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CD19 CD19CAR-T 细胞治疗非霍奇金淋巴瘤:I 期临床试验(Bioray Laboratories)

英文原题:The Safety and Efficacy of BRL-201 in the Treatment of r/r B Lymphocyte Non-Hodgkin Lymphoma

ClinicalTrials.gov 2023/02/23(首次登记) I 期注册临床试验 · 招募中

简要介绍

这是一项 I 期注册临床试验,评估 CD19CAR-T 细胞治疗非霍奇金淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 18 例。试验地点:中国 · 武汉、天津、杭州(共 3 个中心,其中中国 3 个)。登记号:NCT05741359。

入组条件决定能不能参加

不限性别 · ≥ 18 Years

纳入标准:
1. 愿意参加本临床研究并签署知情同意书。
2. 年龄≥18岁。
3. 预计生存期≥3个月。
4. 至少有1个按2014年Lugano淋巴瘤疗效评价分类可测量病灶:CT横断面图像显示淋巴结病灶长径>15 mm或结外病灶长径>10 mm,且FDG-PET阳性。接受过放疗的病灶仅在放疗后明确进展时方可视为可测量病灶。
5. 组织病理学确诊侵袭性B细胞非霍奇金淋巴瘤(B-NHL),免疫组化或流式细胞术检测肿瘤CD19阳性,病理类型符合WHO 2016淋巴瘤分类。
6. 疾病复发或难治。
7. 已接受充分的既往治疗。
8. 头颅MRI未见中枢神经系统(CNS)淋巴瘤侵犯。
9. 血液学指标符合要求。
10. 血液生化指标符合要求。
11. LVEF≥55%。
12. 无严重肺部疾病。
13. 既往抗淋巴瘤治疗引起的毒性稳定且已恢复至≤1级。
14. ECOG评分0–1分。
15. 具备外周血单采条件。
16. 愿意遵守研究方案规定。

排除标准:
1. 妊娠或哺乳期女性。
2. 既往接受过异基因细胞治疗,包括异基因干细胞移植。
3. 既往接受抗CD19靶向治疗者排除;本研究中接受BRL-201且符合再次输注条件者除外。
4. 既往接受任何CAR-T细胞产品或其他基因修饰T细胞治疗。
5. 有慢性淋巴细胞白血病(CLL)Richter转化史。
6. 存在需要全身治疗的未控制真菌、细菌、病毒或其他感染;单纯尿路感染或咽炎经治疗有效者可入组。
7. HBsAg阳性,或HBcAb阳性且外周血HBV DNA高于检测上限;HCV抗体阳性且外周血HCV RNA阳性;HIV抗体阳性;或梅毒检测阳性。
8. 严重精神障碍;有CNS疾病史(如癫痫、脑血管缺血/出血、痴呆、小脑疾病或累及CNS的自身免疫病)。
9. 活动性自身免疫性疾病需免疫治疗,包括过去2年内自身免疫病造成的终末器官损害(如Crohn病、类风湿关节炎、系统性红斑狼疮),或需要全身使用免疫抑制剂/其他药物控制疾病。
10. 原发性免疫缺陷。
11. 有其他恶性肿瘤史。
12. 严重心血管疾病,包括淋巴瘤浸润心房或心室,或入组前12个月内心肌梗死、心脏血管成形术/支架置入、不稳定型心绞痛或其他临床显著心脏病史。
13. 入组前6个月内有深静脉血栓或肺栓塞史。
14. 正在接受口服抗凝治疗;未接受抗凝药物时PT、APTT或INR>1.5倍ULN。
15. 存在留置管路或导管(如经皮肾造瘘管、留置导尿管、胸腔/腹腔/心包腔导管);专用中心静脉通路导管(如Port-a-Cath或Hickman导管)允许。
16. 脑脊液中检出淋巴瘤细胞、存在脑转移,或有CNS淋巴瘤/脑脊液淋巴瘤细胞/脑转移史。
17. 因肿块(如肠梗阻或血管受压)需要紧急治疗。
18. 对本研究使用的任何药物有严重速发型超敏反应史。
19. 预处理方案开始前≤6周内接种活疫苗;COVID-19疫苗除外。
20. 研究者判断可能增加受试者风险或干扰研究结果的其他情况。
核对登记原文(英文)
Inclusion Criteria:

1. Willing to participate in this clinical study and sign an informed consent form;
2. Age ≥ 18 years old;
3. Estimated survival time ≥ 3 months;
4. Presence of at least one measurable lesion as assessed according to Lugano Classification 2014 for response assessment in lymphomas (i.e., the cross-sectional images obtained by CT show that the long diameter of lymph node lesions is \> 15 mm or the long diameter of extranodal lesions is \> 10 mm, and FDG-PET scan results are positive). Lesions, for which radiotherapy was provided, can be regarded as measurable lesions only if there is an unequivocal progression after radiotherapy;
5. Histopathologically confirmed aggressive B-NHL; positive expression of CD19 in tumors detected by immunohistochemistry or flow cytometry; pathological types of B-NHL (according to WHO Lymphoma Classification 2016);
6. Relapsed or refractory diseases;
7. Subjects who must receive adequate prior therapy;
8. Absence of invasion of central nervous system (CNS) lymphoma by cranial magnetic resonance imaging (MRI);
9. Hematological parameters meeting the requirements;
10. Blood biochemistry meeting the requirements;
11. LVEF ≥ 55%;
12. No severe pulmonary disorders;
13. Toxic reactions induced by prior anti-lymphoma therapy must be stable and resolved to grade ≤ 1;
14. Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1;
15. Patients with physical conditions for apheresis of peripheral blood; 16 . Willing to abide by the rules formulated in the study protocol.

