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:CD7 CAR-T Cells in T-cell Lymphoma/Leukemia
CD7 CAR-T Cells in T-cell Lymphoma/Leukemia
⚠ 该试验的登记信息已有 47 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 CAR-T 细胞治疗淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 20 例。试验地点:中国 · 深圳(共 1 个中心,其中中国 1 个)。登记号:NCT05620680。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 年龄18至75岁(含18岁和75岁),性别不限。 2. 受试者自愿参加研究,并由本人或法定监护人签署知情同意书。 3. 根据美国国家综合癌症网络(NCCN)《T细胞淋巴瘤》(2020年第1版)/《急性淋巴细胞白血病》(2020年第1版)实践指南,确诊T细胞淋巴瘤。 4. 符合复发/难治性T细胞淋巴瘤诊断,包括以下任一情况:诱导治疗结束时未达到完全缓解(CR);或既往达到CR后,外周血或骨髓存在原始细胞(比例>5%)或存在髓外疾病。 5. 细胞治疗前2周内未接受抗体治疗。 6. ECOG评分0至2。 7. 无外周血单采禁忌证。 8. 预期生存期超过3个月。 排除标准: 1. 对细胞产品任一成分有过敏史。 2. 实验室检查存在以下情况(包括但不限于):血清总胆红素≥1.5 mg/dL;ALT或AST>正常值上限的2.5倍;血肌酐≥2.0 mg/dL;血小板≤10×10^9/L。 3. 按纽约心脏病协会(NYHA)心功能分级为III或IV级心力衰竭,或超声心动图显示左心室射血分数(LVEF)<50%。 4. 肺功能异常,室内空气下血氧饱和度<92%。 5. 入组前12个月内发生心肌梗死、冠状动脉成形术或支架置入、不稳定型心绞痛或其他严重临床心脏病。 6. III级高血压且药物治疗后血压控制不佳。 7. 患有其他晚期肿瘤(其他肿瘤治疗后经评估稳定者可入组)。 8. 既往有头部外伤、意识障碍、癫痫、较严重脑缺血或脑出血病史。 9. 已知中枢神经系统白血病(CNS2或CNS3),对鞘内化疗注射耐药和/或正在接受头部和/或脊柱放疗;既往有中枢神经系统病史但已有效控制者可入组。 10. 患有自身免疫性疾病、免疫缺陷或其他需接受免疫抑制治疗的情况。 11. 存在未控制的活动性感染。 12. 既往使用过任何CAR-T细胞产品或其他基因修饰T细胞疗法。 13. 入组前4周内接种过活疫苗。 14. HIV、HBV、HCV或TPPA/RPR感染阳性,或为HBV携带者。 15. 有酗酒、药物成瘾或精神疾病史。 16. 本临床研究入组前3个月内参加过其他临床研究。 17. 女性受试者存在以下任一情况:妊娠/哺乳;试验期间计划妊娠;有生育能力但无法采取有效避孕措施。 18. 研究者认为不适合参加本研究的其他情况。
Inclusion Criteria: 1. Age 18-75 (≥ 18 years old, ≤ 75 years old), gender is not limited; 2. The subject voluntarily participates in the research and signs the "Informed Consent" by himself or his legal guardian; 3. According to the National Comprehensive Cancer Network (NCCN) T lymphocytic lymphoma (2020.V1)/acute lymphoblastic leukemia (2020. V1) practice guidelines, diagnosed with T-cell lymphoma; 4. Meet the diagnostic criteria for relapsed/refractory T-cell lymphoma, including any of the following: 1\) Failure to obtain CR at the end of induction therapy; 2) Patients who have obtained CR have blasts in peripheral blood or bone marrow (proportion \>5%), or extramedullary diseases; 5. Have not received antibody therapy within 2 weeks before cell therapy; 6. ECOG score of 0-2; 7. The subject has no contraindications to peripheral apheresis; 8. Expected survival time of more than 3 months. Exclusion Criteria: 1. Those who have a history of allergy to any of the ingredients in cell products; 2. Laboratory tests for the following: including but not limited to, total serum bilirubin≧ 1.5mg/dl; Serum ALT or AST greater than 2.5 times the upper limit of normal; Blood creatinine≧ 2.0mg/dl; Platelet count≦ 10×109/L; 3. Patients with cardiac insufficiency who belong to class III or IV according to the New York Cardiology Association (NYHA) cardiac function grading standards; or echocardiography with left ventricular ejection fraction (LVEF) \< 50%; 4. Abnormal lung function, blood oxygen saturation under indoor air \< 92%; 5. Myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other serious clinical heart disease within 12 months before enrollment; 6. Grade 3 hypertension with poor control of blood pressure with medication; 7. Patients with other advanced tumors (those who are assessed as stable after treatment of other tumors can be enrolled); 8. Previous head trauma, impaired consciousness, epilepsy, more serious cerebral ischemia or cerebral hemorrhage disease; 9. Known central nervous system leukemia (CNS2 or CNS3), resistance to intrathecal chemotherapy injections and/or ongoing head and/or spinal radiation therapy; Previous CNS history but has been effectively controlled to allow enrollment; 10. Patients with autoimmune diseases, immunodeficiency or other patients requiring immunosuppressant therapy; 11. presence of uncontrolled, active infection; 12. Have previously used any CAR-T cell product or other genetically modified T cell therapy; 13. Live vaccination within 4 weeks prior to enrollment; 14. HIV, HBV, HCV and TPPA/RPR infections, and HBV carriers; 15. Subject has a history of alcoholism, drug addiction or mental illness; 16. The subject has participated in any other clinical research within 3 months before joining this clinical study; 17. Female subjects have any of the following conditions: a) are pregnant/lactating; or b) have plans to become pregnant during the trial; or c) are of childbearing potential and unable to use effective contraception; 18. There are other circumstances in which the investigator believes that the subject is not suitable for this 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:TEAEs · Adverse events during treatment · From date of initial treatment to the 30 days after treatment
次要终点:overall response rate
CD7 CAR-T治疗组。
T细胞淋巴瘤/白血病是一组高致死率疾病,复发率高、预后差。CD7在T细胞恶性肿瘤中广泛表达,因此是具有潜力的治疗靶点。本研究旨在评估CD7 CAR-T细胞治疗T细胞淋巴瘤/白血病的安全性和疗效。
T-cell lymphoma/leukemia is a group of highly lethal diseases with a high relapse rate and poor prognosis. CD7 was proved to be widely expressed in T-cell malignant, which makes it a promising therapeutic target. In this study we aim to test the safety and efficacy of CD7 CAR-T cells in T-cell lymphoma/leukemia.
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