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:GD2/CD70 Bi-specific CAR-T Cell Therapy
这是一项 I/II 期注册临床试验,评估 GD2T 细胞治疗恶性肿瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 30 例。试验地点:中国 · 深圳(共 1 个中心,其中中国 1 个)。登记号:NCT05438368。
不限性别 · ≥ 1 Year 且 ≤ 75 Years
纳入标准: 1. 肿瘤患者已接受标准一线治疗,且经判断肿瘤不可切除、已转移、进展或复发。 2. 通过免疫组化或流式细胞术检测肿瘤组织中GD2或CD70抗原表达以确定是否符合入组条件。阳性表达依据GD2和PMSA抗体染色结果判定(按原登记表述)。 3. 体重≥10 kg。 4. 入组时年龄≥1岁且≤75岁。 5. 预期生存期至少8周。 6. 既往治疗:既往治疗方案数量不限;任何既往治疗导致的3或4级非血液学毒性须已恢复至≤2级。 7. 单核细胞采集前至少1周未接受造血生长因子。 8. 生物制剂、选择性靶向药物或非骨髓抑制性节律化疗结束后至少间隔7天。 9. 既往单克隆抗体治疗结束后至少间隔4周。 10. 入组时距任何放射治疗结束至少1周。 11. Karnofsky/Lansky评分≥60%。 12. 心功能:左心室射血分数≥40%/55%(依适用评估标准)。 13. 室内空气下脉搏血氧饱和度≥90%。 14. 肝功能:丙氨酸氨基转移酶(ALT)<正常值上限(ULN)的3倍、天冬氨酸氨基转移酶(AST)<ULN的3倍;血清胆红素和碱性磷酸酶<ULN的2倍。 15. 肾功能:血清肌酐<ULN的3倍。 16. 骨髓功能:白细胞计数≥1000/μL、中性粒细胞绝对计数≥500/μL、淋巴细胞绝对计数≥500/μL、血小板≥25,000/μL(不得通过输血达到)。 17. 已知有骨髓转移者,只要符合血液学功能标准且骨髓疾病未造成血液学毒性,即可参加研究。 18. 所有入组患者本人或其父母/法定监护人须签署知情同意书和同意书。 排除标准: 1. 存在严重疾病(如显著心、肺、肝疾病等)、主要器官功能障碍或>2级血液学毒性。 2. 存在无法治疗的中枢神经系统(CNS)转移。既往CNS肿瘤受累已接受治疗,且治疗结束后稳定至少6周者可入组。 3. 既往接受过其他基因工程化GD2或CD70特异性CAR-T细胞治疗。 4. 存在活动性HIV、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)感染或未控制的感染。 5. 需要全身性糖皮质激素或其他免疫抑制治疗。 6. 有证据提示肿瘤可能造成气道梗阻。 7. 无法遵守方案要求。 8. 可用CAR-T细胞数量不足。
Inclusion Criteria: 1. Patients with tumors received standard first-line therapy and judged to be non-resectable, metastatic, progressive or recurrent. 2. The expression status of GD2 or CD70 antigens in the tumor tissue will be determined for eligibility. Positive expression is defined by GD2 and PMSA antibody staining results based on immunohistochemistry or flow cytometry analyses. 3. Body weight greater than or equal to 10 kg. 4. Age: ≥1 year and ≤ 75 years of age at the time of enrollment. 5. Life expectancy: at least 8 weeks. 6. Prior Therapy: There is no limit to the number of prior treatment regimens. Any grade 3 or 4 non-hematologic toxicity of any previous therapy must be resolved to grade 2 or less. 7. Participant must not have received hematopoietic growth factors for at least 1 week prior to mononuclear cells collection. 8. At least 7 days must have elapsed since the completion of therapy with a biologic agent, selected targeted agent or a metronomic non-myelosuppressive regimen. 9. At least 4 weeks must have elapsed since prior therapy that included a monoclonal antibody. 10. At least 1 week since any radiation therapy at the time of study entry. 11. Karnofsky/jansky score of 60% or greater. 12. Cardiac function: Left ventricular ejection fraction greater than or equal to 40/55 percent. 13. Pulse Ox greater than or equal to 90% on room air. 14. Liver function: defined as alanine transaminase (ALT) \<3x upper limit of normal (ULN), aspartate aminotransferase (AST) \<3x ULN; serum bilirubin and alkaline phosphatase \<2x ULN. 15. Renal function: Patients must have serum creatinine less than 3 times upper limit of normal. 16. Marrow function: White blood cell count ≥1000/ul, Absolute neutrophil count ≥500/ul, Absolute lymphocyte count ≥500/ul, Platelet count ≥25,000/ul (not achieved by transfusion). 17. Patients with known bone marrow metastatic disease will be eligible for study as long as they meet hematologic function criteria, and the marrow disease does not have hematologic toxicity. 18. For all patients enrolled in this study, themselves or their parents or legal guardians must sign an informed consent and assent. Exclusion Criteria: 1. Existing severe illness (e.g. significant cardiac, pulmonary, hepatic diseases, etc.) or major organ dysfunction, or greater than grade 2 hematologic toxicity. 2. Untreatable central nervous system (CNS) metastasis: Patients with previous CNS tumor involvement that has been treated and is stable for at least 6 weeks following completion of therapy are eligible. 3. Previous treatment with other genetically engineered GD2 or CD70-specific CAR T cells. 4. Active HIV, hepatitis B virus (HBV), hepatitis C virus (HCV) infection or uncontrolled infection. 5. Patients who require systemic corticosteroid or other immunosuppressive therapy. 6. Evidence of tumor potentially causing airway obstruction. 7. Inability to comply with protocol requirements. 8. Insufficient CAR T cells availability.
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 patients with adverse events. · Determine the toxicity profile the bi-4SCAR GD2/CD70 cells with Common Toxicity Criteria for Adverse Effects version 4.0 · 6 months
次要终点:Anti-tumor effects;Anti-tumor effects;The expansion of bi-4SCAR GD2/CD70 T cells;The persistence of bi-4SCAR GD2/CD70 T cells;Survival time of the patients;Survival time of the patients
本研究旨在评估GD2/CD70双特异性CAR-T细胞治疗GD2和/或CD70阳性肿瘤患者的可行性、安全性和疗效,并进一步了解该双特异性CAR-T细胞的功能及其在患者体内的持续存在情况。
The purpose of this study is to assess the feasibility, safety and efficacy of GD2/CD70 bi-specific CAR-T cell therapy in patients with GD2 and/or CD70 positive tumor. Another goal of the study is to learn more about the function of the GD2/CD70 bi-specific CAR-T cells and their persistency in patients.
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