TCR-JANUS 衔接蛋白实现双特异性靶向以克服 TCR-T 细胞治疗中的肿瘤异质性
TCR-JANUS engager proteins enable bispecific targeting to overcome tumor heterogeneity in TCR-T cell therapy.
基于 T 细胞受体(TCR)的免疫疗法受限于肿瘤抗原异质性,后者常导致复发。
英文原题:MAGE-A4-directed TCR-T in the Treatment Amongst Subjects With Advanced Solid Tumors
MAGE-A4-directed TCR-T in the Treatment Amongst Subjects With Advanced Solid Tumors
⚠ 该试验的登记信息已有 34 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 T 细胞治疗晚期实体瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 20 例。试验地点:中国 · 北京(共 1 个中心,其中中国 1 个)。登记号:NCT06170294。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
入选标准 1. 男女不限,年龄18至75岁。 2. 自愿参加研究并签署书面知情同意书。 3. 预期生存期≥12周。 4. 筛选时、白细胞单采(APH)前24小时、淋巴清除(LD)前及细胞输注前,ECOG体能状态均≤1。 5. 组织学确诊复发/转移性晚期实体瘤。 6. 影像学证实至少一线既往全身治疗后疾病进展,且筛选时无可用标准治疗;由研究者判断。 7. 有新鲜或福尔马林固定石蜡包埋(FFPE)样本,免疫组化(IHC)检测MAGE-A4阳性。 8. 人白细胞抗原(HLA)A*02等位基因匹配。 9. 按RECIST v1.1至少有一个可测量病灶。 10. 器官功能充分。 11. 有适合白细胞单采的静脉通路。 12. 既往治疗引起的非血液学不良事件须恢复至CTCAE≤1级;脱发和周围神经病变除外。 13. 有生育能力女性同意从淋巴清除前28天至输注后1年采用有效可靠的避孕方法。未接受输精管结扎且与有生育能力女性有性行为的男性患者,须同意从淋巴清除开始至输注后1年使用屏障避孕;研究期间禁止捐献精子。 14. 有生育能力女性筛选时及淋巴清除前48小时血清β-人绒毛膜促性腺激素(β-hCG)检测均须阴性。 排除标准 1. 妊娠或哺乳期女性。 2. HIV血清学阳性,或活动性HBV/HCV、梅毒、结核或COVID-19感染。 3. CNS转移者须已接受治疗且神经系统状况稳定≥2个月;白细胞单采前≥1个月未使用类固醇,且无需抗癫痫药物。 4. 过去3年内有其他原发恶性肿瘤;完全切除的早期肿瘤等特定情况除外。 5. 研究者认为有广泛转移,或淋巴清除前肿瘤进展较筛选时更快等,可能不适合继续研究治疗。 6. 需长期全身治疗的自身免疫性疾病。 7. 既往接受过基因工程修饰T细胞治疗或其他细胞/基因治疗(CGT)。 8. 器官移植史。 9. 筛选、白细胞单采或淋巴清除前72小时内,或输注前5天内存在未控制或活动性感染。 10. 可能限制患者参加本研究的其他严重疾病。 11. 有临床意义的CNS疾病,如癫痫、卒中、帕金森病等。 12. 筛选前30天内发生≥2级出血,或需长期抗凝治疗。 13. 筛选前3个月内有活动性消化性溃疡或胃肠道出血。 14. 未满足白细胞单采所需的洗脱期。 15. 既往对JWTCR001或其成分过敏或不耐受。 16. 研究者判断不能或不愿遵守研究方案。 17. 研究者认为不适合参加研究的其他情况。
Inclusion Criteria: 1. 18-75 year-old, male or female 2. Voluntarily willing to participate in the study and sign the written informed consent form 3. Life expectation ≥12 weeks 4. European Cooperative Oncology Group (ECOG) ≤1 at screening, 24 hours prior to apheresis (APH), lymphodepletion (LD), and infusion 5. Histologically-confirmed recurrent/metastatic advanced solid tumors 6. Radiologically-confirmed progression disease after at least one prior line of systematic treatment and no available standard of care at screening, judged by investigators 7. Fresh or formalin-fixed paraffin-embedded (FFPE) samples, immunohistochemistry (IHC)-stained MAGE-A4 positive 8. Human leukocyte antigen (HLA)-A\*02 allele matched 9. Per response evaluation criteria in solid tumors (RECIST) version 1.1, at least one measurable lesion 10. Adequate organ functions 11. Adequate venous access for APH 12. Non-hematological adverse events induced by previous treatment must have recovered to Grade ≤1 according to Common Terminology Criteria for Adverse Events (CTCAE), except for alopecia and peripheral neuropathy 13. Women of childbearing potential must agree to use an effective and reliable contraceptive method during 28 days prior to lymphodepletion to 1 year post infusion; Male patients who have not undergone vasectomy and have sexual activity with women of childbearing potential must agree to the use of a barrier contraceptive method since lymphodepletion to 1 year post infusion, and sperm donation is prohibited during the study 14. Women of childbearing potential must have negative serum human chorionic gonadotropin β (β-hCG) test result at screening and 48 hours prior to lymphodepletion Exclusion Criteria: 1. Pregnant or lactating women 2. Human immunodeficiency virus (HIV) serology positive, or active hepatitis B virus (HBV)/hepatitis C virus (HCV)/Syphilis/Tuberculosis/ Coronavirus disease 2019 (COVID-19) 3. Central nerve system (CNS) metastasis must have received treatment and been neurologically stable for ≥2 