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:EGFR/B7H3 CAR-T on Lung Cancer and Triple Negative Breast Cancer
⚠ 该试验的登记信息已有 27 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。
这是一项早期 I 期注册临床试验,评估 CAR-T 细胞治疗肺癌、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 30 例。试验地点:中国 · 广州(共 1 个中心,其中中国 1 个)。登记号:NCT05341492。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: * 1. 所有受试者或法定监护人须在任何筛查程序开始前,书面签署伦理委员会批准的知情同意书; * 2. 年龄18–75岁,组织学或细胞学确诊晚期肺癌或三阴性乳腺癌,常规治疗已失败(包括TKI治疗失败者); * 3. 知情同意签署前3个月内,免疫组化证实肿瘤部位EGFR/B7H3表达阳性; * 4. 筛查期间按实体瘤疗效评估标准RECIST 1.1至少有一个可测量病灶,检查结果须在筛查前1个月内获得; * 5. 预期生存期≥12周; * 6. ECOG体能状态评分0–1分; * 7. 器官功能充分:ALT、AST<正常值3倍,总胆红素<正常值1.5倍,血清肌酐<正常值1.5倍; * 8. 超声心动图或多门控核素血管造影(MUGA)显示血流动力学稳定且左心室射血分数(LVEF)≥50%; * 9. 骨髓储备充分(可通过输血满足),定义为:白细胞≥1×10⁹/L;血小板≥100×10⁹/L;血红蛋白≥100 g/L; * 10. 有生育能力的女性及所有男性受试者同意在EGFR CAR-T输注后至少52周内采取有效避孕措施,并持续至连续两次PCR检测证实体内已无CAR-T细胞。 排除标准: * 1. 未控制高血压(>160/95)、不稳定冠状动脉疾病,或存在未控制心律失常、不稳定型心绞痛、失代偿性充血性心力衰竭(NYHA分级>II级),或细胞输注前6个月内发生心肌梗死; * 2. 严重肝肾功能障碍或意识障碍; * 3. CAR-T输注前14天内接受过淋巴细胞清除化疗以外的抗肿瘤化疗; * 4. 输注前14天内接受过其他研究药物; * 5. 输注前2周内接受过放疗或TKI治疗; * 6. 活动性乙型肝炎:HBV DNA>1000 IU/mL; * 7. HIV抗体、丙肝抗体或梅毒螺旋体抗体阳性; * 8. 结核痰涂片阳性或结核感染T细胞检测阳性; * 9. 间质性肺病或肺炎; * 10. 未控制的急性、危及生命的细菌、病毒或真菌感染(如输注前≤72小时血培养阳性); * 11. 中枢神经系统原发肿瘤或实体瘤中枢转移;脑转移经治疗后稳定超过4周者,或未经治疗但无症状者不属于本排除范围;有心包转移且伴大量心包积液者亦排除; * 12. 既往或同时存在第二种肿瘤,但以下情况除外:经充分治疗的基底细胞癌或鳞状细胞癌(入组前伤口须充分愈合);经根治治疗后至少3年无复发迹象的宫颈或乳腺原位癌;或原发恶性肿瘤已完全切除且完全缓解≥5年; * 13. 妊娠期或哺乳期女性; * 14. 既往或目前患有T细胞肿瘤; * 15. 活动性神经自身免疫性或炎症性疾病(如格林-巴利综合征、肌萎缩侧索硬化症); * 16. 研究者认为因依从性等原因不应参加本临床试验的其他情况。
Inclusion Criteria: * 1.All subjects or legal guardians must sign the informed consent form approved by the ethics committee in writing before starting any screening procedure; * 2.18 Years to 75 Years, Histologically or cytologically confirmed Routine treatment of patients with advanced lung cancer and triple-negative breast cancer(Including TKI treatment failure patients); * 3.EGFR/B7H3 expression was confirmed positive in tumor site by immunohistochemical test within 3 months before signing the informed consent form; * 4.According to RECIST version 1.1 of solid tumor efficacy evaluation criteria, there should be at least one measurable lesion during screening period (results are available within one month prior to screening period) ; * 5.Expected survival time ≥ 12 weeks; * 6.The Eastern oncology group strength status score (ECOG) was 0-1; * 7.Adequate organ function: alanine aminotransferase, aspartate aminotransferase (ALT, AST) \< 3 times of normal value, total bilirubin (TBiL) \< 1.5 times of normal value, serum creatinine (SCr) \< 1.5 times of normal value; * 8.The hemodynamics determined by echocardiography or multichannel radionuclide angiography(MUGA) are stable and the left ventricular ejection fraction (LVEF)≥50%; * 9.Have sufficient bone marrow reserves (subjects can meet this requirement through blood transfusion), defined as: The number of white blood cells should not be less than 1 × 10\^9/L;Platelet≥100 x 10\^9/L; Hemoglobin ≥100 g/L; * 10.Women of childbearing age and all male subjects must agree to use effective contraceptive methods