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:Co-administration of CART22-65s and huCART19 for B-ALL
这是一项 I/II 期注册临床试验,评估自体细胞治疗用于急性淋巴细胞白血病、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 93 例。试验地点:美国 · 费城(共 1 个中心)。登记号:NCT05674175。
不限性别 · ≤ 29 Years
纳入标准: 1. 已签署知情同意书。 2. 有文件证实CD19和/或CD22阳性的ALL/淋巴母细胞淋巴瘤(LLy):A队列为复发或难治性ALL/LLy患者;B队列为既往B细胞靶向基因工程细胞治疗应答不佳者。 3. 既往或目前有中枢神经系统(CNS)3期疾病史的患者,如CNS疾病对治疗有应答,可入组。 4. 在最近一次检测到疾病时,通过流式细胞术记录骨髓、外周血、脑脊液或肿瘤组织中CD19和/或CD22肿瘤表达。若患者在接受CD19和/或CD22靶向治疗后复发,须在该治疗后进行流式细胞术评估,以证实CD19和/或CD22仍表达。 5. 年龄0至29岁。 6. 器官功能充分。 7. 体能状态充分:Lansky或Karnofsky评分≥50。 8. 有生育能力的受试者须同意采用可接受的避孕方法。 排除标准: 1. 活动性乙型肝炎或活动性丙型肝炎。 2. HIV感染。 3. 存在需要全身治疗的活动性急性或慢性GVHD。 4. 细胞采集或输注时正在接受全身性类固醇或免疫抑制治疗,或治疗医生认为在采集期间或输注后可能需要此类治疗的状况。除细胞采集或输注时点外,其他时间为治疗疾病而使用类固醇允许。允许使用生理替代剂量氢化可的松或吸入类固醇。 5. CNS疾病在治疗期间进展,或存在可能增加CNS毒性风险的脑实质病灶。 6. 妊娠或哺乳期女性。 7. 未控制的活动性感染。
Inclusion Criteria: 1. Signed informed consent form 2. Patients with documented CD19+ and/or CD22+ ALL/LLy: 1. Cohort A: Patients with relapsed or refractory ALL/LLy: 2. Cohort B: Patients with poor response to prior B cell directed engineered cell therapy 3. Patients with prior or current history of Central Nervous System 3 disease will be eligible if Central Nervous System disease is responsive to therapy 4. Documentation of CD19 and/or CD22 tumor expression in bone marrow, peripheral blood, Cerebrospinal fluid, or tumor tissue by flow cytometry at the time of last detectable disease. If the patient has experienced a relapse after CD19-directed and/or CD22-directed therapy, flow cytometry should be evaluated after this therapy to demonstrate CD19 and/or CD22 expression. 5. Age 0-29 years 6. Adequate organ function 7. Adequate performance status defined as Lanksy or Karnofsky performance score ≥50. 8. Subjects of reproductive potential must agree to use acceptable birth control methods. Exclusion Criteria: 1. Active hepatitis B or active hepatitis C 2. HIV infection 3. Active acute or chronic Graft Vs. Host Disease requiring systemic therapy 4. Concurrent use of systemic steroids or immunosuppression at the time of cell infusion or cell collection, or a condition, in the treating physician's opinion, that is likely to require steroid therapy or immunosuppression during collection or after infusion. Steroids for disease treatment at times other than cell collection or at the time of infusion are permitted. Use of physiologic replacement hydrocortisone or inhaled steroids is permitted as well. 5. Central nervous system disease that is progressive on therapy, or with Central nervous system parenchymal lesions that might increase the risk of central nervous system toxicity. 6. Pregnant or nursing (lactating) women 7. Uncontrolled active infection
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 of CART22-65s and huCART19 co-administration · The safety of the administering CART22-65s and huCART19 will be measured by the monitoring the frequency and severity of adverse events in patients with advanced or refractory B-Cell Acute Lymphoblastic Leukemia or B Cell Lymphoblastic Lymphoma (B-LLy), including those previously treated with cell therapy. · 1 year;Efficacy of CART22-65s and huCART19 co-administration · The efficacy of CART22-65s and huCART19 co-administration will be measured by the evaluating the overall response rate in patients with advanced or refractory B cell hematologic malignancies, including those previously treated with cell therapy. · 1 year
次要终点:Manufacturing Feasibility;Anti-tumor response due to CART22-65s and huCART19 co-administration;Event Free Survival;Relapse Free Survival;Overall Survival;CAR T Cell Therapy Persistence;Bioreactivity of CART22-65s and huCART19 when co-administered
I期评估既往接受CAR-T细胞治疗后疾病复发的患者联合使用CART22-65s和huCART19的安全性。不计划进行剂量递增,但将根据剂量限制性毒性发生率进行剂量递减。
若I期至少一个剂量水平被判定为安全,将开放II期剂量扩展入组。受试者将接受已确认安全的CART22-65s和huCART19最高剂量。计划设置两个队列:A队列(复发/难治性、既往未接受CAR-T细胞治疗)和B队列(既往接受过CAR-T细胞产品治疗)。
本研究评估向患有晚期B细胞急性淋巴细胞白血病(B-ALL)的儿童联合给予两种CAR-T细胞产品huCART19和CART22-65s的安全性和疗效。
This study will evaluate the safety and efficacy of administering two CAR T cell products, huCART19 and CART22-65s, in children with advanced B cell Acute Lymphoblastic Leukemia (B-ALL).
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