单细胞追踪揭示黑色素瘤 TIL 治疗过程中肿瘤反应性 T 细胞的可塑性
Single-cell tracking reveals tumor-reactive T cell plasticity during melanoma TIL therapy.
TIL(肿瘤浸润淋巴细胞)过继细胞治疗可在转移性黑色素瘤中诱导持久缓解,然而在体外扩增过程中及回输后,调控肿瘤反应性T细胞命运的克隆和转录动态仍知之甚少。
英文原题:Safety and Efficacy of an Autologous Tumor Infiltrating Lymphocyte (TIL) Therapy in Patients with Advanced Solid Tumors
⚠ 该试验的登记信息已有 25 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。
这是一项早期 I 期注册临床试验,评估细胞治疗用于实体瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 16 例。试验地点:中国 · 上海(共 3 个中心,其中中国 3 个)。登记号:NCT05831033。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
入选标准 1. 能够并愿意签署书面知情同意,遵守研究参与全部要求及程序。 2. 年龄18至75岁。 3. 组织学或细胞学确诊晚期转移性实体瘤;按研究者判断,标准治疗后进展,或对标准治疗不耐受、拒绝或无法获益。 4. 至少有一个可切除病灶(或病灶总量),切除后最小直径≥15 mm;或可行粗针活检(组织总量约1 g或两根18G穿刺针)。 5. 至少有一个RECIST 1.1可测量靶病灶。既往放疗/局部治疗区域病灶不得作为靶病灶,除非治疗距筛查≥3个月且该病灶已证实进展。 6. ECOG 0或1;预期寿命≥3个月。 7. 骨髓及器官功能充分:ANC≥1.0×10^9/L;血红蛋白≥80 g/L;血小板≥75×10^9/L;凝血功能aPTT<40、INR<1.5;Cockcroft-Gault肌酐清除率≥45 mL/min或血清肌酐≤1.5 mg/dL(另一处方案标准为估算CrCl≥40 mL/min);ALT/AST≤3×ULN,肝转移者≤5×ULN;总胆红素≤1.5×ULN(Gilbert综合征者亦须≤1.5×ULN);LVEF≥50%或NYHA≤I级;肺功能FEV1≥75%。 排除标准 1. 曾接受器官异体移植或细胞转移治疗。 2. 对研究药物任一成分/辅料超敏。 3. 活动性CNS转移;激素依赖或入组前3个月内接受药物治疗者除外,稳定脑转移可考虑。 4. 会增加参加风险的活动性疾病,包括需全身抗生素治疗的感染、凝血障碍,或心血管、呼吸、免疫系统其他重大活动性疾病。 5. 活动性HCV(抗体和外周血HCV RNA均阳性)、HIV抗体阳性、梅毒初筛抗体阳性;未治疗活动性HBV(HBsAg阳性,或HBcAb阳性且外周血HBV DNA定量高于ULN)。乙肝患者研究期间须接受抗HBV治疗。 6. 免疫缺陷史(原发或获得性)、当前长期全身类固醇/其他免疫抑制剂治疗。肾上腺皮质功能不全替代治疗者,如泼尼松≤10 mg/日或等效剂量,可考虑入组。 7. 过去3年内其他原发恶性肿瘤;乳腺、宫颈或膀胱原位癌、局限性前列腺癌及已充分治疗的非黑色素瘤皮肤癌除外。 8. 知情同意签署前28天内接种活疫苗或减毒活疫苗;既往接受其他细胞治疗产品。 9. 既往免疫调节治疗(如免疫检查点抑制剂、共刺激药物)相关≥3级免疫介导不良事件(包括药物相关AST/ALT升高或细胞因子释放综合征),且需免疫抑制治疗。 10. 妊娠或哺乳。 11. 入组前既往治疗/手术相关不良事件未恢复至CTCAE 5.0版≤1级。例外:脱发、≤2级周围神经病变、支持治疗期间稳定的事件(如激素替代治疗下稳定的甲减)或研究者认为无安全风险的其他事件。 12. 不同意研究期间采用医学认可的避孕方法。 13. 癌症需立即处理,或研究者判断不适合参加研究。
Inclusion criteria 1. Be able and willing to provide written informed consent, and to comply with all requirements of study participation (including all study procedures). 2. Age: 18 - 75 years. 3. Histological or cytological diagnosis of advanced metastatic solid tumors. 4. Progression on standard therapy, or intolerance to, refusal or unable to benefit from standard therapy according to investigator's judgement. 5. At least one resectable lesion (or aggregate of lesions) of a minimum 15 mm in diameter post-resection; or core biopsy (aggregate of around 1 gram or two 18G puncture needles). 6. At least one measurable target lesion, as defined by RECIST v1.1.Lesions in previously irradiated areas (or other local therapy) should not be selected as target lesions, unless treatment was ≥ 3 months prior to screening, and there has been demonstrated disease progression in that particular lesion. 7. ECOG performance status of 0 or 1. 8. Life expectancy of at least 3 months. 9. Adequate organ and marrow function (hematology, renal, hepatic and coagulation). 1. Absolute neutrophil count (ANC) ≥ 1.0×10\^9/L. 2. Hemoglobin (Hb) ≥ 80 g/L. 3. Platelet ≥ 75×10\^9/L. 4. Sufficient coagulation: APPT\<40 and INR\<1,5. 5. Creatinine clearance (CrCL) ≥45 mL/min or serum creatinine ≤1.5mg/dL was estimated using the Cockcroft-Gault formula. 6. Serum alanine transaminase (ALT)/ serum glutamic-pyruvic transaminase (SGPT) and aspartate transaminase (AST)/serum glutamic-oxaloacetic transaminase (SGOT) ≤ 3 times the upper limit of normal (ULN); patients with liver metastasis ≤ 5 times ULN. 7. Estimated creatinine clearance (eCrCl) ≥ 40 mL/min using the Cockcroft-Gault formula. 8. Total bilirubin ≤ 1.5 times ULN. 9. Patients with Gilbert\'s syndrome must have a total bilirubin ≤ 1.5 times ULN. 10. Patients with left ventricular ejection fraction (LVEF) ≥50% or New York Heart Association (NYHA) functional classification ≤ Class 1. 11. Patients with pulmonary function test (forced expiratory volume in 1 second FEV1) ≥75%. Exclusion criteria 1. Patients who have received an organ allograft or prior cell transfer therapy. 