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:Clinical Study of TCR-like CAR-T Cell Targeted MSLN in the Treatment of Ovarian Cancer
⚠ 该试验的登记信息已有 18 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 I/II 期注册临床试验,评估 CAR-T 细胞治疗相关疾病的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 10 例。试验地点:中国 · 南京(共 1 个中心,其中中国 1 个)。登记号:NCT05963100。
仅女性 · ≥ 18 Years 且 ≤ 70 Years
纳入标准: • 组织学确诊晚期铂耐药卵巢癌;肿瘤组织免疫组化(IHC)间皮素阳性率≥26%。需进行新鲜肿瘤活检用于生物标志物分析;若无法活检,可提供18个月内存档肿瘤组织(至少8张未染色FFPE切片)。如有多次取材,优先使用最新样本。 • 不可切除的晚期卵巢癌,标准治疗失败(既往至少接受过一种含铂全身化疗方案)或无有效治疗方法。 • 按RECIST 1.1至少有1个可测量病灶。 • ECOG评分0–1,预期生存期>3个月。 • 实验室及器官功能至少符合:左心室射血分数≥45%;肌酐清除率≥50 mL/min;ANC≥1.5×10⁹/L;ALC≥0.7×10⁹/L;血小板≥100×10⁹/L;血红蛋白≥90 g/L;血氧饱和度>91%;总胆红素≤2×ULN;ALT及AST≤2.5×ULN。研究者认为由疾病(如肝转移、胆道梗阻)或Gilbert综合征导致的ALT/AST升高,可放宽至≤5×ULN。 • 既往治疗相关毒性须恢复至可接受的基线状态或正常/CTCAE 5.0 1级;研究者判断不会增加后续研究治疗安全风险的毒性(如脱发、白癜风等)除外。 • 能理解研究内容并签署知情同意书。 • 可建立静脉通路或进行单次采血。 排除标准: • 筛选前5年内患有卵巢癌以外的其他恶性肿瘤;已充分治疗的宫颈原位癌、基底细胞或鳞状细胞皮肤癌、根治术后的局限性前列腺癌及根治术后的乳腺导管原位癌除外。 • 乙肝表面抗原或核心抗体阳性,且外周血HBV DNA>50 IU/mL或高于研究中心定量检测下限;HCV抗体阳性且外周血HCV RNA高于定量检测下限;HIV抗体阳性或梅毒检测阳性。 • 卵巢癌转移至中枢神经系统,和/或存在其他不稳定中枢神经系统疾病(如出血、活动性梗死、感染等)。 • 细胞输注前4周内接种减毒活疫苗。 • 已知对本研究治疗所用任一成分可能发生过敏反应。 • 药物控制不佳的高血压(收缩压>160 mmHg和/或舒张压>90 mmHg),或有临床意义的心脑血管病,例如活动性脑血管意外、签署总知情同意前6个月内心肌梗死、不稳定型心绞痛、NYHAⅡ级及以上充血性心衰、药物无法控制或可能影响研究治疗的严重心律失常;连续3次心电图(间隔至少5分钟)显示有临床意义异常,或平均QTcB≥450 ms。 • 合并其他严重器质性疾病或精神疾病;需要治疗的活动性全身感染。 • 患有研究者判断不适合本研究的自身免疫病(如系统性红斑狼疮、血管炎、浸润性肺病);白癜风受试者除外。 • 正在全身使用糖皮质激素(局部用药允许)、羟基脲或免疫调节剂(如α/γ干扰素、GM-CSF、mTOR抑制剂、环孢素、胸腺肽等)。 • 筛选前2周内接受化疗、4周内接受免疫治疗、12周内接受放疗,或其他抗肿瘤药物洗脱期不足5个半衰期。 • 妊娠或哺乳期女性;计划在细胞输注后1年内怀孕的女性受试者。 • 研究者判断可能影响研究实施的任何并存疾病或医学状况;细胞回输前6个月内接受过其他细胞基因治疗产品,且研究者认为不适合入组。 • 研究者判断受试者无法完成方案规定的访视/程序(包括随访)、依从性不足或不适合入组。 • 不符合预筛选阶段审核所列的入选或排除标准。
Inclusion Criteria: * Histologically confirmed diagnosis of advanced platinum-resistant ovarian cancer, with a positive rate of IHC mesothelin in tumor tissue ≥ 26% \[Participants need to undergo fresh tumor tissue biopsy for biomarker analysis\]. If biopsy is not possible, it is necessary to provide archived tumor tissue (at least 8 unstained FFPE sections) within 18 months. If there have been multiple tumor tissue collections in the past, the newly collected samples will be prioritized * Non resectable advanced ovarian cancer that has failed standard treatment (has previously received at least one platinum containing systemic chemotherapy regimen) or lacks effective treatment methods * At least 1 measurable lesion (according to RECIST 1.1 standard) * ECOG score 0-1 and estimated survival greater than 3 months * The laboratory test results should at least meet the following indicators: Lambda Left ventricular Ejection fraction ≥ 45%; Creatinine clearance rate ≥ 50mL/min; Absolute neutrophil count (ANC) ≥ 1.5 × 109/L; Absolute lymphocyte count (ALC) ≥ 0.7 × 109/L; Platelet count (PLT) ≥ 100 × 109/L; Hemoglobin ≥ 90g/L; Blood oxygen saturation\>91%; Total bilirubin ≤ 2 × ULN (upper limit of normal value): alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN; Researchers have determined that ALT and AST abnormalities caused by diseases (such as liver metastasis or bile duct obstruction) or Gilbert syndrome can be relaxed to ≤ 5 × ULN; * The researcher determines that the subject needs to recover from all toxicity related to the previous treatment to an acceptable baseline state, or the relevant toxicity needs to return to normal or level 1 of the NCI CTCAE 5.0 scoring standard; Excluding toxicity that the researcher determines will not increase the safety risk of subsequent study drug reinfusion, such as hair loss, vitiligo, etc; * Can understand this experiment and have signed an informed consent form. * Venous access with venous or single blood collection Exclusion Criteria: * Other malignant tumors other than ovarian cancer in the first five years of screening, in addition to fully treated cervical Carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after radical surgery, and Ductal carcinoma in situ after radical surgery; * Hepatitis B B surface antigen (HBsAg) or hepatitis B B core antibody (HBcAb) is positive, and the detection result of hepatitis B virus (HBV) DNA titer in peripheral blood is higher than 50IU/ml or