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CAR-T 细胞治疗脑肿瘤、胶质瘤:I 期临床试验(Chulalongkorn)

英文原题:Safety and Efficacy of Loco-regional B7H3 IL-7Ra CAR T Cell in DIPG

ClinicalTrials.gov 2024/01/24(首次登记) I 期注册临床试验 · 招募中

⚠ 该试验的登记信息已有 18 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。

简要介绍

这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗脑肿瘤、胶质瘤的安全性、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:亚太其他 · 曼谷(共 1 个中心)。登记号:NCT06221553。

入组条件决定能不能参加

不限性别 · ≥ 1 Year 且 ≤ 18 Years

纳入标准:

1. 完成标准放疗后任何时间确诊弥漫性内生性脑桥胶质瘤。
2. 年龄1–18岁。
3. 男性或女性。
4. 有位置适合中枢神经系统(CNS)靶向治疗的CNS储液囊导管,如Ommaya或Rickham导管。
5. Lansky或Karnofsky体能状态评分≥60。
6. 预期生存期≥8周。
7. 器官功能正常:AST和ALT均<ULN的5倍;总胆红素<ULN的3倍;肌酐<ULN的5倍;室内空气下SpO2≥90%。
8. 计划白细胞单采前满足既往治疗洗脱期:末次化疗/生物治疗后至少7天;末次抗肿瘤抗体给药后至少3个半衰期或30天(取较短者);末次细胞输注后至少30天。入组前1周内全身皮质类固醇剂量须稳定或递减,地塞米松最高剂量2.5 mg/m²/日;允许生理性替代治疗。
9. 参与者和/或法定监护人能够理解并愿意签署书面知情同意和/或同意参与文件。

排除标准:

1. ≥3级心功能不全或需要干预的症状性心律失常。
2. 原发性免疫缺陷或骨髓衰竭综合征。
3. 有临床和/或影像学证据提示CNS疝迫近。
4. >3级吞咽困难。
5. 有非黑色素瘤皮肤癌和原位癌(如宫颈、膀胱或乳腺原位癌)以外的活动性恶性肿瘤史。
6. 存在未控制的并发疾病,包括活动性感染、有症状的充血性心力衰竭、不稳定型心绞痛、心律失常、肺部异常,或可能妨碍遵守研究要求的精神疾病/社会状况。
7. 妊娠或哺乳期。CAR-T治疗可能有致畸或导致流产风险;有生育能力女性妊娠检测须为阴性,并停止哺乳。有生育能力的参与者须同意从入组起至CAR-T输注后4个月采取避孕措施。
8. 血清学检查提示活动性HIV、乙肝或丙肝感染;乙肝核心抗体、乙肝表面抗原或丙肝抗体阳性者,入组前PCR须为阴性。
核对登记原文(英文)
Inclusion Criteria:

1. Participants must have diffuse intrinsic pontine glioma at any timepoint following completion of standard radiotherapy
2. Age 1-18 years
3. Sex: Male or female
4. CNS reservoir catheter, such as an Ommaya or Rickham catheter, present in the proper location for CNS-directed therapy
5. Performance status: Lansky or Karnofsky score \&gt;= 60
6. Life expectancy \&gt;= 8 weeks
7. Normal organ function:

   7.1 AST (SGOT) \&lt; 5 times the upper limit of normal (ULN) 7.2 ALT (SGPT) \&lt; 5 times the upper limit of normal (ULN) 7.3 Total bilirubin \&lt; 3 times the upper limit of normal (ULN) 7.4 Creatinine \&lt; 5 times the upper limit of normal (ULN) 7.5 SpO2 room air \&gt;=90%
8. Prior therapy wash-out before planned leukapheresis 8.1 \&gt;= 7 days post last chemotherapy/biologic therapy administration 8.2 3 half-lives or 30 days, whichever is shorter after the last dose of antitumor antibody therapy 8.3 At least 30 days from most recent cellular infusion 8.4 All systemically administered corticosteroid treatment therapy must be stable or decreasing within 1 week prior to enrollment with a maximum dexamethasone dose of 2.5 mg/m2/day. Corticosteroid physiologic replacement therapy is allowed
9. Participants and/or legal guardians must have the ability to understand and willingness to sign a written informed consent and/or assent document

