On June 17, 2025 Lyell Immunopharma, Inc. (Nasdaq: LYEL), a clinical-stage company advancing next-generation CAR T-cell therapies for patients with cancer, reported positive new clinical data from the multi-center Phase 1/2 trial of LYL314, including data from patients with large B-cell lymphoma (LBCL) treated in the third- or later-line (3L+) setting (Press release, Lyell Immunopharma, JUN 17, 2025, View Source [SID1234653949]). LYL314 is an autologous dual-targeting CD19/CD20 chimeric antigen receptor (CAR) T-cell product candidate with Regenerative Medicine Advanced Therapy (RMAT) and Fast Track designations from the FDA that is in development for patients with relapsed and/or refractory (R/R) LBCL. In patients treated in the 3L+ setting (N = 25), LYL314 continued to demonstrate robust clinical responses, with an 88% overall response rate and a 72% complete response rate. Of the 3L+ patients who achieved a complete response, 71% remained in complete response at ≥ 6 months. The single-arm pivotal PiNACLE trial, a seamless expansion of the Phase 1/2 trial of patients with R/R LBCL being treated in the 3L+ setting, is underway.
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"Based on the LYL314 data to be presented at the International Conference on Malignant Lymphoma and my personal experience treating patients in the clinical trial, I believe that LYL314 has the potential to provide differentiated benefit for patients with relapsed/refractory large B-cell lymphoma in both the complete response rate and durability of response," stated Akil Merchant, MD, Associate Professor and Co-Director of the Lymphoma Program at the Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, and an investigator in the Phase 1/2 clinical trial. "We look forward to completing enrollment in the ongoing single-arm pivotal trial evaluating LYL314 in patients in the third- or later-line setting."
Fifty-one CAR T-naive patients with R/R LBCL received LYL314 as of April 15, 2025 (the data cutoff date for the presentation). The efficacy evaluable population consisted of 36 patients with Day 84 assessments or prior disease progression or death. Patient demographics and baseline disease characteristics were consistent with high-risk patient populations: median ages of 65 and 69 years in the 3L+ and 2L, respectively, 41% of 3L+ and 65% of 2L patients had Stage IV disease at trial entry, and 47% of 3L+ and 82% of 2L patients had primary refractory disease. There were 49 patients who received the recommended Phase 2 dose of 100 x 106 CAR T cells; two patients received a dose of 300 x 106 CAR T cells. CD19/CD20 screening was not required prior to enrollment.
In efficacy-evaluable 3L+ patients, with a median follow up of 9 months (N = 25):
The overall response rate was 88% (22/25 patients), with 72% (18/25) of patients achieving a complete response
71% (10/14) of patients with complete response remained in complete response at ≥ 6 months
In initial data from efficacy-evaluable 2L patients, with a median follow up of 5 months (N = 11):
The overall response rate was 91% (10/11 patients), with 64% (7/11) achieving a complete response
100% (7/7) of patients with complete response were in complete response at last assessment, including 3/3 at ≥ 6 months
In patients with primary refractory disease, a difficult to treat population, 70% (7/10) achieved a complete response
These patients had high-risk features, including primary refractory disease (91%), stage IV disease (64%), and older age (27% > 75 years; median age 73 years)
In 51 patients, including patients from both the 3L+ and the 2L cohorts, a manageable safety profile appropriate for outpatient administration was observed. No Grade ≥ 3 and low rates of Grade 1 (22%) or Grade 2 (35%) cytokine release syndrome (CRS) were reported. Immune effector cell-associated neurotoxicity syndrome (ICANS) was reported in 6% (Grade 1), 2% (Grade 2), and 14% (Grade ≥ 3) of patients. The median time to complete resolution of all reports of ICANS was 5 days, with rapid improvement (median of 2 days) to Grade 2 or lower with standard therapy. No deaths were related to LYL314 administration. LYL314 demonstrated robust expansion with a time to peak of 10 days (N = 51). The final drug product contained the desired CD62L-positive naïve T-cell phenotype (median, 95%). Rapid and durable depletion of B cells was demonstrated through month 6 and up to the month 12 assessment using a highly sensitive and robust method.
"Based on these robust data, and our recent End-of-Phase 1 meeting with the FDA, we have initiated PiNACLE, a single-arm pivotal trial of LYL314 in patients with large B-cell lymphoma in the third- or later-line setting and remain on track to initiate a pivotal trial to evaluate LYL314 in the second-line setting by the beginning of 2026," said Lynn Seely, MD, Lyell’s President and Chief Executive Officer.
The data will be presented on Wednesday, June 18, 2025 in an oral session at the International Conference on Malignant Lymphoma in Lugano, Switzerland by Akil Merchant, MD, Associate Professor and Co-Director of the Lymphoma Program at the Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, and will be available as a presentation in the Investors’ section of the Company’s website.
Conference Call Details
Lyell’s management will host an investor conference call and webcast beginning at 8:00 AM ET today. The Webcast registration link can be accessed here.
A replay of the event and presentation materials will be archived on the Investor page of the Lyell Website following the end of the event.
About LYL314
LYL314 (formerly IMPT-314) is a next-generation dual-targeting CD19/CD20 CAR T-cell product candidate designed to increase complete response rates and prolong the duration of the responses as compared to the approved CD19‑targeted CAR T-cell therapies for the treatment of large B-cell lymphoma.
LYL314 is designed with an ‘OR’ logic gate to target B cells that express either CD19, CD20 or both. LYL314 is manufactured to produce a CAR T-cell product with higher proportions of naïve and central memory T cells through a proprietary process that enriches for CD62L-expressing cells. This manufacturing process is designed to generate CAR T cells with enhanced antitumor activity.
LYL314 has received Regenerative Medicine Advanced Therapy (RMAT) designation, as well as Fast Track Designation, from the U.S. Food and Drug Administration for the treatment of patients with relapsed and/or refractory aggressive B-cell lymphoma in the third- or later-line setting.
About the PiNACLE Trial
PiNACLE is a single-arm pivotal trial of LYL314, 100 x 106 CAR T cells, in patients with large B-cell lymphoma treated in the third- or later-line setting. The trial is expected to enroll approximately 120 patients with relapsed and/or refractory diffuse large B-cell lymphoma, primary mediastinal B-cell lymphoma, high grade B-cell lymphoma, grade 3B follicular lymphoma, or transformed follicular lymphoma who have not previously received CAR T-cell therapy. Patients may be treated with LYL314 in either the inpatient or outpatient setting. The primary endpoint of the trial is the overall response rate. More information about the PiNACLE trial can be found on clinicaltrials.gov (NCT05826535) here.