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:CD7 CAR-T in Adults With Relapsed or Refractory T-LBL/ALL Clinical Study
CD7 CAR-T in Adults With Relapsed or Refractory T-LBL/ALL Clinical Study
⚠ 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 细胞治疗淋巴瘤、急性淋巴细胞白血病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 9 例。试验地点:中国 · 上海(共 1 个中心,其中中国 1 个)。登记号:NCT06136364。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
入选标准 按WHO造血及淋巴组织肿瘤分类,难治/复发性T淋巴母细胞淋巴瘤/急性淋巴细胞白血病(T-LBL/ALL)患者已接受充分治疗且缺乏有效治疗选择,并符合以下至少一项: 1. 复发:标准治疗达到完全缓解后,外周血或骨髓原始细胞再次出现(>5%),或出现髓外病灶,包括:12个月内早期复发;≥12个月晚期复发且一个疗程标准诱导化疗后未缓解;自体或异基因造血干细胞移植后复发。 2. 难治:至少接受两个疗程标准诱导方案后未达到完全缓解,或一线及以上挽救治疗后仍未达到完全缓解。 3. 入组筛选时,骨髓流式细胞术检测肿瘤细胞CD7阳性,和/或髓外病灶病理免疫组化诊断CD7阳性。 4. 入组筛选期间外周血检出肿瘤细胞者,流式细胞术须显示肿瘤细胞表面免疫表型为CD4/CD8双阴性。 5. 预期生存期>12周。 6. ECOG体能状态0至2。 7. 年龄18至75岁(含上下限)。 8. 血红蛋白≥70 g/L;血小板≥50×10^9/L,可通过输血支持。 9. 肝、肾及心肺功能符合:室内空气下血氧饱和度≥92%;LVEF≥50%;总胆红素<3×ULN;ALT/AST<3×ULN;肌酐<1.5×ULN或按Cockcroft-Gault公式计算肌酐清除率>50 mL/min。 10. 患者/监护人已获知、理解并签署知情同意书。 排除标准 符合以下任一项者不得入组: 1. 签署知情同意书前1年内NYHA≥III级心衰,或发生心肌梗死、心脏血管成形术/支架置入、不稳定型心绞痛或其他显著心脏病;或筛选时QTc>480 ms(按Fridericia公式计算)。 2. 既往接受造血干细胞移植者,若异基因移植后未满6个月。 3. 活动性移植物抗宿主病(GVHD)或需免疫抑制治疗。 4. 筛选前5年内患有T细胞急性淋巴细胞白血病/淋巴瘤以外的恶性肿瘤;宫颈原位癌、基底或鳞状细胞皮肤癌、根治术后的局限性前列腺癌、根治性手术切除的导管原位癌经充分治疗者除外。 5. 非肿瘤性中枢神经系统疾病史(癫痫、瘫痪、失语、卒中、严重脑损伤、痴呆、帕金森病或神经病变)。 6. 筛选前7天内需全身治疗的活动性或未控制感染;轻度泌尿生殖道感染和上呼吸道感染除外。 7. 过去2年内有自身免疫病(如类风湿关节炎、系统性红斑狼疮、克罗恩病),且需全身免疫抑制剂/改善病情药物治疗。 8. 筛选时HBsAg或HBcAb阳性且外周血HBV DNA高于检测限;HCV抗体阳性且外周血HCV RNA阳性;HIV抗体阳性;CMV DNA检测阳性;或梅毒螺旋体特异性抗体(TPPA)阳性。 9. 签署知情同意前4周内参加其他临床试验,或自签署同意至末次试验用药的时间未超过药物5个半衰期(以较长者为准)。 10. 对生物制品有严重过敏史。 11. 研究者判定存在不稳定全身性疾病,包括但不限于需药物治疗的严重肝、肾或代谢性疾病。 12. 妊娠或哺乳期女性;计划在细胞输注后2年内怀孕的女性受试者,或其伴侣计划在输注后2年内怀孕的男性受试者。 13. 筛选前接受过CAR-T治疗或其他基因修饰细胞治疗。 14. 研究者认为可能增加受试者风险或干扰试验结果的其他情况。
Inclusion Criteria: According to the WHO hematopoietic and lymphoid tissue tumors classification, Subjects with refractory/relapsing T-LBL/ALL has been adequately treated and there is a lack of effective treatment, met one of the following criteria: 1. relapse: Primordial cells (\>5%)in peripheral blood or bone marrow appeared again after complete remission with standard treatment or Extramedullary disease appears,include: 1. Early recurrence within 12 months, 2. Late recurrence at 12 months or above and with no remission after a course of standard induction chemotherapy, 3. Recurrence after autologous or allogeneic hematopoietic stem cell transplantation ; 2. Refractory: patients who have received at least two courses standard induction regimen and failed to achieve a complete response or complete remission was not achieved after first-line or above salvage treatment; 3. The tumor cells detected by bone marrow flow cytometry were CD7+ and/or extramedullary lesions were diagnosed as CD7+ by pathological immunohistochemistry at the time of enrollment and screening; 4. If tumor cells were detected in peripheral blood during enrollment and screening, it was required to meet the requirement that the surface immunophenotype of tumor cells was CD4 and CD8 double negative by flow cytometry. 