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CD70 自体 CAR-T 细胞治疗胶质母细胞瘤:I 期临床试验(University of Florida)

英文原题:IL-8 Receptor-modified CD70 CAR T Cell Therapy in CD70+ Adult Glioblastoma

ClinicalTrials.gov 2022/04/29(首次登记) I 期注册临床试验 · 进行中(不再招募)

简要介绍

这是一项 I 期注册临床试验,评估自体 CAR-T 细胞治疗胶质母细胞瘤的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 39 例。试验地点:美国 · 盖恩斯维尔(共 1 个中心)。登记号:NCT05353530。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 80 Years

纳入标准(成人GBM):

* 年龄 ≥ 18岁
* 新诊断的原发性GBM,基于既往无脑肿瘤病史(WHO IV级胶质瘤),经组织病理学或分子学研究证实。(继发性GBM不符合条件)
* 肿瘤必须具有幕上成分
* CD70阳性(≥5%,1+)

肿瘤表达将按0至3级染色强度评分:

0 = 阴性

1. = 低水平
2. = 中等水平
3. = 高水平

   * 纳入标准为至少5%的细胞评分达到1+染色强度(> 5%,1+)。

     * 经MRI测量,最长垂直平面乘积小于3cm x 3cm(9 cm2)残留强化肿瘤的手术切除,或仅对小于3cm x 3cm的肿瘤进行活检
     * Karnofsky体能状态(KPS)> 70%
     * 全血细胞计数及分类,骨髓功能充足,定义如下:
   * 绝对中性粒细胞计数(ANC)≥ 1500 cells/mm3。
   * 血小板计数 ≥ 100,000 cells/mm3。
   * 血红蛋白 ≥ 10 g/dl。(可接受通过输血或其他干预措施达到Hgb ≥ 10 g/dl。)

     • 肾功能充足,定义如下:
   * BUN ≤ 25 mg/dl
   * 肌酐 ≤ 1.7 mg/dl
• 足够的肝功能,定义如下:
* 胆红素 ≤ 2.0 mg/dl
* ALT ≤ 年龄对应的机构正常上限的5倍
* AST ≤ 年龄对应的机构正常上限的5倍

* 签署知情同意书。如果患者的精神状态使其无法给出知情同意,可由合法授权代表提供书面知情同意。
* 对于有生育能力的女性,入组时血清妊娠试验阴性。
* 有生育能力的女性(WOCBP)必须愿意在整个研究期间以及末次研究药物给药后至少24周内使用可接受的避孕方法以避免怀孕。
* 其女性伴侣有生育能力的男性必须同意在整个研究期间采取充分的避孕措施,并应在末次研究药物给药后24周内避免孕育子女。

排除标准(成人GBM):

* 既往侵袭性恶性肿瘤(非黑色素瘤性皮肤癌除外),除非无病生存≥3年。(原位癌允许)
* 检测到小脑幕下或颅顶外的转移
* 颅顶以外的软脑膜疾病。(局灶性、邻近和软脑膜受累可由PI酌情允许)。
* 复发性或多灶性恶性胶质瘤。
* 根据研究骨髓移植医生的评估,患者不适合接受细胞治疗。
* 已知的免疫抑制性疾病或人类免疫缺陷病毒(HIV)感染。

理由:需要排除患有免疫抑制性疾病或人类

* 严重的、活动的合并症,定义如下:

  * 需要住院治疗的不稳定型心绞痛和/或充血性心力衰竭。
  * 过去6个月内的透壁性心肌梗死。
  * 在开始XRT/TMZ时需要静脉注射抗生素治疗的急性细菌或真菌感染。
  * 在开始XRT/TMZ时,需要住院治疗的慢性阻塞性肺疾病急性加重或其他呼吸系统疾病,或妨碍研究治疗。
  * 导致临床黄疸和/或凝血功能障碍的肝功能不全。
  * 需要使用免疫抑制剂进行医疗管理的自身免疫性疾病患者。
* 研究者认为会妨碍方案治疗实施或完成的重大医学疾病或精神障碍。
  * 研究者认为会使患者处于放射性毒性高风险的活跃性结缔组织病,如狼疮或硬皮病。
* 孕妇或哺乳期妇女,因为可能对发育中的胎儿或婴儿产生不良影响。
* 入组前30天内接受过任何其他治疗性临床方案治疗的患者。
核对登记原文(英文)
Inclusion Criteria (Adult GBM):

* Age ≥ 18 years
* Newly-diagnosed de novo GBM based on the absence of previous history of brain tumor (WHO Grade IV glioma) by histopathology or molecular studies. (secondary GBM not eligible)
* The tumor must have a supratentorial component
* CD70 positive (≥5%, 1+)

Tumor expression will be scored on a scale of 0 to 3 staining intensity:

0 = Negative

1. = Low level
2. = Moderate level
3. = High level

   * The criteria for inclusion will be at least 5% of the cells scoring 1+ staining intensity (\> 5%, 1+).

     * Surgical resection of tumors with less than 3cm x 3cm (9 cm2) residual enhancing tumor as a product of longest perpendicular planes by MRI or biopsy only for tumor measuring less than 3cm x 3cm
     * Karnofsky Performance Status (KPS) of \> 70%
     * CBC with differential with adequate bone marrow function as defined below:
   * Absolute neutrophil count (ANC) ≥ 1500 cells/mm3.
   * Platelet count ≥ 100,000 cells/mm3.
   * Hemoglobin ≥ 10 g/dl. (The use of transfusion or other intervention to achieve Hgb ≥ 10 g/dl is acceptable.)

