为肝细胞癌武装 GPC3 CAR T 细胞:多少才足够,下一步是什么?
Armouring GPC3 CAR T cells for hepatocellular carcinoma: how much is enough and what comes next?
英文原题:Study of HBV-TCR T Cells (LioCyx-M) as Monotherapy or as Combination With Lenvatinib for HBV-related HCC
⚠ 该试验的登记信息已有 19 个月未更新, 页面上显示的「尚未开始招募」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。
这是一项 II 期注册临床试验,评估细胞治疗用于肝细胞癌、肝癌的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 55 例。登记号:NCT05195294。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. ECOG体能状态评分≤1。 2. 晚期HCC,经组织学/细胞学确诊,或肝硬化患者符合AASLD临床诊断标准。 3. 无法通过根治性手术和/或局部区域治疗治愈,或手术和/或局部区域治疗后疾病进展。 4. HCC一线全身治疗失败。 5. 血清HBsAg阳性。 6. 无肝硬化,或Child-Pugh A级代偿期肝硬化(5–6分)。 7. HLA I类基因型与可用TCR的HLA I类限制性元件相匹配。 排除标准: 1. 脑转移。 2. 筛选入组时可临床检出的第二原发恶性肿瘤;宫颈原位癌、非黑色素瘤皮肤癌、局限性前列腺癌、导管原位癌、I期子宫癌及浅表性膀胱肿瘤除外。 3. 缺乏外周静脉或中心静脉通路,或存在妨碍给药/研究样本采集的状况。 4. 对T细胞治疗产品和/或仑伐替尼有严重过敏性速发反应史。 5. 肝内肿瘤病灶的局部或局部区域治疗(如手术、放疗、肝动脉栓塞、化疗栓塞、射频消融、经皮乙醇注射或冷冻消融)须在LioCyx-M首次输注前≥4周完成。 6. 同时接受任何其他抗肿瘤治疗,包括细胞毒性化疗、酪氨酸激酶抑制剂或免疫治疗。 7. 首次输注前2周内接受抗癌治疗(包括研究性治疗)。半衰期>3天的既往治疗须在白细胞单采前至少28天停用。 8. 研究治疗开始前28天内接受其他研究性治疗;参加问卷调查或观察性研究者可参加本研究。 9. 临床试验期间可能需要接受免疫抑制治疗(局部使用类固醇允许)。 10. HIV阳性,或存在需治疗的活动性感染(HBV除外)。 11. 有显著心血管疾病(如NYHA II级及以上心脏病、研究治疗开始前3个月内心肌梗死或脑血管意外)、不稳定性心律失常或不稳定型心绞痛。 12. 经最佳药物治疗后仍未控制的高血压:收缩压>160 mmHg或舒张压>110 mmHg。
Inclusion Criteria: 1. Eastern Cooperative Oncology Group (ECOG) performance status ≤1 2. Advanced HCC with diagnosis confirmed by histology/ cytology or clinically by AASLD criteria in cirrhotic patients. 3. Disease that is not amenable to curative surgical and/or locoregional therapies, or progressive disease after surgical and /or locoregional therapies 4. Patients who failed first-line systemic therapy for HCC 5. Serum HBsAg positivity 6. Non-cirrhotic or compensated cirrhosis Child-Pugh A (5 - 6 points) 7. HLA class 1 profile matching HLA-class I restriction element of the available T cell receptor Exclusion Criteria: 1. Brain metastasis 2. Second primary malignancy that is clinically detectable at the time of consideration for study enrolment, except for in situ carcinoma of the cervix, non-melanoma skin carcinoma localized prostate cancer, ductal carcinoma in situ, or Stage I uterine cancer and superficial bladder tumours. 3. Lack of peripheral venous or central venous access or any condition that would interfere with drug administration or collection of study samples 4. History of severe allergic anaphylactic reactions to T cell therapy products and/or lenvatinib 5. Local or loco-regional therapy of intrahepatic tumour lesions (e.g. surgery, radiation therapy, hepatic arterial embolization, chemoembolization, radiofrequency ablation, percutaneous ethanol injection, or cryoablation) must have been completed ≥4 weeks before the first infusion of LioCyx-M. 6. Concurrent administration of any other anti-tumour therapy, including cytotoxic chemotherapy, tyrosine kinase inhibitor therapy, and immunotherapy. 7. Treatment with anticancer therapy, including investigational therapy, within 2 weeks prior to first infusion. For prior therapies with a half-life longer than 3 days, discontinuation of the therapy must have occurred at least 28 days prior to leukapheresis. 8. Treatment with other investigational therapy within 28 days prior to initiation of study treatment. Patients participating in surveys or observational studies are eligible to participate in this study. 9. Likelihood to require any immunosuppressive treatments during the period of the clinical trial (Localized steroid use should be allowed) 10. Human immunodeficiency virus (HIV) positive or active infection requiring treatment (except for HBV) 11. Significant cardiovascular disease (such as New York Heart Association (NYHA) Functional Classification Class II or greater cardiac disease, myocardial infarction, or cerebrovascular accident within 3 months prior to initiation of study treatment), unstable arrhythmia, or unstable angina 12. Uncontrolled hypertension, defined as systolic blood pressure \>160 mmHg or diastolic pressure \>110 mmHg, despite optimal medical management
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:Assessments of adverse events/serious adverse events · To evaluate the safety of LioCyx-M as a monotherapy and in combination with lenvatinib · Up to 4 years from study treatment initiation;Objective response rate (ORR) · To evaluate the anti-tumor efficacy of LioCyx-M as a monotherapy and in combination with lenvatinib · Up to 4 years from study treatment initiation
次要终点:Progression free survival (PFS);Time to radiographic progression (TTRP);Duration of response (DoR);Overall survival (OS)
患者最多接受8次LioCyx-M输注,每2周一次。LioCyx-M为乙肝病毒抗原特异性TCR重定向T细胞。
患者最多接受8次LioCyx-M输注,每2周一次,同时每日口服仑伐替尼。
这是一项开放标签、多中心Ⅱ期研究,评估自体T细胞单药或联合仑伐替尼治疗晚期乙肝相关肝细胞癌(HCC)的安全性和疗效。自体T细胞经mRNA转染,表达乙肝病毒(HBV)抗原特异性T细胞受体(TCR)(LioCyx-M)。
This is an open-label and multi-center Phase 2 study to evaluate the safety and efficacy of autologous T-cells transfected with mRNA encoding Hepatitis-B virus (HBV)-antigen-specific T cell receptor (TCR) (LioCyx-M) as monotherapy or as combination with lenvatinib for the treatment of advanced HBV-related hepatocellular carcinoma (HCC).
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