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 CEA-targeted CAR-T Therapy for CEA-positive Advanced/Metastatic Malignant Solid Tumors
Clinical Study of CEA-targeted CAR-T Therapy for CEA-positive Advanced/Metastatic Malignant Solid Tumors
⚠ 该试验的登记信息已有 35 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 期注册临床试验,评估 CAR-T 细胞治疗胃癌、结直肠癌、恶性肿瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 36 例。试验地点:中国 · 南昌(共 1 个中心,其中中国 1 个)。登记号:NCT06010862。
不限性别 · ≥ 18 Years
入选标准 1. 年龄≥18岁,男女不限。 2. 组织学/病理确诊晚期、转移性或复发恶性肿瘤,主要包括结直肠癌、食管癌、胃癌、胰腺癌。 3. 至少二线标准治疗失败(疾病进展或不耐受,包括手术、化疗、放疗等),或缺乏有效治疗方法。 4. 3个月内肿瘤组织IHC确认CEA阳性(清晰膜染色,阳性率≥10%),且血清CEA>10 μg/L。 5. RECIST 1.1至少一个可评估病灶;ECOG 0至2;无严重精神障碍。 6. 重要器官功能:血常规白细胞>3.0×10^9/L、中性粒细胞>0.8×10^9/L、淋巴细胞>0.5×10^9/L、血小板>75×10^9/L、血红蛋白>80 g/L;超声心动图LVEF≥50%且心电图无明显异常;血清肌酐≤2.0×ULN;ALT/AST≤3.0×ULN(肝肿瘤浸润者≤5.0×ULN);总胆红素≤3.0×ULN;无需吸氧时血氧≥95%。 7. 符合单采或静脉采血条件,无其他细胞采集禁忌。 8. 同意自签署知情同意至CAR-T输注后1年内采用可靠有效的避孕方法(不包括安全期避孕)。 9. 受试者本人或监护人同意参加并签署知情同意,理解研究目的和程序。 排除标准 1. 筛查时有CNS或脑膜转移,研究者判断不适合入组。 2. 筛查前1个月内参加其他临床研究;筛查前4周内接种活减毒疫苗。 3. 筛查前14天或5个半衰期(取较短者)内接受化疗、靶向治疗或其他试验药。 4. 需全身治疗的活动或未控制感染。 5. 肠梗阻、活动性消化道出血,或过去3个月有消化道出血史。 6. 既往抗肿瘤治疗毒性未恢复至基线或≤1级,脱发和周围神经病变除外。 7. 以下心脏病:NYHA III/IV级心衰;入组前6个月内心肌梗死或冠状动脉旁路移植术;临床显著室性心律失常或无法解释的晕厥(血管迷走反射/脱水所致除外);严重非缺血性心肌病史。 8. 活动性自身免疫病或需长期免疫抑制治疗。 9. 过去3年内或同时患有未治愈恶性肿瘤,宫颈原位癌和皮肤基底细胞癌除外。 10. HBsAg或HBcAb阳性且外周血HBV DNA高于正常范围;HCV抗体阳性且外周血HCV RNA高于正常范围;HIV抗体阳性或梅毒检测阳性。 11. 妊娠或哺乳。 12. 研究者认为不适合参加研究的其他情况。
Inclusion Criteria: 1. Age ≥18 years old, male or female; 2. Advanced, metastatic or recurrent malignant tumors diagnosed by histology or pathology, mainly colorectal cancer, esophageal cancer, gastric cancer, and pancreatic cancer; 3. After receiving at least second-line standard treatment failure (disease progression or intolerance, such as surgery, chemotherapy, radiotherapy, etc.) or lack of effective treatment methods; 4. Immunohistochemical staining of tumor samples within 3 months confirmed that the tumor was CEA positive (clear membrane staining, positive rate ≥ 10%); , the positive rate ≥ 10%), the serum CEA of the patient is required to exceed 10ug/L. 5. At least one assessable lesion according to RECIST 1.1 criteria; 6. ECOG score 0-2 points; 7. No serious mental disorder; 8. Unless otherwise specified, the function of the vital organs of the subject shall meet the following conditions: 1. Blood routine: white blood cells\>3.0×10\^9/L, neutrophils\>0.8×10\^9/L, lymphocytes cells\>0.5×10\^9/L, platelets\>75×10\^9/L, hemoglobin\>80g/L; 2. Cardiac function: echocardiography showed cardiac ejection fraction ≥50%, and no obvious abnormality was found on electrocardiogram; 3. Renal function: serum creatinine≤2.0×ULN; 4. Liver function: ALT and AST ≤3.0×ULN (for patients with liver tumor infiltration, it can be relaxed to ≤5.0×ULN); 5. Total bilirubin≤3.0×ULN; 6. Oxygen saturation ≥95% in non-oxygen state. 9. Have apheresis or venous blood collection standards, and have no other contraindications for cell collection; 10. Subjects agree to use reliable and effective contraceptive methods for contraception within 1 year after signing the informed consent form to receiving CAR-T cell infusion (excluding rhythm contraception); 11. The patients themselves or their guardians agree to participate in this clinical trial and sign the ICF, indicating that they understand the purpose and procedures of this clinical trial and are willing to participate in the research. Exclusion Criteria: 1. Those who have central