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:Study of CT071 Injection in RRMM or PPCL
⚠ 该试验的登记信息已有 21 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。
这是一项早期 I 期注册临床试验,评估 CAR-T 细胞治疗多发性骨髓瘤、白血病的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 20 例。试验地点:中国 · 上海(共 1 个中心,其中中国 1 个)。登记号:NCT05838131。
不限性别 · ≥ 18 Years
入选标准 1. 自愿参加,充分了解研究并签署知情同意,愿意并能够完成全部方案程序。 2. 年龄≥18岁,男女不限。 3. 多发性骨髓瘤患者既往至少3线治疗;至少用过一种蛋白酶体抑制剂及一种免疫调节剂,且治疗后复发、进展或无应答。 4. 原发性浆细胞白血病患者至少接受一方案治疗后进展。 5. 入组时按IMWG骨髓瘤/浆细胞白血病标准存在疾病进展。 6. 至少符合一项可评估疾病标准:血清M蛋白≥5 g/L;24小时尿M蛋白≥200 mg;若血清和尿M蛋白均不满足,多发性骨髓瘤患者受累游离轻链≥100 mg/L且sFLC比值异常;仅浆细胞白血病患者外周循环浆细胞≥5%。 7. 预期生存期>12周;ECOG 0至2;器官功能充分。 8. 有生育能力女性筛查血妊娠试验阴性,同意研究期间及治疗后1年内使用高效可靠避孕,且不捐卵;男性如与有生育能力女性发生性行为,须同意治疗后1年内高效避孕,且研究期间和治疗后1年内不捐精。 排除标准 1. 妊娠或哺乳。 2. 神经系统疾病史,如癫痫、颅内出血、瘫痪、失语、卒中、严重脑损伤、痴呆、帕金森病、小脑疾病、记忆障碍、脊髓压迫、精神疾病或其他CNS病;疑似CNS转移。 3. 过去5年内或当前有其他不可治愈恶性肿瘤,恶性程度极低者除外。 4. 活动性自身免疫病(如银屑病、类风湿关节炎、炎症性肠病等)且需长期免疫抑制治疗。 5. 筛查前2年内异基因干细胞移植;筛查前12周内自体移植,或计划研究期间自体移植。 6. 研究者判断不适合研究的临床重大未控制疾病/障碍。 7. 未控制活动性感染(适当抗感染治疗后相关体征/症状仍持续且未改善),或单采前4周内需静脉抗感染治疗(预防用药除外)。有临床指征时应考虑筛查EBV、CMV等病原体。 8. 筛查前2周内重大手术,或研究治疗后4周内计划重大手术(白内障及局麻手术除外)。 9. 单采前2周或5个药物半衰期(取较短者)内接受研究疾病治疗,包括细胞毒治疗、蛋白酶体抑制剂、免疫调节剂、靶向治疗、放疗、表观遗传治疗等;单采前4周内接受抗PD-1/PD-L1单抗、其他试验药物或侵入性医疗器械。 10. 筛查前8周内接种减毒活疫苗或mRNA疫苗,或前4周接种灭活疫苗。 11. 对淋巴清除(CLD)药物、托珠单抗不耐受,或对CT071细胞输注制剂成分DMSO过敏;或有其他严重过敏(如过敏性休克)史。 12. HIV抗体、梅毒螺旋体抗体、HCV RNA、HBsAg或HBV DNA任一阳性。 13. 既往治疗毒性未恢复至CTCAE≤1级,脱发及研究者认为可耐受的事件除外。 14. LVEF<50%;室内空气血氧<92%。 15. 单采前7天内使用糖皮质激素,吸入剂和生理替代剂量除外。 16. 研究者认为不适合参与的其他情况。
Inclusion Criteria: 1. Volunteer to participate in the clinical trial; fully understand and are informed of this trial and sign the informed consent form; Willing to follow and able to complete all trial procedures; 2. Age ≥ 18 years, male or female; 3. Patients with multiple myeloma who have received at least three lines therapy for multiple myeloma (requires relapse, progression, non-response after treatment with at least 1 proteasome inhibitor and at least 1 immunomodulator. 4. Patients with primary plasma cell leukemia progressed after treatment with at least 1 regimen; 5. Progressive disease at the time of enrollment according to the IMWG consensus for myeloma or plasma cell leukemia; 6. Have any of the following evaluable conditions: 1. Serum M-protein ≥ 5 g/L; 2. 24-hour urine M-protein ≥ 200 mg; 3. Abnormal serum free light chain (sFLC) ratio and affected FLC ≥ 100 mg/L in subjects with multiple myeloma who did not meet evaluable criteria for either serum or urine M-protein levels; 4. Circulating plasma cells ≥ 5% (PCL subjects only); 7. Estimated survival \> 12 weeks; 8. Eastern Cooperative Oncology Group (ECOG) score 0-2; 9. Subjects had adequate organ function. 10. Female subjects of childbearing potential must have a negative serum pregnancy test at screening, be willing to use a highly effective and reliable method of contraception within 1 year after receiving the trial treatment, and absolutely prohibit egg donation during the trial and within 1 year after receiving the trial treatment; 11. Male subjects, if sexually active with a female of childbearing potential, are willing to use a highly effective and reliable method of contraception for 1 year after receiving trial treatment. All male subjects are absolutely prohibited from donating sperm during the trial and for 1 year after receiving the trial treatment. Exclusion Criteria: 1. Pregnant or lactating females; 2. Patients with a history of neurological disease, such as epilepsy, intracranial hemorrhage, paralysis, aphasia, stroke, severe brain injury, dementia, Parkinson's disease, cerebellar disease, memory impairment, spinal cord compression, psychiatric disease or any disease involving the central nervous system, or suspected central nervous system (CNS) metastasis; 3. Patients with other incurable malignant tumors within 5 years or at the same time, except for those with very low degree of malignancy; 4. Patients with active autoimmune diseases, including but not limited to psoriasis, rheumatoid arthritis, inflammatory bowel disease and other patients requiring long-term immunosuppressive therapy; 5. Received allogeneic stem cell transplantation within two years prior to screening; 