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:PSMA-specific CAR-T Cell Therapy
PSMA-specific CAR-T Cell Therapy
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 I/II 期注册临床试验,评估 T 细胞治疗相关疾病的疗效与安全性。当前状态:尚未开始招募。计划入组 100 例。试验地点:中国 · 深圳(共 1 个中心,其中中国 1 个)。登记号:NCT04429451。
不限性别 · ≥ 1 Year 且 ≤ 75 Years
纳入标准: 1. 肿瘤患者已接受标准一线治疗,且疾病被判定为不可切除、转移性、进展性或复发。 2. 通过免疫组织化学或流式细胞术检测肿瘤组织中的PSMA抗原表达,以确定是否符合入组条件;阳性定义为PSMA抗体染色结果阳性。 3. 体重≥10 kg。 4. 入组时年龄≥1岁且≤75岁。 5. 预期生存期至少8周。 6. 既往治疗:既往治疗方案数量不限;既往治疗导致的任何3或4级非血液学毒性必须已恢复至≤2级。 7. 单个核细胞采集前至少1周未接受造血生长因子。 8. 生物制剂、靶向药、酪氨酸激酶抑制剂或节律性非骨髓抑制治疗结束后至少间隔7天。 9. 含单克隆抗体的既往治疗结束后至少间隔4周。 10. 入组前至少1周未接受放射治疗。 11. Karnofsky/Lansky评分≥60%。 12. 心功能:左心室射血分数≥40%/55%。 13. 室内空气下脉搏血氧饱和度≥90%。 14. 肝功能:ALT和AST均<正常值上限(ULN)的3倍;血清胆红素及碱性磷酸酶均<ULN的2倍。 15. 肾功能:血清肌酐<ULN的3倍。 16. 骨髓功能:白细胞≥1000/μL、绝对中性粒细胞≥500/μL、绝对淋巴细胞≥500/μL、血小板≥25,000/μL(不得通过输血达到)。 17. 已知骨髓转移的患者,只要符合血液学功能标准且骨髓病变未造成血液学毒性,即可入组。 18. 所有入组患者本人或其父母/法定监护人均须签署知情同意书;适用时还须签署知情同意/赞同文件。 排除标准: 1. 存在严重疾病(如显著心、肺、肝疾病等)、主要器官功能障碍或>2级血液学毒性。 2. 存在无法治疗的中枢神经系统(CNS)转移;既往CNS肿瘤受累经治疗后,且治疗结束至少6周病情稳定者可入组。 3. 既往接受过其他基因工程改造的PSMA特异性CAR-T 细胞或抗体治疗。 4. 活动性HIV、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)感染或未控制的感染。 5. 需要全身性皮质类固醇或其他免疫抑制治疗。 6. 有证据表明肿瘤可能导致气道梗阻。 7. 无法遵守方案要求。 8. 可用CAR-T 细胞数量不足。
Inclusion Criteria: 1. Patients with tumors have received standard first-line therapy and have been judged to be non-respectable, metastatic, progressive or recurrent. 2. The expression status of PSMA antigens in the tumor tissue will be determined for eligibility. Positive expression is defined by PMSA antibody staining results based on immunohistochemistry or flow cytometry analyses. 3. Body weight greater than or equal to 10 kg. 4. Age: ≥1 year and ≤ 75 years of age at the time of enrollment. 5. Life expectancy: at least 8 weeks. 6. Prior Therapy: There is no limit to the number of prior treatment regimens. Any grade 3 or 4 non-hematologic toxicity of any previous therapy must have resolved to grade 2 or less. 7. Participant must not have received hematopoietic growth factors for at least 1 week prior to mononuclear cells collection. 8. At least 7 days must have elapsed since the completion of therapy with a biologic agent, targeted agent, tyrosine kinase inhibitor or a metronomic non-myelosuppressive regimen. 9. At least 4 weeks must have elapsed since prior therapy that included a monoclonal antibody. 10. At least 1 week since any radiation therapy at the time of study entry. 11. Karnofsky/jansky score of 60% or greater. 12. Cardiac function: Left ventricular ejection fraction greater than or equal to 40/55 percent. 13. Pulse Ox greater than or equal to 90% on room air. 14. Liver function: defined as alanine transaminase (ALT) \<3x upper limit of normal (ULN), aspartate aminotransferase (AST) \<3x ULN; serum bilirubin and alkaline phosphatase \<2x ULN. 15. Renal function: Patients must have serum creatinine less than 3 times upper limit of normal. 16. Marrow function: White blood cell count ≥1000/ul, Absolute neutrophil count ≥500/ul, Absolute lymphocyte count ≥500/ul, Platelet count ≥25,000/ul (not achieved by transfusion). 17. Patients with known bone marrow metastatic disease will be eligible for study as long as they meet hematologic function criteria, and the marrow disease does not have hematologic toxicity. 18. For all patients enrolled in this study, themselves or their parents or legal guardians must sign an informed consent and assent. Exclusion Criteria: 1. Existing severe illness (e.g. significant cardiac, pulmonary, hepatic diseases, etc.) or major organ dysfunction, or greater than grade 2 hematologic toxicity. 2. Untreatable central nervous system (CNS) metastasis: Patients with previous CNS tumor involvement that has been treated and is stable for at least 6 weeks following completion of therapy are eligible. 3. Previous treatment with other genetically engineered PSMA-specific CAR T cells or antibody therapy. 4. Active HIV, Hepatitis B virus (HBV), Hepatitis C virus (HCV) infection or uncontrolled infection. 5. Patients who require systemic corticosteroid or other immunosuppressive therapy. 6. Evidence of tumor potentially causing airway obstruction. 7. Inability to comply with protocol requirements. 8. Insufficient CAR T cells availability.
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 patients with adverse events. · Determine the toxicity profile the 4SCAR-PSMA cells with Common Toxicity Criteria for Adverse Effects version 4.0 · 3 year
次要终点:Anti-tumor effects;The expansion and persistence of 4SCAR-PSMA T cells;Survival time of the patients
通过静脉输注4SCAR-PSMA T细胞,剂量为每公斤体重10^6个细胞。
本临床试验旨在评估PSMA特异性CAR-T 细胞疗法用于PSMA阳性肿瘤患者的可行性、安全性和疗效,并进一步了解PSMA CAR-T 细胞在患者体内的功能及持久性。
The purpose of this clinical trial is to assess the feasibility, safety and efficacy of PSMA-specific CAR-T cell therapy in patients with PSMA positive tumor. Another goal of the study is to learn more about the function of the PSMA CAR-T cells and their persistency in the patients.
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