ClinicalTrials.gg
RecruitingNCT07343934Updated Sep 16, 2026

huCART19-IL18-eDHFR Cells in Relapsed/Refractory Follicular Lymphoma

A Phase 1 interventional study of huCART19-IL18-eDHFR cells and [18F]Fluoropropyl-Trimethoprim in Relapsed or Refractory Follicular Lymphoma, sponsored by University of Pennsylvania. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-16.

Primary conditionLymphoma, FollicularRegistry: RecurrenceReclassifiedWhy we changed it
Registry
Recurrence — the first condition term the registry derived for this study.
ClinicalTrials.gg
Lymphoma, Follicular
Why
  1. Recurrence describes something many studies share rather than a condition a study is about.
  2. The study's listed conditions name Lymphoma, Follicular.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by University of Pennsylvania · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Started May 2026; still recruiting 5 months later.
Phase
Phase 1
Study type
Interventional
Enrollment
6
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a phase 1, open-label study to evaluate the feasibility, safety and preliminary efficacy of huCART19-IL18-eDHFR cells administered in patients with relapsed or refractory follicular lymphoma. This study will be initiated as a single arm study (Treatment Arm A), which will evaluate the use of huCART19-IL18-eDHFR cells without prior lymphodepletion. In this Treatment Arm A, all subjects will receive a single flat dose of 7x10[6] huCART19-IL18-eDHFR cells (Dose Level 1; DL1). Additional treatment arms may also be introduced in the future, via subsequent amendment(s).

Co-expression of eDHFR within huCART19-IL18 cells will allow the trafficking of the transduced CAR T cells to be visualized by PET/CT imaging using an investigational radiolabeled imaging agent [18F]Fluoropropyl-Trimethoprim (also known as [18F]FP-TMP). The feasibility of using [18F]FP-TMP PET/CT imaging to detect and measure the eDHFR-expressing CAR T cells will be investigated, as well as its ability to provide insight into CAR T cell pharmacokinetics, biodistribution, and persistence.

02

Conditions studied

  • Relapsed or Refractory Follicular Lymphoma

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Keywords

  • Follicular Lymphoma
  • CAR T cells
03

In context

Lymphoma, Follicular Reclassified

1,891 studies on the registry are indexed under Lymphoma, Follicular; 290 are open to participants now.

This study's planned enrollment of 6 is below the median of 48 across 1,503 interventional studies indexed under Lymphoma, Follicular.

Browse Lymphoma, Follicular studies →

Lead sponsor

University of Pennsylvania is the lead sponsor of 1,668 studies on the registry; 235 are open to participants now.

Of its 158 completed or terminated interventional studies of FDA-regulated products, 109 (69%) have results posted.

Compared within Lymphoma, Follicular, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Recurrence. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Signed form
  2. Male or females age ≥ 18 years
  3. Diagnosis of follicular lymphoma, grades 1-3A
  4. disease after at least 2 as follows:

    1. Prior therapy must include an anti-CD20 monoclonal or bispecific antibody and an alkylating agent or lenalidomide.
    2. Must have progressed within 2 years after second or higher line of therapy.
  5. Documentation of CD19 expression on malignant cells by flow cytometry/IHC from a CLIA certified laboratory. Results must be within 6 months of physician-investigator confirmation of eligibility and after any intervening CD19 directed therapy since expression confirmed.
  6. Patients with relapsed disease after prior SCT must meet the following criteria:

    1. Have no active and require no
    2. Are more than 6 months from transplant at the time of physician-investigator confirmation of eligibility
  7. Evidence of progressive disease within 12 weeks of physician-investigator confirmation of eligibility.
  8. Performance Status that is either 0 or 1.
  9. Adequate organ function defined as:

    1. Serum creatinine ≤ 1.5x or estimated ≥ 35 mL/min and not on dialysis.
    2. /AST ≤ 3 x ULN
    3. Direct ≤ 2.0 mg/dl; for patients with Gilbert's syndrome direct bilirubin must be ≤ 3.0 mg/dl
    4. (LVEF) ≥ 40% confirmed by ECHO/MUGA
    5. Must have minimum level of pulmonary reserve defined as ≤ Grade 1 dyspnea and pulse oxygen > 92% on room air

Exclusion criteria

Exclusion Criteria:

  1. Active or infection
  2. Any active, uncontrolled infection.
  3. Class III/IV cardiovascular disability according to the Classification (See Appendix 5).
  4. Clinically apparent arrhythmia or arrhythmias that are not stable on medical management within two weeks of physician-investigator confirmation of eligibility.
  5. Severe, active co-morbidity that, in the opinion of the physician-investigator, would preclude participation in this study.
  6. Active acute or chronic requiring systemic therapy.
  7. Dependence on systemic or medications. For additional details regarding use of steroid and immunosuppressant medications, please see Section 5.3.
  8. Receipt of prior huCART19 or huCART19-IL18 therapy.
  9. Active treatment with trimethoprim, methotrexate, or other antifolate chemotherapy, or anticipated use of these drugs during the active treatment phase of the study. For additional details regarding these restrictions, please see Section 5.3.
  10. Active CNS involvement. Patients with a history of CNS involvement that was successfully treated are eligible. A CNS evaluation is only required for eligibility if a subject is experiencing signs/symptoms of CNS involvement.
  11. Prior or concurrent whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the regimen.
  12. Known allergy to trimethoprim or Bactrim (TMP-SMX).
  13. History of allergy or to study product (human serum albumin, DMSO, and Dextran 40).
  14. Active disease requiring systemic immunosuppressive treatment equivalent to ≥ 10mg daily of prednisone. Patients with autoimmune neurologic diseases (such as MS) will be excluded.
  15. Pregnant or nursing (lactating) patients. Participants of must agree to use acceptable methods, as described in Protocol Section 4.3.
Terms in these criteria, in plain language(23)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

GVHD (graft-versus-host disease)

After a transplant from a donor, the donor’s immune cells attack the recipient’s body, often the skin, gut or liver.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
6 participants (estimated)

Study arms

  • Experimental
    Arm A - DL1

    IV administration of a single flat dose of 7x10\[6\] huCART19-IL18-eDHFR cells. \[18F\]FP-TMP PET/CT scan.

