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GT307(TIL)治疗实体瘤:注册临床试验(分期未知)

英文原题:Autologous Tumor-Infiltrating Lymphocyte (GT307 Injection ) for Treatment of Patients With Solid Tumours

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Autologous Tumor-Infiltrating Lymphocyte (GT307 Injection ) for Treatment of Patients With Solid Tumours

ClinicalTrials.gov 2024/05/03(首次登记) 注册临床试验(分期未标注) · 招募中

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

简要介绍

这是一项分期未标注的注册临床试验,评估细胞治疗用于实体瘤的疗效与安全性。当前状态:招募中。计划入组 18 例。试验地点:中国 · 北京、徐州(共 3 个中心,其中中国 3 个)。登记号:NCT06397963。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 70 Years

纳入标准:

* 1. 自愿参加本研究,签署知情同意书,并且愿意且能够遵守研究方案。
* 2. 年龄18-70岁(70岁以上受试者的合格性由研究者和合作方医学监查员共同判定)。
* 3. 诊断为晚期实体瘤患者,标准治疗失败、无可用标准治疗或无法接受标准治疗。
* 4. 至少有一个未经放疗或其他局部治疗的病灶,肿瘤组织可获取(由研究者评估),且切除后可分离出≥1.0 cm³的组织块(可来自单个病灶或多个病灶的组合)用于制备自体TIL(肿瘤浸润淋巴细胞)(TILs);应尽可能采用微创操作。
* 5. 肿瘤取样后,至少有一个符合RECIST v1.1标准定义的可测量病灶,且该病灶必须未接受过放疗或其他局部治疗(除非此类治疗在3个月以前实施且该病灶已显示进展)。
* 6. 东部肿瘤协作组(ECOG)体能状态评分为0或1。
* 7. 预期生存时间≥12周。
* 8. 主要器官功能充分,符合以下要求:

1. 血液学参数:由于不同中心实验室的正常参考范围可能不同,最终评估由研究者根据综合判断作出,参考如下:

* 中性粒细胞绝对计数(ANC)≥1.0×10⁹/L;
* 淋巴细胞计数(LC)≥0.5×10⁹/L;
* 血小板计数(PLT)≥80×10⁹/L;
* 血红蛋白(Hb)≥90 g/L。
2. 肝功能参数:天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)和碱性磷酸酶(ALP)≤2.5×正常值上限(ULN);总胆红素(TBIL)≤1.5×ULN。在以下情况下可放宽标准:

* 对于确诊肝转移的受试者:AST和/或ALT≤5×ULN;
* 对于确诊肝或骨转移的受试者:ALP≤5×ULN;
* 对于确诊Gilbert综合征的受试者:TBIL≤3.0 mg/dL。
3. 肾功能参数:肌酐清除率(CrCL)≥45 mL/min(采用Cockcroft-Gault公式计算),或血清肌酐在正常范围内;且尿蛋白<2+。
4. 凝血功能参数:活化部分凝血活酶时间(APTT)≤1.5×ULN,同时国际标准化比值(INR)或凝血酶原时间(PT)≤1.5×ULN。
5. 心功能充分。
6. 肺功能充分。
* 9. 有生育能力的非手术绝育女性必须同意在研究治疗期间及研究治疗结束后1年内使用至少一种医学认可的避孕方法(如宫内节育器、口服避孕药或避孕套);此类受试者在细胞输注前7天内的血清人绒毛膜促性腺激素(HCG)检测结果必须为阴性。
* 10. 既往治疗引起的不良反应必须在肿瘤取样前恢复至CTCAE 5.0 1级或以下,或经研究者和协作医疗团队判断对研究无干扰。
* 11. 因疾病进展而入组的受试者,在肿瘤取样前必须有影像学资料证实末次既往治疗后疾病进展。

排除标准:

-1. 无法通过手术和/或放疗缓解的脊髓压迫受试者不符合入组条件。

(对于已接受治疗的受试者,如果临床证据表明在手术取样前症状已缓解≥1周,则允许入组。)

* 2. 经研究者评估存在未控制的肿瘤相关疼痛的受试者。需要镇痛治疗的受试者在入组研究时必须处于稳定的镇痛方案中。适合姑息性放疗的症状性病灶必须在入组研究前接受治疗。
* 3. 筛选前3个月内发生过出血事件,包括但不限于胃底或食管静脉曲张引起的消化道出血、门静脉高压导致的出血风险增加、活动性消化道出血等;或经研究者评估存在高的大出血风险的受试者(示例包括但不限于肿瘤包绕或侵犯大血管[即颈动脉、颈静脉、支气管动脉]和/或表现出其他高风险特征,如瘘管、显著空洞性病变、既往出血史[距签署ICF≤60天])。
* 4. 筛选前3个月内发生过动脉/静脉血栓事件,包括但不限于脑血管意外、深静脉血栓形成和肺栓塞等。
* 5. 诊断为间质性肺炎、筛选时存在临床显著的活动性肺炎,或其他严重损害肺功能的呼吸系统疾病。
* 6. 有临床显著的心血管疾病史,包括但不限于:

