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靶向GD2抗原的自体CAR-T细胞治疗肺癌

英文原题:Autologous CAR T-Cells Targeting the GD2 Antigen for Lung Cancer

ClinicalTrials.gov 2022/11/17(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 GD2 细胞治疗用于肺癌、非小细胞肺癌的安全性、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:美国 · 教堂山(共 1 个中心)。登记号:NCT05620342。

入组条件决定能不能参加

不限性别 · ≥ 18 Years

纳入标准:书面知情同意参加细胞采集;预计生存期≥12周;铂类难治,且目前正在或既往接受过PD-1/PD-L1抑制剂;全身性皮质类固醇剂量≥10 mg/日泼尼松或等效剂量者符合原登记标准;低于10 mg/日者可由研究者酌情入组;有生育能力的女性须在采集细胞前72小时内血清妊娠试验阴性;器官功能充分。

排除标准:预计生存期不足12周;未接受过铂类化疗;器官功能不充分。
核对登记原文(英文)
Inclusion Criteria:

1. Written informed consent to undergo cell procurement explained to, understood by, and signed by the subject.
2. Subject has a life expectancy of ≥ 12 weeks.
3. Subject must be platinum-refractory and either currently receiving or has previously received a PD1/PDL1 inhibitor
4. Use of systemic corticosteroids at doses ≥10 mg prednisone daily or it's equivalent; those receiving \<10 mg daily may be enrolled at the discretion of the investigator.
5. Female subjects of childbearing potential must have a negative serum pregnancy test within 72 hours prior to cell procurement.
6. Subject has demonstrated adequate organ function.

Exclusion Criteria:

1 . Subject has less than 12 weeks of life expectancy.

2\. Subject did not receive platinum-based chemotherapy

3\. Subject does not have adequate organ function.

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

  • 主要终点发生不良事件的参与者人数最长4周。
  • 主要终点细胞因子释放综合征(CRS)最长4周。
  • 主要终点神经毒性最长4周。
  • 次要终点确定II期推荐剂量(RP2D)
  • 次要终点总体缓解率(ORR)
  • 次要终点无进展生存期(PFS)
  • 次要终点总生存期(OS)
  • 次要终点缓解持续时间(DOR)
  • 次要终点获益持续时间
  • 次要终点双唾液酸神经节苷脂GD2表达
  • 次要终点GD2表达与肿瘤缓解率的相关性
核对登记原文(英文)

主要终点:Number of participants with adverse event · The number of participants with adverse events (AE)s will be reported as a measure of the safety and tolerability of C9.GD2.CAR.IL-15 T. AEs will be classified and graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0. Grade 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. Grade 2 Moderate; minimal, local, or noninvasive intervention indicated; limiting age-appropriate instrumental Activities of Daily Living (ADL). Grade 3 Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL. Grade 4 Life-threatening consequences; urgent intervention indicated. Grade 5 Death related to AE. · Up to 4 weeks;Cytokine Release Syndrome (CRS) · CRS will be graded according to the American Society for Transplantation and Cellular Therapy (ASTCT) CRS Consensus Grading. Grade 1 - Mild (Symptomatic Management): Fever ≥38\^ o C, No hypotension, No hypoxia, Grade 2 - Moderate (Moderate Intervention): Fever ≥38\^ o C, Hypotension not requiring vasopressors, Hypoxia requiring low-flow nasal cannula (≤6 L/minute) or blow-by, Grade 3 - Severe (Aggressive Intervention): Fever ≥ 38\^ o C , Hypotension requiring a vasopressor with or without vasopressin, Hypoxia requiring high-flow nasal cannula (\>6 L/minute), facemask, nonrebreather mask, or Venturi mask, Grade 4 - Life-threatening (Life-sustaining intervention): Fever ≥38\^oC, Hypotension requiring multiple vasopressors (excluding vasopressin), Hypoxia requiring positive pressure (e.g. Continuous positive airway pressure, BiPAP, intubation, mechanical ventilation), Grade 5 - Death: Death. · Up to 4 weeks;Neurotoxicity · Neurotoxicity will be graded according to the American Society for Transplantation and Cellular Therapy (ASTCT) Immune effector cell-associated neurotoxicity syndrome (ICANS) Consensus Grading criteria. ICANS grading criteria are outlined in the protocol on a scale from 1 (mild) to 4 (critical) based on the Immune Effector Cell-Associated Encephalopathy (ICE) Score. Grade 1:Score: 7-9 (mild impairment), Grade 2:Score: 3-6 (moderate impairment), Grade 3: Score: 0-2 (severe impairment), Grade 4: Score: Subject in critical condition, and/or obtunded and cannot perform an assessment of tasks. · Up to 4 weeks
次要终点:Identification of Recommended phase 2 dose (RP2D);Overall Response Rate (ORR);Progression Free Survival (PFS);Overall Survival (OS);Duration of Response (DOR);Duration of Benefit;Disialoganglioside (GD2) Expression;Disialoganglioside Expression and tumor response rate correlations

