帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
英文原题:CRTE7A2-01 TCR-T Cells for HPV-16 Positive Advanced Cancers
⚠ 该试验的登记信息已有 30 个月未更新, 页面上显示的「尚未开始招募」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。
这是一项 I 期注册临床试验,评估细胞治疗用于宫颈癌、恶性肿瘤、头颈部肿瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 24 例。登记号:NCT06358053。
不限性别 · ≥ 18 Years 且 ≤ 65 Years
纳入标准: • 年龄>18岁且≤65岁。组织学和/或细胞学确诊晚期实体瘤(如宫颈癌、头颈部肿瘤、肛门癌及其他恶性肿瘤),标准治疗失败或不耐受,且无有效后续治疗。具体要求:宫颈癌患者既往至少二线全身治疗失败(至少含一种含铂方案或抗血管生成治疗),最近疗程期间或之后经病理/影像证实进展或不耐受,且不适合手术或放疗、无复发/转移性宫颈癌标准治疗方案;鼻咽癌患者至少三线全身治疗失败或不耐受、不适合手术/放疗且无标准治疗方案,并须EB病毒阴性;非鼻腔来源头颈部鳞癌患者至少二线全身治疗失败或不耐受且无标准治疗方案。 • 确认为HPV16阳性且携带HLA-A*02:01等位基因。ECOG 0–1分;预期生存期≥3个月;至少有一个按RECIST 1.1定义的可测量病灶。 • 有生育能力女性须在研究治疗前7天内血清妊娠试验阴性,并愿意自筛选至末次研究治疗后6个月采用高效、可靠避孕方法。 • 愿意签署知情同意书,且预计能够遵守研究程序。 排除标准: • 既往接受任何基因修饰T细胞治疗。 • 正使用抑制T细胞的药物(如环磷酰胺、FK506/他克莫司、雷公藤多苷)或T细胞免疫激动剂。 • 单采前2周内接受化疗、靶向治疗、免疫治疗或其他研究药物;或前4周内接受放疗。 • 器官功能不符合方案界值:白细胞<3.0×10⁹/L;中性粒细胞绝对计数(原登记标准写为>1.5×10⁹/L);血红蛋白<90 g/L;血小板<100×10¹⁰/L(按原登记值);淋巴细胞<0.5×10⁹/L或比例<15%;肌酐>ULN的1.5倍或肌酐清除率<50 mL/min;总胆红素>ULN的3倍;ALT/AST>ULN的3倍(肝转移患者>5倍);INR或APTT>ULN的1.5倍;SpO₂≤90%。 • 严重疾病、障碍或合并症,包括严重心脏病、脑血管病、癫痫、未控制糖尿病(CTCAE 5.0空腹血糖≥2级)、活动性感染、活动性消化道溃疡/出血、肠梗阻、肺纤维化、肾衰竭或呼吸衰竭。 • 筛选前6个月内严重心血管病,如心肌梗死、严重/不稳定型心绞痛、冠状动脉或外周动脉旁路移植术,或NYHA III/IV级心衰;LVEF<50%。 • 已知活动性脑转移;已知骨髓增生异常综合征或淋巴瘤;活动性自身免疫病(包括获得性/先天性免疫缺陷、器官异体移植、自身免疫性肝炎、系统性红斑狼疮、炎症性肠病等)。 • 活动性乙肝或丙肝;HIV病史或感染;梅毒病史。妊娠或哺乳。 • 已知活动性精神或神经系统疾病;主要研究者判断不适合参加本临床研究。
Inclusion Criteria: 1\. Age \>18 years and 65 years. 2. Patients with advanced solid tumors (such as cervical cancer, head and neck tumors, anal cancer, and other malignancies) who have failed standard treatment confirmed by histology and/or cytology, or who are intolerant to such treatment, and for whom there is no effective therapy available after standard treatment failure are considered as end-stage patients. Specifically for: 1. Cervical cancer: a) Patients who have previously failed at least second-line systemic therapy (including at least one platinum-based regimen or anti-angiogenic therapy) and have shown disease progression or intolerance confirmed by pathological or radiological examination during or after the most recent treatment course, and are not amenable to treatment with surgery or radiotherapy, with no standard treatment options currently available for recurrent or metastatic cervical cancer. 2. Nasopharyngeal cancer: a) Patients who have previously failed at least third-line systemic therapy or are intolerant, not amenable to treatment with surgery or radiotherapy, with no standard treatment options currently available for recurrent or metastatic nasopharyngeal cancer; b) EB virus negative. 3. Head and neck squamous cell carcinoma: a) Patients who have previously failed at least second-line systemic therapy or are intolerant, with no standard treatment options currently available for recurrent or metastatic head and neck squamous cell carcinoma (non-nasal). 3\. Confirmation of HPV16 positive and HLA-A\*02:01 allele. 4. ECOG performance status of 0-1. 5. Estimated life expectancy ≥ 3 months. 6. Patients must have at least one measurable lesion defined by RECIST 1.1. 7. Female patients of childbearing age must undergo a serum pregnancy test within 7 days prior to study treatment and the results must be negative, and are willing to use a very effective and reliable method of contraception from screening through 6 months after the last dose of study treatment. 