CD81 通过阻断 CD274/PD-L1 的选择性自噬降解驱动放射抵抗性胶质母细胞瘤的免疫逃逸
CD81 drives immune evasion in radioresistant glioblastoma by blocking selective autophagic degradation of CD274/PD-L1.
我们的工作确立了CD81作为连接放射抵抗与免疫逃逸的关键桥梁,其通过维持GBM中CD274的丰度发挥作用,并突显CD81作为优化放射免疫治疗的有前景的治疗靶点。
英文原题:A Phase 1b / 2 Drug Resistant Immunotherapy With Activated, Gene Modified Allogeneic or Autologous γδ T Cells (DeltEx) in Combination With Maintenance Temozolomide in Subjects With Recurrent or Newly Diagnosed Glioblastoma
⚠ 该试验的登记信息已有 17 个月未更新, 页面上显示的「进行中(不再招募)」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 I/II 期注册临床试验,评估基因修饰γδ T 细胞治疗胶质母细胞瘤的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 4 例。试验地点:美国 · 伯明翰、坦帕、路易维尔、克利夫兰(共 5 个中心)。登记号:NCT05664243。
不限性别 · ≥ 18 Years
纳入标准: • 组织学或细胞学确诊的IDH野生型胶质母细胞瘤。 • Ⅰb期及Ⅱ期B组:既往胶质母细胞瘤标准治疗不超过1种;既往未使用贝伐珠单抗(仅用于控制水肿者除外);符合手术切除条件。 • A组和C组:新诊断、尚未接受治疗的胶质母细胞瘤。 • Ⅰb期、Ⅱ期B组和C组:有部分匹配的单倍型相合供者或匹配的亲属供者。 • Ⅰb期及B组患者的MRI表现符合并提示恶性胶质瘤复发。 • 同意置入并留置Rickham脑室储液囊导管。 • 年龄≥18岁;Karnofsky体能状态评分≥70分。 • 有生育能力的女性须在入组前72小时内尿或血妊娠试验阴性。有生育能力指未接受绝育手术,且未连续停经超过2年。 • 男性受试者及其女性伴侣、有生育能力的女性受试者须同意在研究期间采用两种避孕方法、已手术绝育,或避免异性性行为。 排除标准: • A组受试者,或Ⅰb期、B组、C组的供者,在白细胞单采前4周内接种疫苗,或前72小时内接受任何大小手术。 • 入组前6周内接受细胞免疫治疗或基因治疗;入组前4周内接受手术切除或烷化剂化疗;正在接受肿瘤电场治疗(Optune);或既往任何时候接受过实验性免疫治疗。 • 研究期间同时接受其他试验药物。 • 既往治疗的不良事件尚未恢复至≤1级;非免疫相关脱发者可例外。 • 既往接受异体治疗,包括骨髓移植或实体器官移植。 • 合并其他活动性恶性肿瘤。既往有第二种恶性肿瘤者,入组前须至少2年无癌症证据,或该肿瘤已手术治愈且复发风险低;入组前须与医学监查员讨论。 • 手术时存在置入Rickham颅内通路装置的禁忌证。 • 胶质母细胞瘤确诊前1年内曾患脑炎、多发性硬化或其他中枢神经系统感染。 • 存在未控制的合并疾病(包括活动性感染)或其他妨碍手术的疾病;或存在可能妨碍遵循研究要求、影响安全性或疗效数据判读的内科、外科、精神疾病或社会状况。因胶质母细胞瘤发生过癫痫者,给药前须已连续3周无癫痫发作并使用适当的抗癫痫药物。 • 对氨基双膦酸盐类药物(如唑来膦酸、帕米膦酸等)过敏或超敏。 • 有HIV病史、活动性肝炎病史(即使控制良好)或自身免疫病史。
Inclusion Criteria: * Subjects with histologically or cytologically confirmed history of IDH-wild type glioblastoma * Phase 1b and Arm B of Phase 2: Subjects must have completed no more than one standard therapy for glioblastoma, have received no prior Avastin® therapy (unless solely used for edema management) and be eligible for resection * Arms A and C: Subjects must have newly diagnosed, treatment naïve glioblastoma * Phase 1b and Arm B and Arm C: Subjects must have a partially matched haploidentical or matched related donor. * Subjects with magnetic resonance imaging (MRI) features consistent with and suspicious for recurrent malignant glioma in Phase 1b and Arm B. * Agreeable to inserting and maintaining a Rickham catheter. * ≥ 18 years of age. * Karnofsky Performance Status ≥ 70% * Female subjects of childbearing potential must have a negative urine/serum pregnancy test within 72 hours of study enrollment. Female subjects of childbearing potential are those who have not been surgically sterilized or have not been free of menses for \> 2 years. * Male subjects and their female partners and female subjects of childbearing potential must be willing to use a combination of two methods of birth control or be surgically sterile or abstain from heterosexual activity for the course of the study. Exclusion Criteria: * Subject in Arm A or donor from Phase 1b, Arms B, and Arm C received vaccinations within 4 weeks or underwent surgery (major or minor) within 72 hours before leukapheresis collection. * Cellular immunotherapy or gene therapy or within six weeks prior to entering the study, surgical resection or alkylating agent chemotherapy within four weeks prior to entering the study, receiving