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CD70 CAR T(CAR-T 细胞)治疗急性髓系白血病、淋巴瘤:早期 I 期临床试验

英文原题:CD 70 CAR T for Patients With CD70 Positive Malignant Hematologic Diseases

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CD 70 CAR T for Patients With CD70 Positive Malignant Hematologic Diseases

ClinicalTrials.gov 2020/12/10(首次登记) 早期I 期注册临床试验 · 招募中

⚠ 该试验的登记信息已有 60 个月未更新, 页面上显示的「招募中」可能已经失效。联系研究中心之前,建议先到 ClinicalTrials.gov 核对登记原文的最新状态与联系方式。

简要介绍

这是一项早期 I 期注册临床试验,评估 CAR-T 细胞治疗急性髓系白血病、淋巴瘤、多发性骨髓瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 108 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT04662294。

入组条件决定能不能参加

不限性别

纳入标准(按疾病类型适用):

**急性髓系白血病(AML)**
• 按美国NCCN 2016.v1 AML临床实践指南,组织学确诊CD70阳性AML。
• 复发/难治性,符合任一项:标准化疗后未达CR;首次诱导达CR但缓解持续<12个月;一次或多次挽救治疗无效;复发≥2次。骨髓原始细胞形态学>5%和/或流式细胞术>0.01%。
• 总胆红素≤51 μmol/L、ALT/AST≤ULN的3倍、肌酐≤176.8 μmol/L;超声心动图LVEF≥50%;无肺部活动性感染且室内空气血氧≥92%;预期生存期≥3个月;ECOG 0–2分。患者或法定监护人自愿参加并签署知情同意书。

**非霍奇金淋巴瘤(NHL)**
• 年龄及性别不限。
• 按WHO 2016标准组织学确诊DLBCL-NOS、滤泡性淋巴瘤、CLL/SLL转化的DLBCL、原发纵隔大B细胞淋巴瘤或高级别B细胞淋巴瘤。
• 复发/难治CD70阳性NHL,二线及以上化疗后未缓解/复发、原发耐药或自体移植后复发;按Lugano 2014标准至少有1个可评估病灶。

**多发性骨髓瘤(MM)**
• 组织学确诊CD70阳性MM,按IMWG标准诊断复发/难治性MM、复发后MRD持续阳性,或有难以通过化疗/放疗根除的髓外病灶。
• 年龄及性别不限。
• 总胆红素≤51 μmol/L、ALT/AST≤ULN的3倍、肌酐≤176.8 μmol/L;超声心动图LVEF≥50%;无肺部活动性感染且室内空气血氧≥92%;预期生存期≥3个月;ECOG 0–2分。患者或法定监护人自愿参加并签署知情同意书。

排除标准:

• 颅脑外伤、意识障碍、癫痫、脑缺血或脑出血病史。
• 心电图QT间期延长或既往严重心脏病(如严重心律失常)。
• 妊娠或哺乳期。
• 严重活动性感染(单纯尿路感染和细菌性咽炎除外);活动性乙肝或丙肝;HIV感染。
• 筛选前2周内同时使用全身性类固醇(近期/当前吸入性类固醇除外)。
• 既往接受任何CAR-T产品或其他基因修饰T细胞治疗。
• 肌酐>2.5 mg/dL、ALT/AST>ULN的3倍或胆红素>2.0 mg/dL。
• 其他不适合参加试验的未控制疾病,或研究者认为可能增加风险/干扰研究结果的其他情况。
核对登记原文(英文)
Inclusion Criteria:

Inclusion criteria only for AML:

1. Histologically confirmed diagnosis of CD70 AML per the US National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Acute Myeloid Leukemia (2016.v1);
2. Relapsed or refractory CD70+ AML (meeting one of the following conditions):

   1. CR not achieved after standardized chemotherapy;
   2. CR achieved following the first induction, but CR duration is less than 12 months;
   3. Ineffectively after first or multiple remedial treatments;
   4. 2 or more relapses;
3. The number of primordial cells in bone marrow is \> 5% (by morphology), and/or \> 0.01% (by flowcytometry);
4. Total bilirubin ≤ 51 umol/L, ALT and AST ≤ 3 times of upper limit ofnormal, creatinine ≤ 176.8 umol/L;
5. Echocardiogram shows left ventricular ejection fraction (LVEF) ≥50%;
6. No active infection in the lungs, blood oxygen saturation in indoorair is ≥ 92%;
7. Estimated survival time ≥ 3 months;
8. ECOG performance status 0 to 2;
9. Patients or their legal guardians volunteer to participate in the studyand sign the informed consent.