the lower limit of the quantitative detection range of the research center; Hepatitis C virus (HCV) antibody is positive and the peripheral blood HCV RNA detection result is higher than the lower limit of the quantitative detection range of the research center; People who are positive for human immunodeficiency virus (HIV) antibodies; Those who have tested positive for syphilis * Patients with ovarian cancer metastasis to the central nervous system and/or other unstable Central nervous system disease (bleeding, active infarction, infection, etc.) * Received attenuated live vaccine within 4 weeks before cell transfusion * It is known that any ingredient used in the treatment of this study may cause allergic reactions * Hypertension with poor drug control (systolic pressure\>160mmHg and/or diastolic pressure\>90mmHg) or cardio cerebral Vascular disease with clinical significance (such as activity), such as cerebrovascular accident (within 6 months before signing the master informed consent), myocardial infarction (within 6 months before signing the master informed consent), unstable angina pectoris, congestive heart failure classified as Grade II or above by New York Heart Association (NYHA), Severe arrhythmia cannot be controlled with medication or has potential impact on research and treatment; The electrocardiogram shows clinically significant abnormalities or an average QTcB of ≥ 450ms after 3 consecutive attempts (with an interval of at least 5 minutes) * Concomitant with other serious organic or mental illnesses * Suffering from systemic active infections that require treatment * Suffering from autoimmune diseases: the history of Autoimmune disease determined by the researcher to be unsuitable for this study, such as systemic lupus erythematosus, vasculitis, and invasive lung diseases, should be excluded (except for Vitiligo subjects) * Systematically available pine steroids (local use allowed), Hydroxycarbamide and immunomodulators (such as: α or γ Interferon, GM-CSF, mTOR inhibitor, cyclosporin, Thymosin, etc.) * Chemotherapy was received 2 weeks before screening, immunotherapy was received within 4 weeks, radiation therapy was received 12 weeks before screening, or other anti-tumor treatment drugs had a washout period of less than 5 half-lives * Pregnant or lactating women, and female subjects who plan to conceive within 1 year after cell transfusion * Subjects with any coexisting medical conditions or diseases that the researcher determines may affect the conduct of this experiment * Patients who have received other cell gene therapy products within 6 months prior to cell reinfusion and are considered unsuitable for inclusion by researchers * The researcher determines that the patient is unable to complete all visits or procedures required by the research protocol (including the follow-up period), or has insufficient compliance to participate in this study; Or patients deemed unsuitable for inclusion by researchers * Items included in the selection and exclusion criteria for the pre screening period audit
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:Maximum tolerated dose (MTD) of KT127 cells · The highest dose level (cells/kg) where ≤2/6 evaluable subjects experience protocol-defined dose-limiting toxicities (DLTs) within 14 days post-infusion, with dose escalation terminated based on pre-specified safety criteria. · up to second year;Adverse events (AEs) · The ASTCT 2019 standard will be used to grade cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), and the CTCAE version 5.0 standard will be used to grade other adverse events. Unless otherwise specified in the protocol, all AEs that occur during the entire study period will be evaluated. · up to second year
次要终点:objective response rate(ORR);progression-free survival(PFS);Overall survival(OS)
本临床试验旨在评估TCR样CAR-T细胞治疗MSLN阳性卵巢癌的安全性和疗效。
The goal of this clinical trial is to test TCR-like CAR-T in the Treatment of MSLN positive Ovarian Cancer. The main question it aims to answer are: the safety and efficacy of TCR-like CAR-T in the Treatment of MSLN positive Ovarian Cancer.
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