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.
英文原题:A Study to Evaluate the Efficacy and Safety of JCAR017 in Adult Subjects With Relapsed or Refractory Indolent B-cell Non-Hodgkin Lymphoma (NHL)
A Study to Evaluate the Efficacy and Safety of JCAR017 in Adult Subjects With Relapsed or Refractory Indolent B-cell Non-Hodgkin Lymphoma (NHL)
分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。
这是一项 II 期注册临床试验,评估细胞治疗用于淋巴瘤的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 276 例。试验地点:美国 · 圣莫尼卡、奥罗拉、纽黑文、芝加哥(共 49 个中心)。登记号:NCT04245839。
不限性别 · ≥ 18 Years
纳入标准: 1. 筛选前6个月内由当地病理学确认复发/难治性滤泡性淋巴瘤(FL,1、2或3a级)或边缘区淋巴瘤(MZL)。 2. 至少接受过一种含抗CD20药物和烷化剂的既往治疗。 3. FL患者:至少接受过1线全身治疗。仅接受过1线全身治疗者须有高危特征;接受过≥2线全身治疗者,只要至少一线含抗CD20药物和烷化剂即可。 4. MZL患者:至少接受过2线全身治疗,且至少一线含抗CD20药物和烷化剂;或造血干细胞移植后复发。 5. ECOG体能状态评分0或1。 6. 器官功能充分。 7. 白细胞单采操作有充分的血管通路。 排除标准: 1. 有弥漫大B细胞淋巴瘤(DLBCL)与FL复合型淋巴瘤或FL转化的证据/病史。 2. WHO分类为十二指肠型FL。 3. 恶性肿瘤仅累及中枢神经系统;继发性CNS受累者可参加本研究。 4. 其他原发恶性肿瘤缓解不足2年;非浸润性恶性肿瘤除外。 5. 既往接受CAR-T 细胞或其他基因修饰细胞治疗。 6. HIV感染史或活动性感染。 7. 活动性乙肝或丙肝。 8. 经适当抗生素或其他治疗仍未控制的全身性真菌、细菌、病毒或其他感染。 9. 需要免疫抑制治疗的活动性自身免疫病。 10. 存在急性或慢性GVHD。 11. 有重大心血管疾病史。 12. 有临床相关CNS病变史或当前存在此类病变。 13. 白细胞单采前90天内接受过异基因造血干细胞移植(Allo-HSCT)。
Inclusion Criteria: 1. Relapsed or refractory follicular lymphoma (FL) (Grade 1, 2 or 3a) or marginal zone lymphoma (MZL) histologically confirmed within 6 months of screening, as assessed by local pathology 2. Patients should have received at least one prior therapy that includes anti-CD20 and alkylating agent 3. Follicular lymphoma patients: Received at least one prior line of systemic therapy. Patients that received one prior line of systemic therapy are eligible if they present with high risk features. Patients that received two or more prior lines of systemic therapy are eligible, assuming one of the prior lines includes anti-CD20 and alkylating agent (as listed in criterion 2) 4. Marginal zone lymphoma patients: Received two or more prior lines of systemic therapy, assuming one of the prior lines includes anti-CD20 and alkylating agent (as listed in criterion 2) or relapsed after hematopoietic stem cell transplant 5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 6. Adequate organ function 7. Adequate vascular access for leukapheresis procedure Exclusion Criteria: 1. Evidence or history of composite Diffuse large B-cell lymphoma (DLBCL) and FL, or of transformed FL 2. WHO subclassification of duodenal-type FL 3. Central nervous system-only involvement by malignancy (subjects with secondary central nervous system (CNS) involvement are allowed on study) 4. History of another primary malignancy that has not been in remission for at least 2 years, with the exception of non-invasive malignancies 5. Prior CAR T-cell or other genetically-modified cell therapy 6. History of or active human immunodeficiency virus (HIV) 7. Active hepatitis B or active hepatitis C 8. Uncontrolled systemic fungal, bacterial, viral or other infection despite appropriate antibiotics or other treatment 9. Active autoimmune disease requiring immunosuppressive therapy 10. Presence of acute or chronic graft-versus-host=disease 11. History of significant cardiovascular disease 12. History or presence of clinically relevant central nervous system pathology 13. Allogenic-hematopoietic stem cell transplant (Allo-HSCT) within 90 days of 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:Overall Response Rate (ORR) · Is defined as the percentage of participants achieving either a partial response (PR) or complete response (CR) at any time up to 60 months after JCAR017 treatment as assessed by PET-CT and/or CT using "The Lugano classification" · Up to 60 months
次要终点:Complete response rate (CRR) as assessed but PET-CT and/or CT using "The Lugano Classification";Duration of Response (DOR) if Best Overall Response (BOR) is CR, as assessed by PET-CT and/or CT using "The Lugano Classification";Duration of Response (DOR) as assessed by PET-CT and/or CT using "The Lugano Classification";Progression-Free Survival (PFS) as assessed by PET-CT and/or CT using "The Lugano Classification";Overall Survival (OS);Adverse Events (AEs);Pharmacokinetics - Cmax;Pharmacokinetics - Tmax
受试者先接受氟达拉滨静脉给药(30 mg/m²/日,连续3天)及环磷酰胺静脉给药(300 mg/m²/日,连续3天),之后输注JCAR017。药物给药详情参见最新说明书。淋巴细胞清除化疗结束后2–7天,于第1天输注目标剂量1×10^8个CAR阳性活T细胞(CAR+ T细胞)。每剂JCAR017均含CD4+ CAR+ T细胞和CD8+ CAR+ T细胞。
这是一项全球性、开放标签、单臂、多队列、多中心Ⅱ期研究,评估JCAR017用于复发/难治性滤泡性淋巴瘤(FL)或边缘区淋巴瘤(MZL)成年患者的疗效和安全性。研究遵循国际人用药品注册技术协调会(ICH)药物临床试验质量管理规范(GCP)及适用监管要求。研究分为三阶段:治疗前阶段包括筛查、白细胞单采和治疗前评估;治疗阶段从淋巴细胞清除化疗开始,至第1天给予JCAR017并随访至第29天;治疗后阶段进行疾病状态和安全性评估,随访5年。
This is a global Phase 2, open-label, single-arm, multicohort, multicenter study to evaluate efficacy and safety of JCAR017 in adult subjects with r/r FL or MZL. The study will be conducted in compliance with the International Council on Harmonisation (ICH) of Technical Requirements for Registration of Pharmaceuticals for Human Use/Good Clinical Practice (GCP) and applicable regulatory requirements. This study is divided into three periods: * Pretreatment, which consists of screening assessments, leukapheresis and the Pretreatment evaluation; * Treatment, which starts with the administration of lymphodepleting (LD) chemotherapy and continues through JCAR017 administration at Day 1 with follow-up through Day 29; * Posttreatment, which includes follow-up assessments for disease status and safety for 5 years.
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