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:CD7 CAR-T Bridging to alloHSCT for R/R CD7+Malignant Hematologic Diseases
CD7 CAR-T Bridging to alloHSCT for R/R CD7+Malignant Hematologic Diseases
⚠ 该试验的登记信息已有 14 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 I/II 期注册临床试验,评估 CAR-T 细胞治疗肿瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 30 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT05827835。
不限性别 · ≥ 18 Years
入选标准 • 提供已签署并注明日期的知情同意书;男女均可,年龄≥18岁;预期生存期>12周;ECOG≤2。 • 按NCCN急性淋巴细胞白血病及急性髓系白血病临床指南(2016 v1)确诊CD7阳性ALL或AML,并符合复发/难治性CD7阳性急性白血病之一:标准化疗后未达CR;首次诱导达CR但缓解持续≤12个月;一线或多线挽救治疗无应答;多次复发。 • Ph阴性;或不能耐受TKI;或Ph阳性且对两种TKI均无应答。 • 肺功能正常,室内空气无需吸氧时血氧饱和度>92%。 • 生化指标:AST/ALT≤2.5×ULN;总胆红素≤1.5×ULN;24小时肌酐清除率≥30 mL/min;脂肪酶及淀粉酶≤2×ULN。 • 有生育能力男女须自签署知情同意至研究药物使用后2年内采取有效避孕。有生育能力女性包括绝经前及绝经后2年内女性,筛查血妊娠试验须阴性。 排除标准 • 癫痫或其他CNS疾病史;临床显著CNS病灶(如惊厥、脑血管缺血/出血、痴呆、小脑疾病、精神病、活动性CNS受累或癌性脑膜炎)。 • 妊娠或哺乳;未治愈的活动性感染;QT间期延长或严重心脏病;对本研究所用任何药物过敏/不耐受。 • 筛查前2周内接受抗癌化疗或其他药物治疗;筛查前5年内需治疗或有复发证据的既往恶性肿瘤。 • 过去2年内自身免疫病导致终末器官损伤(如克罗恩病、类风湿关节炎、系统性红斑狼疮),或需系统性免疫抑制/其他全身疾病控制药物。 • 严重活动性病毒/细菌感染或未控制的全身真菌感染;遗传性出血/凝血障碍、非创伤性出血或血栓栓塞史,以及其他增加出血风险的疾病。 • 筛查前8周内接受自体造血干细胞移植(ASCT),或计划研究期间接受ASCT。 • 筛查前4周或5个药物半衰期(取较长者)内参加其他药物临床试验。 • 研究者认为会增加患者风险或干扰试验结果的任何情况。
Inclusion Criteria: * Provision of signed and dated informed consent form (ICF) * Male or female, older than 18 years (including 18 years) * Anticipated survival time more than 12 weeks * Eastern Cooperative Oncology Group (ECOG) performance status ≤2 * According to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Acute Lymphocytic Leukemia and Acute Myeloid Leukemia (2016. v1), patients diagnosed as CD7+ALL and AML * Consistent with r/r CD7+acute leukemia diagnosis, including any of the following conditions * a. No CR after standard chemotherapy * b. The first induction reaches CR, but CR ≤ 12 months * c. Patients with r/r CD7+acute leukemia have not responded to the first or multiple remedial treatments * d. Multiple recurrences * Philadelphia chromosome negative (Ph -) subjects; Or cannot tolerate tyrosine kinase inhibitor (TKI) treatment; Or Philadelphia chromosome positive (Ph+) subjects who did not respond to both TKI treatments * Normal lung function, oxygen saturation greater than 92% without oxygen inhalation * The blood biochemical test results are consistent with the following results * a. (AST) and (ALT) ≤ 2.5 × (ULN) * b. Total bilirubin ≤ 1.5 × ULN * c. 24-hour serum creatinine clearance ≥ 30 mL/min * d. Lipase and amylase ≤ 2 × ULN * Fertility capable men and women of childbearing age must agree to use effective contraception starting with the signing of an informed consent form until within 2 years after the use of the study drug. Women of reproductive age include pre menopausal women and women within 2 years after menopause. The blood pregnancy test for women of reproductive age must be negative at screening Exclusion Criteria: * Patients with the history of epilepsy or other CNS disease * Pregnant or breastfeeding * Active infection with no cure * Patients with prolonged QT interval time or severe heart disease * Have experienced hypersensitivity or intolerance to any drug used in this study * Patients who received anticancer chemotherapy or other drug treatment within 2 weeks before screening * Previous malignant tumors that require treatment or have evidence of recurrence within the previous 5 years of screening * Clinically significant central nervous system lesions such as seizures, cerebral vascular ischemia/hemorrhage, dementia, cerebellar disease, psychosis, active central nervous system involvement, or cancerous meningitis * In the past 2 years, terminal organ damage caused by autoimmune diseases (such as Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus) or the need for systematic application of immunosuppressive or other systemic disease control drugs * Severe active viral, bacterial, or uncontrolled systemic fungal infections; Genetic bleeding/coagulation disorders, a history of non-traumatic bleeding or thromboembolism, and other diseases that may increase the risk of bleeding * Patients who received autologous hematopoietic stem cell transplantation (ASCT) within 8 weeks before screening, or who plan to undergo ASCT during this study * Participated in clinical trials of other drugs within 4 weeks or 5 drug half-lives (T1/2) before screening * Any situation that the researchers believe may increase the risk of patients or interfere with the test results.
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:Incidence and level of AE and SAE · Adverse events assessed according to NCI-CTCAE v5.0 criteria · Baseline up to 28 days after CD7 CAR T-cells infusion
次要终点:CAR-T cell expression;CAR-T related cytokine expression;Survival Rate (SR);Time-To-Progression(TTP);Progression-free survival (PFS);Duration of remission,DOR;Overall response rate,ORR;Clinical Benefit Rate(CBR)
对复发/难治性CD7阳性恶性血液病患者输注CD7 CAR-T细胞,作为后续异基因造血干细胞移植的桥接治疗。
本单臂、开放标签、单中心I/II期研究评估CD7 CAR-T桥接异基因造血干细胞移植治疗复发/难治性CD7阳性恶性血液病的安全性及临床结局。
This is a single-arm, open-label, single-center, phase I/II study. The primary objective is to evaluate the safety of CD7 CAR-T Bridging to allo-HSCT therapy for patients with CD7-positive relapsed or refractory Malignant Hematologic Diseases
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