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
不适用(单臂)
  • iC9.GD2.CAR.IL-15 T细胞治疗试验组

    单臂试验。广泛期肺癌或铂类难治IV期非小细胞肺癌患者,且既往接受过PD-1和/或PD-L1治疗,将接受由采集的患者血液制备的iC9.GD2.CAR.IL-15 T细胞。

核对分组登记原文(英文)
  • iC9.GD2.CAR.IL-15 T Therapy · EXPERIMENTAL · Experimental: Single Arm Subjects with extensive stage lung cancer or stage IV non-small cell lung cancer that is platinum-refractory and received PD-1 and/or PD-L1 therapy will receive iC9.GD2.CAR.IL-15 T cells were manufactured from their collected blood sample.

关键日期

开始日期
2023-06-21
主要完成日期
2027-11-24
全部完成日期
2029-10-24
登记状态核实于
2026-01

联系与责任方

申办方
UNC Lineberger Comprehensive Cancer Center
合作方
Bellicum Pharmaceuticals、United States Department of Defense、M.D. Anderson Cancer Center
联系邮箱
UNCImmunotherapy@med.unc.edu
联系电话
919-445-4208

登记简述

这是一项单中心、开放标签I期研究,招募广泛期肺癌或铂类难治的IV期非小细胞肺癌成人患者,且患者目前正在或既往接受过PD-1和/或PD-L1治疗。研究评估靶向GD2抗原的自体嵌合抗原受体T细胞(iC9-GD2.CAR.IL-15 T细胞)的安全性,确定不会造成过多副作用的剂量及最大耐受剂量。研究治疗结合经过改造的免疫细胞,利用患者自身血液制备表达GD2靶向受体、白细胞介素-15(IL-15)和诱导型半胱天冬酶9安全开关(iC9)的T细胞。治疗分两步:采血、分离并改造T细胞;随后将由患者自身血液制备的iC9-GD2.CAR.IL-15 T细胞回输。该治疗仍属试验性,尚未获FDA批准。

核对登记原文(英文)

This is a phase 1, single-center, open-label study that enrolls adult subjects with extensive stage lung cancer or stage IV non-small cell lung cancer that is platinum-refractory and received PD-1 and/or PD-L1 therapy. The purpose of this study is to test the safety of using a new treatment called autologous T lymphocyte chimeric antigen receptor cells against the GD2 antigen (iC9-GD2.CAR.IL-15 T cells) in subjects with lung cancer. How much (dose) of the iC9-GD2.CAR.IL-15 T cells are safe to use without causing too many side effects and what is the maximum dose that could be tolerated will be studied. Modified immune cells as an experimental treatment that combines antibodies and T cells will be used. Antibodies are proteins that protect the body from foreign invaders like bacteria. T cells, also called T lymphocytes, are special infection-fighting blood cells that can kill viruses and other cells, including tumor cells. Although antibodies and T cells have been used to treat cancer and they both have shown promise, neither alone has been able to cure most patients. This study will combine T cells and antibodies to create a more effective treatment. The treatment that is being researched in this study is called autologous T lymphocyte chimeric antigen receptor cells targeted against the disialoganglioside (GD2) antigen that expresses Interleukin (IL)-15, and the inducible caspase 9 safety switch (iC9). The short name for this treatment is iC9.GD2.CAR.IL-15 T cells therapy is an experimental therapy and has not been approved by the Food and Drug Administration. There are two steps. In the first step, blood will be collected from the subjects to prepare the iC9-GD2.CAR.IL-15 T cells. T cells will be isolated from the blood and modified to make iC9-GD2.CAR.IL-15. In the second step, the iC9-GD2.CAR.IL-15 T cells produced from the subject's own blood will be administered to the subject.

登记原文与核验信息

试验登记号
NCT05620342
试验期别
早期I 期
试验状态
招募中
试验中心
Lineberger Comprehensive Cancer Center · 教堂山 · 美国
适应症(原文)
Lung Cancer; Small Cell Lung Carcinoma; Non Small Cell Lung Cancer
干预方式(原文)
iC9.GD2.CAR.IL-15 T Infusion