简要介绍
这是一项 I/II 期注册临床试验,评估间充质干细胞治疗急性淋巴细胞白血病、卵巢癌的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 34 例。试验地点:美国 · 罗切斯特(共 1 个中心)。登记号:NCT02068794。
入组条件决定能不能参加
不限性别 · ≥ 18 Years
纳入标准:
• 既往接受铂类和紫杉烷治疗后复发或进展的卵巢癌、原发性腹膜癌或输卵管癌;原发肿瘤组织学确诊;既往接受双侧卵巢切除。符合组织学类型包括浆液性、子宫内膜样、黏液性、未分化、透明细胞、混合上皮、移行细胞癌、恶性Brenner瘤或非特指腺癌。
• ECOG体能状态0–2分。登记前7天内ANC≥1,500/μL、血小板≥100,000/μL、总胆红素≤ULN、AST≤ULN的2倍、肌酐≤ULN的1.5倍、血红蛋白≥9.0 g/dL。MUGA或超声心动图提示射血分数正常。
• 提供书面知情同意;愿意返回Mayo Clinic Rochester随访;预期生存期≥12周;愿按方案提供所有生物样本。体格检查或CT可测量疾病;CA-125升高或影像无可测量病灶的微小残留病患者,若完成6个治疗周期后无影像进展,愿接受腹腔镜评估疗效。CD4计数≥200/μL或占外周血淋巴细胞≥15%。
排除标准:
• 卵巢低度恶性潜能上皮肿瘤、间质肿瘤或生殖细胞肿瘤。存在可能根治或确定可延长生存期的标准治疗;首次复发且完成初始辅助化疗>6个月后复发者排除。
• 登记前≤5天有活动性感染;结核病史或结核菌素皮肤试验阳性史。登记前≤5年有其他恶性肿瘤史,非黑色素瘤皮肤癌、宫颈原位癌和乳腺导管原位癌除外。
• 既往治疗间隔不足:化疗≤3周;免疫治疗≤4周;生物治疗≤4周;涉及肠切开的广泛腹部手术≤3周(登记时放置腹腔Port-A-Cath或同时松解粘连不适用此条);任何既往病毒或基因治疗;既往腹部/盆腔放疗。
• NYHA III/IV级心脏病、已知有症状冠心病或心律失常(房颤或室上性心动过速);研究者判断会影响治疗安全的其他心肺疾病;需要血液制品支持;CNS转移或癫痫;HIV阳性或其他免疫缺陷;器官移植史;慢性乙肝/丙肝史。
• 同时接受其他化疗、免疫治疗、放疗或研究性辅助治疗。登记时腹腔内病灶>8 cm、肝内病灶或腹腔外病灶;腹腔淋巴结受累可入组(腹腔给药后病毒可播散至淋巴结)。
• 口服/全身使用皮质类固醇(局部或吸入激素除外);家中有≤15个月婴儿或已知免疫缺陷家庭成员;对麻疹疫苗过敏或既往麻疹疫苗严重反应;对碘过敏(不包括静脉造影剂反应);主要研究者认为会对治疗安全性产生不利影响的其他病理或状况。
核对登记原文(英文)
Inclusion Criteria:
* Must have:
* Recurrent or progressive ovarian cancer, primary peritoneal cancer or fallopian tube cancer after prior treatment with platinum and taxanes
* Histologic confirmation of the original primary tumor
* Prior bilateral oophorectomy
* The following histologic epithelial cell types are eligible: serous adenocarcinoma, endometrioid adenocarcinoma, mucinous adenocarcinoma, undifferentiated carcinoma, clear cell adenocarcinoma, mixed epithelial carcinoma, transitional cell carcinoma, malignant Brenner's tumor, or adenocarcinoma not otherwise specified (NOS)
* Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, 2
* Absolute neutrophil count (ANC) \>= 1500/uL (obtained =\< 7 days prior to registration)
* Platelet (PLT) \>= 100,000/uL (obtained =\< 7 days prior to registration)
* Total bilirubin =\< upper normal limit (obtained =\< 7 days prior to registration)
* Aspartate aminotransferase (AST) =\< 2 x upper limit of normal (ULN) (obtained =\< 7 days prior to registration)
* Creatinine =\< 1.5 x ULN (obtained =\< 7 days prior to registration)
* Hemoglobin (Hgb) \>= 9.0 g/dL (obtained =\< 7 days prior to registration)
* Normal cardiac function as defined by a normal ejection fraction by MUGA (multi gated acquisition scan) or echocardiogram
* Provide informed written consent
* Willing to return to Mayo Clinic Rochester for follow-up
* Life expectancy \>= 12 weeks
* Willing to provide all biologic specimens as required by the protocol
* Measurable disease by exam or CT scan, or for patients with cancer antigen (CA)-125 elevation or with microscopic residual but without measurable disease on imaging, willingness to undergo laparoscopy for evaluation of treatment effect if no radiographic progression after 6 treatment cycles
* CD4 count \>= 200/uL or \>= 15% of peripheral blood lymphocytes
Exclusion Criteria:
* Epithelial tumors of low malignant potential, stromal tumors, and germ cell tumors of the ovary
* Known standard therapy for the patient's disease that is potentially curative or definitely capable of extending life expectancy; subjects will be excluded if this is their first relapse and they have recurred \> 6 months from completion of primary (adjuvant) chemotherapy
* Active infection =\< 5 days prior to registration
* History of tuberculosis or history of tuberculosis skin test purified protein derivative (PPD) positivity
* History of other malignancy =\< 5 years prior to registration except for non-melanoma skin cancer, carcinoma in situ of the cervix, and ductal carcinoma in situ (DCIS)
* Any of the following prior therapies:
* Chemotherapy =\< 3 weeks prior to registration
* Immunotherapy =\< 4 weeks prior to registration
* Biologic therapy =\< 4 weeks prior to registration
