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CNCT19 CAR-T(细胞治疗)治疗多发性骨髓瘤:I 期临床试验

英文原题:CNCT19 for Patients With Autoimmune Hemolytic Anemia After Failure ≥3 Lines of Therapy.

ClinicalTrials.gov 2024/01/30(首次登记) I 期注册临床试验 · 进行中(不再招募)

⚠ 该试验的登记信息已有 17 个月未更新, 页面上显示的「进行中(不再招募)」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,评估细胞治疗用于多发性骨髓瘤的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 6 例。试验地点:中国 · 天津(共 1 个中心,其中中国 1 个)。登记号:NCT06231368。

入组条件决定能不能参加

不限性别 · ≥ 12 Years

入选标准

• 受试者和/或其法定个人代表充分理解研究内容并自愿签署知情同意书。
• 男女不限,年龄≥12岁。
• 自身免疫性溶血性贫血(AIHA)或Evans综合征患者,且≥3线治疗失败。须同时满足:血红蛋白<10 g/dL且有贫血症状;一线皮质类固醇治疗失败;二线利妥昔单抗治疗失败;至少一种三线治疗失败(脾切除、环孢素、环磷酰胺、硫唑嘌呤、吗替麦考酚酯、氟达拉滨、硼替佐米等)。
• 有生育能力女性入组前7天内血清HCG检测阴性。有生育能力受试者须从入组起至细胞输注后1年随访结束遵守避孕要求。
• 器官功能检查充分:ALT和AST≤3×ULN;肺储备至少达到呼吸困难≤1级,非吸氧状态下血氧饱和度>93%。
• ECOG体能状态≤2。
• 预期生存期>3个月。

排除标准

• 有其他淋巴增殖性肿瘤史。
• 药物或感染所致继发性AIHA。
• Evans综合征患者血小板<30×10^9/L。
• 妊娠或哺乳。
• 入组前规定时间内接受以下治疗:抗CD20单克隆抗体<12周;sutimlimab或其他已上市生物制剂<5个半衰期;血浆置换<4周;脾切除术后<12周。
• 既往接受器官或干细胞移植。
• 过去6个月内发生新发血栓或器官梗死。
• 结缔组织病处于活动期。
• 有其他遗传性或获得性溶血性疾病。
• 活动性感染,如脓毒症、菌血症、真菌血症、未控制肺部感染或活动性结核等。
• HBsAg或HBeAg阳性;HBeAb或HBcAb阳性且HBV DNA拷贝数高于可测下限;HCV抗体阳性;HIV抗体阳性;梅毒检测阳性。
• 筛选前4周内接受重大手术且研究者认为不适合入组。
• 入组前5年内患有恶性肿瘤;转移或死亡风险可忽略、且可治愈的肿瘤除外,如已充分治疗的宫颈原位癌、皮肤基底细胞癌等。
• 有以下任一心血管疾病:LVEF≤45%;活动性心脏病或NYHA III/IV级充血性心衰;需治疗的严重心律失常(房颤、阵发性室上性心动过速除外);男性QTcB≥450 ms或女性QTcB≥470 ms;研究前6个月内心肌梗死、冠状动脉旁路手术或支架置入;或研究者认为不适合入组的其他心脏病。
• 入组前6周内接种活减毒疫苗。
• CNCT19 CAR-T治疗期间参加其他干预性临床研究,且研究药物半衰期<5;或研究期间使用活性试验药物、计划参加其他临床试验,或计划接受方案规定以外的治疗。
• 癫痫或其他活动性中枢神经系统疾病史。
• 对本研究所用药物成分过敏。
• 既往接受CAR-T细胞治疗。
• 研究者基于上述以外原因认为不适合参加研究。
核对登记原文(英文)
Inclusion Criteria:

* Subject and/or subject's legal personal representative fully understand and voluntarily sign informed consent forms
* Male or female age ≥ 12 years
* Subjects with autoimmune hemolytic anemia or Evans syndrome after Failure ≥3 lines of therapy. The Failure of ≥3 lines of therapy meets all the following conditions: Hemoglobin less than 10g/dl and symptoms of anemia; Failure of first-line corticosteroid therapy; Failure of second-line rituximab therapy; Failure of any one or more of the third-line treatments (splenectomy, cyclosporine, cyclophosphamide, azathioprine, mycophenolate mofetil, fludarabine, bortezomib, etc.)
* Female subjects of childbearing potential must have a negative Serum HCG test within 7 days before enrollment. Subjects of childbearing potential will be required to follow contraception requirements from the time of enrollment until the 1-year follow-up after cell infusion
* Laboratory tests of adequate organ function: Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤3×ULN; and have a minimum level of pulmonary reserve defined as ≤ Grade 1 dyspnea and the blood oxygen saturation in a non-oxygenated state is \>93%
* ECOG performance status ≤2
* Subject with a life expectancy of more than 3 months

Exclusion Criteria:

