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:Universal CAR-T Cells Targeting Multiple Myeloma
这是一项 I 期注册临床试验,评估通用型 CAR-T 细胞治疗多发性骨髓瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 20 例。试验地点:中国 · 深圳(共 1 个中心,其中中国 1 个)。登记号:NCT06006741。
不限性别 · ≥ 18 Years 且 ≤ 80 Years
纳入标准: 1. 确诊多发性骨髓瘤,且现有根治性治疗选择(包括自体或异基因造血干细胞移植)均已失败。 2. 至少接受过2种既往治疗方案后仍未达到完全缓解(CR)。 3. 高危多发性骨髓瘤处于第一次或第二次完全缓解(CR1/CR2),因年龄或合并症不适合移植。 4. 末次化疗至疾病进展间隔不足1年(即最近一次无进展间期<1年)。 5. 既往自体或异基因移植后复发,至少接受过一种既往治疗后仍有残留病灶,且不适合异基因移植。 6. 一线治疗后仍有残留病灶且不适合自体移植(ASCT)。 7. 预期生存期>12周;肌酐<2.5 mg/dL;ALT/AST<正常值上限的3倍。 8. 胆红素<2.0 mg/dL。 9. 既往移植后任何复发均可入组,不受其他既往治疗情况限制。 10. 静脉通路适合单采,且无其他白细胞分离禁忌证。 11. 自愿签署知情同意书。 排除标准: 1. 妊娠或哺乳期女性。 2. 未控制的活动性感染。 3. 活动性乙型或丙型肝炎感染。 4. 同时使用全身性类固醇;近期或当前使用吸入性类固醇不构成排除条件。 5. 既往接受过相关CAR-T细胞治疗。 6. 存在可能妨碍参加研究的未控制活动性疾病。 7. HIV感染。
Inclusion Criteria: 1. Patients with confirmed multiple myeloma failed curative treatment options (including autologous or allogeneic SCT). 2. Complete remission (CR) cannot be achieved after at least 2 prior therapy regimens. 3. High risk MM in CR1 or CR2 and not eligible for SCT because of age or comorbid diseases. 4. Less than 1 year between last chemotherapy and progression (i.e. most recent progression free interval \< 1 year). 5. Relapsed after prior autologous or allogenic SCT with residual disease after at least 1 prior therapy and not eligible for allogeneic SCT. 6. Residual disease after primary therapy and not eligible for ASCT 7. Expected survival \> 12 weeks• Creatinine \< 2.5 mg/dl• ALT (alanine aminotransferase)/AST (aspartate aminotransferase) \< 3x normal 8. Bilirubin \< 2.0 mg/dl 9. Any relapse after prior SCT is eligible regardless of other prior therapy 10. Adequate venous access for apheresis, and no other contraindications for leukapheresis 11. Voluntary informed consent is signed Exclusion Criteria: 1. Pregnant or lactating women 2. Uncontrolled active infection 3. Active hepatitis B or hepatitis C infection 4. Concurrent use of systemic steroids. Recent or current use of inhaled steroids is not exclusionary. 5. Previous related CAR-T cell therapy 6. Any uncontrolled active medical disorder that would preclude participation 7. HIV infection
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:Percentage of patients with treatment related adverse effect · percentage of participants with treatment-related adverse events, as assessed by physical examination, vital signs, standard clinical lab tests. · 6 months
次要终点:Anti-tumor activity of the universal 4SCAR-T cells after infusion;Anti-tumor activity of fourth generation universal CAR-T cells in patients with relapsed or refractory MM
本研究旨在评估靶向多发性骨髓瘤的通用型CAR-T细胞的可行性、安全性和疗效,并进一步了解其在体内的持续性和功能。
The aim of this study is to assess the feasibility, safety and efficacy of universal CAR T cells targeting multiple myeloma. Another goal of the study is to learn more about the persistence and function of the universal CAR T cells in the body.
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