months, not requiring anti-seizure medications and off steroids for ≥ 1 month prior to APH 4. Another primary malignancy within 3 years (with some exceptions for completely-resected early-stage tumors) 5. Subjects with extensive metastases, or more rapid tumor progression prior to lymphodepletion in comparison to screening, etc. which might not be appropriate for further study treatment judged by the investigators 6. Systematic autoimmune disorders requiring long-term systematic treatment 7. Previously treated with any genetically engineered modified T cell therapy or other cell and gene therapy (CGT) 8. History of organ transplant 9. Uncontrolled or active infection within 72 hours prior to screening, APH, LD, or within 5 days prior to infusion 10. Subjects with other serious diseases that may restrict them from participating in this study 11. Clinically significant CNS disorders, such as epilepsy, stroke, Parkinson disease, etc 12. Grade ≥ 2 hemorrhage within 30 days prior to screening, or in need of longterm anticoagulants 13. Active digestive ulcer or gastrointestinal (GI) bleeding within 3 months prior to screening 14. Not satisfying wash-out period for APH 15. Previously allergic or intolerable to JWTCR001 or its components 16. Unable or unwilling to comply with the study protocol, judged by the investigators 17. Other situations implying that the subject might not be appropriate to participate in the study
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:Rate of dose-limiting toxicities (DLTs) · Dose-limiting toxicity (DLT) is defined as an adverse event that occurred within 28 days after JWTCR001 infusion that met any of the following criteria. Any Grade ≥3 non-hematologic toxicity associated with JWTCR001 that has not resolved to Grade ≤2 within 7 days, excluding clinically insignificant abnormalities in laboratory indicators. Grade ≥3 hematological toxicities. Grade ≥3 anaphylaxis. Grade ≥3 infection did not resolve to Grade ≤2 within 7 days after anti-infective treatment. Grade ≥3 autoimmune toxicity during treatment. Grade ≥3 cytokine release syndrome (CRS) during treatment that did not resolve to Grade ≤2 within 72 hours. Grade ≥3 TCR-T cell-associated encephalopathy syndrome/immune effector cell-associated neurotoxicity syndrome (CRES/ICANS) that did not resolve to Grade ≤2 within 72 hours. Grade 5 events of any nonmalignant cause. · 28 days;Rate and severity of adverse events (AEs) and severe adverse events (SAEs) · An AE is defined as any unfavorable and unintended sign, symptom, or disease (new or worsening) temporally associated with the use of study therapy, regardless of whether or not a causal relationship with the study therapy can be determined. · 2 years;Rate and severity of clinically-significant abnormalities in laboratory testings · Clinically-significant abnormalities in laboratory testings. · 2 years
次要终点:Copy number of the vector transgene of JWTCR001 in peripheral blood;MAGE-A4 specific TCR+ T Cell concentration of JWTCR001 in peripheral blood;Antitumor efficacy-Progression-free survival (PFS);Antitumor efficacy-Duration of response (DOR);Antitumor efficacy-Time to response (TTR);Antitumor efficacy-Overall survival (OS);Antitumor efficacy-Objective response rate (ORR);Antitumor efficacy-Disease control rate (DCR)
入组受试者依次分配至相应剂量水平。
这是一项单臂、开放标签、剂量探索研究,评估自体人源化抗MAGE-A4 T细胞受体工程化T细胞(TCR-T)治疗晚期实体瘤的安全性、疗效及药代动力学。
A single-arm, open-label, dose exploratory study to evaluate the safety, efficacy, and pharmacokinetics of autologous humanized anti-MAGE-A4 T cell receptor-engineered T cell (TCR-T) in advanced solid tumors.
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