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RecruitingLast updated: 24 April 2026

ALPHA3: CAR T-cell therapy compared to standard of care observation for people with minimal residual disease after response to first-line therapy for large B-cell lymphomaA Randomized, Open-label Study Evaluating the Efficacy and Safety of Cemacabtagene Ansegedleucel in Participants With Minimal Residual Disease After Response to First Line Therapy for Large B-cell Lymphoma

Trial purpose

Medical clipboardCancer treatment

Tumor type

Blood Cancers Haematological

Age

People18+

Trial acronym

ALPHA3

Clinical summary

Summary

This is a clinical trial for adults with large B-cell lymphoma (LBCL) who have finished their standard treatment. People can take part if their lymphoma has responded well to treatment (either a complete response or a partial response that does not need further treatment right now), but there is still a very small amount of disease left that can only be picked up by a sensitive blod test. This is called minimal residual disease (MRD). 

The aim of the study is to find out whether giving an extra treatment called cemacabtagene ansegedleucel (cema-cel) is safe and works better than the usual approach, which is careful monitoring without treatment (also known as observation).

Cema-cel is a type of CAR T-cell therapy made from donor immune cells that are designed to recognise and attack lymphoma cells.

If you take part and are found to have MRD, you will be randomly assigned (by chance) to one of two groups:

  • one group receives cema-cel treatment
  • the other group is placed on observation only, which is the current standard approach.

Before receiving cema-cel, participants have a short course of chemotherapy medicines (fludarabine and cyclophosphamide). This is done to prepare the body so the CAR T-cells can work effectively.

The study will compare how well these two approaches work and monitor any side effects, to help guide future treatment for people with LBCL.

Conditions

This trial is treating people with diffuse large B-cell lymphoma, high-grade B-cell lymphoma, or primary mediastinal B-cell lymphoma

Eligibility

Inclusion

  1. LBCL per WHO 2017 including diffuse large B-cell lymphoma, high-grade B-cell lymphoma, and primary mediastinal B-cell lymphoma histologically confirmed by pathology report.
  2. Participant has completed a full course of standard first line therapy (e.g., R-CHOP, dose-adjusted EPOCH-R, Pola-R-CHP) as intended. Participants cannot have received additional lines of therapy.
  3. Participant achieved CR, or PR suitable for observation, at the end of first line therapy based on PET/CT evaluation
  4. Foresight CLARITY™ IUO MRD test, powered by PhasED-Seq™, is positive.
  5. Adult participants ≥18 years of age.
  6. Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1.
  7. Adequate hematological, renal, hepatic, pulmonary, and cardiac function
  8. Non-hematologic toxicities related to prior therapy must be recovered to baseline or grade ≤1.

Exclusion

  1. LBCL with history of central nervous system involvement, transformed from other malignancy (e.g., transformed follicular lymphoma or marginal zone lymphoma, Richter's transformation), or T-cell/histiocyte rich LBCL.
  2. Prior treatment with anti-CD19 targeted therapies.
  3. Anti-cancer treatment, including radiation, after end of treatment PET/CT and/or MRD testing is performed.
  4. Active and clinically significant autoimmune disease.
  5. Active systemic bacterial, fungal, or viral infections requiring systemic treatment.
  6. History of another primary malignancy or bone marrow disorder (e.g., myelofibrosis, smoldering multiple myeloma) within 3 years prior to enrollment.

Inclusion

  • You have had a certain type of treatment or surgical procedure.
  • You have the type of cancer, symptoms, or health risks that this clinical trial is focused on.

Exclusion

  • You have been diagnosed with a prior or secondary type of cancer.
  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
Message

Clinical trials have complex eligibility criteria, and other criteria may apply for this trial. Ask your doctor about whether this trial could be right for you.

Participating hospitals

Recruiting hospitals

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More information

Trial Identifiers

Information on this page is partially produced from ClinicalTrials.gov *. View further details about this trial on the registry via the links below:

Trial sponsor

Allogene Therapeutics

Scientific Title

A Randomized, Open-label Study Evaluating the Efficacy and Safety of Cemacabtagene Ansegedleucel in Participants With Minimal Residual Disease After Response to First Line Therapy for Large B-cell Lymphoma

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