1. 充血性心力衰竭(NYHA分级>2级);
2. 不稳定型心绞痛;
3. 过去3个月内发生心肌梗死;
4. 任何需要治疗或干预的室上性或室性心律失常。
* 7. 筛选时存在≥3个未经治疗的中枢神经系统(CNS)转移灶的受试者。
(若受试者存在≤3个CNS转移灶,最大直径<1 cm,脑影像(MRI或CT)未见瘤周水肿,且脑影像显示治疗后至少3个月内无CNS疾病进展证据,则允许入组。)

* 8. 有自身免疫性疾病病史,或患有需要全身性糖皮质激素或免疫抑制剂(>10 mg/天泼尼松或等效剂量)治疗的活动性自身免疫性疾病。
* 9. 存在药物无法控制的不耐受性或难治性癫痫、大量胸腔积液、腹水、心包积液,活动性胃肠道出血,或存在IL-2给药禁忌症。
* 10. 筛选前5年内有目标适应症以外的恶性肿瘤病史(不包括已充分治疗的基底细胞癌或鳞状细胞皮肤癌、手术切除的乳腺导管原位癌等),除非研究者判断受试者的潜在获益大于风险。
* 11. 筛选前1年内有感染性疾病病史,如HIV、梅毒、活动性病毒性肝炎、活动性结核、活动性EBV和/或CMV感染;或活动性结核感染病史超过1年且未接受标准治疗。活动性乙型或丙型肝炎受试者排除。

HBsAg或HBcAb阳性受试者,若其HBV DNA检测结果低于研究中心检测实验室的正常值下限(LLN),可参加本研究。

HCV抗体阳性受试者,若其HCV RNA检测结果低于研究中心检测实验室的LLN,可参加研究。

对于入组研究的携带者,应酌情安排抗病毒治疗,并在研究期间定期进行核酸拷贝数定量检测。

* 12. 有既往异基因骨髓移植或实体器官移植史的受试者。
* 13. 采样前4周内使用过抗血管生成药物(如贝伐珠单抗、VEGF抑制剂)。
* 14. 在淋巴细胞清除预处理前4周内接受过全身性抗肿瘤治疗,但以下情况除外:

* 桥接治疗;
* 若既往治疗包含亚硝基脲或丝裂霉素化疗,则化疗结束至预期首次研究治疗给药之间的间隔必须至少为6周方可入组;
* 若既往治疗包含小分子靶向治疗,则治疗结束至预期首次研究治疗给药之间的间隔必须至少为该药物的5个半衰期方可入组。
* 15. 既往接受过基因修饰或编辑的细胞治疗产品(不包括在细胞输注日期前1年以上给予的未经基因修饰或编辑的自体免疫细胞治疗产品)。
* 16. 对研究中拟使用的任何药物成分有过敏反应史,包括但不限于自体TIL(肿瘤浸润淋巴细胞)(TILs)、环磷酰胺、氟达拉滨、白细胞介素-2(IL-2)、二甲基亚砜(DMSO)、人血清白蛋白(HSA)、右旋糖酐-40和抗生素(β-内酰胺类抗生素、庆大霉素)。
* 17. 已知有精神疾病、酗酒、吸毒或药物滥用等病史。
* 18. 既往免疫治疗出现3级或以上不良反应,且28天内未恢复至CTCAE 1级或以下;任何合理怀疑可能禁忌使用研究药物、干扰研究结果解读、或使受试者处于治疗相关并发症高风险的疾病或状况(包括其他疾病、代谢紊乱、体格检查发现或实验室检查结果异常)。
* 19. 妊娠期或哺乳期女性;或计划在细胞输注后1年内妊娠、哺乳或受孕的女性。
* 20. 筛选前4周内接受过其他研究药物/研究治疗,或计划在研究期间参加其他研究药物/研究治疗。
* 21. 研究者认为不适合入组的其他情况。
核对登记原文(英文)
Inclusion Criteria:

