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:A Clinical Study of CD70-targeted CAR-T in the Treatment of CD70-positive Advanced/Metastatic Solid Tumors
A Clinical Study of CD70-targeted CAR-T in the Treatment of CD70-positive Advanced/Metastatic Solid Tumors
⚠ 该试验的登记信息已有 16 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。
这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗晚期实体瘤、肾细胞癌、卵巢癌的安全性、可行性及初步疗效。当前状态:招募中。计划入组 30 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT05518253。
不限性别 · ≥ 18 Years
纳入标准: 1. 年龄≥18岁,男性或女性。 2. 组织病理学或细胞学(石蜡切片或新鲜活检肿瘤组织标本)确诊晚期/转移性实体瘤,并经组织学/病理学确认CD70阳性(IHC 3+)。 3. 标准治疗(如手术、化疗、放疗、靶向治疗等)失败或不耐受(疾病进展或不耐受),且目前无有效治疗方案。 4. 按RECIST 1.1至少有1个可测量靶病灶:结外病灶CT最长径≥10 mm,淋巴结病灶CT短径≥15 mm;扫描层厚≤5 mm;病灶未接受过局部治疗。 5. ECOG评分0–2。 6. 预期生存期>12周。 7. 无严重精神障碍。 8. 主要器官功能基本正常:造血功能,中性粒细胞>1.0×10^9/L、血小板>75×10^9/L、血红蛋白>80 g/L;心功能,超声心动图LVEF≥50%,心电图无明显异常;肾功能,血清肌酐≤ULN的2倍;肝功能,ALT和AST≤ULN的2倍(肝肿瘤浸润者可放宽至≤3倍);总胆红素≤ULN的2倍(Gilbert综合征或合并肝肿瘤浸润者可放宽至≤3倍);未吸氧时血氧饱和度>92%。 9. 符合单采或静脉采血标准,且无其他细胞采集禁忌证。 10. 受试者同意自签署知情同意书起至CAR-T细胞输注后1年内使用可靠有效的避孕方法(安全期避孕除外)。 11. 受试者或监护人同意参加本临床试验并签署知情同意书(ICF),表明理解研究目的和程序且愿意参加。 排除标准: 1. 筛选前接受过抗CD70药物治疗。 2. 筛选时存在活动性/有症状CNS转移或脑膜转移。既往接受脑转移治疗者须在治疗结束≥4周后影像学确认无进展方可入组。 3. 筛选前接受以下治疗:参加过其他干预性临床研究,未上市新药末次使用距细胞回输不足3个月,或已上市药物距回输不足5个半衰期;单采前2周内或至少5个半衰期(取较短者)接受化疗、靶向治疗等抗肿瘤治疗;单采前2周内接受>10 mg/日泼尼松或等效剂量的全身性皮质类固醇(无活动性自身免疫病时允许吸入或局部类固醇,以及>10 mg/日泼尼松剂量的肾上腺皮质激素替代治疗);筛选前4周内接种减毒活疫苗。 4. 筛选前1周内存在需全身治疗的活动性或未控制感染。 5. 筛选前3年内有目标肿瘤以外的恶性肿瘤,根治治疗后≥3年无活动性疾病者或充分治疗且无病证据的非黑色素瘤皮肤癌除外。 6. 存在以下心脏疾病:NYHA III/IV级充血性心力衰竭;入组前6个月内心肌梗死或冠状动脉旁路移植术;有临床意义的室性心律失常或无法解释的晕厥史(迷走神经性或脱水所致除外);严重非缺血性心肌病史。 7. 已知活动性或未控制的自身免疫病,如克罗恩病、类风湿关节炎、系统性红斑狼疮、系统性血管炎等。 8. HBsAg或HBcAb阳性且外周血HBV DNA滴度高于正常范围;HCV抗体阳性且外周血HCV RNA滴度高于正常范围;HIV抗体阳性、梅毒检测阳性或CMV DNA阳性。 9. 既往静脉血栓栓塞(如肺栓塞)且仍需抗凝治疗,或存在以下情况:3–4级出血持续超过30天;静脉血栓后遗症(如持续呼吸困难、低氧)。未达到上述情况的静脉血栓患者可参加。 10. 高血压控制不佳,定义为收缩压≥150 mmHg和/或舒张压≥90 mmHg;血压取至少间隔2分钟的3次测量平均值。首次筛选≥150/90 mmHg者允许接受降压治疗,治疗后控制至<150/90 mmHg可继续筛选。 11. 妊娠或哺乳期女性,或计划CAR-T细胞回输后1年内生育的男性/女性受试者。 12. 研究者认为不适合参加研究的其他情况。
Inclusion Criteria: 1. Age ≥18 years old, male or female; 2. Histopathology or cytology (paraffin section or fresh biopsy tumor tissue specimen) diagnosed as advanced/metastatic solid tumor (positive tumor CD70 expression (tumor CD70 positive (IHC 3+) confirmed by histology or pathology)); 3. Failure or intolerance after standard treatment (disease progression or intolerance such as surgery, chemotherapy, radiotherapy, targeted therapy, etc.), and there is currently no effective treatment; 4. According to the RECIST version 1.1 standard, at least one target lesion with measurable diameter and evaluable, measurable lesions are defined as: extranodal CT scan long diameter ≥ 10mm, lymph node lesions CT scan short diameter ≥ 15mm, scan slice thickness Not larger than 5mm, and has not received local treatment; 5. ECOG 0-2 points; 6. The expected survival time is more than 12 weeks; 7. No serious mental disorder; 8. The function of important organs is basically normal: 1. Hematopoietic function: neutrophils\>1.0×109/L, platelets\>75×109/L, hemoglobin\>80g/L; 2. Cardiac function: echocardiography showed cardiac ejection fraction ≥50%, and no obvious abnormality was found on electrocardiogram; 3. Renal function: serum creatinine≤2.0×ULN; 4. Liver function: ALT and AST ≤2.0×ULN (for patients with liver tumor infiltration, it can be relaxed to ≤3.0×ULN); 5. Total bilirubin ≤2.0×ULN (Gilbert syndrome or combined liver tumor infiltration can be relaxed to ≤3.0×ULN); 6. Oxygen saturation \> 92% in non-oxygen state. 9. Have apheresis or venous blood collection standards, and have no other contraindications for cell collection; 10. Subjects agree to use reliable and effective contraceptive methods for contraception (excluding safe period contraception) within 1 year after signing the informed consent form to receiving CAR-T cell infusion; 11. Subjects or their guardians agree to participate in this clinical trial and sign the ICF, indicating that they understand the purpose and procedures of this clinical trial and are willing to participate in the research. Exclusion Criteria: 1. Received anti-CD70 drug treatment before screening; 2. Active/symptomatic central nervous system metastases or meningeal metastases at the time of screening; subjects with brain metastases who have been treated must be confirmed to have no imaging-proven progression ≥4 weeks after the end of treatment before they can be enrolled; 3. Received any of the following treatments prior to