     • Adequate renal function as defined below:
   * BUN ≤ 25 mg/dl
   * Creatinine ≤ 1.7 mg/dl

     • Adequate hepatic function as defined below:
   * Bilirubin ≤ 2.0 mg/dl
   * ALT ≤ 5 times institutional upper limits of normal for age
   * AST ≤ 5 times institutional upper limits of normal for age

     * Signed informed consent. If the patient's mental status precludes his/her giving informed consent, written informed consent may be given by the legally authorized representative.
     * For females of childbearing potential, a negative serum pregnancy test at enrollment.
     * Women of childbearing potential (WOCBP) must be willing to use an acceptable contraceptive method to avoid pregnancy throughout the study and for at least 24 weeks after the last dose of study drug.
     * Males with female partners of childbearing potential must agree to practice adequate contraceptive methods throughout the study and should avoid conceiving children for 24 weeks following the last dose of study drug.

Exclusion Criteria (Adult GBM):

* Prior invasive malignancy (except for non-melanomatous skin cancer) unless disease free for ≥ 3years. (In situ cancer are permissible)
* Metastases detected below the tentorium or beyond the cranial vault
* Leptomeningeal disease beyond the cranial vault. (Focal, adjacent and leptomeningeal involvement is allowable at the discretion of the PI).
* Recurrent or multifocal malignant gliomas.
* The patient is not a candidate for cellular therapy as assessed by the study bone marrow transplant physician.
* Known immunosuppressive disease or human immunodeficiency virus (HIV) infection.

Rationale: The need to exclude patients with the immunosuppressive disease or human

* Severe, active co-morbidity, defined as follows:

  * Unstable angina and/or congestive heart failure requiring hospitalization.
  * Transmural myocardial infarction within the last 6 months.
  * Acute bacterial or fungal infection requiring intravenous antibiotics at the initiation of XRT/TMZ.
  * Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the initiation of XRT/TMZ.
  * Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects.
  * Patients with an autoimmune disease requiring medical management with immunosuppressants.
  * Major medical illnesses or psychiatric impairments that, in the investigator's opinion, will prevent administration or completion of protocol therapy.
  * Active connective tissue disorders such as lupus or scleroderma that, in the investigator's opinion, place the patient at high risk for radiation toxicity.
* Pregnant or lactating women, due to possible adverse effects on the developing fetus or infant.
* Patients treated on any other therapeutic clinical protocols within 30 days prior to enrollment.

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8R-70CAR T 细胞疗法在成人新发 CD70+ GBM 患者中的安全性输注后 28 天
  • 主要终点8R-70CAR T 细胞疗法在成人新发 CD70+ GBM 患者中的可行性10 周
核对登记原文(英文)

主要终点:Safety of 8R-70CAR T-cell therapy in adult patients with de novo CD70+ GBM · Defined as ≤ 1 DLT out of 6 patients is observed at the 1x10\^8 cells/Kg dose. Dose-Limiting toxicity (DLT) will be defined as any adverse event attributable (possible, probable, or definite) to the administration of 8R-70CAR T cells and occurring from the time of infusion through 28 days post-infusion. · 28 days post-infusion;Feasibility of 8R-70CAR T-cell therapy in adult patients with de novo CD70+ GBM · Feasibility will be defined as the ability to infuse 8R-70CAR T-cell safely in 66.7 % of enrolled patients (patients who signed consent and were deemed eligible for the study). · 10 weeks

研究设计怎么做的

研究类型
干预性研究
入组人数
39 人(预计)
分组方式
不适用(单臂)
  • 8R-70CAR T 细胞试验组

    第1队列将接受 1 x 10^6 个细胞/kg。第2队列将接受 1 x 10^7 个细胞/kg。第3队列将接受 1 x 10^8 个细胞/kg。第4队列将接受 Cy/Flu + 已确定最大耐受剂量的 CAR T 细胞。

核对分组登记原文(英文)
  • 8R-70CAR T cells · EXPERIMENTAL · Cohort 1 will receive 1 x 10\^6 cells/kg. Cohort 2 will receive 1 x 10\^7 cells/kg. Cohort 3 will receive 1 x 10\^8 cells/kg. Cohort 4 will receive Cy/Flu + CAR T cells at established maximum tolerated dose.

关键日期

开始日期
2023-07-25
主要完成日期
2027-12
全部完成日期
2042-12
登记状态核实于
2026-09

联系与责任方

申办方
University of Florida
合作方
AM Rosen Foundation

登记简述

这是一项I期研究,旨在评估IL-8受体修饰的患者来源活化CD70 CAR T细胞疗法在CD70+成人胶质母细胞瘤中的安全性和可行性。

核对登记原文(英文)

This is a phase I study to assess the safety and feasibility of IL-8 receptor modified patient-derived activated CD70 CAR T cell therapy in CD70+ adult glioblastoma

登记原文与核验信息

试验登记号
NCT05353530
试验期别
I 期
试验状态
进行中(不再招募)
试验中心
University of Florida Health · 盖恩斯维尔 · 美国
适应症(原文)
Glioblastoma Multiforme; Glioblastoma
干预方式(原文)
Ex-Vivo expanded autologous IL-8 receptor (CXCR2) modified CD70 CAR (8R-70CAR) T cells