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CAR-T 治疗急性髓系白血病:I 期临床试验(Union Hospital, Tongji)

英文原题:Anti-FLT3 CAR-T Cell (TAA05 Cell Injection) in the Treatment of Relapsed / Refractory Acute Myeloid Leukemia

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Anti-FLT3 CAR-T Cell (TAA05 Cell Injection) in the Treatment of Relapsed / Refractory Acute Myeloid Leukemia

ClinicalTrials.gov 2022/07/06(首次登记) I 期注册临床试验 · 招募中

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⚠ 该试验的登记信息已有 51 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。

简要介绍

这是一项 I 期注册临床试验,评估细胞治疗用于急性髓系白血病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 12 例。试验地点:中国 · 武汉(共 1 个中心,其中中国 1 个)。登记号:NCT05445011。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 70 Years

纳入标准:

1. 年龄18–70岁(含),性别不限。
2. FLT3阳性急性髓系白血病。
3. 预期生存期>3个月。
4. ECOG评分0–2。
5. 标准治疗后复发/难治性AML,符合以下任一条件:完全缓解(CR)后骨髓白血病细胞/原始细胞≥5%,外周血中有白血病细胞或存在髓外病灶(巩固化疗后骨髓恢复等其他原因所致者除外);初治患者接受2个疗程治疗无效;强化巩固治疗达到CR后12个月内复发;CR后超过12个月复发但常规化疗无效;复发两次或以上,或持续存在髓外白血病。
6. 肾、心肺、肝和凝血功能符合以下要求:肌酐≤ULN的1.5倍;LVEF≥50%,超声心动图无心包积液,心电图无有临床意义的异常波形;血氧饱和度>92%;总胆红素≤ULN的2倍,ALT和AST≤ULN的2.5倍。若研究者认为ALT/AST异常由疾病导致(如肝浸润或胆管梗阻),可放宽至≤ULN的5倍;PT/INR和PTT≤ULN的1.5倍。
7. 患者理解研究并已签署知情同意书。

排除标准:

1. 筛选前5年内患有AML以外的恶性肿瘤;已充分治疗的宫颈原位癌、皮肤基底细胞癌或鳞状细胞癌、根治术后的局限性前列腺癌及根治术后的乳腺导管原位癌除外。
2. 乙肝表面抗原(HBsAg)或乙肝核心抗体(HBcAb)阳性且外周血HBV DNA滴度超出正常参考范围;HCV抗体及外周血HCV RNA阳性;HIV抗体阳性;CMV DNA阳性;梅毒检测阳性。
3. 严重心脏病,包括但不限于不稳定型心绞痛、筛选前6个月内心肌梗死、NYHA≥III级充血性心力衰竭、严重心律失常。
4. 研究者判断存在不稳定的全身疾病,包括但不限于需药物治疗的严重肝、肾或代谢性疾病。
5. 筛选前7天内存在需全身治疗的活动性或未控制感染;轻度泌尿生殖道感染和上呼吸道感染除外。
6. 妊娠或哺乳期女性;计划细胞回输后2年内妊娠的女性受试者;或男性受试者的伴侣计划细胞回输后2年内妊娠。
7. 筛选前7天内接受全身类固醇治疗,或研究者判定治疗期间需要长期全身类固醇治疗(吸入或局部使用除外)。
8. 筛选前1个月内参加过其他临床研究。
9. 筛选时有CNS侵犯证据(如脑脊液发现肿瘤细胞或影像提示中枢浸润)。
10. 患有移植物抗宿主病(GVHD)或需使用免疫抑制药物。
11. 有癫痫或其他CNS疾病史。
12. 原发性免疫缺陷病。
13. 研究者认为不适合进行细胞制备。
14. 研究者认为不适合入组的其他情况。
核对登记原文(英文)
Inclusion Criteria:

1. Aged 18 \~ 70 years old (including boundary value), regardless of gender;
2. FLT-3 positive acute myeloid leukemia;
3. The expected survival time was more than 3 months;
4. ECOG score 0-2;
5. Refractory or relapsed AML patients after standardized treatment who meet any of the following criteria:

