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CD70靶向CAR-T细胞治疗儿童血液系统恶性肿瘤

英文原题:CAR T-cell Therapy Directed to CD70 for Pediatric Patients With Hematological Malignancies

ClinicalTrials.gov 2024/03/22(首次登记) I 期注册临床试验 · 招募中

简要介绍

这是一项 I 期注册临床试验,评估自体 CAR-T 细胞治疗血液系统恶性肿瘤、急性淋巴细胞白血病、急性髓系白血病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 18 例。试验地点:美国 · 孟菲斯(共 1 个中心)。登记号:NCT06326463。

入组条件决定能不能参加

不限性别 · ≤ 21 Years

纳入标准:年龄≤21岁;复发/难治性CD70阳性血液系统恶性肿瘤。复发定义为既往完全缓解(CR)后疾病复发;难治定义为诱导化疗3个周期后疾病仍持续。复发/难治性CD70阳性AML或MDS:复发疾病CD70阳性,或化疗3个周期后仍持续的难治疾病。复发/难治性CD70阳性B细胞ALL:复发疾病CD70阳性且CD19阴性/弱表达,或因其他原因不适合CD19靶向治疗(包括≥第二次复发、异体HSCT后复发)。复发/难治性CD70阳性T细胞ALL:复发/难治疾病CD70阳性。混合表型急性白血病(MPAL):复发/难治且CD70阳性。复发/难治性CD70阳性淋巴瘤:复发疾病CD70阳性且CD19阴性/弱表达,或不适合CD19靶向治疗(包括≥第二次复发、异体HSCT后复发)。预期生存期>12周;Karnofsky或Lansky(依年龄)评分≥50;既往异体HCT患者须已从移植临床恢复、无活动性GVHD,且白细胞单采前28天内未接受供者淋巴细胞输注(DLI);须已确定HCT供者;有生育能力女性不得哺乳且无哺乳计划,妊娠者须排除,并须在入组前7天内血清或尿妊娠试验阴性。排除标准:已知原发性免疫缺陷;已知HIV阳性史;严重并发细菌、病毒或真菌感染;对玉米淀粉或羟乙基淀粉过敏史;急性早幼粒细胞白血病(APL);存在方案规定的氟达拉滨/环磷酰胺淋巴细胞清除化疗禁忌证。
核对登记原文(英文)
Inclusion Criteria

Age ≤21 years old

Relapsed/refractory CD70+ hematological malignancy

Relapsed disease: Patients developing recurrent disease after a prior complete remission (CR)

Refractory disease: Patients with persistent disease despite 3 cycles of induction chemotherapy.

* Relapsed/refractory CD70+ AML or MDS:

  * Relapsed disease that is CD70 positive
  * Refractory disease that is persistent despite 3 cycles of chemotherapy
* Relapsed/refractory CD70+ B-cell ALL:

  * Relapsed disease that is CD70 positive and CD19 negative/dim or patients otherwise ineligible for CD19-directed therapies including:
  * Patients in 2nd or greater relapse
  * Patients with relapse after allogeneic HSCT
* Relapsed/refractory CD70+ T-cell ALL:

  * Relapsed /refractory disease that is CD70 positive
* Mixed Phenotype Acute Leukemia (MPAL):

  * Relapsed/refractory that is CD70 positive
* Relapsed/refractory CD70+ lymphoma:

  * Relapsed disease that is CD70 positive and CD19 negative/dim or patients otherwise ineligible for CD19-directed therapies including:
  * Patients in 2nd or greater relapse
  * Patients with relapse after allogeneic HSCT

Estimated life expectancy of \>12 weeks

Karnofsky or Lansky (age- dependent) performance score ≥50

Patients with a history of prior allogeneic HCT must be clinically recovered from prior HCT therapy, have no evidence of active GVHD and have not received a donor lymphocyte infusion (DLI) within the 28 days prior to apheresis

Patient must have an identified HCT donor

For females of childbearing age:

i. Not lactating with intent to breastfeed

ii. Not pregnant with negative serum or urine pregnancy test within 7 days prior to enrollment

Exclusion Criteria

* Known primary immunodeficiency
* Known history of HIV positivity
* Severe intercurrent bacterial, viral or fungal infection
* History of hypersensitivity to cornstarch or hydroxyethyl starch
* Patients with acute promyelocytic leukemia (APL)
* Known contraindication to protocol defined lymphodepleting
* chemotherapy regimen of Fludarabine/cyclophosphamide

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CD70 CAR-T细胞最大耐受剂量CD70 CAR-T细胞输注后28天。
核对登记原文(英文)

主要终点:Maximum tolerated dose of CD70-CAR T cells · Phase I design to determine the maximum tolerated dose (MTD) of autologous, CD70-CAR T cells. Three (3) dose levels will be evaluated (1x10e6, 3x10e6, and 1x10e7 cells/kg). · 28 days after CD70-CAR T-cell infusion

研究设计怎么做的

研究类型
干预性研究
入组人数
18 人(预计)
分组方式
不适用(单臂)
  • CD70 CAR-T细胞治疗实验性

    患者接受自体(患者自身)细胞。

核对分组登记原文(英文)
  • CD70- CAR T cell Therapy · EXPERIMENTAL · Patients will receive autologous (their own) cells.

关键日期

开始日期
2024-10-16
主要完成日期
2030-07-01
全部完成日期
2031-07-01
登记状态核实于
2026-01

联系与责任方

申办方
St. Jude Children's Research Hospital
联系邮箱
referralinfo@stjude.org
联系电话
866-278-5833

登记简述

研究参与者患有以下一种血液系统恶性肿瘤:急性髓系白血病(AML)/骨髓增生异常综合征(MDS)、急性淋巴细胞白血病(B-ALL、T-ALL)或淋巴瘤。癌症治疗困难(难治)或治疗后复发。主要目标是确定淋巴细胞清除化疗后静脉输注递增剂量CD70 CAR-T细胞治疗≤21岁复发/难治性CD70阳性血液系统恶性肿瘤患者的安全性和最大耐受剂量。次要目标是评估CD70 CAR-T细胞的抗白血病活性,包括骨髓中的活性及对髓外疾病的治疗作用。

核对登记原文(英文)

The study participant has one of the following blood cancers: acute myelogenous leukemia (AML)/myelodysplastic syndrome (MDS), acute lymphoblastic leukemia (B-ALL, T-ALL) or Lymphoma. Your cancer has been difficult to treat (refractory) or has come back after treatment (relapse). Primary Objective To determine the safety and maximum tolerated dose of intravenous infusions of escalating doses of CD70-CAR T cells in patients (≤21 years) with recurrent/refractory CD70+ hematological malignancies after lymphodepleting chemotherapy. Secondary Objectives To evaluate the antileukemic activity of CD70-CAR T cells. We will determine the anti- leukemic activity of the CD70-CAR T cells in the bone marrow and in the treatment of extramedullary disease.

登记原文与核验信息

试验登记号
NCT06326463
试验期别
I 期
试验状态
招募中
试验中心
St. Jude Children's Research Hospital · 孟菲斯 · 美国
适应症(原文)
Hematologic Malignancy; ALL, Childhood; AML, Childhood; Lymphoma; MDS
干预方式(原文)
Fludarabine; Cyclophosphamide; CD70-CAR T cell infusion (Autologous); Mesna