COBALT trial

Chief investigator - Dr Karl Peggs, University College London
Evaluating CAR19 as an optimal bridge to allogeneic transplantation
Amount awarded: £421,759
Award start date: 01 Dec 2014
Recruitment start date: 03 Aug 2016
Award duration: 3 years

Chemotherapy with rituximab is standard treatment for diffuse large B cell lymphoma (DLBCL). Radiotherapy might also be a part of the treatment. Although this works well, the lymphoma might come back and need further treatment. This is called salvage treatment. After salvage treatment, some people might have an autologous stem cell transplant, which is a transplant using their own stem cells.

But for some people the salvage treatment might not work well enough, and for others their lymphoma might come back after the autologous stem cell transplant. Whilst allogeneic transplantation - using another persons blood and immune cells to help fight the cancer - has shown promising results, it is only effective in those whose disease is responding to treatment. Researchers are looking for new ways to treat these people.

Several research groups have shown that genetic modification of donor immune cells (T-cells) by adding Chimeric Antigen Receptors (CAR) allows the modified CAR T-cells to seek out cancer cells in patients. For this study, researchers are modifying T-cells to recognise a protein called CD19, which features in high numbers on the surface of lymphoma cells. Once the modified T-cell binds to CD19 on the surface of a lymphoma cell, a signal is sent to the body’s immune system to kill that cancer cell.

This is the first time this type of treatment has been used for people with DLBCL.

The aims of the trial are to:

  • Find if this type of treatment is safe for people with DLBCL before doing further trials
  • Find out well this treatment works for people with DLBCL
  • Find the best dose to give
  • See if CD19 T cell treatment increases the possibility of having a donor stem cell transplant

You may be eligible to join this trial if:

  • You have diffuse large B cell lymphoma (DLBCL) that has the CD19 protein
  • Your lymphoma continued to get worse during, or came back after salvage treatment with chemotherapy or your lymphoma came back after an autologous stem cell transplant followed by more chemotherapy
  • You are able to have a stem cell transplant from a donor (allogeneic stem cell transplant)
  • You are between 16 and 65 years old

To find out further eligibility criteria, and more information about this trial, please click here.