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:Study of PD-1 Inhibitors After CD30.CAR T Cell Therapy in Relapsed/Refractory Hodgkin Lymphoma
这是一项早期 I 期注册临床试验,评估细胞治疗用于霍奇金淋巴瘤的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 10 例。试验地点:美国 · 教堂山(共 1 个中心)。登记号:NCT04134325。
不限性别 · ≥ 18 Years
第1组纳入标准:既往接受CD30 CAR-T后复发 • 已取得参加研究的书面知情同意,并授权依据HIPAA规定披露个人健康信息。 • 签署同意时年龄≥18岁。 • 经治肿瘤科医生计划按照当地标准医疗实践给予标准治疗的抗PD-1治疗。 • 确诊经典型霍奇金淋巴瘤,在至少三线既往治疗后复发/难治,并在接受ATLCAR.CD30和/或ATLCAR.CD30.CCR4治疗后出现临床进展。CAR-T产品可为UNC、Baylor或Tessa产品。 • 既往接受异基因造血干细胞移植者也可参加,但将在知情同意过程中获告知:异基因移植后接受抗PD-1治疗可能增加移植物抗宿主病风险。 • 在接受自体CAR-T细胞治疗前,曾接受过抗PD-1治疗(标准治疗或研究性治疗均可)。 • 愿意在按当地标准医疗实践接受抗PD-1治疗期间提供临床所需的血液样本。 第2组纳入标准:未接受过CD30 CAR-T者复发 • 已取得参加研究的书面知情同意,并授权依据HIPAA规定披露个人健康信息。 • 签署同意时年龄≥18岁。 • 经治肿瘤科医生计划按照当地标准医疗实践给予标准治疗的抗PD-1治疗。 • 确诊经典型霍奇金淋巴瘤。 • 既往接受异基因造血干细胞移植者也可参加,但将在知情同意过程中获告知移植后接受抗PD-1治疗可能增加移植物抗宿主病风险。 • 愿意在按当地标准医疗实践接受抗PD-1治疗期间提供临床所需的血液样本。 • 根据研究者或方案指定人员的判断,愿意且能够遵守研究程序。 • 愿意同意研究要求的采血。 第1组排除标准:既往接受CD30 CAR-T后复发 • 过去6周内接受过抗CD30 CAR-T治疗。 • 已知存在HIV、HTLV、HBV或HCV活动性感染,或任何活动性、未控制的感染或脓毒症。 • CD30 CAR-T细胞产品输注后接受过化疗或抗PD-1治疗。 • 已知患有需要治疗且处于活动期和/或进展中的其他恶性肿瘤;基底细胞癌、鳞状细胞皮肤癌、宫颈原位癌、膀胱原位癌,或已无病生存至少5年的其他癌症除外。 • 目前正在使用每日剂量≥10 mg泼尼松或等效剂量的全身性皮质类固醇,或其他免疫抑制药物。 第2组排除标准:未接受过CD30 CAR-T者复发 • 既往接受过抗CD30 CAR-T治疗。 • 目前正在使用每日剂量≥10 mg泼尼松或等效剂量的全身性皮质类固醇,或其他免疫抑制药物。
Inclusion Criteria for Arm 1: Relapse After Prior CD 30 CAR-T Therapy * Written informed consent obtained to participate in the study and HIPAA authorization for release of personal health information. * Age ≥18 years at the time of consent. * Subject is planned to start on standard of care anti-PD-1 therapy per community standards of medical care by their treating oncologist. * Subject has a diagnosis of relapsed/refractory classical Hodgkin lymphoma after at least three lines of prior therapy with clinical progression after either ATLCAR.CD30 and/or ATLCAR.CD30.CCR4. The CAR-T cell product may be either the UNC, Baylor or Tessa product. * Subjects with prior allogeneic stem cell transplant will be eligible but will be counseled during consent regarding possible increased risk of graft versus host disease with anti-PD-1 therapy after allogeneic stem cell transplant. * Subjects must have previously been treated with anti-PD-1 therapy (any anti-PD-1 therapy either standard of care or investigational) prior to receiving autologous CAR-T-cell therapy. * Subject is willing to provide blood samples that are clinically necessary during anti-PD-1 therapy administered per community standards of medical care. Inclusion Criteria for Arm 2: Relapse with no Prior CD 30 CAR-T Therapy * Written informed consent obtained to participate in the study and HIPAA authorization for release of personal health information. * Age ≥18 years at the time of consent. * Subject is planned to start on standard of care anti-PD-1 therapy per community standards of medical care by their treating oncologist. * Subject has a diagnosis of classical Hodgkin lymphoma. * Subjects