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:Efficacy and Safety of CAR-T Cells Therapy for Chronic or Refractory Primary Immune Thrombocytopenia (ITP)
⚠ 该试验的登记信息已有 27 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。
这是一项 I/II 期注册临床试验,评估 CAR-T 细胞治疗多发性骨髓瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 10 例。试验地点:中国 · 昆明(共 1 个中心,其中中国 1 个)。登记号:NCT06352281。
不限性别 · ≥ 8 Years 且 ≤ 75 Years
纳入标准: 1. 愿意完成知情同意程序,并遵守研究程序和访视安排。 2. 男性或女性,年龄8–75岁。 3. 确诊慢性ITP(病程>12个月)或难治性ITP(记录显示对一线和二线标准治疗不耐受或应答不足)。 4. 体格检查、影像/器械检查和实验室检查未提示除ITP以外可能导致血小板减少的疾病。 5. 血小板计数<30×10⁹/L。 6. 正在使用皮质类固醇者,治疗方案/剂量须稳定(筛选前至少2周)。 7. 体格检查、器械检查和实验室结果在正常范围内,或研究者认为偏差无临床意义。 8. 同意在整个研究期间采用有效可靠的避孕方法。 排除标准: 1. 患有可导致继发性免疫性血小板减少的疾病。 2. 既往接受预防性脾切除。 3. 除慢性血小板减少外存在止血障碍。 4. 研究开始前2周至研究结束期间,连续>3天使用影响血小板功能的药物(包括但不限于阿司匹林、氯吡格雷和/或NSAIDs)或抗凝药。 5. 有血小板凝集异常史,导致血小板计数无法可靠测定。 6. 合并恶性肿瘤,和/或有细胞毒性化疗及/或放疗史。 7. 入组前1年内有Ⅲ–Ⅳ级心力衰竭、心肌梗死、心脏血管成形术或支架置入、不稳定型心绞痛或其他明显心脏病。 8. 有血栓形成史或存在显著血栓风险因素。 9. 患有伴出血风险的活动性或急性加重的慢性胃肠道疾病、急性感染性疾病或呼吸系统疾病。 10. 有临床意义的肝功能损害(血清转氨酶>ULN的3倍)。 11. 血清肌酐>相应年龄和性别ULN的2倍。 12. 研究者认为可能显著影响结果的其他失代偿性合并疾病或急性状况。 13. HIV血清阳性;乙肝表面抗原阳性,或乙肝核心抗体阳性且HBV-DNA阳性;丙肝患者HCV-RNA定量阳性;或存在其他严重活动性病毒/细菌感染或未控制的全身真菌感染。 14. 有严重过敏史或过敏体质。 15. 妊娠或哺乳期。 16. 有精神疾病史或已知酒精/药物成瘾。 17. 因生理、家庭、社会、地理或其他因素依从性差,无法配合研究方案及随访计划。 18. 参加本试验前4周内参加过其他临床试验。
Inclusion Criteria: 1. Willingness to complete the informed consent process and to comply with study procedures and visit schedule; 2. Men and women aged 8-75; 3. Participants diagnosed with chronic (\>12 months duration) or refractory (a documented intolerance or insufficient response to the first and second line standard treatment of ITP) ITP; 4. The results of physical, instrumental, and laboratory examination of patients not suggest any disease which may cause thrombocytopenia other than ITP; 5. Platelet count \<30 x 109 / L; 6. If the patient is taking corticosteroids, the treatment regimen/dose should be stable (at least 2 weeks prior to screening); 7. The results of physical, instrumental, and laboratory examination of patients should be within the normal range or deviations should be regarded by the researcher as clinically insignificant; 8. Willingness to use effective and reliable methods of contraception throughout the entire study period; Exclusion Criteria: 1. All subjects with diseases which may cause secondary immune thrombocytopenia 2. Patients with preventive splenectomy; 3. Hemostatic disorders other than chronic thrombocytopenia; 4. Subject treated with drugs that affect platelet function (including but not limited to aspirin, clopidogrel and/or NSAIDs) or anti-coagulants for \> 3 consecutive days within 2 weeks of the study start and until the end of the study; 5. History of platelet agglutination abnormality that prevents reliable measurement of platelet counts; 6. Concurrent malignant disease and/or history of cancer treatment with cytotoxic chemotherapy and/or radiotherapy; 7. Grade III-IV heart failure or myocardial infarction, cardiac angioplasty or stenting, unstable angina pectoris, or other clinically prominent heart disease within one year prior to enrollment; 8. History of thrombosis or presence of significant risk factors for thrombosis; 9. Persons with acute or exacerbation of chronic diseases of the gastrointestinal tract associated with the risk of bleeding, acute infectious diseases, pathologies of the respiratory system; 10. Any clinically significant hepatic impairment (increase of serum transaminase levels by more than 3 times the upper limit of normal); 11. Serum creatinine levels are more than two times higher than the upper limit of normal for a given age and sex; 12. Any other concomitant decompensated diseases or acute conditions, the presence of which, according to the researcher, may significantly affect the results of the study; 13. Human immunodeficiency virus (HIV) seropositivity, Hepatitis B surface antigen positive or hepatitis B core antibody positive and HBV-DNA positive, Patients with hepatitis C (HCV-RNA quantitative test results positive), Or the presence of other serious active viral or bacterial infections or uncontrolled systemic fungal infections; 14. Patients with severe history of allergy or allergic constitution; 15. Pregnancy and lactation; 16. History of mental illness and known alcohol/drug addiction; 17. Poor compliance due to physiological, family, social, geographical and other factors, unable to cooperate with the study protocol and follow-up plan; 18. Had undergone other clinical trials in the 4 weeks prior to participating in this trial;
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:Portion of patients with response (R) · platelet count\>30x10\^9/L and at least 2-fold increase of the baseline count, confirmed on at least 2 separate occasions at least 7 days apart, and absence of bleeding · At least 2 weeks after infusion
次要终点:Portion of patients with complete response (CR);Portion of patients with relapse;Time (in days) from treatment start to response (R);Time (in days) from treatment to complete response (CR);Duration (in days) of response (R);Incidence of adverse events(AE) after infusion
符合入组条件的受试者先接受淋巴细胞清除治疗,随后静脉输注CAR-T细胞。
这是一项单中心、单臂、开放标签临床试验,旨在评估CAR-T细胞治疗慢性或难治性原发免疫性血小板减少症(ITP)的疗效和安全性。
It is a single-center, single-arm, open-labeled clinical trial to evaluate the efficacy and safety of CAR-T cells therapy for Chronic or Refractory Primary Immune Thrombocytopenia (ITP).
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