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CAR(CAR-T)治疗鼻咽癌:早期 I 期临床试验

英文原题:Clinical Study on the EBV CAR-T /TCR-T Cells in the Treatment of Nasopharyngeal Carcinoma

ClinicalTrials.gov 2022/10/20(首次登记) 早期I 期注册临床试验 · 招募中

简要介绍

这是一项早期 I 期注册临床试验,评估细胞治疗用于鼻咽癌的安全性、可行性及初步疗效。当前状态:招募中。计划入组 24 例。试验地点:中国 · 上海(共 1 个中心,其中中国 1 个)。登记号:NCT05587543。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 75 Years

纳入标准:

* 自愿签署书面知情同意书;
* 年龄≥18岁且≤75岁,男女均可;
* 预期生存期≥3个月;
* 东部肿瘤协作组(ECOG)体能状态评分为0–2分;
* 通过EBER原位杂交(EBER-FISH)确诊EBV阳性鼻咽癌;
* 知情同意签署前5年内的病理石蜡切片检测结果;
* 至少有一个符合实体瘤RECIST 1.1标准的可测量病灶;
* 既往接受过二线或以上全身治疗且治疗失败的复发/转移性鼻咽癌患者;
* 可建立单采或静脉通路,且无其他血细胞采集禁忌证;
* 既往抗肿瘤治疗(放疗、化疗、靶向治疗等)所致不良反应已恢复至CTCAE 5.0的1级以下;
* 研究期间及给药结束后6个月内,有生育能力的受试者(男女均包括)须采取有效医学避孕措施。育龄女性须在首次给药前72小时内进行妊娠检测,结果须为阴性。

排除标准:

* 活动性中枢神经系统转移(治疗后稳定者除外);
* HIV阳性、HBsAg阳性且HBV DNA阳性(定量检测≥1000 CPS/ml),或HCV抗体阳性且HCV RNA阳性;
* 存在精神或心理障碍,无法配合治疗及疗效评估;
* 患有严重自身免疫性疾病或长期使用免疫抑制剂;
* 入组前14天内存在需要全身治疗的活动性或未控制感染;
* 存在任何不稳定的全身性疾病;
* 合并肺、脑、肾等重要器官功能障碍;
* 细胞治疗前4周内接受过大手术或遭受严重创伤,或预计研究期间需要接受大手术;
* 细胞治疗前4周内接受过最后一次放疗或抗肿瘤治疗;
* 目前患有或曾患有其他癌症,且治愈时间不足3年;宫颈原位癌、皮肤基底细胞癌,以及无病生存超过5年的其他癌症除外;
* 6个月内接受过嵌合抗原受体T细胞治疗;
* 存在移植物抗宿主病(GVHD);
* 筛查前正在接受全身性类固醇治疗,且研究者认为治疗期间需要长期全身使用类固醇(吸入或局部用药除外);或细胞回输前72小时内接受过全身性类固醇治疗(吸入或局部用药除外);
* 有严重过敏或过敏史;
* 需要接受抗凝治疗;
* 妊娠期或哺乳期女性,或计划在6个月内妊娠者(男女均适用);
* 研究者认为存在其他不适合参加研究的原因。
核对登记原文(英文)
Inclusion Criteria:

* Voluntary written informed consent;
* Age ≥18 years old, ≤75 years old, male and female;
* Expected survival ≥3 months;
* The Eastern Cooperative Oncology Group (ECOG) physical fitness score was 0-2;
* Ebv-positive nasopharyngeal carcinoma was diagnosed by in situ hybridization with Ebers (Eber-fish) .
* Pathological Paraffin section testing (within 5 years before signing the informed consent form) ;
* At least one measurable lesion according to RECIST v1.1 criteria for solid tumors;
* Recurrent/metastatic nasopharyngeal carcinoma patients who had previously failed second-line or more systemic therapy;
* An apheresis or venous access can be established and there are no other contraindications to blood cell isolation;
* CTCAE 5.0 was lower than grade 1 in the side effects of previous anti-tumor therapy (radiotherapy, chemotherapy, targeted therapy, etc.)
* During the study period and up to 6 months after the end of the administration, fertile subjects -LRB-both male and female) were required to use effective medical contraception. For women of reproductive age, a pregnancy test should be performed within 72 hours before the first dose, and the results were negative.

