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SCRI-CAR22v2(CD22)治疗白血病、淋巴瘤:I/II 期临床试验

英文原题:A Pediatric and Young Adult Trial of Genetically Modified T Cells Directed Against CD22 for Relapsed/Refractory Leukemia or Lymphoma

ClinicalTrials.gov 2020/09/30(首次登记) I/II 期注册临床试验 · 进行中(不再招募)

简要介绍

这是一项 I/II 期注册临床试验,评估细胞治疗用于白血病、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 35 例。试验地点:美国 · 洛杉矶、印第安纳波利斯、休斯顿、西雅图(共 4 个中心)。登记号:NCT04571138。

入组条件决定能不能参加

不限性别 · ≤ 30 Years

纳入标准:

* 男性或女性,年龄≤30岁;前2名入组受试者须为≥18且≤30岁。
* 有难治性或复发性CD22阳性白血病或淋巴瘤的证据。
* 能耐受单采术,或已有足量且可用于研究产品制备的单采产物/T细胞。
* 预期生存期≥8周。
* Lansky或Karnofsky评分(按适用情况)≥50。
* 既往化疗、免疫治疗和放疗的急性毒性均已恢复;若已有可接受且可用于CAR-T制备的单采产物,则不受此项限制。
* 距末次化疗及生物治疗≥7天;鞘内化疗和维持化疗除外。
* 距末次皮质类固醇治疗≥7天。
* 距末次酪氨酸激酶抑制剂(TKI)治疗≥3天。
* 距末次羟基脲治疗≥1天。
* 距最近一次CAR-T细胞输注≥30天。
* 器官功能充分。
* 实验室检查值符合要求,包括绝对淋巴细胞计数≥100个/μL。
* 有生育能力或可能使他人受孕的受试者,同意自签署知情同意书至研究产品输注后12个月采取高效避孕措施。
* 受试者和/或其法定授权代表已签署本研究知情同意书。

排除标准:

* 除本研究所针对疾病外,存在其他活动性恶性肿瘤。
* 有症状的中枢神经系统(CNS)疾病史或当前存在有症状的CNS疾病。
* 白血病或淋巴瘤累及CNS且有症状,并且研究者认为在入组至CAR-T输注期间无法控制。
* 恶性细胞均匀表达CD19、符合入组条件,但尚未尝试抗CD19 CAR-T治疗者。
* 既往接受干细胞移植者,在入组前4周内存在活动性移植物抗宿主病(GVHD),或正在接受GVHD预防/治疗的免疫抑制治疗。
* 存在活动性严重感染。
* 存在原发性免疫缺陷综合征。
* 既往接受过病毒治疗。
* 妊娠或哺乳期。
* 如接受CAR-T治疗,受试者和/或法定授权代表不同意参加规定的15年随访。
* 研究者认为会妨碍受试者按本方案接受治疗的任何情况。
核对登记原文(英文)
Inclusion Criteria:

* Male and female subjects aged ≤ 30 years. First 2 enrolled subjects: age ≥ 18 and ≤ 30 years
* Evidence of refractory or recurrent CD22+ leukemia or lymphoma
* Able to tolerate apheresis, or subject with sufficient existing apheresis product or T cells for manufacturing investigational product.
* Life expectancy ≥ 8 weeks
* Lansky or Karnofsky, as applicable, score ≥ 50
* Recovered from acute toxic effects of all prior chemotherapy, immunotherapy, and radiotherapy, if the subject does not have a previously obtained apheresis product that is acceptable and available for manufacturing of CAR T cells
* ≥ 7 days post last chemotherapy and biologic therapy, with the exception of intrathecal chemotherapy and maintenance chemotherapy
* ≥ 7 days post last corticosteroid therapy
* ≥ 3 days post Tyrosine Kinase Inhibitor (TKI) use
* ≥ 1 day post hydroxyurea
* 30 days post most recent CAR T cell infusion
* Adequate organ function
* Adequate laboratory values, including absolute lymphocyte count ≥ 100 cells/uL
* Subjects of childbearing or child-fathering potential must agree to use highly effective contraception from consent through 12 months following infusion of investigational product on trial
* Subject and/or legally authorized representative has signed the informed consent form for this study