2. Patients who have a history of hypersensitivity to any component or excipient of study drugs. 3. Patients who have active central nervous system (CNS) metastases(except stable brain metastases without hormone dependence or drug treatment within 3 months before enrollment). 4. Patients who have active medical illness(es) that would pose increased risk for study participation, including: active systemic infections requiring systemic antibiotic therapy, coagulation disorders, or other active major medical illnesses of the cardiovascular, respiratory, or immune system. 5. Active hepatitis C subjects (Hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive), human immunodeficiency virus (HIV) antibody positive; syphilis primary screening antibody positive; untreated active hepatitis B subjects (hepatitis B surface antigen (HBsAg) positive, or hepatitis B core antibody (HBcAb) positive and peripheral blood HBV DNA quantitative test greater than ULN), hepatitis B subjects need to receive anti-HBV treatment during the study period. 6. Previous history of immunodeficiency (any form, primary or acquired), current long-term use of systemic corticosteroids or other immunosuppressants. Patients receiving steroids as replacement therapy for adrenocortical insufficiency at ≤ 10 mg/day of prednisone or other steroid equivalent may be eligible. 7. Patients who have had another primary malignancy within the previous 3 years (with the exception of carcinoma in situ of the breast, cervix, or bladder; localized prostate cancer; and non-melanoma skin cancer that has been adequately treated). 8. Patients who have received a live or attenuated vaccine within 28 days before signing the informed consent. 9. Received other cell therapy products in the past. 10. History of Grade ≥3 immune mediated AE (including AST/ALT elevations that where considered drug related and cytokine release syndrome) that was considered related to prior immune modulatory therapy (eg, immune checkpoint inhibitors, co-stimulatory agents, etc.) and required immunosuppressive therapy. 11. Patients who are pregnant or breastfeeding. 12. Before enrollment, adverse event due to any previous treatment or surgery which had not recovered to ≤ Grade 1 (according to CTCAE V5.0); except: alopecia, peripheral neuropathy ≤ grade 2, events that remain stable during supportive therapy (such as stable hypothyroidism with hormone replacement therapy), or other events that have no safety risk as assessed by the investigator. 13. Patients who do not consent to the use of medically approved contraceptive methods during the study. 14. Patients whose cancer requires immediate attention or who in the investigator's judgement is not suitable to participate in this trial.
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:Adverse Events (AE) · Adverse events according to CTCAE v5.0, Treatment Emergent Adverse event (TEAE) \>=grade 3; Treatment related adverse event (TRAE). · 6 month
次要终点:Objective Response Rate (ORR);Disease Control Rate (DCR);Duration of response (DOR);Progression free survival (PFS);Overall survival (OS)
接受单剂BEN101肿瘤浸润淋巴细胞输注,目标剂量1×10^9至1×10^11个细胞,且不少于1×10^9;最终剂量取决于从肿瘤组织分离的TIL起始数量。输注前接受非清髓性淋巴清除预处理,输注后给予IL-2。
本多中心、单臂、非随机、前瞻性、开放标签干预研究,评估复发/转移性实体瘤患者接受自体肿瘤浸润淋巴细胞BEN101输注的安全性和疗效。治疗前采用非清髓性淋巴清除预处理,输注后给予IL-2。
Multicenter, single arm, non-randomized, prospective, open label, interventional study evaluating adoptive cell therapy (ACT) with autologous tumor infiltrating lymphocytes (TIL) infusion (BEN101) followed by IL-2 after a non-myeloablative (NMA) lymphodepletion preparative regimen for the treatment of patients with recurrent and/or metastatic solid tumor.
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