* History of other lymphoproliferative neoplasms
* Secondary AIHA caused by drugs or infection
* Platelets in subjects with Evans syndrome\<30×10\^9/L
* Pregnant or breast-feeding subjects
* Treatment with any of the following within the noted period prior to study entry: a.anti-CD20 monoclonal antibodies \<12 weeks, b.sutimlimab or other marketed biologics \<5 half-lives; c.plasma exchange \<4 weeks; d.post-splenectomy \<12 weeks
* Previously received organ or stem cell transplantation
* History of new thrombosis or organ infarction in the past 6 months
* Diagnosis of the active stage of the connective tissue disease
* Had other inherited or acquired hemolytic diseases
* Have active infections, such as sepsis, bacteremia, fungemia, uncontrolled pulmonary infection and active tuberculosis, etc.
* Positive hepatitis B surface antigen (HBsAg) or hepatitis B e antigen (HBeAg); positive hepatitis B e antibody (HBe-Ab) or hepatitis B core antibody (HBc-Ab), and the HBV-DNA copy number is above the lower limit of the measurable capacity; positive hepatitis C (HCV) antibody; positive human immunodeficiency virus (HIV) antibody; positive syphilis test
* Received major surgery within 4 weeks before screening that was assessed by the researcher as unsuitable for enrollment
* Have malignant tumors within 5 years before enrollment, except tumors with negligible risk of metastasis or death and curable tumors, such as adequately treated cervical carcinoma in situ, cutaneous basal cell carcinoma, etc.
* Have any of the following cardiovascular diseases: a.Left ventricular ejection fraction (LVEF) ≤45%, b. presence of active heart disease or congestive heart failure (New York Heart Association \[NYHA\] Class III or IV)), c.severe arrhythmias requiring treatment (except atrial fibrillation, paroxysmal supraventricular tachycardia), d.QTcB interval ≥450ms for men and ≥470ms for women, e.have myocardial infarction, bypass surgery, or stent placement within the 6 months before the study, f.other heart diseases judged by the researcher to be unsuitable for enrollment
* Have a history of live attenuated vaccines within 6 weeks before enrollment
* Participate in other interventional clinical studies during CNCT19 CAR T-Cell therapy, and the drug has a half-life of \<5. Subjects treated with active investigational drugs or intend to participate in another clinical trial or receive treatment other than that specified in the protocol throughout the study period
* Have a history of epilepsy or other active central nervous system diseases
* Have an allergy to the ingredients of the medicine used in this study
* Previously received CAR-T cell therapy
* Patients considered to be ineligible for the study by the investigator for reasons other than the above

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

  • 主要终点不良事件发生率及严重程度12个月内
  • 次要终点血液学应答患者比例
核对登记原文(英文)

主要终点:Incidence and the severity of the adverse event · Use Common Terminology Criteria for Adverse Events (CTCAE) Version 5 to assess the adverse event · Within 12 months
次要终点:Percentage of patients with hematological response

研究设计怎么做的

研究类型
干预性研究
入组人数
6 人(实际)
分组方式
不适用(单臂)
  • CNCT19 CAR-T细胞治疗试验组

    预处理后输注CNCT19细胞。CAR-T输注后须严密监测24小时,并建议输注后至少住院14天。住院及观察时长由研究者综合评估受试者情况决定。

核对分组登记原文(英文)
  • CNCT19 CAR T-Cell Therapy · EXPERIMENTAL · Participants will receive CNCT19 cell infusion after preconditioning, and they need to be closely monitored for 24 hours following CAR-T cell infusion. Participants are advised to remain in the hospital for a minimum of 14 days following cell infusion. The duration of hospitalization and observation will be determined based on the researcher's comprehensive assessment of the subject's condition.

关键日期

开始日期
2024-02-04
主要完成日期
2024-11-18
全部完成日期
2025-08-31
登记状态核实于
2024-11

联系与责任方

申办方
Institute of Hematology & Blood Diseases Hospital, China
合作方
Juventas Cell Therapy Ltd.

登记简述

这是一项I期、单臂、开放标签、剂量递增及剂量扩展研究,旨在评估CNCT19 CAR-T细胞治疗≥3线治疗失败的自身免疫性溶血性贫血患者的安全性、耐受性及疗效。受试者经预处理后接受CNCT19细胞输注,并随访1年。

核对登记原文(英文)

This is a Phase 1, single-arm, open-label, dose-escalation and dose-expansion study. The main purpose is to evaluate the safety and tolerability, efficacy of CNCT19 CAR T-cell therapy in patients with autoimmune hemolytic anemia after failure of three or more lines of therapy. Participants will receive CNCT19 cell infusion after preconditioning, and they will receive a 1-year follow-up.

登记原文与核验信息

试验登记号
NCT06231368
试验期别
I 期
试验状态
进行中(不再招募)
中国试验中心(1 个)
Regenerative Medicine Center · 天津 · 中国
适应症(原文)
Autoimmune Hemolytic Anemia; Autologous CD19 CAR-T; Failure of Three or More Lines of Therapy
干预方式(原文)
CNCT19 CAR-T cell therapy