   1. After complete remission (CR), there were ≥5% leukemia cells or blast cells in the bone marrow(except for other reasons such as bone marrow regeneration after consolidation chemotherapy)in the peripheral blood and extramedullary lesions;
   2. Naive patients who are treated with 2 courses of treatment and are ineffective;
   3. Those who have relapsed within 12 months after CR after consolidation and intensive treatment;
   4. Those who relapse after 12 months but are ineffective after conventional chemotherapy;
   5. Subjects who experienced relapses twice or multiple times; with persistent extramedullary leukemia.
6. Kidney function, cardiopulmonary function, liver function, and coagulation function meet the following requirements:

   1. Creatinine ≤ 1.5 ULN;
   2. Left ventricular ejection fraction ≥ 50% and echocardiography does not reveal pericardial effusions and ECG does not reveal clinically significant abnormal bands;
   3. Blood oxygen saturation \> 92%;
   4. Total bilirubin ≤ 2 × ULN; ALT and AST ≤ 2.5 × ULN; for the patients with ALT and AST abnormalities caused by disease which researchers judge (e.g. liver infiltrates or bile duct obstruction), the indicators of which can be relaxed to ≤5× ULN;
   5. PT/INR and PTT ≤ 1.5 ULN;
7. Patients understand the trial and have signed the informed consent form.

Exclusion Criteria:

1. Patients with malignant tumors other than acute myeloid leukemia within 5 years before the screening, except fully treated cervical carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after the radical operation, and breast ductal carcinoma in situ after radical operation;
2. Patients with hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood hepatitis B virus (HBV) DNA titer detection is not within the normal reference range; Hepatitis C virus (HCV) antibody positive and hepatitis C virus (HCV) RNA positive in peripheral blood; Human immunodeficiency virus (HIV) antibody-positive; Cytomegalovirus (CMV) DNA positive; Syphilis test positive;
3. Patients with severe heart disease: including but not limited to unstable angina pectoris, myocardial infarction (within 6 months before screening), congestive heart failure (New York Heart Association \[NYHA\] classification ≥ grade III), severe arrhythmia;
4. Patients with unstable systemic diseases judged by the researcher: including but not limited to severe liver, kidney, or metabolic diseases requiring drug treatment;
5. Within 7 days before screening, there were active or uncontrollable infections requiring systemic treatment (except mild urogenital infection and upper respiratory tract infection);
6. Pregnant or lactating women, female subjects who planned pregnancy within 2 years after cell reinfusion, or male subjects whose partners planned pregnancy within 2 years after cell reinfusion;
7. Subjects who were receiving systemic steroid treatment within 7 days before screening or who were determined by the investigator to need long-term systemic steroid treatment during treatment (except inhalation or local use);
8. Participated in other clinical studies within 1 month before screening;
9. There was evidence of central nervous system invasion during subject screening(e.g. detection of tumor cells in cerebrospinal fluid or imaging suggests central infiltrates;);
10. Patients with graft-versus-host disease (GVHD) or requiring immunosuppressive agents;
11. Patients with a history of epilepsy or other central nervous system disorders;
12. Patients with primary immunodeficiency diseases;
13. Patients who are not suitable for cell construction judged by researchers;
14. Other situation researchers believe that it is not suitable for inclusion.

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

  • 主要终点最大耐受剂量(MTD)输注后2年内
  • 次要终点治疗相关不良事件发生率
  • 次要终点复发/难治性AML患者接受抗FLT3 CAR-T 细胞后的总体缓解率(ORR)
  • 次要终点复发/难治性AML患者接受抗FLT3 CAR-T 细胞后的完全缓解率(CRR)
  • 次要终点复发/难治性AML患者接受抗FLT3 CAR-T 细胞后的总生存期(OS)
  • 次要终点复发/难治性AML患者接受抗FLT3 CAR-T 细胞后的无进展生存期(PFS)
  • 次要终点复发/难治性AML患者接受抗FLT3 CAR-T 细胞后的缓解持续时间(DOR)
  • 次要终点抗FLT3 CAR-T 细胞的体内扩增和存活
核对登记原文(英文)

