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:Autologous CAR-T Cells Targeting B7-H3 in Recurrent or Refractory GBM CAR.B7-H3Tc
这是一项 I 期注册临床试验,评估 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:招募中。计划入组 36 例。试验地点:美国 · 教堂山(共 1 个中心)。登记号:NCT05366179。
不限性别 · ≥ 18 Years
纳入标准: 1. Karnofsky评分>60%。 2. 根据神经肿瘤疗效评估(RANO)MRI标准,确诊或复发的幕上/幕下多形性胶质母细胞瘤(GBM;WHO 2016或2021分类)。不允许沿脊髓播散的GBM。初诊时须已接受切除术或活检。 3. 曾接受至少4005 cGy放疗并同期使用替莫唑胺。 4. 目前或既往未使用抗血管生成药物,如贝伐珠单抗。 5. 有生育能力女性须愿意从签署知情同意至停止研究治疗后6个月内禁欲或采用两种有效避孕方法。 6. 有女性伴侣的男性受试者须既往接受输精管结扎,或同意从首次研究治疗至细胞输注后3个月采用适当避孕方法;如接受多次输注,须在整个治疗期间及末次细胞输注后3个月持续避孕。 7. 根据研究者判断,受试者愿意且能够遵守研究程序。 排除标准: 1. 妊娠或哺乳期(研究治疗期间不得储存母乳以供日后使用)。 2. 既往或同期存在自然病程或治疗可能干扰研究方案安全性/疗效评价的恶性肿瘤。 3. HIV、乙肝病毒或丙肝病毒(HCV)活动性感染。入组者须HIV抗体阴性、HTLV-1/2抗体阴性、乙肝表面抗原阴性、HCV抗体和病毒载量阴性。 4. 对MRI造影剂有禁忌,或因植入材料不兼容而不能接受MRI检查。 5. 既往为治疗GBM接受过嵌合抗原受体T细胞治疗。 6. 有累及脑干、小脑或脊髓的播散性疾病证据。 7. 既往植入过治疗胶质瘤用卡莫司汀缓释片,或接受过近距离放疗。
INCLUSION CRITERIA 1. Karnofsky score of \> 60% 2. Diagnosis or recurrent supratentorial- or infra-tentorial glioblastoma multiforme (GBM) (World Health Organization 2016 or 2021) based on Response assessment in neuro-oncology criteria (RANO) magnetic resonance imaging (MRI) criteria. Disseminated GBM down the spinal cord is not allowed. Must have previously undergone resection or biopsy at initial diagnosis. 3. Must have undergone at least 4005 cGy of radiation with concurrent temozolomide. 4. No current or previous exposure to antiangiogenic agents, such as bevacizumab. 5. Female subjects of childbearing potential must be willing to abstain from heterosexual activity or to use 2 forms of effective methods of contraception from the time of informed consent until 6 months after study treatment discontinuation. 6. Male subjects with female partners must have had a prior vasectomy or agree to use an adequate method of contraception starting with the first dose of study therapy through 3 months after the cell infusion therapy. If a male subject receives multiple infusions, they must remain on contraception throughout the duration and 3 months after the last cell infusion therapy. 7. The subject is willing and able to comply with study procedures based on the judgment of the investigator. EXCLUSION CRITERIA 1. Subject is pregnant or lactating (Note: Breast milk cannot be stored for future use while the mother is being treated on study). 2. Subjects with a prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen. 3. Active infection with HIV, hepatitis B virus, hepatitis C virus (HCV). Note: To meet eligibility subjects are required to be negative for HIV antibody, negative for HTLV1 and 2 antibodies, negative for Hepatitis B surface antigen, and negative for HCV antibody and viral load. 4. Contraindication to MRI contrast agents or an inability to undergo MRI scans due to MRI non-compatible implanted materials. 5. Prior exposure to chimeric antigen receptor T cell therapy for treatment of glioblastoma. 6. Evidence of disseminated disease involving the brainstem, cerebellum or spinal cord. 7. Previously implanted carmustine wafers or brachytherapy for the treatment of glioma.
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:Number of participants with adverse event · Number of participants with adverse event (AE)s as a measure of safety and tolerability of intraventricular administration CAR.B7-H3 T cells in subjects with progressive recurrent or refractory glioblastoma multiforme.
AEs will be classified and graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0. Dose Limiting Toxicities (DLTs) are defined as at least possibly related to CAR.B7-H3T cell product administration. · Up to 10 weeks;Cytokine Release Syndrome · Cytokine Release Syndrome (CRS) will be graded according to American Society for Transplantation and Cellular Therapy (ASTCT) CRS Consensus Grading.
Grade 1 - Mild (Symptomatic Management): Fever ≥38\^ o C, No hypotension, No hypoxia, Grade 2 - Moderate (Moderate Intervention): Fever ≥38\^ o C, Hypotension not requiring vasopressors, Hypoxia requiring low-flow nasal cannula (≤6 L/minute) or blow-by, Grade 3 - Severe (Aggressive Intervention): Fever ≥ 38\^ o C , Hypotension requiring a vasopressor with or without vasopressin, Hypoxia requiring high-flow nasal cannula (\>6 L/minute), facemask, nonrebreather mask, or Venturi mask, Grade 4 - Life-threatening (Life-sustaining intervention): Fever ≥38\^oC, Hypotension requiring multiple vasopressors (excluding vasopressin),Hypoxia requiring positive pressure (e.g. Continuous positive airway pressure, BiPAP, intubation, mechanical ventilation), Grade 5 - Death: Death. · Up to 10 weeks;Neurotoxicity · Neurotoxicity will be graded according to the Central Nervous System (CNS) Toxicity criteria.
Grade 0: Normal or no change from baseline exam at start of therapy, Grade 1: Mild lethargy and/or irritability or visual, motor, or sensory symptoms without change in neurological exam, Grade 2: Moderate lethargy, disorientation, or psychosis lasting \< 48 hours or mild increase in pre-existing neurological deficit, Grade 3: \>48hours of severe lethargy, but responsive to verbal stimuli or disorientation or psychosis lasting \>48 hours, Grade 4: Coma, unresponsive to verbal stimuli, increasing neurological deficit above grade 3, evidence of herniation, development of uncontrolled seizures, intracerebral hemorrhage. · Up to 10 weeks
次要终点:Identification of Recommended phase 2 dose (RP2D);Objective Response Rate (ORR);Progression Free Survival (PFS);Overall Survival (OS);Duration of Response (DOR)
复发/难治性GBM患者的细胞采集应在初次手术切除后进行,以制备CAR.B7-H3 T细胞;最好在开始辅助放化疗前完成采集。
本研究旨在评估靶向B7-H3抗原的嵌合抗原受体T细胞(CAR.B7-H3T)治疗胶质母细胞瘤患者的安全性。CAR.B7-H3T细胞治疗尚未在人体中进行试验,也未获美国食品药品监督管理局批准用于胶质母细胞瘤。
The purpose of this study is to test the safety of using T lymphocyte chimeric antigen receptor cells against the B7-H3 antigen (CAR.B7-H3T cells) in patients with glioblastoma. CAR.B7-H3T cells treatment has not been tested in humans and is not an approved treatment by the Food and Drug Administration for glioblastoma.
MEMBER ACCOUNT
登录成功会直接打开下一页。