nervous system metastasis or meningeal metastasis at the time of screening are judged by the investigator to be unsuitable for inclusion; 2. Participated in other clinical studies within 1 month before screening; 3. vaccinated with live attenuated vaccine within 4 weeks before screening; 4. Received the following anti-tumor treatments before screening: Received chemotherapy, targeted therapy or other experimental drug treatments within 14 days or at least 5 half-lives (whichever is shorter); 5. Active infection or uncontrollable infection requiring systemic treatment; 6. Patients with intestinal obstruction, active gastrointestinal bleeding, or a history of gastrointestinal bleeding within 3 months; 7. Except for alopecia or peripheral neuropathy, the toxicity of previous anti-tumor therapy has not improved to the baseline level or ≤ grade 1; 8. Suffering from any of the following heart diseases: 1. New York Heart Association (NYHA) stage III or IV congestive heart failure; 2. Myocardial infarction or coronary artery bypass grafting (CABG) within 6 months before enrollment; 3. Clinically significant ventricular arrhythmia, or a history of unexplained syncope (except those caused by vasovagal or dehydration); 4. History of severe non-ischemic cardiomyopathy; 9. Patients with active autoimmune disease, or other patients requiring long-term immunosuppressive therapy; 10. Suffering from other uncured malignant tumors in the past 3 years or at the same time, except cervical carcinoma in situ and basal cell carcinoma of the skin; 11. Hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood hepatitis B virus (HBV) DNA titer test is greater than the normal range; hepatitis C virus (HCV) antibody positive and peripheral blood hepatitis C Virus (HCV) RNA test is greater than the normal range; human immunodeficiency virus (HIV) antibody positive; syphilis test positive; 12. Women who are pregnant or breastfeeding; 13. Other investigators deem it unsuitable to participate in the research.
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 of Adverse events after CEA CAR-T cells infusion [Safety and Tolerability] · Therapy-related adverse events were recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0) · 28 days;Obtain the maximum tolerated dose of CEA CAR-T cells[Safety and Tolerability] · Dose-limiting toxicity after cell infusion · 28 days
次要终点:Disease control rate of CAR-T cell preparations in CEA positive advanced malignancies [Effectiveness];Objective response rate (ORR) of CEA CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness];Duration of Response (DOR) of CEA CAR-T treatment in patients with CEA-positive advanced malignancies[Effectiveness];Overall survival(OS)of CEA CAR-T treatment in patients with CEA-positive advanced malignancies[Effectiveness];Progress-free survival(PFS) of CEA CAR-T treatment in patients with CD70-positive advanced malignancies[Effectiveness];AUCS of CEA CAR-T cells [Cell dynamics];CMAX of CEA CAR-T cells [Cell dynamics];TMAX of CEA CAR-T cells[Cell dynamics]
按1至10×10^6个细胞/kg剂量给予CEA靶向CAR-T细胞,经静脉输注。
按1至10×10^6个细胞/kg剂量给予CEA靶向CAR-T细胞,经腹腔注射。
本I期临床研究评估CEA阳性晚期/转移性实体瘤患者接受CEA靶向CAR-T治疗的安全性、耐受性及最大耐受剂量。
This is a phase I clinical study to evaluate the safety and tolerability of CAR-T in patients with CEA-positive advanced/metastatic solid tumors, and to obtain the maximum tolerated dose of CAR-T and phase II Recommended dose.
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