapy ALL-R3. All patients will receive one SOC consolidation and one Blina course, which will be assessed against historical controls. IntReALL 2020 will then leverage clinical and genetic data to personalise treatments.

Objective

Relapse of acute lymphoblastic leukemia (ALL) remains a leading cause of mortality in childhood cancer. IntReALL 2020 will conduct randomized and historically controlled trials in children with relapsed B-cell precursor (BCP) ALL with the aim to replace toxic chemotherapy with better tolerated and more efficacious immunotherapeutic drugs. In standard risk (SR) patients, the CD22 directed antibody-drug conjugate inotuzumab ozogamicin (InO) will be randomly compared with standard of care (SOC) ALL-R3 induction. All patients will receive one SOC consolidation- and one Blina course, compared to historical controls. SR patients with MRD good response will receive 2 additional Blina courses replacing chemotherapy randomly compared with SOC. Patients with high-risk relapse will receive induction investigating InO versus ALL-R3 in an industry-sponsored trial, followed by IntReALL consolidation and allogeneic HSCT. Patients with isolated extramedullary (IEM) relapse are treated based on ALL-REZ BFM 2002 backbone. IntReALL 2020 will establish a federated relapsed/refractory leukaemia board generating personalized recommendations based on clinical, molecular-genetic and drug response profiling data. Patients with very-high risk disease will receive experimental/personalized therapies, including a trial investigating CD19-directed chimeric receptor antigen (CAR) T-cells produced in academic institutions. Other CAR T-cells trials as well as an induction trial for T-ALL relapse will be developed. Documentation and monitoring of the trials and the individualized treatment will be realized using the MARVIN database. Comprehensive statistical and data management activities will warrant the accuracy and interpretability of the data. IntReALL 2020 involves representatives from participating pharmaceutical companies and EMA as well as patient/parent advocates to discuss strategies for developing new drugs within academic trials warranting a benefit for all patients on the results.
“This action is part of the Cancer Mission cluster of projects on ‘Diagnosis and treatment’.”

Programme(s)

Coordinator

CHARITE - UNIVERSITAETSMEDIZIN BERLIN
Net EU contribution
€ 1 060 000,00
Address
Chariteplatz 1
10117 Berlin
Germany

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Region
Berlin Berlin Berlin
Activity type
Higher or Secondary Education Establishments
Links
Total cost
€ 1 060 000,00

Participants (24)

Partners (1)