← 返回临床试验

CAR-T 细胞治疗淋巴瘤:II 期临床试验(M.D. Anderson)

英文原题:Pilot Trial of Fecal Microbiota Transplantation for Lymphoma Patients Receiving Axicabtagene Ciloleucel Therapy.

查看英文原题

Pilot Trial of Fecal Microbiota Transplantation for Lymphoma Patients Receiving Axicabtagene Ciloleucel Therapy.

ClinicalTrials.gov 2024/01/23(首次登记) II 期注册临床试验 · 招募中

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

简要介绍

这是一项 II 期注册临床试验,评估 CAR-T 细胞治疗淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 40 例。试验地点:美国 · 休斯顿(共 1 个中心)。登记号:NCT06218602。

入组条件决定能不能参加

不限性别 · ≥ 18 Years

纳入标准:

1. 签署知情同意书当日年龄≥18岁;
2. 组织学/细胞学确诊B细胞淋巴瘤;
3. 计划接受FDA批准的标准治疗抗CD19阿基仑赛;
4. 阿基仑赛输注计划日期前180天内,至少连续2天已接受或正在接受高风险广谱抗生素。此类抗生素包括碳青霉烯类(美罗培南、亚胺培南、多利培南)、抗假单胞菌抗生素(头孢吡肟、哌拉西林/他唑巴坦、头孢他啶)或抗厌氧菌药物(甲硝唑、克林霉素、阿莫西林/舒巴坦);
5. ECOG体能状态评分0–2分,须在签署研究知情同意书前7天内评估;
6. 受试者(或适用时的法定代理人)提供书面知情同意;
7. 粪便灌肠给药时中性粒细胞绝对计数须>1000/μL;
8. 肝功能充分:总胆红素≤1.5×ULN(Gilbert综合征患者可≤3×ULN),AST≤2.5×ULN,ALT≤2.5×ULN;存在肝转移时AST和ALT须≤4×ULN;
9. 肾功能充分:按Cockcroft-Gault公式估算的肌酐清除率>30 mL/min,或24小时尿液测得肌酐清除率>30 mL/min;
10. 有受孕可能的男女受试者须采取高效避孕措施:首次研究药物给药前30天开始使用,持续整个试验治疗期;女性治疗结束后至少12个月、男性至少4个月继续使用。如女性受试者或男性受试者的女性伴侣在参加研究期间怀孕或怀疑怀孕,应立即告知治疗医生。

排除标准:

1. 过去4周内接受过大手术者,须在开始研究治疗前充分恢复手术相关毒性和/或并发症;
2. 首次研究药物给药前30天内接种过活疫苗。活疫苗包括但不限于麻疹、腮腺炎、风疹、水痘/带状疱疹、黄热病、狂犬病、卡介苗及伤寒疫苗。注射用季节性流感疫苗通常为灭活疫苗,可允许;鼻喷流感疫苗(如FluMist)为减毒活疫苗,不允许;
3. 确诊原发性免疫缺陷(IgA缺乏除外);
4. 治疗研究者认为受试者存在可能混淆研究结果、妨碍完成全程研究或使其不宜参加研究的病史、当前情况、治疗或实验室异常;
5. 已知有会妨碍配合试验要求的精神疾病或物质滥用障碍;
6. 妊娠或哺乳期女性;
7. 有生育能力的女性须在入组前72小时内进行血清妊娠检测;结果阳性者不得入组;
8. 有肠易激综合征或炎症性肠病史;
9. 无法口服给药或有误吸风险(如神经系统问题)。
核对登记原文(英文)
Inclusion Criteria:

