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:Clinical Study of Senl-T7 CAR T Cells in the Treatment of Relapsed and Refractory CD7+ Acute T-ALL/T-LBL
⚠ 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,评估细胞治疗用于急性淋巴细胞白血病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 100 例。试验地点:中国 · 北京村(共 1 个中心,其中中国 1 个)。登记号:NCT05626400。
不限性别 · ≥ 2 Years 且 ≤ 70 Years
纳入标准: 1. 确诊复发/难治性T细胞淋巴母细胞白血病或T淋巴母细胞淋巴瘤:诱导治疗未能达到完全缓解及微小残留病阴性;或复发,即完全缓解后外周血或骨髓肿瘤负荷达到5%或出现微小残留病阳性,或出现新的髓外病灶。 2. 流式细胞术检测证实肿瘤细胞表达CD7。 3. 预期寿命>12周。 4. KPS或Lansky评分≥60。 5. 血红蛋白≥70 g/L(可输血)。 6. 年龄2至70岁。 7. 血氧饱和度≥90%。 8. 血红蛋白≥70 g/L(允许输血)。 9. 总胆红素≤正常值上限(ULN)的3倍,AST和ALT≤ULN的5倍。 10. 知情同意书已向患者/监护人说明、被理解并由其签署。 排除标准: 1. 符合以下任一心脏情况:房颤/房扑;过去12个月内发生心肌梗死;长QT综合征或继发性QT延长(由研究者酌情判断);超声心动图显示左心室短轴缩短率(LVSF)<30%或左心室射血分数(LVEF)<50%;具有临床意义的心包积液;纽约心脏协会(NYHA)III或IV级心功能不全。须有治疗前12个月内的超声心动图,以确认不存在上述情况。 2. 存在活动性移植物抗宿主病(GVHD)。 3. 有严重肺功能损害史。 4. 同时患有处于晚期恶性阶段且已发生全身转移的其他肿瘤。 5. 存在严重或持续且无法有效控制的感染。 6. 合并严重自身免疫性疾病或免疫缺陷病。 7. 存在活动性乙肝或丙肝(HBV DNA阳性或HCV RNA阳性)。 8. HIV感染或梅毒感染。 9. 有生物制品(包括抗生素)严重过敏史。 10. 存在具有临床意义的病毒感染,或EB病毒(EBV)、巨细胞病毒(CMV)、腺病毒(ADV)、BK病毒或人疱疹病毒6型(HHV-6)再激活且未受控制。 11. 存在有症状的中枢神经系统疾病,包括但不限于未控制的癫痫、脑血管缺血/出血、痴呆或小脑疾病。 12. 入组前不足6个月接受过移植治疗。 13. 妊娠、哺乳或未来12个月内计划妊娠。 14. 研究者认为可能增加受试者风险或影响研究结果的任何其他情况。
Inclusion Criteria: 1. Diagnosis of relapsed/refractory T-cell lymphoblastic leukemia or T-cell lymphoblastic lymphoma: Induction therapy failed to achieve a complete remission of minor residual negative; Recurrence: after complete remission, any tumor load in the peripheral blood or bone marrow was 5%, or slightly residual positive, or new extramedullary lesions occurred; 2. CD7 expression in tumor cells was detected by flow cytometry; 3. Life expectancy greater than 12 weeks; 4. KPS or Lansky score≥60; 5. HGB≥70g/L (can be transfused); 6. 2-70 years old; 7. Oxygen saturation of blood#90%#; 8. HGB≥70g/L(blood transfusion allowed); 9. Total bilirubin (TBil)≤3 × upper limit normal, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 5×upper limit of normal; 10. Informed consent explained to, understood by and signed by patient/ guardian. Exclusion Criteria: 1. Any of the following cardiac criteria: Atrial fibrillation/flutter; Myocardial infarction within the last 12 months; Prolonged QT syndrome or secondary prolonged QT, per investigator discretion. Cardiac echocardiography with LVSF (left ventricular shortening fraction)\<30% or LVEF(left ventricular ejection fraction)\<50%; or clinically significant pericardial effusion. Cardiac dysfunction NYHA(New York Heart Association) III or IV (Confirmation of absence of these conditions on echocardiogram within 12 months of treatment); 2. Has an active GvHD; 3. Has a history of severe pulmonary function damaging; 4. With other tumors which is/are in advanced malignant and has/have systemic metastasis; 5. Severe or persistent infection that cannot be effectively controlled; 6. Merging severe autoimmune diseases or immunodeficiency disease; 7. Patients with active hepatitis B or hepatitis C(\[HBVDNA+\]or \[HCVRNA+\]); 8. Patients with HIV infection or syphilis infection; 9. Has a history of serious allergies on Biological products (including antibiotics); 10. Clinically significant viral infection or uncontrolled viral reactivation of EBV(Epstein-Barr virus), CMV(cytomegalovirus), ADV(adenovirus), BKvirus, or HHV(human herpesvirus)-6; 11. Presence of symptomatic disorders of the central nervous system, which include but not limited to uncontrolled epilepsy, cerebrovascular ischemia/hemorrhage, dementia, and cerebellar disease, etc.; 12. Have received transplant treatment for less than 6 months in prior to enrollment; 13. Being pregnant and lactating or having pregnancy within 12 months; 14. Any situations that the researchers believe will increase the risks for the subject or affect the results 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 CD7 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;Remission Rate · To obsere the efficacy of CAR-T cells after infusion, complete remission (CR), complete remission with incomplete recovery of blood cells (CRi), minimal tumor residual positive(MRD+) or negative (MRD-) CR/CRi, disease recurrence or progression (PD) will be used for evaluation. · 3 months post CAR-T cells infusion
患者接受CD7 CAR-T细胞治疗。
这是一项开放性、前瞻性剂量递增临床研究,旨在评估Senl-T7治疗复发或难治性CD7阳性T细胞急性淋巴母细胞白血病或T淋巴母细胞淋巴瘤患者的安全性和疗效,同时收集Senl-T7的药代动力学/药效学(PK/PD)指标。
This is an open, prospective, dose-escalation clinical study to evaluate the safety and efficacy of Senl-T7 in patients with relapsed or refractory CD7+ acute T lymphoblastic leukemia or T lymphoblastic lymphoma.Meanwhile, PK/PD indexes of Senl-T7 were collected.
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