决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Modified Immune Cells (Autologous CAR T Cells) in Treating Patients with Advanced, Recurrent Platinum Resistant Ovarian, Fallopian Tube or Primary Peritoneal Cancer
⚠ 该试验的登记信息已有 23 个月未更新, 页面上显示的「进行中(不再招募)」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 CAR-T 细胞治疗急性淋巴细胞白血病、卵巢癌、恶性肿瘤的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 71 例。试验地点:美国 · 贝塞斯达、西雅图(共 2 个中心)。登记号:NCT03907527。
仅女性 · ≥ 18 Years
纳入标准: • 女性,复发、晚期、铂耐药的卵巢癌、输卵管癌或原发性腹膜癌;标准治疗后进展或不适合已知有临床获益的现有治疗。至少有一个按RECIST 1.1可准确测量的病灶(CT、超声或MRI上最长径≥1.0 cm,淋巴结>1.5 cm)。铂耐药定义为铂类方案治疗后6个月内疾病进展。已完成标准治疗(包括PARP抑制剂)的BRCA突变患者可入组。 • 能理解并签署书面知情同意书。 • 采集细胞时距既往细胞毒化疗至少14天。 • 实验室指标提示器官功能充分。 • 入组前至少28天未使用全身类固醇;造影剂过敏预处理或方案要求的其他药物除外。 • ECOG体能状态≤2分。 • 既往重大急性感染和/或近期手术已恢复,研究者认为无妨碍方案治疗的显著活动性合并症。 • 有生育能力女性妊娠试验阴性;有生育能力女性指未接受绝育手术、年龄<60岁或过去12个月内有月经。须同意治疗前、治疗期间及PRGN-3005输注后至少4个月采用两种避孕方法。 排除标准: • 存在以下任一心脏疾病:有症状的限制型心肌病;入组前4个月内不稳定型心绞痛或症状性冠状动脉疾病;正在治疗的NYHAⅢ–Ⅳ级心力衰竭;有症状心包积液;充血性心力衰竭;有临床意义的低血压。 • 筛选期间CA-125≤ULN(原登记条件)。 • HIV、西尼罗病毒、寨卡病毒感染史,或活动性乙肝/丙肝。 • 严重、有症状腹水,需利尿剂、定期穿刺放液或其他侵入性干预。 • 其他试验药物给药后未满28天。 • 肺动脉高压、肺纤维化或限制性肺病;室内空气下基线血氧<92%、FEV1≤50%或校正DLCO<40%。 • 妊娠或哺乳期。 • 过去5年内有第二种恶性肿瘤;皮肤基底/鳞状细胞癌或根治治疗的宫颈原位病变除外。 • 活动性自身免疫病需免疫抑制治疗或治疗未控制。 • 同时参加其他治疗性研究。 • 签署知情同意前30天内有临床或影像学急性肠梗阻证据。 • 已知或经治疗的脑转移;活动性癫痫。 • 年龄<60岁的女性,若不符合以下至少一项,视为有生育能力:连续停经至少12个月,或已接受绝育手术(子宫切除、输卵管切除或双侧卵巢切除;输卵管结扎不视为绝育)。有生育能力女性须在白细胞单采前14天内妊娠试验阴性。
Inclusion Criteria: * Women with recurrent, advanced, platinum resistant ovarian, fallopian tube, and primary peritoneal cancer that have progressed after receiving standard of care therapies or are not eligible to receive available therapies with known clinical benefit will be eligible for the study. Patients must have measurable disease that can be accurately measured by RECIST 1.1 criteria in at least one dimension as \>= 1.0 cm or \> 1.5 cm lymph node with computed tomography (CT), ultrasound, or magnetic resonance imaging (MRI) techniques. * Platinum resistant is defined as progression of disease within six months of platinum regimen. * Patients with BRCA mutations who have completed standard therapies (including PARP inhibitors) are allowed on this study. * Patients must be capable of understanding and providing a written informed consent. * Patients must be 14 days from previous cytotoxic chemotherapy at time of cell collection. * Laboratory values must indicate adequate organ function. * Patients must be at least 28 days post systemic steroids prior to enrollment except as premedication for contrast allergy and/or other protocol-mandated medication. * Patients must have Eastern Cooperative Oncology Group (ECOG) performance status score of =\< 2. * Patients must have recovered from major acute infections and/or recent surgical procedures, and in the opinion of the investigator, not have any significant active concurrent medical illnesses precluding protocol treatment. * Negative pregnancy test for women of childbearing potential. Women of childbearing potential are those who have not been surgically sterilized, are \< 60 years old, or have had menses within the past 12 months. * Women of childbearing potential must be willing to use 2 methods of contraception before, during, and at least 4 months after the PRGN-3005 cell infusion. Exclusion Criteria: * Patients with any of the following cardiac conditions: * Symptomatic restrictive cardiomyopathy * Unstable angina or symptomatic