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NK 细胞治疗结直肠癌:I 期临床试验(Medigen)

英文原题:A Phase I, Autologous ex Vivo Expanded and Activated NK Cell, Magicell-NK, Infusion for Colon Cancer Post Resection Study

ClinicalTrials.gov 2022/05/27(首次登记) I 期注册临床试验 · 招募中

简要介绍

这是一项 I 期注册临床试验,评估 NK 细胞治疗结直肠癌的安全性、可行性及初步疗效。当前状态:招募中。计划入组 18 例。试验地点:中国 · 桃园(共 1 个中心,其中中国 1 个)。登记号:NCT05394714。

入组条件决定能不能参加

不限性别 · ≥ 20 Years

纳入标准:

1. 已注明日期并签署知情同意书;
2. 男女不限,签署知情同意时年龄≥20岁;
3. 组织学确诊Ⅰ期或Ⅱa期结肠癌;
4. 筛查访视前4–8周内接受根治性结肠切除术,且无需辅助化疗或放疗;
5. 无≥3级术后并发症,或已恢复且研究者认为适合入组;
6. 血液学功能充分:ANC≥1,500/μL、白细胞总数≥3,000/μL、血小板≥100,000/μL、血红蛋白≥9 g/dL;
7. 肝肾功能充分:血清肌酐≤ULN的1.5倍、总胆红素≤ULN的1.5倍、ALT和AST≤ULN的2.5倍、碱性磷酸酶≤ULN的5倍;
8. HIV和梅毒检测阴性;
9. 有生育能力者同意从签署知情同意书至末次/提前终止访视期间禁欲或使用高效避孕措施;
10. ECOG体能状态<2;
11. 同意遵守临床方案规定的治疗计划。

排除标准:

1. 第1天前28天内接受过其他试验性药物、抗肿瘤药物(经冷冻手术或单纯手术切除治愈的皮肤鳞状细胞癌、基底细胞癌或原位癌除外)或免疫细胞治疗;
2. 第1天前14天内正在接受免疫抑制治疗,或全身性类固醇等效泼尼松剂量>30 mg/日且持续超过7天;
3. 已知肿瘤转移或合并其他恶性肿瘤;
4. 有活动性疾病,或过去2年内有严重合并症(如NYHA Ⅲ/Ⅳ级心血管疾病、Child-Pugh C级肝病、酒精/药物滥用等精神疾病),或研究者认为可能影响结果/受试者安全的病史、体征或实验室异常;
5. 已知对氨基糖苷类或杆菌肽过敏(如链霉素、庆大霉素);
6. 已知对Magicell-NK任何成分(包括人血清白蛋白)过敏;
7. 女性受试者哺乳,或筛查时尿妊娠试验阳性。
核对登记原文(英文)
Inclusion Criteria:

1. A dated and signed informed consent
2. Either gender and aged over 20 years old (inclusive) at date of consent
3. With histologically confirmed stage I or stage IIa colon cancer
4. Received curative colon resection within 4\~8 weeks prior to the screening visit and does not need adjuvant chemotherapy or radiotherapy
5. With no ≥ grade 3 postoperative complications or has been recovered and is suitable for study enrollment according to the investigator's judgment
6. With adequate hematology function:

   * Absolute neutrophil count (ANC) ≥ 1,500 cells/μL
   * Total white blood cell (WBC) ≥ 3,000 cells/μL
   * Platelets ≥ 100,000 counts/μL
   * Hemoglobin ≥ 9 g/dL
7. With adequate hepatic and renal function:

   * Serum creatinine ≤ 1.5 × Upper Limit of Normal (ULN)
   * Total bilirubin (TB) ≤ 1.5 × ULN
   * ALT and AST ≤ 2.5 × ULN
   * Alkaline phosphatase (ALP) ≤ 5X ULN
8. Negative response in HIV and syphilis test
9. Subject with childbearing potential must agree to abstain from intercourse or use highly effective contraceptives from when signing informed consent to the Final/ET Visit.
10. Performance status (ECOG) \< 2
11. Patients agree to be in compliant to clinical protocol planned treatment plan

Exclusion Criteria:

1. Received any other investigational, anti-neoplastic medication (except squamous cell carcinoma, basal cell carcinoma, or carcinoma in situ of the skin, curatively treated with cryosurgery or surgical excision only), or immune cell therapy within 28 days prior to Day 1.
2. Currently under immunosuppressive or systemic steroid treatment with equivalent dosage higher than prednisolone 30 mg/day for more than 7 days within 14 days prior to Day 1
3. With known tumor metastasis or coexisting malignant disease
4. With ongoing acute diseases, or within the past 2 years having serious medical conditions (e.g. concomitant illness) such as cardiovascular (e.g. New York Heart Association grade III or IV), hepatic (e.g. Child-Pugh Class C), psychiatric condition (e.g. alcoholism, drug abuse), medical history, physical findings, or laboratory abnormality that, judged by the investigator, could interfere with the results of the trial or adversely affect the safety of the subject
5. Known hypersensitivity to aminoglycoside or bacitracin (e.g. Streptomycin, Gentamicin)
6. Known hypersensitivity to any of the components of Magicell-NK, including human serum albumin
7. Female subject who is lactating or has positive urine pregnancy test at screening

