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肿瘤浸润淋巴细胞治疗胶质瘤:早期 I 期临床试验(Shanghai Juncell)

英文原题:Study of GC101 TIL in Brain Glioma (Soochow2)

ClinicalTrials.gov 2021/06/29(首次登记) 早期I 期注册临床试验 · 招募中

简要介绍

这是一项早期 I 期注册临床试验,评估TIL(肿瘤浸润淋巴细胞)治疗胶质瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 50 例。试验地点:中国 · 苏州(共 1 个中心,其中中国 1 个)。登记号:NCT04943913。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 75 Years

纳入标准:

1. 年龄18–75岁。
2. 组织学确诊原发性、复发性或转移性脑胶质瘤。
3. 预期生存期>3个月。
4. Karnofsky评分≥60%或ECOG 0–2分。
5. 标准治疗方案失败或无可用标准治疗。
6. 有可活检/切除并获取TIL的肿瘤区域,或有可分离TIL的恶性体液;至少有1个可评估肿瘤病灶。
7. 入组前7天内血液学和生化指标符合:白细胞≥2.5×10⁹/L、ANC≥1.5×10⁹/L、淋巴细胞≥0.7×10⁹/L、血小板≥100×10⁹/L、血红蛋白≥90 g/L;APTT≤ULN的1.5倍(过去3天接受抗凝者除外);INR≤ULN的1.5倍(过去3天接受抗凝者除外);肌酐≤1.5 mg/dL(132.6 μmol/L)或清除率≥50 mL/min;ALT/AST≤ULN的3倍;总胆红素≤ULN的1.5倍。
8. 无手术或活检的绝对/相对禁忌证。
9. 有生育能力者同意采用获批的高效避孕方式,知情同意时开始并持续至淋巴清除结束后1年。
10. 放疗、化疗、生物制剂等抗肿瘤治疗须在获取TIL前停止至少28天。
11. 能理解并签署知情同意书,且能遵守随访和协议要求。

排除标准:

1. 需要泼尼松>15 mg/日(或等效剂量)糖皮质激素治疗,或自身免疫病需免疫调节治疗。
2. FEV1<2 L或校正DLCO<40%。
3. 有显著心血管异常,包括NYHA心功能Ⅲ/Ⅳ级心力衰竭、有临床意义的低血压、未控制的症状性冠状动脉疾病、射血分数<35%,或需临床干预的室性心律失常、二/三度房室传导阻滞等严重心律/传导异常。
4. HIV感染或抗HIV抗体阳性;活动性乙肝/丙肝(HBsAg和/或抗HCV阳性);梅毒感染或梅毒螺旋体抗体阳性。
5. 严重躯体或精神疾病;需治疗的全身活动性感染、血培养阳性或影像学有感染证据。
6. 过去1个月内接受过其他药物、生物治疗、化疗或放疗,或目前正在接受上述治疗。
7. 对与细胞治疗相似的化学/生物物质有过敏史。
8. 既往免疫治疗发生>3级免疫相关不良事件(irAE)。
9. 既往抗肿瘤治疗不良事件尚未恢复至CTCAE 5.0版≤1级;研究者认为无安全性影响的毒性(如脱发)除外。
10. 妊娠或哺乳期;有器官移植、异体造血干细胞移植或肾脏替代治疗史。
11. 研究者认为有其他严重全身性疾病史或其他不适合参加研究的原因。
核对登记原文(英文)
Inclusion Criteria

1. Age: 18 years to 75 years;
2. Histologically diagnosed as primary/relapsed/metastasized brain glioma;
3. Expected life-span more than 3 months;
4. Karnofsky≥60% or ECOG score 0-2;
5. Test subjects have failed standard treatment regimens, or there are no standard treatment regimens available.
6. Test subjects must have tumor regions eligible for biopsy or resection, or malignant body fluid where TILs can be isolated;
7. At least 1 evaluable tumor lesion;
8. Hematology and Chemistry(within 7 days prior to enrollment):

   * Absolute count of white blood cells≥2.5×10\^9/L;
   * Absolute count of neutropils≥1.5×10\^9/L;
   * Absolute count of lymphocytes ≥0.7×109/L;
   * Platelet count≥100×10\^9;
   * hemoglobin≥90 g/L;
   * Activated partial thromboplastin time (APTT) ≤1.5xULN (Unless received anticoagulant therapy within the previous 3 days);
   * International normalized ratio (INR) ≤1.5xULN (Unless received anticoagulant therapy within the previous 3 days);
   * Serum creatinine ≤1.5mg/dL(or ≤132.6μmol/L), or clearance rate≥50mL/min;
   * Serum ALT/AST ≤3×ULN(subjects with liver metastasis ≤3×ULN);
   * Totol bilirubin≤1.5×ULN;
9. No absolute or relative contraindications to operation or biopsy;
10. Test subjects with child-bearing potential must be willing to practice approved highly effective methods of contraception at the time of informed consent, and continue within 1 year after the completion of lymphodepletion;
11. Any malignant tumor-targeting therapies, including radiotherapy, chemotherapy and biologics must cease 28 days before obtaining TILs;
12. Be able to understand and sign the informed consent document;
13. Be able to stick to follow-up visit plan and other requirements in the agreement.

