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.
英文原题:Study Evaluating UCART20x22 in B-Cell Non-Hodgkin Lymphoma
Study Evaluating UCART20x22 in B-Cell Non-Hodgkin Lymphoma
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⚠ 该试验的登记信息已有 13 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/II 期注册临床试验,评估细胞治疗用于非霍奇金淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 80 例。试验地点:美国 · 芝加哥、波士顿、新不伦瑞克、奥斯汀(共 10 个中心)。登记号:NCT05607420。
不限性别 · ≥ 18 Years 且 ≤ 80 Years
纳入标准: • ECOG体能状态0–1分。 • 按WHO 2016标准确诊复发/难治性成熟B-NHL,CD20和/或CD22阳性。剂量探索阶段包括成熟B-NHL,但排除CLL/SLL、既往CLL/SLL转化的Richter综合征、Burkitt淋巴瘤和Waldenström巨球蛋白血症。剂量扩展阶段包括复发/难治性大B细胞淋巴瘤:DLBCL、MYC及BCL2和/或BCL6重排的高级别B细胞淋巴瘤、转化型滤泡性淋巴瘤/边缘区淋巴瘤,以及3B级滤泡性淋巴瘤。 • 至少2线既往治疗后复发/难治,且既往治疗须按亚型包括:DLBCL、高级别B细胞淋巴瘤、PMBCL或转化型滤泡性/边缘区淋巴瘤须接受抗CD20单抗及蒽环类;滤泡性淋巴瘤须接受烷化剂联合抗CD20单抗;套细胞淋巴瘤须接受含蒽环类或苯达莫司汀的化疗及BTK抑制剂。若适应证淋巴瘤亚型已有获批自体抗CD19 CAR-T,须既往接受该治疗,除非患者无法或不适合接受(如白细胞单采/制备失败、无法等待制备、CD19阴性等)。若患者被认为长期血液学毒性风险高,淋巴清除(LD)前须有可用的自体造血干细胞。 排除标准: • 淋巴清除前5个半衰期或14天(取较短者)内使用试验药物(细胞/基因治疗及单抗除外);或在同一时间窗内接受复发/难治B-NHL获批化疗、生物治疗(单抗除外)或靶向治疗。 • 淋巴清除前复发/难治B-NHL治疗线数>4;LD前30天内接受单抗;前3个半衰期内接受全身免疫刺激剂。 • LD前6个月内接受获批或试验性细胞/基因治疗,或既往接受同时靶向CD20和CD22的细胞/基因治疗。 • LD前6周内接受自体造血干细胞移植;前3个月内接受异体移植;前6周内接受供者淋巴细胞输注。 • 有活动性急性或慢性GVHD;LD前至少6周未停用全部免疫抑制治疗。 • LD前8周内接受放疗(特定靶病灶姑息放疗除外)。 • 活动性中枢神经系统淋巴瘤或既往B-NHL中枢神经系统受累;存在活动性且有临床意义的中枢神经系统疾病。 • 每日需服泼尼松>20 mg或等效剂量。 • 存在已知活动性感染或潜伏感染再激活,包括细菌、病毒、真菌、分枝杆菌或其他病原体。 • 对阿仑单抗过敏,或有抗阿仑单抗中和抗体史。 • 入组前3个月内有任何未控制的心血管疾病。 • 需要免疫抑制治疗;LD前28天内接受重大手术。 • 筛选前2年内存在其他未控制恶性肿瘤;原位非黑色素瘤皮肤癌和/或宫颈原位癌除外。
Inclusion Criteria: * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 * Relapsed or refractory (R/R) mature B-NHL per 2016 WHO criteria and positive for CD20 and/or CD22 * Subjects with NHL subtypes defined by WHO: * Dose-Finding Part: R/R mature B-NHL (except chronic lymphocytic leukemia/small lymphocytic leukemia \[CLL/SLL\], Richter's transformation from prior CLL/SLL, Burkitt's lymphoma, and Waldenstrom's macroglobulinemia) * Dose-Expansion Part: R/R LBCL, defined as: i. DLBCL; ii. High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements; iii. Transformed FL or transformed marginal zone lymphoma (MZL); iv. Follicular lymphoma Grade 3B * R/R disease after at least 2 lines of prior treatment, which must have included: * An Anti-CD20 MoAb and an anthracycline for DLBCL, high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements, primary mediastinal large B-cell lymphoma (PMBCL), or transformed FL or MZL * An alkylating agent in combination with an anti-CD20 MoAb for FL * An anthracycline or bendamustine-containing chemotherapy regimen and a Bruton's tyrosine kinase (BTK) inhibitor for mantle cell lymphoma (MCL) * Autologous anti-CD19 CAR T-cell therapy, if approved and available for the indicated lymphoma subtype, unless the subject is unable or is ineligible to receive approved autologous anti-CD19 CAR T-cell therapy (e.g., fail leukapheresis or manufacture, unable to wait for manufacture, CD19 negative disease, etc.) * Autologous hematopoietic stem cells must be available prior to the start of the LD regimen if the subject is considered high-risk for prolonged hematologic toxicity. Exclusion Criteria: * Prior use of an investigational product (except for cell or gene therapies and MoAbs) within 5 half-lives or within 14 