1. At least 18 years of age on the day of signing informed consent.
2. Histologically/cytologically confirmed diagnosis of B-cell lymphomas.
3. Is being planned to received FDA approved standard of care anti-CD19 Axicabtagene Ciloleucel.
4. Participants must have received or is receiving high-risk broad-spectrum antibiotics for minimum of two days within 180 days of scheduled Axicabtagene ciloleucel infusion. High-risk broad-spectrum antibiotics include carbapenems (meropenem, imipenem, doripenem), anti-pseudomonal antibiotics (cefepime, piperacillin-tazobactam, ceftazidime) or anaerobic antibiotics including metronidazole, clindamycin, amoxicillin-sulbactam.
5. An Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2. Evaluation of ECOG is to be performed within 7 days prior to the date of signing study consent.
6. The participant (or legally acceptable representative if applicable) provides written informed consent for the trial.
7. Absolute neutrophil counts should be greater than 1000/ul at the time of administration of fecal enema.
8. Adequate hepatic function defined by a total bilirubin level ≤ 1.5 ≤ x the upper limit of normal (ULN)\[except if Gilberts syndrome and then total bilirubin ≤ 3x is allowed\], an AST, level ≤ 2.5 x ULN, and an ALT level ≤ 2.5 x ULN. If liver metastases are present, then AST and ALT levels must be ≤ 4 x ULN
9. Adequate renal function defined by an estimated creatinine clearance \>30 mL/min according to the Cockcroft-Gault formula or by a creatinine clearance measurement from a 24-hour urine collection.
10. Highly effective contraception for both male and female subjects if the risk of conception exists. Highly effective contraception must be used 30 days prior to first study-drug administration, for the duration of trial treatment, and for at least for 12 months after treatment for females and 4 months after treatment for males. Should a female patient (or male participant's sexual partner) become pregnant or should either the female patient (or male participant's partner) suspect she is pregnant while the participant's study-participation is ongoing, the treating physician should be informed immediately.

Exclusion Criteria:

1. If participant received major surgery within last 4 weeks, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting study treatment.
2. Has received a live vaccine within 30 days prior to the first dose of study drug. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus Calmette-Guérin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines and are not allowed.
3. Has a diagnosis of primary immunodeficiency (excluding IgA deficiency).
4. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the study subject's best interest to participate, in the opinion of the treating investigator.
5. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
6. Pregnant or nursing women
7. For women of childbearing age, a serum pregnancy test will be required within 72 hours prior to enrollment. If the serum test is positive, patient will not be allowed to enroll in the trial.
8. Participants with history of irritable bowel disease and inflammatory bowel disease will be excluded from clinical trial.
9. Participants with difficulties in oral administration or at risk of aspiration (e.g., neurological issues)

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。

研究终点衡量什么算有效

  • 主要终点安全性及不良事件(AE)至研究完成,平均约1年
核对登记原文(英文)

主要终点:Safety and adverse events (AEs) · Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5.0 · Through study completion; an average of 1 year.

研究设计怎么做的

研究类型
干预性研究
入组人数
40 人(预计)
分组方式
随机分组
  • A组试验组

    接受FMT治疗(包括结肠镜下FMT操作和口服胶囊),并按计划接受化疗及CAR-T 细胞治疗。

  • B组试验组

    不接受FMT治疗,仅按计划接受化疗及CAR-T 细胞治疗。

核对分组登记原文(英文)
  • Arm A · EXPERIMENTAL · Will receive FMT therapy (both as a colonoscopy / FMT procedure and as capsules taken by mouth) plus the scheduled chemotherapy and CAR-T cell therapy.
  • Arm B · EXPERIMENTAL · Will receive no FMT therapy and only receive their scheduled chemotherapy and CAR-T cell therapy.

关键日期

开始日期
2024-02-19
主要完成日期
2028-08-01
全部完成日期
2028-08-01
登记状态核实于
2026-08

联系与责任方公示信息

申办方
M.D. Anderson Cancer Center
联系电话
(713) 792-4504

以上邮箱 / 电话是登记库里的申办方联系方式,通常不直达某家医院。中国中心的联系方式请以医院或登记平台最新公示为准。

登记简述

本研究旨在了解,对接受标准抗CD19CAR-T 细胞治疗的受试者,联合粪菌移植(FMT)能否有效治疗抗生素治疗引起的肠道相关副作用。

核对登记原文(英文)

To find out if adding treatment with fecal microbiota transplantation (FMT) is effective at treating gut-related side effects of antibiotic treatment in participants who are receiving standard therapy with anti-CD19 chimeric antigen receptor T-cell (CAR-T cell) therapy.

登记原文与核验信息

试验登记号
NCT06218602
试验期别
II 期
试验状态
招募中
试验中心(1 个)
美国 1
适应症(原文)
Lymphoma
干预方式(原文)
Fecal Microbiota Transplantation; Chemotherapy; CAR-T Therapy