5. Life expectancy greater than 12 weeks; 6. ECOG 0-2; 7. Age 18-75 (upper and lower limits included); 8. HGB at least 70g/L,PLT 50x109/L, can be transfused; 9. Liver and kidney functions The cardiopulmonary functions meet the following requirements: 1. Oxygen saturation under air ≥ 92%; 2. LVEF≥50%; 3. Total bilirubin \<3×ULN; 4. ALT/AST\<3×ULN; 5. Creatinine \<1.5×ULN or creatinine clearance rate(Cockroft-Gault)\>50ml/min; 10. Informed consent explained to, understood by and signed by patient/ guardian. Exclusion Criteria: Those who meet any of the following criteria are not eligible to join the group: 1. New York Heart Association (NYHA) classification ≥ grade III heart failure or myocardial infarction, cardiac angioplasty or stenting, unstable angina pectoris or other clinically prominent heart disease within one year before signing the informed consent form, Or QTc interval \>480ms at screening (QTc interval calculated by Fridericia formula); 2. If the patient has a history of hematopoietic stem cell transplantation, 6 months after the patient received allogeneic hematopoietic stem cell transplantation; 3. Those with active GvHD or those who require immunosuppressive therapy; 4. Malignancy other than T-cell acute lymphoblastic leukemia/lymphoma within 5 years prior to screening, except for adequately treated carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer after radical surgery, radical surgery ductal carcinoma in situ; 5. History of non-neoplastic central nervous system disease (Seizures, paralysis, aphasia, stroke, severe brain injury, dementia, Parkinson's disease, neuropathy) 6. Active or uncontrollable infection requiring systemic treatment within 7 days prior to screening (except for mild urogenital infections and upper respiratory tract infections); 7. History of autoimmune disease (eg, rheumatoid arthritis, systemic lupus erythematosus, Crohn's disease) requiring systemic immunosuppressive/systemic disease modulating medication within the past 2 years; 8. When screening, if the hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HbcAb) is positive, and the peripheral blood hepatitis B virus (HBV) DNA is higher than the detection limit, it needs to be excluded; if the hepatitis C virus (HCV) antibody is positive, the peripheral blood HCV Those with positive RNA need to be excluded; those with positive human immunodeficiency virus (HIV) antibody; those with positive cytomegalovirus (CMV) DNA test; those with positive test for Treponema pallidum specific antibody (TPPA) need to be excluded; 9. Participate in other clinical trials within 4 weeks before the informed consent is signed, or the date of the informed consent is signed and the last medication of the drug is still within 5 half-lives of the drug (whichever is longer); 10. History of severe allergy to biological products; 11. Unstable systemic disease as judged by the investigator: including but not limited to severe liver, kidney or metabolic disease requiring drug therapy; 12. Pregnant or breastfeeding women, and female subjects planning pregnancy within 2 years of cell infusion or male subjects whose partner is planning pregnancy within 2 years of cell infusion; 13. Subjects who have received CAR-T therapy or other gene-modified cell therapy prior to screening; 14. Circumstances that the investigator believes may increase the risk to the subject or interfere with the results of the trial.
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:Safety: Incidence and severity of adverse events · Incidence and severity of adverse events · 28 days after infusion
接受CD7 CAR-T细胞治疗。
本研究旨在评估SENL101治疗复发/难治性T-LBL/ALL患者的耐受性和安全性。
To evaluate the tolerability and safety of SENL101 in patients with relapsed or refractory T-LBL/ALL.
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