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:Phase 1 Study of BAFF CAR-T Cells (LMY-920) for Non-Hodgkin Lymphoma
Phase 1 Study of BAFF CAR-T Cells (LMY-920) for Non-Hodgkin Lymphoma
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。
⚠ 该试验的登记信息已有 24 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。
这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗非霍奇金淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 20 例。试验地点:美国 · 克利夫兰(共 2 个中心)。登记号:NCT05312801。
不限性别 · ≥ 18 Years
纳入标准: 1. 组织学确诊非霍奇金淋巴瘤,且接受≥2线治疗后复发,或对化疗难治(最近一次化疗最佳疗效为疾病进展或疾病稳定≤6个月;或既往自体干细胞移植后≤12个月疾病进展/复发)。 2. 无中枢神经系统(CNS)淋巴瘤证据。 3. 男性或女性,年龄>18岁。 4. ECOG体能状态评分≤2。 5. 至少有1个可测量病灶。 6. 白细胞单采时距既往放疗或全身治疗>2周。 7. 总胆红素≤1.5 mg/dL(Gilbert综合征患者除外)。 8. AST/ALT≤机构正常值上限的2.5倍。 9. 血清肌酐<1.5 mg/dL。 10. 超声心动图显示心脏射血分数>50%,且无心包积液证据。 11. 肺功能充分:室内空气下脉搏血氧饱和度≥92%。 12. 受试者(或法定监护人)能够理解并愿意签署书面知情同意书。 13. 有生育能力女性同意在治疗期间及BAFF CAR-T 细胞输注后至少90天内禁欲(避免异性性交),或使用年失败率<1%的避孕方法。 14. 男性同意禁欲(避免异性性交)或采取避孕措施,并同意不捐献精子。 排除标准: 1. 签署知情同意书前6周内接受自体干细胞移植(ASCT)。 2. 既往接受异基因造血干细胞移植。 3. 活动性移植物抗宿主病(GVHD)。 4. 淋巴瘤或白血病活动性累及CNS或脑膜。 5. 活动性恶性肿瘤,非黑色素瘤皮肤癌或原位癌(如宫颈、膀胱或乳腺)除外。 6. 既往使用研究性药物至淋巴细胞采集日不足28天。 7. NYHA IV级充血性心力衰竭。 8. 登记前6个月内发生心血管疾病,包括不稳定型心绞痛、有临床意义的心律失常、心肌梗死或卒中(包括短暂性脑缺血发作或其他缺血事件)。 9. 存在需静脉全身治疗的活动性感染。 10. HIV血清阳性。 11. 妊娠或哺乳期女性。 12. 治疗开始前任何骨髓活检显示骨髓增生异常或提示骨髓增生异常的细胞遗传学异常。 13. 血清学结果提示活动性乙肝或丙肝感染。 14. 有临床相关CNS病变史,包括癫痫、惊厥性疾病、轻瘫、失语、未控制的脑血管病、严重脑损伤、痴呆或帕金森病。 15. 存在未控制的合并疾病。 16. 已知有需全身治疗的其他恶性肿瘤。 17. 过去6个月内有需免疫抑制药物治疗(低剂量类固醇除外)的自身免疫病史。
Inclusion Criteria: 1. Subjects must have histologically confirmed non-Hodgkin lymphoma relapsed after 2 or more lines of therapy or disease refractory to chemotherapy (defined as progressive disease or stable disease lasting ≤6 months, as best response to most recent chemotherapy regimen; or disease progression or recurrence ≤12 months after prior autologous stem cell transplantation (ASCT). 2. No evidence of central nervous system (CNS) lymphoma. 3. Male or female \> 18 years of age. 4. Eastern Cooperative Oncology Group Performance status ≤ 2. 5. At least one measurable lesion. 6. \>2 weeks since prior radiation therapy or systemic therapy at the time of leukapheresis. 7. Total bilirubin ≤ 1.5 mg/dL (except in patients with Gilbert's syndrome). 8. Aspartate aminotransferase/alanine transferase ≤ 2.5 X institutional upper limit of normal. 9. Serum creatinine \< 1.5 mg/dL. 10. Cardiac ejection fraction of \>50%, and no evidence of pericardial effusion, as determined by an echocardiogram. 11. Adequate pulmonary function as defined as pulse oximetry ≥ 92% on room air. 12. Subjects (or legal guardians) must have the ability to understand and the willingness to sign a written informed consent document. 13. For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use a contraceptive method with a failure rate of \< 1% per year during the treatment period and for at least 90 days after the BAFF CAR-T cell infusion. 14. For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures, and agreement to refrain from donating sperm. Exclusion Criteria: 1. ASCT within 6 weeks of informed consent. 