for at least 52 weeks after EGFR CAR-T infusion, and until two consecutive PCR tests show that CAR-T cells are no longer present in the body. Exclusion Criteria: * 1.Uncontrolled hypertension (\> 160/95), unstable coronary artery disease confirmed by uncontrolled arrhythmia, unstable angina pectoris, decompensated congestive heart failure (\> New York Heart Association Class II), or myocardial infarction within 6 months prior to cell infusion; * 2.Patients with severe liver and kidney dysfunction or consciousness disorder; * 3.Patients who received antitumor chemotherapy other than lymphocyte clearance chemotherapy within 14 days prior to CAR T infusion; * 4.Patients who received other study drugs within 14 days prior to infusion; * 5\. Patients treated with radiotherapy or TKI within 2 weeks prior to infusion; * 6\. Patients with active hepatitis B: HBV DNA\>1000IU/mL; * 7\. HIV antibody, hepatitis C antibody, treponema pallidum antibody positive patients; * 8\. Sputum smears and patients who test positive for T cells of tuberculosis infection * 9.Patients with interstitial lung disease or pneumonia; * 10.patients with uncontrolled acute life-threatening bacterial, viral or fungal infection (e.g. positive blood culture ≤72 hours prior to infusion); * 11.Patients with central nervous primary tumor or central metastasis solid tumor (patients with stable treatment for more than 4 weeks after brain metastasis or patients with asymptomatic brain metastasis without treatment are excluded from this range), and patients with pericardial metastasis accompanied by large pericardial effusion. * 12.Patients with a prior or concurrent second tumor, except in the following cases: * Adequately treated basal cell or squamous cell carcinoma (adequate wound healing required prior to enrollment); * Carcinoma in situ of cervical or breast cancer with no signs of recurrence for at least 3 years prior to study after curative treatment; * The primary malignancy has been completely resected and in complete remission for ≥5 years. * 13.Pregnant or lactating women; * 14.Patients who have a history of or currently have T-cell tumors; * 15\. have active neuroautoimmune or inflammatory disorders (e.g. Guillian-Barre syndrome, AMyotrophic lateral sclerosis); * 16.Other conditions, such as compliance, that the investigator considers should not be included in this clinical trial.
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:Safety by Common Terminology Criteria for Adverse Events (CTCAE) V5.0 · The type, frequency, severity, and duration of adverse events as a result of EGFR/B7H3 CAR-T cells infusion will be summarized · In CAR-T cells infusion, up to 52 weeks.
次要终点:Objective Response Rate (ORR)
患者接受2×10⁶个CAR-T细胞/kg。
这是一项单臂、开放标签的探索性临床研究,评估EGFR/B7H3 CAR-T治疗EGFR/B7H3阳性晚期实体瘤(肺癌和三阴性乳腺癌)患者的安全性和有效性。
This study is a single-arm, open, exploratory clinical study to evaluate the safety and efficacy of EGFR/B7H3 CAR-T in patients with EGFR/ B7H3-positive advanced solid tumors (lung cancer and triple-negative breast cancer)
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