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:The Safety and Efficay Investigation of CAR-T Cell Therapy for Patients With Hematological Malignancies
⚠ 该试验的登记信息已有 15 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。
这是一项分期未标注的注册临床试验,评估自体 T 细胞治疗急性淋巴细胞白血病、淋巴瘤、多发性骨髓瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 50 例。试验地点:中国 · 太原(共 1 个中心,其中中国 1 个)。登记号:NCT05618041。
不限性别 · ≥ 14 Years 且 ≤ 75 Years
纳入标准: • 签署知情同意书,愿意且能够遵守研究流程中规定的访视、治疗方案、实验室检查及其他要求。 • 诊断为复发或难治性淋巴瘤、白血病或骨髓瘤。 • 肿瘤细胞表达CAR-T治疗靶点(经流式细胞术或免疫组化证实)。 • 年龄14~75岁(含),性别不限。 • ECOG评分≤2分。 • 血红蛋白≥70 g/L(允许输血)。 • 肝肾、心肺功能符合以下要求:肌酐≤正常值上限(ULN)的1.5倍;左心室射血分数≥50%;血氧饱和度>90%;总胆红素≤ULN的1.5倍,ALT和AST≤ULN的2.5倍。 • T细胞肿瘤患者若筛选时外周血检测到肿瘤细胞,应以流式细胞术检测其表面免疫表型为CD4和CD8双阴性;若不是CD4/CD8双阴性,则外周血肿瘤细胞比例须≤1%。 • 有生育计划者须同意入组前及研究结束后6个月内避孕;妊娠或疑似妊娠须立即告知研究者。 • 受试者或监护人理解并签署知情同意书。 • 预期生存期>3个月。 排除标准: • 严重心功能不全。 • 有严重肺功能损害史。 • 合并其他晚期恶性肿瘤。 • 合并无法有效控制的严重或持续性感染。 • 合并严重自身免疫性疾病或先天性免疫缺陷。 • 活动性肝炎(HBV DNA或HCV RNA阳性)。 • 人类免疫缺陷病毒(HIV)感染或梅毒感染。 • 有对生物制品(包括抗生素)严重过敏史。 • 有造血干细胞移植史者,距异基因造血干细胞移植须不超过6个月(按原登记表述)。 • 筛选前接受过CAR-T治疗或其他基因修饰细胞治疗。 • 研究者认为可能增加受试者风险或干扰研究结局的情况。
Inclusion Criteria: * Sign the informed consent and be willing and able to comply with the visit, treatment protocol, laboratory examination, and other requirements of the study as specified in the study procedure sheet; * Diagnosed as recurrent or refractory lymphoma, leukemia or myeloma; * Tumor cells express targets for CAR-T cell therapy (results: flow cytometry or Immunohistochemical test confirmation); * Age 14-75 (including threshold), gender unlimited; * Eastern Cooperative Oncology Group (ECOG) score ≤2; * HGB ≥ 70g/L (blood transfusion allowed); * Liver and kidney functions, heart and lung functions meet the following requirements: 1. Creatinine ≤ 1.5 × ULN; 2. Left ventricular ejection fraction ≥ 50%; 3. Blood oxygen saturation\>90%; 4. Total bilirubin ≤ 1.5 × ULN; ALT and AST ≤ 2.5 × ULN; * For T cell tumor patients, if tumor cells are detected in peripheral blood during screening, flow cytometry should be used to detect that the tumor cell surface immunophenotype is CD4 and CD8 double negative. If the immunophenotype of peripheral blood tumor cells is not double negative for CD4 and CD8, the condition that the proportion of peripheral blood tumor cells is ≤ 1% shall be met; * Subjects with pregnancy plans must agree to use contraception before entering the study and after the study lasts for six months; If the subject is pregnant or suspected of being pregnant, the investigator shall be informed immediately; * The subject or guardian understands and signs the informed consent form; * Expected survival longer than 3 months. Exclusion Criteria: * Severe cardiac insufficiency; * Have a history of severe lung impairment; * Complicated with other advanced malignant tumors; * Complicated with severe or persistent infection that cannot be effectively controlled; * Complicated with severe autoimmune diseases or congenital immune deficiency; * Active hepatitis (HBV DNA or HCV RNA positive); * Human immunodeficiency virus (HIV) infection or syphilis infection; * Have a history of severe allergy to biological products (including antibiotics); * If there is a history of hematopoietic stem cell transplantation, it should be no more than 6 months before the patient receives allogeneic hematopoietic stem cell transplantation; * Subjects who received CAR-T therapy or other gene modified cell therapy before screening; * Conditions that the investigator believes may increase the risk to the subject or interfere with the outcome of 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:Safety: Incidence and severity of adverse events · To evaluate the possible adverse events occurred within first one month after CAR-T infusion, including the incidence and severity of symptoms such as cytokine release syndrome and neurotoxicity · First 1 month post CAR-T cells infusion;Efficacy: Remission Rate · Complete remission (CR) Complete remission with incomplete recovery of blood cells (CRI), positive minimal residual tumor (MRD+) or negative tumor (MRD -) CR/CRI, disease recurrence or progression (PD) were evaluated, and the overall remission rate was ORR=CR+CRI; For drenching Complete remission (CR), partial remission (PR), disease stability (SD) Disease recurrence or progression (PD) was evaluated, and the overall remission rate was ORR=CR+PR; For multiple myeloma Complete remission (CR), partial remission (VGPR, PR), disease stability (SD), disease recurrence or progression (PD) were adopted, Overall remission rate ORR=CR+VGPR+PR; · 3 months post CAR-T cells infusion
次要终点:progression-free survival (PFS);CAR-T proliferation;Cytokine release
患者接受CAR-T细胞治疗。
本研究旨在评估CAR-T技术用于复发或难治性血液淋巴系统恶性肿瘤患者的耐受性和安全性。
To evaluate the tolerability and safety of CAR-T technology in patients with relapsed or refractory hematolymphoid malignancies.
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