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:To Evaluate the Safety and Efficacy of Human BCMA Targeted CAR-NK Cells Injection for Subjects With R/R MM or PCL
⚠ 该试验的登记信息已有 37 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,评估人源 NK 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:招募中。计划入组 18 例。试验地点:中国 · 上海(共 1 个中心,其中中国 1 个)。登记号:NCT06045091。
不限性别 · ≥ 18 Years
纳入标准:须满足以下全部条件。 • 自愿参加临床试验,理解并签署知情同意书,愿意完成全部试验程序。 • 年龄≥18岁,男女均可。 • 预计生存期>12周。 • 按2014年IMWG更新标准确诊多发性骨髓瘤,或按《血液病诊断及疗效标准》第4版确诊浆细胞白血病。 • 符合以下任一疾病指标:血清M蛋白:IgG≥5 g/L、IgA≥5 g/L,或IgD高于ULN;尿M蛋白≥200 mg/24小时;受累血清游离轻链≥100 mg/L且血清游离轻链比值异常;非分泌型骨髓瘤克隆性骨髓浆细胞≥10%。 • 复发/难治性MM或浆细胞白血病,且至少接受过3种MM/PCL治疗方案,其中至少包括一种蛋白酶体抑制剂和一种免疫调节剂;最近一次抗肿瘤治疗后60天内有疾病进展,或疗效评估未达到微小缓解(MR)及以上。 • 肝、肾及心肺功能符合要求:按Cockcroft-Gault公式估算CrCl≥30 mL/min;LVEF>50%;基线外周血氧饱和度>95%;总胆红素≤2倍ULN;ALT/AST≤2.5倍ULN。 • 血常规:血红蛋白≥60 g/L、中性粒细胞≥1.0×10⁹/L、血小板≥30×10⁹/L,且研究者判断可完成试验。 排除标准:符合以下任一项者不得参加。 • 合并其他未控制的恶性肿瘤。 • HBsAg或HBcAb阳性且HBV DNA高于研究中心正常范围下限;HCV抗体阳性且外周血HCV RNA阳性;HIV抗体阳性;或梅毒初筛抗体阳性。 • 存在任何不稳定的全身性疾病,包括但不限于不稳定型心绞痛、脑血管意外、短暂性脑缺血(筛查前6个月内)、心肌梗死(筛查前6个月内)、NYHA≥III级充血性心力衰竭、需药物治疗的严重心律失常、肝病、肾病或代谢性疾病。 • 研究者认为不适合参加本试验。 • 妊娠或哺乳期女性;计划在细胞输注后1年内妊娠的女性,或其伴侣计划在输注后1年内妊娠的男性。 • 入组前接受过CAR-NK治疗或其他基因治疗。 • 患有影响签署书面知情同意或无法遵守研究程序的疾病,或不愿/不能遵守研究要求。 • 对研究使用的任何药物有严重速发型超敏反应。 • 入组前14天内存在需全身治疗的活动性或未控制感染。 • 过去2年内自身免疫病导致终末器官损害(如Crohn病、类风湿关节炎、系统性红斑狼疮),或需要全身使用免疫抑制剂/其他全身性疾病控制药物。 • 有中枢神经系统症状。
Inclusion Criteria:Subjects must meet all of the following criteria to be enrolled: * Subjects volunteer to participate in clinical trials, understand and sign the informed consent document, be willing to complete all the trial procedures; * 18 years and older, Male and female; * Expected survival \> 12 weeks; * Documented evidence of multiple myeloma at diagnosis as defined by IMWG updated criteria (2014), or plasma cell leukemia at diagnosis as defined by Diagnosis and therapeutic criteria of hematologic disease (4th edition); * One of the following indicators is satisfied: 1. Serum M protein: IgG M protein ≥5 g/L; or IgA M protein ≥5 g/L; or IgD M protein and IgD \>ULN; 2. Urine M protein ≥200 mg/24h; 3. Affected serum free light chain ≥100 mg/L and Serum free light chain ratio is abnormal; 4. Clonal bone marrow plasma cells ≥10 % for non-secretory myeloma; * Patients with relapsed/refractory multiple myeloma or plasma cell leukemia, satisfying: 1. Patients have received at least 3 prior MM or PCL treatment regimens containing at least one proteasome inhibitor and one immunomodulatory; 2. Progress is documented within 60 days of the most recent anti-tumor treatment, or efficacy assessment does not reach minimal response(MR) or above; * Liver, kidney and cardiopulmonary functions meet the following requirements: 1. Creatinine clearance rate (estimated by CockcroftGault formula) ≥30mL/min; 2. Left ventricular ejection fraction \> 50%; 3. Baseline peripheral oxygen saturation \> 95%; 4. Total bilirubin≤ 2×ULN; Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5×ULN; * Blood routine examination satisfying hemoglobin≥60 g/L, neutrophils≥ 1.0×10\^9/L, and platelets≥30×10\^9/L, can complete this trial according to the judgement of investigators. Exclusion Criteria:Any one of the following conditions cannot be selected as a subject: * Accompanied by other uncontrolled malignancies; * Subjects with positive Hepatitis B surface antigen(HBsAg) or