    Biological: huCART19-IL18-eDHFR cells · Drug: [18F]Fluoropropyl-Trimethoprim

  • Experimental
    Arm A - DL-1

    IV administration of a single flat dose of 3x10\[6\] huCART19-IL18-eDHFR cells. \[18F\]FP-TMP PET/CT scan.

    Biological: huCART19-IL18-eDHFR cells · Drug: [18F]Fluoropropyl-Trimethoprim

Interventions

  • BiologicalhuCART19-IL18-eDHFR cells

    Genetically modified autologous T cells engineered by co-transduction with two lentiviral vectors; one vector expressing a chimeric antigen receptor (CAR) targeting the CD19 antigen and human Interleukin 18 (IL-18), and a second vector expressing E.coli dihydrofolate reductase (eDHFR)

  • Drug[18F]Fluoropropyl-Trimethoprim

    Co-expression of eDHFR within huCART19-IL18 cells will allow the trafficking of the transduced CAR T cells to be visualized by PET/CT imaging using an investigational radiolabeled imaging agent \[18F\]Fluoropropyl-Trimethoprim (also known as \[18F\]FP-TMP).

    Also known as: [18F]FP-TMP

06

What researchers measure

Primary outcomes

  1. Change in Tumor Uptake on [18F]FP-TMP PET/CT

    In order to evaluate the feasibility of using \[18F\]FP-TMP PET/CT imaging to detect and measure eDHFR-expressing CAR-T cells, the change in tumor uptake on the post-infusion \[18F\]FP-TMP PET/CT scans will be compared to baseline.

    Time frame: Up to 6 months after huCART19-IL18-eDHFR administration

Secondary outcomes

  1. Evaluate manufacturing feasibility

    The proportion of subjects with huCART19-IL18-eDHFR products that fail to meet the product release criteria, out of the number of eligible subjects in whom manufacturing was attempted,

    Time frame: 3 Months

  2. Incidence of adverse events as assessed by CTCAE v6.0

    Type, frequency, severity, and attribution of adverse events

    Time frame: up to 15 years after huCART19-IL18-eDHFR administration

  3. Occurrence of Treatment-Limiting Toxicities (TLTs)

    Unacceptable toxicity as defined by the protocol

    Time frame: 28 days after huCART19-IL18-eDHFR administration

  4. Overall Response/Remission Rate (ORR)

    Proportion of subjects with CR or PR at Month 3 as compared to baseline

    Time frame: Month 3

  5. Best Overall Response (BOR)

    Proportion of subjects with a best overall disease response of CR or PR recorded between the protocol-required Month 3 disease assessment timepoint and the end of primary follow-up (Month 12); or start of new anticancer therapy (including huCART19-IL18-eDHFR retreatment), whichever comes first.

    Time frame: From Month 3 up to Month 12

  6. Duration of Response (DOR)

    Time from the date when the response criteria of CR or PR is first met (at or following Month 3), to the date of confirmed disease progression, death, or other censoring event

    Time frame: From Month 3 up to 15 years

  7. Progression-Free Survival (PFS)

    Duration of time from huCART19-IL18-eDHFR cell infusion (Day 0) to the date of confirmed disease progression or death.

    Time frame: Up to 15 years

  8. Overall survival (OS)

    Duration of time from the first huCART19-IL18-eDHFR infusion (Day 0) to the date of death, for any reason

    Time frame: Up to 15 years after last huCART-IL18-eDHFR administration

  9. Retreatment - Overall Response/Remission Rate (ORR)

    Proportion of subjects with CR or PR at Month 3-R as compared to retreatment baseline

    Time frame: Up to Month 3-Retreatment

  10. Retreatment - Best Overall Response (BOR)

    Proportion of subjects with a best overall disease response of CR or PR recorded between the protocol-required Month 3-R disease assessment timepoint and the end of primary retreatment follow-up (Month 12-R); or start of new anticancer therapy, whichever comes first

    Time frame: From Month 3-Retreatment up to Month 12-Retreatment

  11. Retreatment - Duration of Response (DOR)

    Time from the date when the response criteria of CR or PR is first met (at or following Month 3-R), to the date of confirmed disease progression, death, or other censoring event

    Time frame: From Month 3-Retreatment up to 15 years after last huCART-IL18-eDHFR administration

  12. Retreatment - Progression-Free Survival (PFS)

    Duration of time from huCART19-IL18-eDHFR retreatment infusion (Day 0-R) to the date of confirmed disease progression or death

    Time frame: Up to 15 years after last huCART-IL18-eDHFR administration

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 16, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07343934
Collaborators
Follicular Lymphoma Foundation
Responsible party
Sponsor
First posted
Jan 15, 2026
Start date
May 18, 2026
Primary completion
Nov 2027 (estimated)
Completion
Nov 2042 (estimated)
Last update
Sep 16, 2026

Study contacts

Abramson Cancer Center Clinical Trials Service
Contact
PMCancerResearch@Pennmedicine.upenn.edu
215-349-8245
Stephen Schuster, MD
Contact
Stephen Schuster, MD
principal investigator · University of Pennsylvania

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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