Exclusion Criteria:

1. Presence of \&gt;= grade 3 cardiac dysfunction or symptomatic arrythmia requiring intervention
2. Presence of primary immunodeficiency or bone marrow failure syndrome
3. Presence of clinical and/or radiographic evidence of impending herniation of CNS
4. Presence of \&gt; Grade 3 dysphagia
5. History of active malignancy other than nonmelanoma skin cancer and carcinoma in situ (e.g., cervix, bladder, breast).
6. Presence of uncontrolled intercurrent illness including but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, pulmonary abnormalities, or psychiatric illness/social situations that would limit compliance with study requirements.
7. Pregnant or breastfeeding women were excluded from this study because CAR-T-cell therapy may be associated with the potential for teratogenic or abortifacient effects. Women of childbearing potential must have a negative serum pregnancy test. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with CAR-T cells, breastfeeding should be discontinued. These potential risks may also apply to other agents used in this study. Participants of childbearing or child-fathering potential must be willing to practice birth control from the time of enrollment in this study and for four months after receiving CAR-T-cell infusion.
8. Serologic status reflecting active HIV, hepatitis B or C infection. Participants who are positive for hepatitis B core antibody, hepatitis B surface antigen or hepatitis C antibody must have negative PCR prior to enrollment.

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B7H3-IL7Ra CAR-T细胞输注治疗弥漫性内生性脑桥胶质瘤患者的安全性B7H3-IL7Ra CAR-T细胞输注后最长28天
  • 次要终点弥漫性内生性脑桥胶质瘤的总缓解率
核对登记原文(英文)

主要终点:Safety of B7H3-IL7Ra CAR T cells infusion in diffuse intrinsic pontine glioma (DIPE) patients. · The incidence of adverse events assessed by the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 5.0 · Up to 28 days after B7H3-IL7Ra CAR-T cell infusion
次要终点:The overall response rate of diffuse intrinsic pontine glioma (DIPE)

研究设计怎么做的

研究类型
干预性研究
入组人数
9 人(预计)
分组方式
不适用(单臂)
  • DIPG患者局部区域给予B7H3/IL-7Ra CAR-T细胞试验组

    将CAR-T细胞给入脑室系统。使用自体、靶向B7H3并带有IL-7Ra信号结构域的嵌合抗原受体T细胞;剂量水平为1×10⁷、3×10⁷或10×10⁷个CAR-T细胞。

核对分组登记原文(英文)
  • Locoregional delivery of B7H3/IL-7Ra CAR T cell in DIPG · EXPERIMENTAL · Patients with DIPG for whom CAR T cells will be delivered into the ventricular system Interventions: Biological: Autologous B7H3-specific chimeric antigen receptor (CAR) T cell with additional of IL-7Ra signaling domain Dose level: 1x10e7 CAR T cell, 3x10e7 CAR T cell, 10x10e7 CAR T cell

关键日期

开始日期
2024-03-01
主要完成日期
2026-03-01
全部完成日期
2026-09-01
登记状态核实于
2025-03

联系与责任方

申办方
Chulalongkorn University
合作方
King Chulalongkorn Memorial Hospital
联系邮箱
piti.t@chula.ac.th
联系电话
6622564900

登记简述

这是一项Ⅰ期临床试验,旨在评估靶向B7H3并带有IL-7Ra信号的CAR-T细胞,在完成标准治疗后的弥漫性内生性脑桥胶质瘤(DIPG)儿童患者中的安全性和早期疗效。

核对登记原文(英文)

A Phase 1 clinical trial to evaluate the safety and early efficacy of CAR T-cell with IL-7Ra signal targeting B7H3 in children with diffuse intrinsic pontine glioma (DIPG) patients after complete standard treatments.

登记原文与核验信息

试验登记号
NCT06221553
试验期别
I 期
试验状态
招募中
试验中心
King Chulalongkorn Memorial Hospital · 曼谷 · 泰国
适应症(原文)
DIPG Brain Tumor; Diffuse Intrinsic Pontine Glioma
干预方式(原文)
B7H3 specific CAR T cell with IL-7Ra signaling domain