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:Autologous CAR T-Cells Targeting the GD2 Antigen for Lung Cancer
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。
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。
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。
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
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。
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。
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.
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