决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:CAR T-cell Therapy Directed to CD70 for Pediatric Patients With Hematological Malignancies
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。
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。
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。
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
患者接受自体(患者自身)细胞。
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。
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.
MEMBER ACCOUNT
登录成功会直接打开下一页。