tumor treating fields (TTF) Optune therapy, or have received experimental immunotherapy at any time * Subjects receiving any other investigational agents concurrently while on study. * Have not recovered from adverse events (≤ Grade 1) from previously administered therapy. Subjects with alopecia unless of immune origin are an exception to this criterion and may qualify for this study * Have received prior treatment with an allogeneic therapy, including bone marrow or solid tumor transplant. * Concurrent malignancy or an active second malignancy. Subjects with a history of second malignancy must have no evidence of cancer for two years prior to enrolment or have a surgically cured cancer with low risk of recurrence to enroll. Discuss with medical monitor prior to enrolment. * Contraindication to the placement of an intracranial access device (Rickham catheter) at the time of surgery. * Prior history of encephalitis, multiple sclerosis, or other CNS infection \<1 year prior to glioblastoma diagnosis. * Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, or any other medical condition that precludes surgery. Also, medical/surgical/psychiatric illness/social situations that would limit compliance with study requirements or confound interpretation of safety and efficacy data. Subjects with a history of seizure as a result of their glioblastoma must be seizure free and on appropriate anti-epileptic medication for 3 weeks prior to dosing with the investigational agent. * Allergies/hypersensitivity to amino bisphosphonates such as Zoledronate®, Pamidronate® or similar. * History of HIV or active hepatitis even if well controlled or history of an autoimmune condition.
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:Autologous Phase 2, Arm A in newly diagnosed glioblastoma: 12-month overall survival (OS) rate · Date of first dose to date of death by any cause · 12 Months;Allogeneic Phase 1b, establishes the recommended phase 2 dose (RP2D) for phase 2 allogeneic arms and subject or product characteristics that will optimize manufacturing · \<30% dose limiting toxicity (DLT) observed with dose · 28 days;Allogeneic Phase 2, Arm B confirmed recurrent glioblastoma, 9-month overall survival (OS) · Date of first dose to date of death by any cause · 9 Months;Allogeneic Phase 2, Arm C newly diagnosed glioblastoma, 12-month overall survival (OS) rate · Date of first dose to date of death by any cause · 12 Months
次要终点:Assessment of safety;Assessment of tolerability;Overall response rate (ORR);Time to progression (TTP);Progression free survival (PFS);Definition of product characteristics
新诊断患者接受自体来源、经基因修饰的γδ T细胞,并联合维持性替莫唑胺。
复发患者接受异体来源、经基因修饰的γδ T细胞,并联合替莫唑胺。
新诊断患者接受异体来源、经基因修饰的γδ T细胞,并联合维持性替莫唑胺。
本多中心Ⅰb/Ⅱ期研究旨在评估实验性细胞疗法的安全性、耐受性,并观察其能否延缓新诊断或复发性胶质母细胞瘤(GBM)复发。治疗采用活化、耐药基因修饰的自体或异体γδ T细胞(DeltEx),并联合标准化疗替莫唑胺(TMZ)。若研究显示生存获益提高至少25%,将考虑进一步研究。
This multicenter, Phase 1b/2 study is being conducted to determine if the experimental cell therapy is safe, tolerable and can delay the return of cancer in patients with a newly diagnosed or recurrent glioblastoma multiforme (GBM) in combination with standard chemotherapy treatment temozolomide (TMZ). If there is a 25% or greater improvement in survival in this study then the therapy should be studied further.
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