screening: 1. Participated in other interventional clinical studies before screening, including: the last use of unmarketed new drugs is less than 3 months before cell reinfusion, or the last use of marketed drugs is less than 5 half-lives from cell reinfusion; 2. Received anti-tumor therapy such as chemotherapy and targeted therapy within 2 weeks or at least 5 half-lives (whichever is shorter) before apheresis; 3. Received systemic corticosteroid therapy at doses greater than 10 mg/day prednisone (or equivalent doses of other corticosteroids) within 2 weeks prior to apheresis (inhalation or topical is allowed in the absence of active autoimmune disease Use steroids and adrenal corticosteroid replacement at doses greater than 10 mg/day of prednisone); 4. Received live attenuated vaccine within 4 weeks before screening; 4. Active infection or uncontrollable infection requiring systemic treatment within 1 week before screening; 5. Malignant tumors other than the target tumor within 3 years prior to screening, except for the following: malignant tumors that have received radical treatment and no known active disease within ≥ 3 years prior to enrollment; or adequately treated of non-melanoma skin cancers with no evidence of disease; 6. Have any of the following heart conditions: 1. New York Heart Association (NYHA) stage III or IV congestive heart failure; 2. Myocardial infarction or coronary artery bypass grafting (CABG) within 6 months before enrollment; 3. Clinically significant ventricular arrhythmia, or a history of unexplained syncope (except those caused by vasovagal or dehydration); 4. History of severe nonischemic cardiomyopathy. 7. Known to have active or uncontrolled autoimmune diseases, such as Crohns disease, rheumatoid arthritis, systemic lupus erythematosus, systemic vasculitis, etc.; 8. Hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood hepatitis B virus (HBV) DNA titer is greater than the normal range; hepatitis C virus (HCV) antibody positive and peripheral blood hepatitis C Virus (HCV) RNA titer test is greater than the normal range; human immunodeficiency virus (HIV) antibody positive; syphilis test positive; cytomegalovirus (CMV) DNA test positive; 9. The subject has experienced venous thromboembolic events (eg: pulmonary embolism) and still needs anticoagulation therapy, or meets the following conditions: a. Bleeding with grades 3 to 4 for more than 30 days; b. venous thrombosis Sequelae (such as persistent dyspnea and hypoxia); (Note: although subjects with venous thrombosis but not meeting the above conditions can participate in the trial); 10. Poorly controlled hypertension, defined as systolic blood pressure ≥ 150 mmHg and/or diastolic blood pressure ≥ 90 mmHg (blood pressure values measured based on the average of 3 readings at least 2 minutes apart, blood pressure ≥ 150/90 mmHg at initial screening is acceptable Antihypertensive treatment, screening can be performed if the blood pressure is less than 150/90mmHg and well controlled after treatment); 11. Women who are pregnant or breastfeeding, and male or female subjects who plan to have children within 1 year after receiving CAR-T cell reinfusion; 12. Other investigators deem it inappropriate to participate in the study.
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:Incidence of Adverse events after CD70 CAR-T cells infusion [Safety and Tolerability] · Therapy-related adverse events were recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0) · 28 days;Obtain the maximum tolerated dose of CD70 CAR-T cells[Safety and Tolerability] · Dose-limiting toxicity after cell infusion · 28 days
次要终点:Disease control rate of CAR-T cell preparations in CD70 positive advanced malignancies [Effectiveness];Objective response rate (ORR) of CD70 CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness];Duration of Response (DOR) of CD70 CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness];AUCS of CD70 CAR-T cells [Cell dynamics];CMAX of CD70 CAR-T cells [Cell dynamics];TMAX of CD70 CAR-T cells[Cell dynamics];Pharmacodynamics of CD70 CAR-T cells[Cell dynamics]
输注CD70靶向CAR-T细胞。
输注CD70靶向CAR-T细胞。
这是一项Ⅰ期临床研究,旨在评估CD70阳性晚期/转移性实体瘤患者接受CD70靶向CAR-T治疗的安全性和耐受性,并确定CAR-T的最大耐受剂量及推荐Ⅱ期剂量。
This is a phase I clinical study to evaluate the safety and tolerability of CAR-T in patients with CD70-positive advanced/metastatic solid tumors, and to obtain the maximum tolerated dose of CAR-T and phase II Recommended dose.
MEMBER ACCOUNT
登录成功会直接打开下一页。