TCR-JANUS 衔接蛋白实现双特异性靶向以克服 TCR-T 细胞治疗中的肿瘤异质性
TCR-JANUS engager proteins enable bispecific targeting to overcome tumor heterogeneity in TCR-T cell therapy.
基于 T 细胞受体(TCR)的免疫疗法受限于肿瘤抗原异质性,后者常导致复发。
英文原题:Individualized Tumor Specific TCR- T Cells in the Treatment of Advanced Solid Tumors
⚠ 该试验的登记信息已有 25 个月未更新, 页面上显示的「招募中」可能已经失效。联系研究中心之前,建议先到 ClinicalTrials.gov 核对登记原文的最新状态与联系方式。
这是一项 I 期注册临床试验,评估 T 细胞治疗实体瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 30 例。试验地点:中国 · 广州(共 1 个中心,其中中国 1 个)。登记号:NCT03891706。
不限性别 · ≥ 18 Years 且 ≤ 70 Years
纳入标准: 1. 年龄18~70岁,性别不限。 2. 经组织病理学确诊为实体瘤,且肿瘤病灶可检测或评估。 3. 已接受标准治疗,或缺乏有效治疗方案。 4. 患者及家属愿意参加临床试验并签署知情同意书。 5. ECOG体能状态评分0~1分。 6. 预期生存期>3个月。 7. HIV抗体阴性、乙肝表面抗原阴性、丙肝抗体阴性;血常规及凝血指标基本正常;淋巴细胞>0.8×10⁹/L,血红蛋白>100 g/L;有生育能力的女性妊娠试验阴性。 8. 心脏超声提示左心室射血分数50%;血清ALT/AST<正常值上限的2.5倍;血清肌酐1.6 mg/dL;总胆红素1.5 mg/dL;Gilbert综合征受试者总胆红素<3 mg/dL。 9. 末次全身治疗后至少间隔4周,治疗毒副作用须恢复至≤1级(脱发或白癜风除外)。入组前3周内接受过小手术者,只要所有毒性均恢复至≤1级,即符合入组要求。 10. 整个研究期间能够定期前往入组研究机构接受相关检测、评估和管理。 11. TCR-T细胞输注前4周内不得使用任何抗肿瘤药物或治疗。 12. 可通过手术或穿刺取得患者肿瘤病灶,且能够从所得肿瘤组织中成功分离肿瘤浸润T细胞。 13. 患者外周血T细胞在预培养中能够有效增殖,扩增至少10倍。 14. 研究者根据患者状态或病情评估认为,参加临床试验的获益大于风险。 排除标准: 1. 患有任何类型的原发性免疫缺陷病(如严重联合免疫缺陷病)。 2. 正在发生中重度感染或可能发生机会性感染。 3. 有自身免疫性疾病史(如系统性红斑狼疮、银屑病等)。 4. 存在急性全身感染、凝血功能障碍或其他严重心肺疾病。 5. 过去4周内大量使用糖皮质激素或其他免疫抑制药物。 6. 对本研究使用的任何药物过敏。 7. 存在临床不稳定的中枢神经系统转移或急性脑膜炎(治疗后临床稳定者除外)。临床稳定须满足:试验治疗前至少4周,(1)MRI确认无新发脑部病灶或原有病灶未扩大;(2)至少2周未接受激素治疗;(3)神经系统症状已恢复至基线。 8. 妊娠或哺乳期女性,以及研究期间无法配合避孕的男性或女性患者。
Inclusion Criteria: 1. Aged between 18 and 70 years old, regardless of gender; 2. Diagnosed as solid tumors by histopathology, and the tumor lesions could be detected or evaluated; 3. Be after standard treatment or who lack effective treatment programs; 4. Patients and their families were willing to participate in the clinical trial and signed the informed consent; 5. Physical status: ECOG score 0-1; 6. Expected survival time \> 3 months; 7. HIV antibody negative;Hepatitis b surface antigen negative;Hepatitis c antibody negative;The results of blood routine and coagulation were roughly normal, lymphocyte \>0.8×10\^9/L, hemoglobin \>100g/L, and the pregnancy test of female patients with fertility potential was negative. 8. Left ventricular ejection fraction 50% as indicated by cardiac ultrasound;Upper normal level of serum ALT/AST \< 2.5 times;Serum creatinine 1.6mg/dl;Total bilirubin 1.5mg/dl, subject's total bilirubin \< 3mg/dl except for Gilberts Syndrome; 9. At least 4 weeks after the last systemic treatment, the patient's toxic and side effects must be restored to grade 1 or lower (except for alopecia or vitiligo).If the subject undergoes minor surgery within 3 weeks prior to enrollment, as long as all toxicity is recovered to level 1 or lower, the subject will meet the enrollment requirements. 10. During the whole study period, patients can regularly visit the enrolled research institutions for relevant detection, evaluation and management; 11. The patient is not allowed to use any anti-tumor drugs or treatments for 4 weeks prior to the infusion of TCR-T cells; 12. Patients' tumor lesions can be obtained by surgery or puncture, and tumor infiltrating T cells can be successfully isolated from the obtained tumor tissue; 13. T cells in patients' peripheral blood can effectively proliferate and expand by at least 10 times in the Pre-culture; 14. The benefits of participating in the clinical trial outweigh the risks,which was evaluated by the researchers base on the status or condition of the patients. Exclusion Criteria: 1. Any form of primary immunodeficiency disease (such as severe combined immunodeficiency disease); 2. Experiencing moderate to severe infection or possible opportunistic infection; 3. Patients with a history of autoimmunity (e.g., SLE, psoriasis, etc.); 4. Acute systemic infection, coagulation dysfunction or other serious cardiopulmonary diseases; 5. Patients who have is suffering a large amount of glucocorticoid or other immunosuppressive agents within 4 weeks; 6. Be allergic to any drug used in this study; 7. Central nervous system metastases patients with clinically unstable or acute meningitis (except these clinically stable after treatment) Clinical stability needs to be met as follows: 4 weeks at least before the trial treatment, 1) no new brain lesion or no expanded of the original lesions confirmed by MRI); 2) no hormone therapy for at least 2 weeks; 3) neurological symptoms have returned to baseline; 8. Pregnant and lactating women, as well as male and female patients who could not cooperate with contraception during the study period.
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。
主要终点:Number of participants with treatment-related adverse events as assessed by CTCAE v4.03 · Keep records the adverse events experienced by subjects in 30 days after the last infusion. · At least 45 days
次要终点:Disease Control Rate(DCR);overall survival(OS);progression-free survival(PFS)
患者接受个体化肿瘤特异性T细胞受体(TCR)介导的T细胞治疗。
本研究主要旨在评估肿瘤特异性TCR-T细胞治疗晚期实体瘤的安全性;次要目的为初步观察TCR-T细胞治疗晚期实体瘤的效果。
The primary purpose of this study is to evaluate the safety of the tumor-specific TCR-T cells in the treatment of advanced Solid Tumor . The secondary purpose of this study is to preliminarily showed the effect of TCR-T cells in the treatment of advanced Solid Tumor .
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