Exclusion Criteria:

* Presence of active malignancy other than disease under study
* History of symptomatic CNS pathology or ongoing symptomatic CNS pathology
* CNS involvement of leukemia or lymphoma that is symptomatic and in the opinion of the investigator, cannot be controlled during the interval between enrollment and CAR T cell infusion
* Subjects with uniform expression of CD19 on their malignant cells who are eligible but have not attempted CD19 directed CAR T cell therapy
* For subjects having had a previous stem cell transplant: presence of active GVHD, or receiving immunosuppressive therapy for treatment or prevention of GVHD within 4 weeks prior to enrollment
* Presence of active severe infection,
* Presence of primary immunodeficiency syndrome
* Subject has received prior virotherapy
* Pregnant or breastfeeding
* Subject and/or legally authorized representative unwilling to provide consent/assent for participation in the 15-year follow-up period, required if CAR T cell therapy is administered
* Presence of any condition that, in the opinion of the investigator, would prohibit the subject from undergoing treatment under this protocol

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

  • 主要终点剂量限制性毒性(DLT)输注后28天
  • 主要终点成功制备SCRI-CAR22v2的能力28天
  • 主要终点SCRI-CAR22v2对复发/难治性CD22阳性白血病的缓解情况输注后28天
核对登记原文(英文)

主要终点:Dose Limiting Toxicities · Number of participants who experienced an adverse event meeting the dose-limiting toxicity definition · 28 days post-infusion;The Ability to Successfully Manufacture SCRI-CAR22v2 · Number of participants who have a releasable cell product generated · 28 days;The Leukemia Response to SCRI-CAR22v2 in Subjects With Relapsed or Refractory CD22+ Leukemia Will be Assessed · Number of participants with an MRD negative complete remission after initial CAR T cell infusion (by Day 28 post infusion assessment +/- 3 Days) · 28 days post-infusion

研究设计怎么做的

研究类型
干预性研究
入组人数
35 人(实际)
分组方式
不适用(单臂)
  • SCRI-CAR22v2治疗组试验组

    患者在Ⅰ期或Ⅱ期接受SCRI-CAR22v2治疗。

核对分组登记原文(英文)
  • SCRI-CAR22v2 · EXPERIMENTAL · Patients will receive SCRI-CAR22v2 in either Phase I or Phase II

关键日期

开始日期
2020-09-25
主要完成日期
2025-08-08
全部完成日期
2040-02
登记状态核实于
2026-07

联系与责任方

主要研究者
Colleen Annesley
申办方
Seattle Children's Hospital

登记简述

复发或难治性白血病/淋巴瘤患者往往对后续化疗仍不敏感。本研究拟采集患者自身T细胞并进行基因工程改造,使其表达可识别白血病和淋巴瘤细胞表面CD22的嵌合抗原受体(CAR)。Ⅰ期将确定CAR-T细胞的安全性和合适剂量,Ⅱ期将评估疗效。既往未接受或已接受过CAR-T治疗的患者均可能符合入组条件。

核对登记原文(英文)

Patients with relapsed or refractory leukemia or lymphoma are often refractory to further chemotherapy. In this study, the investigators will attempt to use T cells obtained directly from the patient, which can be genetically engineered to express a chimeric antigen receptor (CAR). The CAR used in this study can recognize CD22, a protein expressed on the surface of leukemia and lymphoma cells. The phase 1 part of this study will determine the safety and appropriate dose level of these CAR T cells, and the phase 2 part of the study will determine how effective this CAR T cell therapy is. Both patients who have never had prior CAR T cell therapy and those who have had prior CAR T cell therapy may be eligible to participate in this study.

登记原文与核验信息

试验登记号
NCT04571138
试验期别
I 期 / II 期
试验状态
进行中(不再招募)
试验中心
Children's Hospital Los Angeles · 洛杉矶 · 美国 | Riley Hospital for Children · 印第安纳波利斯 · 美国 | Texas Children's Hospital · 休斯顿 · 美国 | Seattle Children's Hospital · 西雅图 · 美国
适应症(原文)
Leukemia; Lymphoma
干预方式(原文)
SCRI-CAR22v2