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

  • 主要终点发生严重不良事件(SAE)及治疗期间出现不良事件(TEAE)的受试者人数最长60周
  • 主要终点至少发生一次剂量限制性毒性的受试者人数首次治疗后14天观察期;最长60周
  • 主要终点最大耐受剂量(MTD)及Ⅱ期推荐剂量(RP2D)治疗开始后3周;最长60周
  • 次要终点无病生存期(DFS)
  • 次要终点循环肿瘤DNA(ctDNA)检出频率和持续时间变化
  • 次要终点循环肿瘤细胞(CTC)及PD-L1阳性CTC的检出频率和持续时间变化
  • 次要终点生物标志物(CEA和CA19-9)变化
核对登记原文(英文)

主要终点:Number of Participants With Serious Adverse Events (SAEs) and Treatment Emergent Adverse Events (TEAEs) · Number of participants with serious adverse events and treatment emergent adverse events assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0) to assess tolerability of Magicell-NK treatment. Evaluation of side effects conducted during the study period. A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned. · Up to 60 weeks;Number of Participants With at Least One Dose Limiting Toxicity · Dose Limiting Toxicity (DLT) as defined by the Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 as treatment-related any greater or equal to Grade 4 adverse event of hematologic toxicity, or any greater or equal to Grade 3 adverse event of non-hematologic toxicity during Visit 3\~ visit 10. With the exception of (1) fever grade 3 or grade 4 which is controllable by antihistamine and resolves to grade 2 or less within 48 hours, (2) hypersensitivity reactions occurring within 2 hours of infusion finished (related to cell infusion) that are reversible to a grade 2 or less within 48 hours with standard therapy, (3) grade 3 electrolyte imbalance or dehydration that resolves to grade 1 or less within 48 hours, (4) grade 3 nausea, vomiting, or diarrhea which is controllable by standard medication that resolves to grade 1 or less within 48 hours, (5) fatigue which resolves to grade 1 or less within 7 days. · Within 14-day observation of the first treatment. up to 60 weeks;Maximum Tolerated Dose (MTD) and Recommended Phase II Dose (RP2D) · MTD is defined as the highest dose level at which ≤ 1/6 of subjects experiences DLT during Visit 3\~10, when at least 6 patients are treated at that dose and are evaluable for toxicity. Dose escalations proceeded according to a standard 3+3 design. Maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of therapy was determined by monitoring dose-limiting toxicity and adverse events in the dosing cohorts · 3 weeks from start of treatment, up to 60 weeks
次要终点:Disease free survival (DFS);Changes in Frequency and Duration of ctDNA;Changes in Frequency and Duration of Circulating Tumor Count (CTC) and Programmed Death-Ligand 1 Circulating Tumor Count (PD-L1+ CTC) counts;Changes in Biomarkers (CEA and CA19-9)

研究设计怎么做的

研究类型
干预性研究
入组人数
18 人(预计)
分组方式
不适用(单臂)
  • Magicell-NK试验组

    Magicell-NK队列1:2×10⁸个细胞,每次给药,共输注6次;队列2:6×10⁸个细胞,每次给药,共输注6次;队列3:12–18×10⁸个细胞,每次给药,共输注6次。

核对分组登记原文(英文)
  • Magicell-NK · EXPERIMENTAL · Magicell-NK Cohort 1: 2 x 10\^8 cells x 6 infusions Cohort 2: 6 x 10\^8 cells x 6 infusions Cohort 3: 12\~18 x 10\^8 cells x 6 infusions

关键日期

开始日期
2022-03-10
主要完成日期
2028-06-30
全部完成日期
2028-06-30
登记状态核实于
2026-07

联系与责任方

申办方
Medigen Biotechnology Corporation
联系邮箱
jude@medigen.com.tw
联系电话
886-2-7722-5200

登记简述

这是一项Ⅰ期、开放标签研究,在台湾单中心开展,旨在探索Magicell-NK的安全性,并确定其最大耐受剂量(MTD)或最大可行剂量(MFD)。研究对象为切除术后的Ⅰ期或Ⅱa期结肠癌患者。研究采用3+3设计评估三个Magicell-NK剂量水平:队列1低剂量2×10⁸个细胞;队列2中剂量6×10⁸个细胞;队列3高剂量12–18×10⁸个细胞。

核对登记原文(英文)

This is a Phase I, open-label study to explore the safety profile and to find the maximum tolerated dose (MTD) or maximum feasible dose (MFD) of Magicell-NK in subjects diagnosed with stage I or stage IIa colon cancer post resection from a single site in Taiwan. During this study, 3 dose levels of Magicell-NK will be tested with a 3+3 design to determine the MTD/MFD: Cohort 1, low dose (2×10\^8 cells), Cohort 2, middle dose (6×10\^8 cells), and Cohort 3, high dose (12\~18 ×10\^8 cells).

登记原文与核验信息

试验登记号
NCT05394714
试验期别
I 期
试验状态
招募中
中国试验中心(1 个)
Chang Gung Memorial Hospital, Linkou · 桃园 · 中国台湾
适应症(原文)
Colon Cancer Stage I
干预方式(原文)
Magicell-NK contains NK cells suspended in 100 mL normal saline