Hepatitis B core antibody (HBcAb) and hepatitis B virus (HBV) DNA titers higher than the lower limit of the normal range of the investigative site; Hepatitis C virus (HCV) antibody positive and peripheral blood HCV RNA positive; Human Immunodeficiency Viral (HIV) antibody positive; syphilis primary screening antibody positive; * Any instability of systemic disease, including but not limited to unstable angina, cerebrovascular accident, or transient cerebral ischemic (within 6 months prior to screening), myocardial infarction (within 6 months prior to screening), congestive heart failure (New York heart association (NYHA) classification ≥ III), need drug therapy of severe arrhythmia, liver, kidney, or metabolic disease; * Subjects who are considered unsuitable to participate in this trial by the investigator. * Pregnant or lactating woman, and female subject who plans to have a pregnancy within 1 year after cell transfusion, or male subject whose partner plans to have a pregnancy within 1 year after cell transfusion; * Received CAR-NK treatment or other gene therapies before enrollment; * Subjects who have a disease that affects the signing of written informed consent or who are unable to comply with research procedures; or who are unwilling or unable to comply with research requirements; * Subjects who have had severe immediate hypersensitivity reactions to any drugs used in this research; * Active or uncontrollable infection requiring systemic therapy within 14 days prior to enrollment; * In the past two years, the terminal organ was damaged due to autoimmune diseases (such as Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus), or the systemic use of immunosuppressive or other systemic disease control drugs was required; * Patients with symptoms of central nervous system.
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:Dose limited toxicity (DLT) · Safety Indicators · 28 days post infusion
次要终点:Pharmacokinetics parameters - the highest concentration of human BCMA targeted CAR-NK cells amplified in peripheral blood and bone marrow after infusion;Pharmacokinetics parameters - the time to reach the highest concentration of human BCMA targeted CAR-NK cells amplified in peripheral blood and bone marrow after infusion;Pharmacokinetics parameters - the 28-day area under the curve of human BCMA targeted CAR-NK cells amplified in peripheral blood and bone marrow after infusion;Pharmacodynamics characteristics - the detection values of CRP, IL-6, IL-15, Granzyme B cytokines in peripheral blood;Pharmacodynamics characteristics - the detection values of monoclonal plasma cell in bone marrow;Overall response rate (ORR, include PR, VGPR, CR and sCR) after administration;Percentage of subjects with negative minimal residual disease (MRD);Duration of subjects with negative minimal residual disease (MRD)
第0天和第7天各给药一次。每次剂量为1.5×10⁸、3.0×10⁸或6.0×10⁸个CAR阳性NK细胞。
这是一项单臂、开放标签、剂量递增试验,初步评估人源BCMA靶向CAR-NK细胞注射治疗复发/难治性多发性骨髓瘤或浆细胞白血病患者的安全性、耐受性、药代/药效学特征及疗效。
This study is a single-arm, open-label, dose-escalation trial to explore the safety, tolerability and pharmacokinetic/pharmacodynamics characteristics of human BCMA targeted CAR-NK Cells injection, and to preliminarily observe the efficacy of the trial drug in patients with relapsed/refractory multiple myeloma or plasma cell leukemia.
MEMBER ACCOUNT
登录成功会直接打开下一页。