with prior allogeneic stem cell transplant will be eligible but will be counseled during consent regarding possible increased risk of graft versus host disease with anti-PD-1 therapy after allogeneic stem cell transplant. * Subject is willing to provide blood samples that are clinically necessary during anti-PD-1 therapy administered per community standards of medical care. * Subject is willing and able to comply with study procedures based on the judgment of the investigator or protocol designee. * Subject is willing to consent to study-required blood draws. Exclusion Criteria for Arm 1: Relapse After Prior CD 30 CAR-T Therapy * Subject has received anti-CD30 CAR-T therapy within the previous 6 weeks. * Subject has known active infection with HIV, HTLV, HBV, HCV or any active, uncontrolled infection or sepsis. * Subject has received chemotherapy or anti-PD-1 therapy following CD30 CAR-T cell product administration. * Subject has a known additional malignancy that is active and/or progressive requiring treatment; exceptions include basal cell or squamous cell skin cancer, in situ cervical or bladder cancer, or other cancer for which the subject has been disease-free for at least five years. * Subject is currently using systemic corticosteroids at doses ≥10 mg prednisone daily or its equivalent, or other immunosuppressive medications. Exclusion Criteria for Arm 2: Relapse with no Prior CD 30 CAR-T Therapy * Subject has received anti-CD30 CAR-T therapy * Subject is currently using systemic corticosteroids at doses ≥10 mg prednisone daily or its equivalent, or other immunosuppressive medications.
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:Objective response, defined as complete response (CR) or partial response (PR) at 12 weeks after initiating anti-PD-1 therapy · Response will be determined by the Lymphoma Response to Immunomodulatory Therapy Criteria in order to evaluate the efficacy of anti-PD-1 therapy after progression on CD30 CAR-T cell therapy in relapsed/refractory (r/r) classical Hodgkin Lymphoma (cHL). · 12 weeks
次要终点:Peripheral T-cell receptor frequency per 100,000 clones on Day 1, Day 21, and Day 42 of anti-PD-1 therapy.;Percent change in peripheral blood T-cell subsets;Progression free survival
既往接受抗PD-1治疗后进展、曾接受CD30 CAR-T细胞治疗且有疾病进展证据的复发/难治性经典型霍奇金淋巴瘤患者。将按照复发/难治性经典型霍奇金淋巴瘤的标准治疗,由经治肿瘤科医生酌情提供纳武利尤单抗或帕博利珠单抗等抗PD-1治疗。
既往接受抗PD-1治疗后进展、未接受过CD30 CAR-T细胞治疗且有疾病进展证据的复发/难治性经典型霍奇金淋巴瘤患者。将按照标准治疗,由经治肿瘤科医生酌情提供纳武利尤单抗或帕博利珠单抗等抗PD-1治疗。
这是一项前瞻性两组试点研究,旨在评估嵌合抗原受体T细胞(CAR-T)治疗能否产生免疫调节作用,并进一步利用程序性细胞死亡蛋白1(PD-1)抗体,在复发/难治性经典型霍奇金淋巴瘤患者中获得临床疗效。
LCCC1852-ATL is a prospective 2-arm study designed to determine if chimeric antigen receptor T (CAR-T) cells result in immunomodulation which can be subsequently exploited by programmed cell death protein 1 (PD-1) antibodies to achieve clinical responses in subjects with relapsed/refractory (r/r) classical Hodgkin Lymphoma (cHL).
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