2. History of allogeneic hematopoietic stem cell transplantation. 3. Active graft-versus-host disease. 4. Active central nervous system or meningeal involvement by lymphoma or leukemia. 5. Active malignancy, other than non-melanoma skin cancer or carcinoma in situ (e.g. cervix, bladder, breast). 6. Less than 28 days elapsed between prior treatment with investigational agent(s) and the day of lymphocyte collection. 7. New York Heart Association class IV congestive heart failure. 8. Cardiovascular disorders including unstable angina pectoris, clinically significant cardiac arrhythmias, myocardial infarction or stroke (including transient ischemic attack, or other ischemic event) within 6 months prior to registration. 9. Active infection requiring intravenous systemic treatment. 10. HIV seropositivity. 11. Pregnant or breastfeeding women. 12. Evidence of myelodysplasia or cytogenetic abnormality indicative of myelodysplasia on any bone marrow biopsy prior to initiation of therapy. 13. Serologic status reflecting active hepatitis B or C infection. 14. Patients with history of clinically relevant CNS pathology such as epilepsy, seizure disorders, paresis, aphasia, uncontrolled cerebrovascular disease, severe brain injuries, dementia and Parkinson's disease. 15. Subjects with uncontrolled intercurrent illness. 16. Known additional malignancies which require systemic treatment. 17. History of autoimmune disease with requirement of immunosuppressive medications (other than low dose steroids) within 6 months.
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:To determine recommended phase II dose of human LMY-920. · Maximum tolerated dose. · 24 months
次要终点:To establish toxicity profile for the infusion of LMY-920.;To determine the objective response rate .;To determine the complete response rate.;To determine the duration of response.;To determine the progression-free survival.;To determine the overall survival.;To determine incidence of adverse events.;To determine incidence of anti- LMY-920 antibodies.
开放标签剂量递增研究,LMY-920最多设置4个剂量水平。采用3+3剂量递增设计确定LMY-920的最大耐受剂量(MTD)。
以上邮箱 / 电话是登记库里的申办方联系方式,通常不直达某家医院。中国中心的联系方式请以医院或登记平台最新公示为准。
CAR-T 细胞疗法已显示可治疗难治性淋巴瘤,但并非所有肿瘤都对靶向CD19的CAR-T 细胞有应答或维持应答。研究者提出,表达BAFF的CAR-T 细胞可成为治疗难治性淋巴瘤的新策略,包括CD19靶向CAR-T 治疗后复发的患者。本Ⅰ期研究使用单一淋巴细胞清除方案及BAFF CAR-T 细胞制备工艺,评估安全剂量并初步观察其治疗复发性非霍奇金淋巴瘤的活性。
Therapy with chimeric antigen receptor T (CAR-T) cells has demonstrated activity against refractory lymphoma, however not all tumors respond or remain in response to CD19 targeted CAR-T cells. We posit that CAR-T cells expressing BAFF (BAFF CAR-T cells) can become another strategy to treat refractory lymphoma, even after relapse following cluster of differentiation antigen 19 (CD19) targeting CAR-T treatment. This phase 1 study will evaluate safe dose and provide initial signal of the activity of BAFF CAR-T cells against relapsed non-Hodgkin lymphoma using a single lymphodepletion regimen and using a BAFF CAR-T cell manufacturing process.
MEMBER ACCOUNT
登录成功会直接打开下一页。