Exclusion Criteria:

1. Pregnant or lactating women;
2. Subjects who previously received allogeneic cell therapies, including allogeneic stem cell transplant;
3. Subjects who previously received anti-CD19 targeted therapy, except those who receive BRL-201 and are eligible to receive reinfusion in this study;
4. Prior treatment with any CAR-T cell product or other genetically modified T cell therapies;
5. History of Richter's transformation of chronic lymphocytic leukemia (CLL);
6. Presence of uncontrollable fungal, bacterial, viral, or other infections requiring systemic therapy. Patients can be enrolled if the simple urinary tract infection or pharyngitis responds to treatment;
7. Subjects with positive hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) and peripheral blood HBV DNA titer higher than the upper limit of detection; hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; human immunodeficiency virus (HIV) antibody positive; syphilis test positive;
8. Severe mental disorders; history of CNS disorders (e.g., epileptic seizure, cerebrovascular ischemia/hemorrhage, dementia, cerebellar diseases, or any CNS-involved autoimmune disorders);
9. Active autoimmune disorders requiring immunotherapy, including but not limited to end organ damages caused by autoimmune disorders (e.g., Crohn's disease, rheumatoid arthritis, and systemic lupus erythematosus) in the past 2 years, or requiring systemic application of immunosuppressive drugs or other drugs for systemic control of diseases;
10. Primary immunodeficiency;
11. History of other malignancies;
12. Patients with severe cardiovascular disorders, including but not limited to those with lymphoma infiltration in the cardiac atrium or ventricles and those with a history of myocardial infarction, cardioangioplasty or stent implantation, unstable angina, or other clinically significant heart diseases within 12 months before enrollment;
13. History of deep venous thrombosis or pulmonary embolism within 6 months before enrollment;
14. Patients who are receiving oral anticoagulant therapy; prothrombin time (PT), activated partial thromboplastin time (APTT), or international normalized ratio (INR) \> 1.5 × ULN without anticoagulant therapy;
15. Presence of any indwelling tube or catheter (e.g., tube or catheter for percutaneous nephrostomy, indwelling catheter, or catheter in pleural cavity/peritoneal cavity/pericardium). Dedicated central venous access catheters (e.g., Port-a-Cath or Hickman catheter) are permitted;
16. Lymphoma cells detected in cerebrospinal fluid, presence of brain metastases, history of CNS lymphoma, or history of lymphoma cells detected in cerebrospinal fluid or brain metastases;
17. Conditions (e.g., intestinal obstruction or vascular compression) requiring emergency treatment due to tumor masses;
18. History of severe immediate hypersensitivity to any drug to be used in this study;
19. Vaccination of live vaccines, excluding corona virus disease 2019 (COVID-19) vaccines, within ≤ 6 weeks before the start of the pretreatment regimen;
20. Any circumstances that possibly increase the risk of subjects or interfere with the study results as judged by the investigator.

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。

研究终点衡量什么算有效

  • 主要终点剂量限制性毒性(DLT)BRL-201输注后28天内
  • 主要终点不良事件(AE)BRL-201输注后最长24个月
  • 主要终点II期推荐剂量(RP2D)BRL-201输注后28天内
核对登记原文(英文)

主要终点:DLT · The number and severity of dose-limiting toxicity (DLT) events · Within 28 Days After BRL-201 Infusion;AEs · The total number, incidence, and severity of AEs · Up to 24 Months After BRL-201 Infusion;RP2D · The recommended phase 2 dose · Within 28 Days After BRL-201 Infusion

研究设计怎么做的

研究类型
干预性研究
入组人数
18 人(预计)
分组方式
不适用(单臂)
  • 治疗组试验组

    给药剂量为5–10.0×10⁶/kg体重。

核对分组登记原文(英文)
  • Treatment group · EXPERIMENTAL · 5- 10.0×10\^6/kgBW

关键日期

开始日期
2023-04-25
主要完成日期
2026-11-20
全部完成日期
2027-01-15
登记状态核实于
2025-11

联系与责任方

申办方
Bioray Laboratories
合作方
Chinese Academy of Medical Sciences、Zhejiang University、Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
联系邮箱
wli@brlmed.com
联系电话
18621670308

登记简述

这是一项多中心、单臂、开放标签临床研究,计划纳入12–18名受试者。

核对登记原文(英文)

This is a multi-center, single-arm, open-label clinical study, and the sample size is set to 12-18 subjects.

登记原文与核验信息

试验登记号
NCT05741359
试验期别
I 期
试验状态
招募中
中国试验中心(3 个)
Wuhan Union Hospital · 武汉 · 中国 | Tianjin Institute of Hematology · 天津 · 中国 | The First Affiliated Hospital of Zhejiang University · 杭州 · 中国
适应症(原文)
Non-hodgkin Lymphoma,B Cell
干预方式(原文)
CD19-targeted non-viral PD1 site-specific integrated CAR-T cell injection