coronary artery disease within 4 months prior to enrollment * New York Heart Association functional class III-IV heart failure on active treatment * Symptomatic pericardial effusion * Congestive heart failure * Clinically significant hypotension. * Patients with CA 125 =\< ULN during screening. * Patients with history of human immunodeficiency virus (HIV), West Nile, Zika, or active hepatitis B or C infections. * Patients with severe, symptomatic ascites requiring diuretics, regular paracentesis, or other invasive interventions. * Patients within 28 days of receiving another investigational agent. * Patients with pulmonary hypertension, pulmonary fibrosis, or restrictive lung disease, patients with baseline oxygen saturation on room air \< 92%, forced expiratory volume in 1 second (FEV1) =\< 50%, or diffusion capacity of the lung for carbon monoxide (DLco) (corrected) of \< 40% will be excluded. * Women who are pregnant or breast feeding. * Patients with second malignancy within the last 5 years excluding basal carcinoma of the skin, squamous carcinoma of the skin, or in situ cervical dysplasia that has undergone curative therapy. * Patients with an active autoimmune disease requiring immunosuppressive therapy or uncontrolled with treatment. * Patients who are simultaneously enrolled in any other treatment study. * Clinical or radiological evidence of acute bowel obstruction within 30 days of signing consent. * Patients with known or treated brain metastases. * Patients with an active seizure disorder. * Any female patient \<60 years old who does not meet at least one of the following criteria will be considered to have reproductive potential: * Post-menopausal for at least 12 consecutive months (i.e., no menses), or * Undergone a sterilization procedure (hysterectomy, salpingectomy, or bilateral oophorectomy; tubal ligation is not considered a sterilization procedure). Pregnancy test for females of reproductive potential must be negative within 14 days before leukapheresis.
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:Incidence of adverse events · Toxicity grading will be evaluated according to the Cancer Therapy Evaluation Program Common Terminology Criteria for Adverse Events version 5.0 and monitoring of adverse events · Up to 12 months after infusion;Maximal tolerated dose of PRGN-3005 · Will be determined by a 3 X 3 dose escalation study for both intraperitoneal infusion and intravenous infusion of the trial. · Up to 28 days
次要终点:Evidence of anti-tumor activity;Number of PRGN-3005 T Cells
腹腔内给予自体PRGN-3005 UltraCAR-T细胞,可联合或不联合淋巴清除化疗。
静脉给予自体PRGN-3005 UltraCAR-T细胞,可联合或不联合淋巴清除化疗。
本Ⅰ/Ⅰb期剂量递增及剂量扩展研究评估PRGN-3005 UltraCAR-T(Precigen开发的自体嵌合抗原受体T细胞)治疗已转移、复发且对铂类化疗耐药的卵巢癌、输卵管癌或原发性腹膜癌患者的安全性并确定推荐剂量。自体CAR-T细胞经实验室基因修饰后可特异性靶向肿瘤蛋白并杀伤癌细胞。
This is a Phase I/Ib dose escalation, dose expansion, study to evaluate the safety and identify the recommended dose of modified immune cells PRGN-3005 (autologous chimeric antigen receptor (CAR) T cells developed by Precigen, Inc.) in treating patients with ovarian, fallopian tube, or primary peritoneal cancer that has spread to other places in the body, that has come back and is resistant to platinum chemotherapy. Autologous CAR T cells are modified immune cells that have been engineered in the laboratory to specifically target a protein found on tumor cells and kill them.
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