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:Treatment of Advanced Malignant Solid Tumors With Claudin18.2CAR-T
⚠ 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 Claudin18.2CAR-T 细胞治疗胰腺癌、胃癌的安全性、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:NCT05620732。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 年龄18~75岁(含),性别不限。 2. 受试者自愿参加研究,且本人或法定监护人签署知情同意书。 3. 组织病理学确诊为不可切除、局部晚期复发或转移性胃癌或胰腺癌;按美国癌症联合委员会(AJCC)2017年第8版TNM分期为Ⅲ或Ⅳ期。 4. 根据RECIST 1.1标准,有明确可测量、可评估的病灶。 5. 免疫组化染色证实肿瘤组织中Claudin 18.2中度或高度表达。 6. 受试者须已接受一线和二线标准治疗方案。 7. 受试者不适合接受根治性治疗(如根治性化疗和放疗和/或手术/免疫检查点抑制剂治疗),或拒绝手术切除。 8. 细胞治疗前2周内未使用抗体类药物。 9. ECOG评分0~2分。 10. 无外周血采集禁忌证。 11. 预期生存期超过3个月。 排除标准: 1. 对细胞产品中任何成分有过敏史。 2. 血常规符合以下任一情况:白细胞≤1×10⁹/L、中性粒细胞绝对计数(ANC)≤0.5×10⁹/L、淋巴细胞绝对计数(ALC)≤0.5×10⁹/L、血小板≤25×10⁹/L。 3. 实验室检查符合以下任一情况(包括但不限于):血清总胆红素≥1.5 mg/dL;血清ALT或AST>正常值上限的2.5倍;血肌酐≥2.0 mg/dL。 4. 根据纽约心脏病协会(NYHA)心功能分级,心功能不全为Ⅲ或Ⅳ级;或超声心动图显示左心室射血分数(LVEF)<50%。 5. 肺功能异常,室内空气下血氧饱和度<92%。 6. 入组前12个月内临床发生心肌梗死、冠状动脉血管成形术或支架置入、不稳定型心绞痛或其他严重心脏病。 7. 3级高血压且药物治疗后血压控制不佳。 8. 既往有脑外伤、意识障碍、癫痫、较严重脑缺血或脑出血性疾病。 9. 患有自身免疫性疾病、免疫缺陷,或需要接受免疫抑制治疗。 10. 存在未控制的活动性感染。 11. 既往接受过任何CAR-T细胞产品或其他基因修饰T细胞治疗。 12. 入组前4周内接种过活疫苗。 13. HIV、HBV、HCV或TPPA/RPR阳性,或为HBV携带者。 14. 有酒精滥用、药物滥用或精神疾病史。 15. 加入本临床研究前3个月内参加过任何其他临床研究。 16. 女性受试者符合以下任一情况:a)妊娠期/哺乳期;b)试验期间计划妊娠;或c)有生育能力但无法采取有效避孕措施。 17. 研究者认为不适合受试者参加本研究的其他情况。
Inclusion Criteria: 1. Age 18-75 (≥ 18, ≤ 75), regardless of gender; 2. Subjects voluntarily participate in the study, and they or their legal guardians sign the Informed Consent Form; 3. Non resectable, locally late recurrent or metastatic gastric cancer or pancreatic cancer confirmed by histopathology; Patients with gastric cancer or pancreatic cancer diagnosed as stage III or IV according to the TNM staging system of the American Joint Commission on Cancer (AJCC) (8th edition in 2017); 4. According to RECIST 1.1 standard, there are clearly measurable and evaluable lesions; 5. Immunohistochemical staining confirmed that Claudin 18.2 was moderately and highly expressed in tumor tissues; 6. Subjects must have received the first and second line standard treatment scheme; 7. The subject must not be suitable for receiving radical treatment methods, such as radical chemotherapy and radiotherapy and/or surgery/immunosuppressant at the checkpoint, or refuse surgical resection 8. Within 2 weeks before cell therapy, no antibody drugs were used; 9. ECOG score is 0-2; 10. The subjects had no contraindication for peripheral blood collection; 11. The expected survival period is more than 3 months. Exclusion Criteria: 1. People who have a history of allergy to any component in cell products; 2. The following conditions occur in blood routine examination: WBC ≤ 1 × 109/L, absolute value of central granulocyte ANC ≤ 0.5 × 109/L, absolute value of lymphocyte ALC ≤ 0.5 × 109/L , PLT≦25 × 109/L ; 3. The following conditions occur in laboratory testing: including but not limited to, total serum bilirubin ≥ 1.5mg/dl; Serum ALT or AST is more than 2.5 times of the upper limit of normal; Blood creatinine ≥ 2.0mg/dl; 4. According to the NYHA cardiac function grading standard, patients with cardiac insufficiency belong to Grade III or IV; Or left ventricular ejection fraction (LVEF)\<50% by echocardiography; 5. Pulmonary function is abnormal, and the saturation of blood oxygen under indoor air is less than 92%; 6. Myocardial infarction, cardiac angioplasty or stenting, unstable angina pectoris, or other serious heart diseases clinically within 12 months before enrollment; 7. Grade 3 hypertension and poor blood pressure control after drug treatment; 8. Have suffered from brain trauma, consciousness disorder, epilepsy, relatively serious cerebral ischemia or cerebral hemorrhage disease in the past; 9. Patients with autoimmune diseases, immunodeficiency or other patients requiring immunosuppressive treatment; 10. There is uncontrolled active infection; 11. Have used any CAR-T cell product or other genetically modified T cell therapy before; 12. Live vaccine inoculation within 4 weeks before enrollment; 13. HIV, HBV, HCV and TPPA/RPR positive persons, and HBV carriers; 14. Subjects have a history of alcohol abuse, drug abuse or mental illness; 15. Subjects have participated in any other clinical research within 3 months before joining this clinical research; 16. Female subjects have any of the following conditions: a) are in pregnancy/lactation; Or b) having a pregnancy plan during the trial; Or c) is fertile and unable to take effective contraceptive measures; 17. The investigator believes that there are other circumstances that are not suitable for the subject to participate in 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:AE/SAE · adverse events/ severe adverse events · From date of infusion to 30 days after infusion
次要终点:ORR
接受Claudin 18.2 CAR-T细胞治疗的患者。
晚期胰腺癌和胃癌的疗效仍有进一步提升空间。Claudin是一类位于上皮和内皮紧密连接中的整合膜蛋白,在胃癌和胰腺癌中高表达。临床前研究提示,Claudin18.2 CAR-T可能有效提高晚期实体瘤患者的缓解率。
The efficacy of advanced pancreatic cancer and gastric cancer needs to be further improved. Claudin is a kind of integrin membrane protein in the tight junction between epithelium and endothelium, which is highly expressed in gastric cancer and pancreatic cancer. Preclinical studies suggest that Claudin18.2CAR-T can effectively improve the remission rate of patients with advanced solid tumors.
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