Exclusion Criteria:

1. Need glucocorticoid treatment, and daily dose of Prednisone greater than 15mg (or equivalent doses of hormones) or outoimmune diseases requiring immunomodulatory treatment;
2. Forced expiratory volume in one second (FEV1) less than 2L, diffusing capacity of the lung for carbon monoxide (DLCO) (calibrated) less than 40%;
3. Significant cardiovascular anomalies according to any of the following definition: New York Heart Association (NYHA) Grade III or IV congestive heart failure, clinically significant low blood pressure, uncontrollable symptomatic coronary artery diseases, or ejection fraction less than 35%; Severe cardiac rhythm and conduction anomaly, such as ventricular arrhythmia requiring clinical intervention, second-third degree atrio-ventricular conductive block, etc.
4. Human immunodeficiency virus (HIV) infection or anti-HIV antibody positive, active HBV or HCV infection (HBsAg positive and/or anti-HCV positive), syphilis infection or Treponema pallidum antibody positive;
5. Severe physical or mental diseases;
6. Have a systemic active infection requiring treatment, or have positive blood cultures(or imaging evidence of infection);
7. Having been treated within a month or being treated now with other medicines, or other biologic therapy, chemo-or radiotherapy;
8. History of allergy to chemical compound consisting of chemical and biologic substances resembling cell therapy;
9. Having received immunotherapy and developed irAE level greater than Level 3;
10. Previous anti-tumor treatment AE did not return to CTCAE5.0 version grade 1 or below (toxicity considered by the investigator as non-safety concerns like alopecia excluded);
11. Females in pregnancy or lactation;
12. History of organ transplantation, allogeneic stem cell transplantation, and renal replacement therapy;
13. Researchers considering the test subject as having a history of other severe systemic diseases, or other reasons inappropriate for the clinical 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

  • 主要终点不良事件(AE)1个月
  • 主要终点客观缓解率(ORR)最长36个月
  • 主要终点疾病控制率(DCR)最长36个月
  • 主要终点缓解持续时间(DOR)最长36个月
  • 主要终点无进展生存期(PFS)最长36个月
  • 主要终点总生存期(OS)最长36个月
  • 次要终点完全缓解(CR)
  • 次要终点部分缓解(PR)
  • 次要终点疾病稳定(SD)
  • 次要终点疾病进展(PD)
  • 次要终点生活质量变化
核对登记原文(英文)

主要终点:Adverse Events (AE) · To characterize the safety profile of GC101 TIL in patients with advanced brain glioma as assessed by incidence of adverse events. · 1 month;Objective Response Rate (ORR) · Proportion of patients with response per Response Evaluation Criteria in Solid Tumors (RECIST v1.1): ORR (proportion of patients) = # with CR + # with PR / # with CR + # with PR + # with SD + # with PD. ( Except baseline evaluation within 28 days before GC101 TIL infusion,PET/CT scan will be performed at 6 weeks after TIL infusion, and than every 6 weeks for 6 months, and then every 6 months after that for up to 3 years) · Up to 36 months;Disease Control Rate (DCR) · Percentage of patients that meet CR, PR and SD criteria set in this study according to RECIST 1.1 · Up to 36 months;Duration of Response (DOR) · The time length between the first confirmed objective response per RECIST 1.1 to the treatment and the subsequent disease progression per RECIST 1.1 · Up to 36 months;Progression-Free Survival (PFS) · The time length between TIL infusion and confirmed subsequent disease progression according to RECIST 1.1 · Up to 36 months;Overall Survival (OS) · The length of time from the date of the start of TIL treatment that the patients are still alive · Up to 36 months
次要终点:Complete Response(CR);Partial Response (PR);Stable Disease (SD);Progressive Disease (PD);Change in Quality of Life

研究设计怎么做的

研究类型
干预性研究
入组人数
50 人(预计)
分组方式
不适用(单臂)
  • 肿瘤浸润淋巴细胞(TIL)组试验组

    非清髓性淋巴清除后静脉输注1×10⁹–5×10¹⁰个体外扩增的自体TIL;预处理包括羟氯喹单次600 mg及环磷酰胺。

核对分组登记原文(英文)
  • Tumor Infiltrating Lymphocytes · EXPERIMENTAL · 1x10\^9-5x10\^10 in vitro expanded autologous TILs will be infused i.v. to patients with brain glioma after NMA lymphodepletion treatment with hydroxychloroquine(600mg,single-dose) and cyclophosphamide.

关键日期

开始日期
2021-05-06
主要完成日期
2026-12-30
全部完成日期
2027-05-31
登记状态核实于
2025-12

联系与责任方

申办方
Shanghai Juncell Therapeutics
合作方
Second Affiliated Hospital of Soochow University
联系邮箱
clinicaltrials@juncell.com
联系电话
086-18001759113

登记简述

本研究旨在评估肿瘤浸润淋巴细胞(TIL)治疗恶性胶质瘤患者的安全性和疗效。自体TIL从肿瘤切除组织中扩增,患者接受羟氯喹(单次600 mg)和环磷酰胺非清髓性淋巴清除后,将TIL静脉输注回患者体内。

核对登记原文(英文)

This study is to investigate the safety and efficacy of tumor infiltrating lymphocyte (TIL) therapy in patients with malignant glioma . Autologous TILs are expanded from tumor resections and infused i.v. into the patient after NMA lymphodepletion treatment with hydroxychloroquine(600mg,single-dose) and cyclophosphamide.

登记原文与核验信息

试验登记号
NCT04943913
试验期别
早期I 期
试验状态
招募中
中国试验中心(1 个)
The Second Affiliated Hospital of Soochow University · 苏州 · 中国
适应症(原文)
Glioma
干预方式(原文)
Tumor Infiltrating Lymphocytes (TIL)