Inclusion criteria only for NHL:

1. No gender and age limit;
2. Histologically confirmed diagnosis of DLBCL (NOS), FL, DLBCL transformed from CLL/SLL, PMBCL, and HGBCL per the WHO Classification Criteria for Lymphoma (2016);
3. Relapsed or refractory CD70+ NHL (meeting one of the following conditions):

   1. No response or relapse after second-line or above chemotherapy regimens;
   2. Primary drug resistance;
   3. Relapse after auto-HSCT;
4. At least one assessable tumor lesion per Lugano 2014 criteria

Inclusion criteria only for MM:

1. Histologically confirmed diagnosis of CD70 multiple myeloma (MM):

   1. According to the diagnostic criteria of IMWG multiple myeloma, the diagnosis was recurrent / refractory multiple myeloma
   2. Cases with recurrent positive minimal residual disease;
   3. Extramedullary leision which is hard to be eradicated by chemotherapy or radiotherapy.
2. No gender and age limit;
3. Total bilirubin ≤ 51 umol/L, ALT and AST ≤ 3 times of upper limit of normal, creatinine ≤ 176.8 umol/L;
4. Echocardiogram shows left ventricular ejection fraction (LVEF) ≥50%;
5. No active infection in the lungs, blood oxygen saturation in indoorair is ≥ 92%;
6. Estimated survival time ≥ 3 months;
7. ECOG performance status 0 to 2;
8. Patients or their legal guardians volunteer to participate in the studyand sign the informed consent.

Common inclusion criteria :

1. Total bilirubin ≤ 51 umol/L, ALT and AST ≤ 3 times of upper limit of normal, creatinine ≤ 176.8 umol/L;
2. Echocardiogram shows left ventricular ejection fraction (LVEF) ≥ 50%;
3. No active infection in the lungs, blood oxygen saturation in indoor air is ≥ 92%;
4. Estimated survival time ≥ 3 months;
5. ECOG performance status 0 to 2;
6. Patients or their legal guardians volunteer to participate in the study and sign the informed consent -

Exclusion Criteria:

1. History of craniocerebral trauma, conscious disturbance, epilepsy, cerebrovascular ischemia, and cerebrovascular hemorrhagic diseases;
2. Electrocardiogram shows prolonged QT interval, severe heart diseases such as severe arrhythmia in the past;
3. Pregnant (or lactating) women;
4. Patients with severe active infections (excluding simple urinary tract infection and bacterial pharyngitis);
5. Active infection of hepatitis B virus or hepatitis C virus;
6. Concurrent therapy with systemic steroids within 2 weeks prior to screening, except for the patients recently or currently receiving inhaled steroids;
7. Previously treated with any CAR-T cell product or other geneticallymodified T cell therapies;
8. Creatinine \>2.5mg/dl, or ALT / AST\>3 times of normal amounts, or bilirubin\>2.0 mg/dl;
9. Other uncontrolled diseases that were not suitable for this trial;
10. Patients with HIV infection;
11. Any situations that the investigator believes may increase the risk of patients or interfere with the results of study. -

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)基线至CD70靶向CAR-T输注后28天
  • 主要终点治疗期间出现的不良事件(TEAE)发生率CD70靶向CAR-T输注后最长2年
  • 次要终点急性髓系白血病(AML):客观缓解率(ORR)
  • 次要终点AML:总生存期(OS)
  • 次要终点AML:无事件生存期(EFS)
  • 次要终点非霍奇金淋巴瘤(NHL):客观缓解率(ORR)
  • 次要终点NHL:总生存期(OS)
  • 次要终点NHL:无事件生存期(EFS)
  • 次要终点多发性骨髓瘤(MM):客观缓解率(ORR)
  • 次要终点MM:总生存期(OS)
核对登记原文(英文)

主要终点:Dose-limiting toxicity (DLT) · Adverse events assessed according to NCI-CTCAE v5.0 criteria · Baseline up to 28 days after CD70 targeted CAR T-cells infusion;Incidence of treatment-emergent adverse events (TEAEs) · Incidence of treatment-emergent adverse events \[Safety and Tolerability\] · Up to 2 years after CD70 targeted CAR T-cells infusion
次要终点:Acute Myeloid Leukemia (AML), Overall response rate (ORR);AML, Overall survival (OS);AML, Event-free survival (EFS);Non-Hodgkin's lymphoma (NHL), Overall response rate (ORR);NHL, Overall survival (OS);NHL, Event-free survival (EFS);Multiple myeloma (MM), Overall response rate (ORR);MM, Overall survival (OS)

研究设计怎么做的

研究类型
干预性研究
入组人数
108 人(预计)
分组方式
非随机分组
  • T-ALL组试验组
  • T-NHL组试验组
  • AML组试验组
核对分组登记原文(英文)
  • T-ALL · EXPERIMENTAL
  • T-NHL · EXPERIMENTAL
  • AML · EXPERIMENTAL

关键日期

开始日期
2021-11-18
主要完成日期
2024-01-15
全部完成日期
2027-01-15
登记状态核实于
2020-12

联系与责任方

主要研究者
He Huang
申办方
Zhejiang University
合作方
Yake Biotechnology Ltd.
联系邮箱
hehuangyu@126.com
联系电话
86-13605714822

登记简述

本研究评估CD70 CAR-T治疗CD70阳性血液系统恶性肿瘤患者的安全性和疗效。

核对登记原文(英文)

A Study of CD 70 CAR T for patients with CD70 positive malignant hematologic diseases

登记原文与核验信息

试验登记号
NCT04662294
试验期别
早期I 期
试验状态
招募中
中国试验中心(1 个)
The first affiliated hospital of medical college of zhejiang university · 杭州 · 中国
适应症(原文)
Acute Myeloid Leukemia; Non-hodgkin's Lymphoma; Multiple Myeloma
干预方式(原文)
CD70 CAR T-cells