days, whichever is shorter, prior to start of LD regimen * Previous approved therapy including chemotherapy, biologic (except MoAbs), or targeted therapy for R/R B-NHL with 5 half-lives or within 14 days, whichever is shorter, prior to start of the LD regimen * \> 4 lines of therapy R/R B-NHL prior to start of the LD regimen. * Prior MoAb therapy (approved or investigational) within 30 days prior to start of LD * Prior systemic immunostimulatory agent within 3 half-lives prior to start of the LD regimen * Prior cell or gene therapy (approved or investigational) within 6 months of the start of LD * Prior cell or gene therapy (approved or investigational) targeting both CD20 and CD22 * Autologous HSCT infusion within 6 weeks of the start of LD * Allogeneic HSCT within 3 months of the start of LD, or donor lymphocyte infusion within 6 weeks of the start of LD * Active acute or chronic graft versus host disease (GvHD). Subjects should be off all immunosuppressive therapies for at least 6 weeks prior to start of LD * Radiotherapy within 8 weeks (except for palliative radiotherapy for specific on-target lesions) (prior to start of LD regimen) * Evidence of active central nervous system (CNS) lymphoma or previous CNS involvement of R/R B-NHL * Presence of an active and clinically relevant CNS disorder * Daily treatment with \>20 mg prednisone or equivalent * Known active infection, or reactivation of a latent infection, whether bacterial or viral, fungal, mycobacterial, or other pathogens * History of hypersensitivity to alemtuzumab * History of neutralizing anti-drug antibody against alemtuzumab * Any known uncontrolled cardiovascular disease within 3 months of enrollment * Subjects requiring immunosuppressive treatment * Major surgery within 28 days prior to start of LD * Evidence of another uncontrolled malignancy within 2 years prior to Screening (except in situ nonmelanoma skin cell cancers and/or carcinoma in-situ of the cervix)
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:Dose finding and expansion parts: Incidence of adverse events/serious adverse events/dose limiting toxicity [Safety and Tolerability] · Incidence, nature and severity of adverse events and serious adverse events in relation to UCART20x22 and/or lymphodepletion · From study entry through month 12;Dose finding part: Occurrence of Dose Limiting Toxicities (DLTs) · Up to Day 28 post UCART20x22 infusion
次要终点:Investigator assessed overall response rate (ORR) according to Lugano Response Criteria for Malignant Lymphoma;Duration of Response;Progression-free survival (PFS);Overall survival
在多个剂量水平给予UCART20x22,直至确定最大耐受剂量(MTD)和/或推荐Ⅱ期剂量(RP2D)。 剂量扩展阶段:给予剂量探索阶段确定的RP2D。
以上邮箱 / 电话是登记库里的申办方联系方式(+1,美国 / 加拿大),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。
本首次人体开放标签剂量探索和剂量扩展研究评估UCART20x22静脉给药治疗复发/难治性B细胞非霍奇金淋巴瘤(B-NHL)的安全性和临床活性,并确定最大耐受剂量(MTD)及推荐Ⅱ期剂量(RP2D)。
First-in-human, open-label, dose-finding and dose-expansion study of UCART20x22 administered intravenously in subjects with relapsed or refractory B-Cell Non-Hodgkin Lymphoma (B-NHL). The purpose of this study is to evaluate the safety and clinical activity of UCART20x22 and determine the Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D).
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