Exclusion Criteria:

* Active central nervous system metastases (except those that are stable after treatment);
* HIV positive, HBsAg positive and HBV DNA copy number positive (quantitative detection ≥1000 CPS/ml) , HCV antibody positive and HCV RNA positive;
* Patients with mental or psychological disorders who can not cooperate with the treatment and evaluation of the curative effect;
* Subjects with severe autoimmune disease and long-term use of immunosuppressants;
* Active or uncontrolled infection requiring systemic therapy was present within 14 days prior to enrollment;
* Any unstable systemic disease;
* Complicated with dysfunction of important organs such as lung, brain and kidney.
* Subjects had undergone major surgery or severe trauma within 4 weeks before receiving cell therapy, or were expected to undergo major surgery during the study period.
* Participants received their last dose of radiation or anti-tumor therapy within 4 weeks of receiving the cell therapy.
* Participants had or had had other cancers that were incurable for up to 3 years, except for cervical cancer in situ or skin basal-cell carcinoma, and other cancers that had disease-free survival of more than 5 years.
* Treated with Chimeric antigen receptor t-cell therapy within six months.
* Graft-versus-host disease (GVHD);
* Subjects who were receiving systemic steroid therapy before screening and who required long-term systemic steroid therapy during treatment as determined by the investigator (with the exception of inhaled or topical use) ; And subjects treated with systemic steroids within 72 hours before cell reinfusion (except for inhalation or topical use) .
* Severe allergies or a history of allergies;
* Subjects requiring anticoagulant therapy;
* Pregnant or lactating women, or a six-month pregnancy plan (for both men and women);
* Researchers believe there are other reasons not to include people in treatment.

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

  • 主要终点剂量限制性毒性1年
  • 主要终点最大耐受剂量(MTD)或最佳有效剂量1年
  • 主要终点不良事件(AE)、严重不良事件(SAE)及特别关注的不良事件(AESI)的发生率1年
  • 次要终点药代动力学参数:Cmax(峰浓度)
  • 次要终点药代动力学参数:Tmax(达峰时间)
  • 次要终点客观缓解率(ORR)
  • 次要终点疾病控制率(DCR)
  • 次要终点缓解持续时间(DOR)
  • 次要终点无进展生存期(PFS)
核对登记原文(英文)

主要终点:Dose Limiting Toxicities · Analysis based on clinical trial data of subjects · one year;MTD or the best effective dose · Analysis based on clinical trial data of subjects · one year;Incidence of AE、SAE、AESI · Analysis based on clinical trial data of subjects · one year
次要终点:PK parameter:Cmax;PK parameter:Tmax;ORR;DCR;DOR;PFS

研究设计怎么做的

研究类型
干预性研究
入组人数
24 人(预计)
分组方式
非随机分组
  • CAR-T细胞治疗组试验组

    靶点A阳性的受试者分配至CAR-T细胞治疗组。

  • TCR-T细胞治疗组试验组

    靶点A阴性、靶点B阳性且靶点C阳性的受试者分配至TCR-T细胞治疗组。

核对分组登记原文(英文)
  • CAR-T · EXPERIMENTAL · Target A positivity was assigned to CAR-T cell therapy.
  • TCR-T · EXPERIMENTAL · Target A negative, Target B positive and Target C positive were assigned to TCR-T cell treatment group.

关键日期

开始日期
2022-12-28
主要完成日期
2027-10
全部完成日期
2030-10
登记状态核实于
2026-03

联系与责任方

主要研究者
Ji Dongmei
申办方
Fudan University
联系邮箱
jidongmei2000@hotmail.com
联系电话
13564183928

登记简述

这是一项单臂、开放标签、采用“3+3”剂量递增设计的探索性研究。受试者分为EBV TCR-T细胞组和EBV CAR-T细胞组。EBV CAR-T组接受三个递增剂量水平的治疗:3.0×10⁶、9.0×10⁶和1.5×10⁷个细胞/kg;EBV TCR-T组接受三个递增剂量:5.0×10⁶、1.5×10⁷和3.0×10⁷个细胞/kg。

核对登记原文(英文)

This study was a single-arm, open-label, "3 + 3" dose-escalation Exploratory research. The patients were divided into two groups: EBV TCR-T-cell Group and EBV CAR-T-cell group. The EBV CAR-T-treated group received three progressively increasing dose levels (3.0 × 106 cells/kg, 9.0 × 106 cells/kg, 1.5 × 107 cells/kg) of EBV CAR-T-cell therapy; The EBV TCR-T-cell group received three progressively increasing doses (5.0 × 106 cells/kg, 1.5 × 107 cells/kg, 3.0 × 107 cells/kg) of EBV TCR-T-cell therapy.

登记原文与核验信息

试验登记号
NCT05587543
试验期别
早期I 期
试验状态
招募中
中国试验中心(1 个)
Fudan University · 上海 · 中国
适应症(原文)
Nasopharyngeal Carcinoma
干预方式(原文)
PK Blood Collection; CAR; TCR