下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:Study of HER2 Directed Dendritic Cell (DC1) Vaccine + Weekly Paclitaxel, Trastuzumab & Pertuzumab
这是一项 II 期注册临床试验,评估细胞治疗用于乳腺癌的安全性、可行性及初步疗效。当前状态:招募中。计划入组 53 例。试验地点:美国 · 坦帕(共 1 个中心)。登记号:NCT05325632。
不限性别 · ≥ 18 Years
纳入标准: * 组织学确诊临床I–III期HER2阳性浸润性乳腺癌(按ASCO/CAP标准);临床检查或影像学测得原发肿瘤至少1 cm。 * 经主治医师判断,适合接受紫杉醇、曲妥珠单抗和帕妥珠单抗新辅助化疗,之后接受标准局部治疗。 * ECOG体能状态评分0或1。 * 器官和骨髓功能符合方案要求。 * 基线多门控采集(MUGA)扫描或超声心动图显示心脏射血分数处于机构正常范围。 * 有生育能力的女性及其男性伴侣同意在入组前及整个研究期间采取充分避孕措施(激素或屏障避孕,或禁欲)。若女性受试者研究期间妊娠或怀疑妊娠,须立即告知主治医师。男性受试者须在化疗期间至手术前使用屏障避孕法或禁欲。 * 能够理解并愿意签署书面知情同意书。 排除标准: * 炎性乳腺癌;胸壁/淋巴结区域广泛局部晚期且不可切除、无法根治性手术的疾病;或疑似/确诊初诊转移性疾病。 * 正在使用其他研究性药物治疗乳腺癌。 * 对与研究疫苗成分或化疗药物(紫杉醇、曲妥珠单抗、帕妥珠单抗)化学/生物组成相似的化合物有过敏反应史。 * 不愿意或无法接受用于疫苗制备的白细胞单采。 * 未控制的合并疾病,包括但不限于持续或活动性感染、有症状的充血性心力衰竭、不稳定型心绞痛、心律失常,或会妨碍遵守研究要求的精神疾病/社会状况。 * 妊娠或哺乳期女性。 * 已知先天性或获得性免疫缺陷(包括需使用全身免疫抑制药治疗自身免疫病或器官移植者)。
Inclusion Criteria: * Participants must have histologically confirmed clinical stage I- III, HER2+ (per ASCO/CAP criteria) invasive carcinoma of the breast. Primary tumor should measure at least 1 cm by clinical exam or radiologic tests * Candidate for neoadjuvant chemotherapy with Paclitaxel, Trastuzumab, Pertuzumab regimen followed by standard of care local therapy as determined by the treating physician * Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 * Participants must have normal organ and marrow function as defined per protocol. * Cardiac ejection fraction within institutional normal limits by either Multigated Acquisition Scan (MUGA) or Echocardiogram at baseline. * Women of child-bearing potential and their male partners must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Sexually active male participants should use a barrier method or exercise abstinence during chemotherapy administration until surgery. * Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: * Participants with inflammatory breast cancer, widespread locally advanced unresectable disease involving the chest wall/nodal basins in which a curative surgical resection cannot be performed, or those in whom de novo metastatic disease is suspected or confirmed. * Patients may not be receiving any other investigational agents for the treatment of their breast cancer. * History of allergic reactions attributed to compounds of similar chemical or biologic composition to the study vaccine components and any of the chemotherapy drugs (paclitaxel, trastuzumab, pertuzumab). * Participants who are unwilling or unable to undergo an apheresis for production of their vaccine. * Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. * Pregnant women and women who are breastfeeding. * Participants with known congenital or acquired immune deficiency (including those patients who require systemic immunosuppressant drugs for autoimmune disease or organ transplant).
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:Lead in Phase: Immunogenicity of each dose level · Immunogenicity: will be characterized by quantifying CD4TH1 response via ELISPot. ELISPot is an enzyme-linked immunospot assay. It is a highly sensitive immunoassay that measures the frequency of cytokine-secreting cells at the single-cell level. · at 4 weeks;Expansion Phase: Pathologic Complete Response Rate · Pathologic complete response rate of participants treated in the Expansion Phase. Clinical efficacy will be defined by the pathologic complete response (pCR) rate, the percentage of patients who achieve pCR based on surgical pathology assessment. Pathologic Complete Response defined as no residual invasive disease in the breast and nodes (ypT0/is N0) at definitive surgery after completion of protocol therapy. The pathologic response to treatment will be assessed by the pathologist. The "Residual Cancer Burden" (RCB) for each patient as described in the online calculator also will be evaluated per the pathologist. (http://www3.mdanderson.org/app/medcalc/index.cfm?pagename=jsconvert3) · at 12 months
次要终点:Expansion Phase: Radiologic tumor response rate after 6 weeks;Expansion Phase: Radiologic tumor response rate at completion of therapy;Expansion Phase: Immunogenicity;Recurrence Free Survival
6名受试者接受剂量水平1:DC疫苗每周给予一次,每次5000万个细胞,连续6周。
6名受试者接受剂量水平2:DC疫苗每周给予一次,每次1亿个细胞,连续6周。
若导入阶段确认剂量水平2安全,将另纳入24名受试者,使病理缓解评估的可评价受试者总数达到28名(包括导入阶段的6名)。
若导入阶段确认剂量水平2安全,将另纳入23名受试者,使病理缓解评估的可评价受试者总数达到28名(包括导入阶段的6名)。
本研究旨在评估在标准新辅助治疗(主要治疗前给予的治疗)基础上加用研究性树突状细胞(DC1)疫苗,能否帮助治疗HER2(人表皮生长因子受体2)阳性乳腺癌患者。
The purpose of the study is to find out if an investigational drug called Dendritic Cell (DC1) vaccine added to standard neoadjuvant (given before main treatment) therapy can help people with HER2 (human epidermal growth factor receptor 2) positive breast cancer.
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