8\. The patient must be willing to sign the informed consent form and have a good anticipation of compliance with study procedure. Exclusion Criteria: 1. Patient received any genetically modified T cell therapy. 2. Patient is being treated with T cell immunosuppressive agent (such as cyclophosphamide, FK506,tripterygium glycosides) or T cell immunoagonist. 3. Patients received chemotherapy, targeted therapy, immunotherapy, or other investigational agents within 2 weeks and received radiotherapy within 4 weeks before apheresis. 4. Patients have any organ system function impairment as defined below: * leukocytes\<3.0 x 109/L * absolute neutrophil count \>1.5 x 109/L * hemoglobin\<90g/L * platelets \<100 x 1010/L * lymphocytes\<0.5 x 109/L * percentage of lymphocytes\<15% * creatinine\>1.5×ULN or creatinine clearance \<50mL/min * total bilirubin\>3×ULN; ALT/AST\>3×ULN (patients with liver metastasis,\>5×ULN) * INR\>1.5×ULN; APTT\>1.5×ULN * SpO2≤90% 6\. Patinets has serious medical conditions, disorders, and / or comorbidities, including, but are not limited to: severe heart disease, cerebrovascular disease, epileptic seizures, uncontrolled diabetes (CTCAE 5.0: FBG ≥ 2 grade), active infection, active digestive tract Ulcer, gastrointestinal bleeding, intestinal obstruction, pulmonary fibrosis, renal failure, respiratory failure. 7\. Patient has a severe cardiovascular disease with 6 months before screening, including, but are not limited to, myocardial infarction, severe or unstable angina, coronary or peripheral artery bypass grafting, Heart failure NYHA grade Ⅲ or Ⅳ. 8\. Left Ventricular Ejection Fractions (LVEF) \<50%. 9. Patient has a known active brain metastases. 10. Patient has a known myelodysplastic syndrome (MDS) or lymphoma. 11. Patient has a known active autoimmune disease, including , but are not limited to, acquired or congenital immunodeficiency disease, allogeneic organ transplantation, autoimmune hepatitis, systemic lupus erythematosus, inflammatory bowel disease. 12\. Patient has a known active Hepatitis B or Hepatitis C. 13. Patient has a history of Human Immunodeficiency Virus (HIV) . 14. Patient has a history of syphilis. 15. Pregnant or lactating women. 16. Patient has a known active mental and neurological diseases. 17. The principal investigator judged that it is not suitable to participate in this clinical study.
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:DLT · Dose-limiting toxicity · 28 days;RP2D · Recommended Phase 2 Dose · 2 years;cevents (SAEs). · Incidence of treatment related AEs, AEs of special interest and serious adverse events (SAEs). · 2 years
次要终点:Objective Response Rate (ORR);Disease Control Rate (DCR);Duration of Response (DOR);Progression-Free Survival (PFS);Overall Survival(OS)
单组Ⅰ期研究,包含剂量递增和剂量扩展阶段。患者接受淋巴细胞单采,随后以递增剂量输注TCR-T细胞并给予IL-2。
本单中心、开放标签、单组Ⅰ期剂量递增和扩展研究,评估CRTE7A2-01 TCR-T细胞治疗HLA-A*02:01阳性且HPV16阳性的晚期宫颈癌、肛门癌、头颈部癌及其他实体瘤患者的安全性、耐受性和疗效,并确定Ⅱ期推荐剂量。
A single center, open, single arm dose escalation and dose expansion phase I study to evaluate the safety, tolerability, and efficacy of CRTE7A2-01 TCR-T cells in HLA-A\*02:01+ Subjects HPV16 positive advanced cervical, anal, or head and neck cancers. The study will determine RP2D of CRTE7A2-01 TCR-T cell injection.
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