主要终点:Maximal tolerable dose (MTD) · Fludarabine + Cyclophosphamide + TAA05 Cell Injection Patients will receive lymphodepletion with fludarabine (25 mg/kg) and cyclophosphamide (250 mg/kg) for 3 days on day -7\~-2, followed by the infusion of TAA05 Cell with the dose of 1×10\^8, 2×10\^8 or 4×10\^8 cells on day 0. If no dose-limited toxicity(DLT) emerges in the group, then the subsequent higher dose will be used in the next group. If DLT emerges in a single subject in any dose level, 3 more subjects will be enrolled to the same dose level. MTD is defined as the highest dose at which DLT occurs in no more than 2 of the 6 patients. After the end of dose climbing, if the maximum dose group(MTD) is still not observed, the highest dose group is defined as MTD. · within 2 yeas after infusion
次要终点:Incidence of Treatment-related Adverse Events;Overall response rate(ORR) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia;Complete response rate(CRR) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia;Overall survival(OS) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia;Progress-free survival(PFS) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia;Duration of Response(DOR) of administering Anti-FLT3 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia;In vivo expansion and survival of Anti-FLT3 CAR-T Cell

研究设计怎么做的

研究类型
干预性研究
入组人数
12 人(预计)
分组方式
不适用(单臂)
  • TAA05细胞注射组试验组

    氟达拉滨+环磷酰胺+TAA05细胞注射液:患者于第-7至-2天连续3天接受氟达拉滨(25 mg/kg)和环磷酰胺(250 mg/kg)淋巴细胞清除;第0天输注1×10^8、2×10^8或4×10^8个TAA05细胞。若该组未发生DLT,下一组使用更高剂量;任一剂量组如1名受试者发生DLT,则该剂量组再纳入3名受试者。剂量递增结束后,如尚未观察到MTD,则最高剂量组定义为MTD。

核对分组登记原文(英文)
  • TAA05 Cell Injection · EXPERIMENTAL · Fludarabine + Cyclophosphamide + TAA05 Cell Injection Patients will receive lymphodepletion with fludarabine (25 mg/kg) and cyclophosphamide (250 mg/kg) for 3 days on day -7\~-2, followed by the infusion of TAA05 Cell with the dose of 1×10\^8, 2×10\^8 or 4×10\^8 cells on day 0. If no dose-limited toxicity(DLT) emerges in the group, then the subsequent higher dose will be used in the next group. If DLT emerges in a single subject in any dose level, 3 more subjects will be enrolled to the same dose level. After the end of dose climbing, if the maximum dose group(MTD) is still not observed, the highest dose group is defined as MTD.

关键日期

开始日期
2022-06-14
主要完成日期
2025-06-14
全部完成日期
2027-06-14
登记状态核实于
2022-06

联系与责任方公示信息

主要研究者
MEI HENG
申办方
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
合作方
PersonGen BioTherapeutics (Suzhou) Co., Ltd.
联系邮箱
hmei@hust.edu.cn
联系电话
027-8572600

以上邮箱 / 电话是登记库里的申办方联系方式(中国内地座机),通常不直达某家医院。中国中心的联系方式请以医院或登记平台最新公示为准。

登记简述

本临床试验评估抗FLT3 CAR-T 细胞(TAA05细胞注射液)治疗复发/难治性急性髓系白血病(AML)患者的安全性和疗效。

核对登记原文(英文)

This is a clinical trial of Anti-FLT3 CAR-T Cell (TAA05 Cell Injection) in the treatment of patients with relapsed / refractory acute myeloid leukemia. The purpose is to evaluate the safety and efficacy of anti-FLT3 CAR-T cells in patients with relapsed / refractory acute myeloid leukemia.

登记原文与核验信息

试验登记号
NCT05445011
试验期别
I 期
试验状态
招募中
中国试验中心(1 个)
武汉
适应症(原文)
Acute Myeloid Leukemia
干预方式(原文)
Fludarabine + Cyclophosphamide + TAA05 Cell Injection