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CD30 CAR-T 治疗霍奇金淋巴瘤:早期 I 期临床试验(UNC Lineberger)

英文原题:Study of PD-1 Inhibitors After CD30.CAR T Cell Therapy in Relapsed/Refractory Hodgkin Lymphoma

ClinicalTrials.gov 2019/10/22(首次登记) 早期I 期注册临床试验 · 进行中(不再招募)

简要介绍

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。

入组条件决定能不能参加

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。
核对登记原文(英文)
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。

研究终点衡量什么算有效

  • 主要终点客观缓解:开始抗PD-1治疗12周后达到完全缓解(CR)或部分缓解(PR)12周
  • 次要终点抗PD-1治疗第1、21和42天每10万克隆中的外周T细胞受体频率
  • 次要终点外周血T细胞亚群比例变化
  • 次要终点无进展生存期
核对登记原文(英文)

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

研究设计怎么做的

研究类型
干预性研究
入组人数
10 人(实际)
分组方式
非随机分组
  • 第1组:既往接受CD30 CAR-T治疗后复发试验组

    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。

  • 第2组:复发且既往未接受CD30 CAR-T治疗试验组

    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。

核对分组登记原文(英文)
  • Arm 1: Relapse After Prior CD30 CAR-T Therapy · EXPERIMENTAL · Subjects with relapsed/refractory classical Hodgkin lymphoma (r/r cHL) who have previously progressed on anti-PD-1 therapy, have received a CD30 CAR-T cell therapy and have evidence of progression. Subjects will be offered anti-PD-1 therapy (nivolumab or pembrolizumab, at the discretion of treating oncologist), as per standard of care in r/r cHL.
  • Arm 2: Relapse with no Prior CD30 CAR-T Therapy · EXPERIMENTAL · Subjects with relapsed/refractory classical Hodgkin lymphoma (r/r cHL) who have previously progressed on anti-PD-1 therapy, have not received a CD30 CAR-T cell therapy and have evidence of progression. Subjects will be offered anti-PD-1 therapy (nivolumab or pembrolizumab, at the discretion of treating oncologist), as per standard of care in r/r cHL.

关键日期

开始日期
2019-09-01
主要完成日期
2025-04-01
全部完成日期
2037-07-07
登记状态核实于
2026-04

联系与责任方

申办方
UNC Lineberger Comprehensive Cancer Center
合作方
American Society of Clinical Oncology

登记简述

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。

核对登记原文(英文)

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).

登记原文与核验信息

试验登记号
NCT04134325
试验期别
早期I 期
试验状态
进行中(不再招募)
试验中心
Lineberger Comprehensive Cancer Center at University of North Carolina · 教堂山 · 美国
适应症(原文)
Relapsed Hodgkin Lymphoma; Refractory Hodgkin Lymphoma
干预方式(原文)
Nivolumab; Pembrolizumab