CELL INTELLIGENCE · 肿瘤细胞治疗研究

Inclusion Criteria:

1. Fully understood and voluntarily signed informed consent for this study;
2. male, aged 18-75 years;
3. expected survival of more than 6 months;
4. metastatic castration-resistant prostate adenocarcinoma (CRPC) patients.
5. Receiving CRPC standard treatment (such as new endocrine therapy, chemotherapy and radium-223, etc., one or more of the combination therapy) after the diagnosis of CRPC, ineffective or progressive disease (PSA continued to rise for 3 months, or bone scan/whole-body MRI/PET-CT showed local recurrence or new metastatic lesions, demonstrating disease progression);
6. PSMA expression in tumor cells was positive in immunohistochemical staining of prostate/metastatic biopsy tissue before enrollment;
7. ECOG score \< 2 ;
8. virological examination HAV (hepatitis A virus), HBV (hepatitis B virus), HCV (hepatitis C virus), HIV (human immunodeficiency virus), TP (Treponema pallidum) quantitative detection was negative, (antigen and antibody screening method unknown, confirmed by nucleic acid method); hematological parameters met the following criteria: a. hemoglobin \> 100 g/L; b. platelet count \> 100 × 109/L; c. neutrophils \> 1.5 × 109/L.

Exclusion Criteria:

Subjects meeting any of the following exclusion criteria will be excluded:

1. have received any previous treatment with CAR-T therapy ;
2. have received any previous treatment that targets PSMA;
3. tumor pathology suggests a special type of prostate cancer (e.g., neuroendocrine prostate cancer, etc.)
4. severe mental disorders;
5. suffered from previous malignancies, except for the following: a. basal cell carcinoma or squamous cell carcinoma after standardized treatment; b. having a primary malignancy, but completely resected, with a complete remission time of ≥ 5 years.
6. Subjects with severe cardiovascular disease; a.New York Heart Association (NYHA) stage III or IV congestive heart failure; b.Myocardial infarction ≤ 6 months prior to enrollment or coronary artery bypass graft (CABG); c.Clinically significant ventricular arrhythmia, or history of unexplained syncope, nonvasovagal or not due to dehydration; d.History of severe non-ischemic cardiomyopathy; e.Decreased left ventricular ejection fraction (LVEF \< 55%) as assessed by echocardiogram or multigated acquisition (MUGA) scan, abnormal interventricular septal thickness and atrioventricular size associated with myocardial amyloidosis;
7. active infectious disease or any major infectious event requiring high grade antibiotics;
8. organ function in the following abnormalities: a. serum aspartate aminotransferase or alanine aminotransferase \> 2.5ULN; CK \> ULN; CK-MB \> ULN; TnT \> 1.5ULN; b. total bilirubin \> 1.5ULN; c. partial prothrombin time or activated partial thromboplastin time or international normalized ratio \> 1.5ULN in the absence of anticoagulant therapy;
9. participation in other clinical studies in the past three months or previous treatment with any gene therapy product;
10. intolerance or hypersensitivity to cyclophosphamide and fludarabine chemotherapy;
11. unsuitability to participate in this clinical study in the opinion of the investigator.

主要终点：DLT · The number and severity of dose-limiting toxicity (DLT) events · Within 28 Days After Enhanced autologous PSMA-CAR T Infusion；The National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE V5.0) · Safety assessment: toxicity profile · Through 6 months after CAR-T cell infusion；Cytokine Release Syndrome (CRS) grading post CAR T cell infusion · Safety assessment: toxicity profile · Through 6 months after CAR-T cell infusion
次要终点：Efficacy assessment: PSA changes；Efficacy assessment: radiographic Progression-Free Survival (rPFS)；Pharmacokinetics (PK) assessment: expansion of CAR-T cells；Pharmacokinetics (PK) assessment: persistence of CAR T cells；Pharmacodynamics (PD) assessment eg. (Level of IL-6)

• Enhanced autologous PSMA-CAR T: · EXPERIMENTAL · Enhanced autologous PSMA-CAR T is an electrotransfer system based on non-viral transposons that integrates the CAR gene into the genome of host cells by electrotransfer using PMSA as a target, while this CAR vector co-expresses enhanced factors and plays a strong regulatory role in innate and adaptive immunity.

This is one center, single-arm, open-label investigator initiated trial to assess the safety and efficacy of enhanced autologous PSMA chimeric antigen receptor T cells in the treatment for patients with refractory castration resistant prostate cancer, and the sample size is set to 7-18 subjects.