6. Received autologous stem cell transplantation within 12 weeks prior to screening, or plan to receive autologous stem cell transplantation during the trial; 7. Any uncontrolled disease or disorder with important clinical significance investigator considered not applicable for the study; 8. Patients who had any uncontrolled active infection (defined as the presence of persistent signs or symptoms associated with infection that did not improve despite appropriate antiinfective treatment) or who required intravenous antiinfective agents (except for prophylactic treatment) within 4 weeks before apheresis. If there is clinical indications, investigators should consider screening EBV, CMV, and other related pathogenic microorganisms; 9. Major surgery within 2 weeks prior to screening, or planning to undergo major surgery within 4 weeks after trial treatment (excluding cataract and other surgery under local anesthesia); 10. Received treatment for the disease under study within 2 weeks prior to apheresis(or within five half-lives of the drug, whichever is shorter), including but not limited to cytotoxic therapy, proteasome inhibitors, immunomodulators, targeted therapy, radiotherapy, epigenetic therapy, etc.; Received anti-PD-1/PD-L1 monoclonal antibody or other investigational drug/invasive medical device within 4 weeksprior to apheresis; 11. Vaccination with live attenuated vaccine or mRNA vaccine within 8 weeks and inactivated vaccine within 4 weeks before screening; 12. Patients who are allergic or intolerant to CLD drugs, tocilizumab, or allergic to the ingredients of CT071 cell infusion preparation (DMSO); Or previous history of other severe allergies, such as anaphylactic shock; 13. Positive test results for any of the following: human immunodeficiency virus (HIV) antibody, Treponema pallidum antibody, hepatitis C virus (HCV) RNA, hepatitis B virus (HBV) surface antigen (HBsAg), HBV DNA; 14. The toxicities caused by the previous treatment have not recovered to Common Terminology Criteria for Adverse Events (CTCAE) ≤ Grade 1, except for alopecia and other tolerable events as judged by the investigator; 15. Left ventricular ejection fraction (LVEF) \< 50%; 16. Oxygen saturation \< 92% at room air; 17. Received glucocorticoids within 7 days prior to apheresis, with the exception of inhaled glucocorticoids and physiologic replacement doses; 18. Other conditions considered inappropriate for participation in this clinical trial 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。
主要终点:DLT after CT071 infusion · Evaluate DLT and adverse events after CT071 infusion · Assessed from the date of first dose of study treatment until 21~28 days;AE of Neurotoxicity and cytokine release syndrome after CT071 infusion · Cytokine release syndrome(CRS)should be evaluated according to the American Society for Transplantation and Cellular Therapy (ASTCT) consensus grading,higher scores mean a worse outcome. · From first dose of study drug adminisration to end of treatment (up to 12 months);Adverse Events (AE) after CT071 infusion · An assessment of severity grade will be made according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), with the exception of cytokine release syndrome (CRS), and immune effector cellassociated neurotoxicity syndrome (ICANS). · From first dose of study drug administration to end of treatment (up to 12 months)
次要终点:Level of CAR-T Cell Expansion (proliferation), and Persistence;Cytokines in the peripheral blood after CT071 infusion;Preliminary evaluation of immunogenicity;Overall response rate (ORR) as measured by International Myeloma Working Group (IMWG) criteria after CT071 infusion;Rate of very good partial response (VGPR) and above, complete response/stringent complete response (CR/sCR);;Duration of response (DOR);Minimal residual disease (MRD) negative rate;;Time to response (TTR)
输注嵌合抗原受体T细胞(CT071),评估其治疗复发/难治性多发性骨髓瘤或原发性浆细胞白血病的安全性和疗效。
本临床研究评估CT071注射治疗复发/难治性多发性骨髓瘤或原发性浆细胞白血病的安全性和疗效。
A Clinical Trial to Explore the Safety and Efficacy of CT071 injection in Patients with Relapsed/Refractory Multiple Myeloma or Primary Plasma Cell Leukemia
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