* Extensive abdominal surgery if it includes enterotomy(ies) =\< 3 weeks prior to registration; this criterion does not apply to placement of the peritoneal Port-A-Cath or lysis of adhesions at the time of registration
* Any viral or gene therapy prior to registration
* Radiation therapy to the abdomen or pelvis
* New York Heart Association classification III or IV, known symptomatic coronary artery disease, or symptoms of coronary artery disease on systems review, or known cardiac arrhythmias (atrial fibrillation or supraventricular tachycardia \[SVT\])
* Other cardiac or pulmonary disease that, at the investigators discretion, can impair treatment safety
* Requiring blood product support
* Central nervous system (CNS) metastases or seizure disorder
* Human immunodeficiency virus (HIV)-positive test result or history of other immunodeficiency
* History of organ transplantation
* History of chronic hepatitis B or C
* Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy considered investigational (utilized for a non-Food and Drug Administration \[FDA\]-approved indication and in the context of a research investigation)
* Intra-abdominal disease \> 8 cm in diameter at the time of registration, intrahepatic disease, or disease beyond the abdominal cavity; patients with intra-abdominal lymph node involvement are eligible based on biodistribution data indicating viral dissemination to lymph nodes following intraperitoneal administration
* Treatment with oral/systemic corticosteroids, with the exception of topical or inhaled steroids
* Exposure to household contacts =\< 15 months old or household contact with known immunodeficiency
* Allergy to measles vaccine or history of severe reaction to prior measles vaccination
* Allergy to iodine; this does not include reactions to intravenous contrast materials
* Any other pathology or condition where the principle investigator may deem to negatively impact treatment safety
以上为辅助阅读译文。是否适合入组须由主治医生判断,最终以登记平台与研究者确认为准。
研究终点衡量什么算有效
- 主要终点发生剂量限制性毒性(DLT)的参与者人数28天
- 主要终点12个月总生存率12个月
- 次要终点肿瘤反应
- 次要终点4个月无进展生存率
- 次要终点Ⅱ期总生存期
- 次要终点Ⅱ期无进展生存期
核对登记原文(英文)
主要终点:Count of Participants That Experience a DLT · Maximum tolerated dose will be defined as the dose level below the lowest dose that induces dose-limiting toxicity (DLT) in at least one-third of patients (at least 2 of a maximum of 6 new patients). · 28 days;Overall Survival at 12 Months · The proportion of patients that were followed and alive at 12 months post registration. · 12 months
次要终点:Tumor Response;4 Month Progression Free Survival Rate;Overall Survival (Phase II);Progression Free Survival (Phase II)
研究设计怎么做的
- 研究类型
- 干预性研究
- 入组人数
- 34 人(实际)
- 分组方式
- 不适用(单臂)
核对分组登记原文(英文)
- Treatment (MV-NIS infected mesenchymal stem cells) · EXPERIMENTAL · Patients receive oncolytic measles virus encoding thyroidal sodium iodide symporter IP over 30 minutes on day 1 of cycle 1 and MV-NIS infected MSC (if MSC are not available, MV-NIS may be given alone) IP over 30 minutes of subsequent cycles. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.
Additionally, patients undergo ECHO or MUGA prior to registration and blood sample collection, chest X-ray, SPECT/CT, CT or MRI throughout the study.
关键日期
- 开始日期
- 2014-04-25
- 主要完成日期
- 2024-03-15
- 全部完成日期
- 2027-03-15
- 登记状态核实于
- 2026-08
联系与责任方
- 申办方
- Mayo Clinic
- 合作方
- National Cancer Institute (NCI)
登记简述
本Ⅰ/Ⅱ期试验研究表达甲状腺钠碘同向转运体(NIS)的溶瘤麻疹病毒(MV-NIS)及感染该病毒的间充质干细胞治疗复发性卵巢癌、原发性腹膜癌或输卵管癌的副作用、最佳剂量及疗效。间充质干细胞可能将杀伤肿瘤的物质直接递送至上述肿瘤细胞。
核对登记原文(英文)
This phase I/II trial studies the side effects and best dose of oncolytic measles virus encoding thyroidal sodium iodide symporter (MV-NIS) infected mesenchymal stem cells and to see how well it works in treating patients with ovarian, primary peritoneal or fallopian tube cancer that has come back. Mesenchymal stem cells may be able to carry tumor-killing substances directly to ovarian, primary peritoneal and fallopian tube cancer cells.