* 1\. Voluntarily participate in the study, sign the informed consent form, and be willing and able to comply with the study protocol.
* 2\. Aged 18-70 years old (eligibility for subjects over 70 years old shall be jointly determined by the investigator and the medical monitor of the collaborating party).
* 3\. Diagnosed as patients with advanced solid tumors who have failed standard treatment, have no available standard treatment, or are unable to receive standard treatment.
* 4\. Having at least one lesion that is untreated with radiotherapy or other local therapies, with accessible tumor tissue (assessed by the investigator), and from which a tissue block of ≥1.0 cm³ can be isolated after resection (either from a single lesion or a combination of multiple lesions) for the preparation of autologous tumor-infiltrating lymphocytes (TILs); minimally invasive procedures should be used whenever possible.
* 5\. After tumor sampling, having at least one measurable lesion as defined by the RECIST v1.1 criteria, and the lesion must not have received radiotherapy or other local therapies (unless such therapies were administered more than 3 months prior and the lesion has demonstrated progression).
* 6\. Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1.
* 7\. Expected survival time of ≥12 weeks.
* 8\. Adequate function of major organs meeting the following requirements:

  1. Hematological parameters: Since the normal reference ranges may vary among different central laboratories, the final assessment shall be made by the investigator based on comprehensive judgment, with the following references:

     * Absolute Neutrophil Count (ANC) ≥1.0×10⁹/L;
     * Lymphocyte Count (LC) ≥0.5×10⁹/L;
     * Platelet Count (PLT) ≥80×10⁹/L;
     * Hemoglobin (Hb) ≥90 g/L.
  2. Liver function parameters: Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Alkaline Phosphatase (ALP) ≤2.5×Upper Limit of Normal (ULN); Total Bilirubin (TBIL) ≤1.5×ULN. The criteria may be relaxed under the following circumstances:

     * For subjects with confirmed liver metastases: AST and/or ALT ≤5×ULN;
     * For subjects with confirmed liver or bone metastases: ALP ≤5×ULN;
     * For subjects with confirmed Gilbert's syndrome: TBIL ≤3.0 mg/dL.
  3. Renal function parameters: Creatinine Clearance Rate (CrCL) ≥45 mL/min (calculated using the Cockcroft-Gault formula), or serum creatinine within the normal range; and urine protein \<2+.
  4. Coagulation function parameters: Activated Partial Thromboplastin Time (APTT) ≤1.5×ULN, and International Normalized Ratio (INR) or Prothrombin Time (PT) ≤1.5×ULN simultaneously.
  5. Adequate cardiac function.
  6. Adequate pulmonary function.
* 9\. Non-surgically sterilized women of childbearing potential must agree to use at least one medically approved contraceptive method (e.g., intrauterine device, oral contraceptives, or condoms) during the study treatment period and for 1 year after the end of study treatment; the serum human chorionic gonadotropin (HCG) test result of such subjects must be negative within 7 days prior to cell infusion.
* 10\. Adverse reactions caused by prior treatments must have resolved to CTCAE 5.0 Grade ≤1 before tumor sampling, or be judged by the investigator and the collaborating medical team as having no interference with the study.
* 11\. For subjects enrolled in the study due to disease progression, imaging documentation confirming disease progression after the last prior treatment must be available before tumor sampling.

Exclusion Criteria:

-1. Subjects with spinal cord compression that cannot be relieved by surgery and/or radiotherapy are not eligible for enrollment.

(For treated subjects, enrollment is permitted if clinical evidence demonstrates that symptoms have been relieved for ≥1 week prior to surgical sampling.)

* 2\. Subjects with uncontrolled tumor-related pain as assessed by the investigator. Subjects requiring analgesic treatment must be on a stable analgesic regimen at the time of study entry. Symptomatic lesions suitable for palliative radiotherapy must be treated before study entry.
* 3\. A history of bleeding events occurring within 3 months prior to screening, including but not limited to gastrointestinal bleeding caused by fundic or esophageal varices, increased bleeding risk due to portal hypertension, active gastrointestinal bleeding, etc.; or subjects assessed by the investigator as having a high risk of major bleeding (examples include but are not limited to tumors encasing or invading major blood vessels \[i.e., carotid artery, jugular vein, bronchial artery\] and/or exhibiting other high-risk features such as fistulas, significant cavitary lesions, a history of prior bleeding \[≤60 days from signing the ICF\]).
* 4\. A history of arterial/venous thrombotic events occurring within 3 months prior to screening, including but not limited to cerebrovascular accident, deep vein thrombosis, and pulmonary embolism, etc.
* 5\. A diagnosis of interstitial pneumonia, clinically significant active pneumonia at screening, or other respiratory system diseases that severely impair pulmonary function.
* 6\. A history of clinically significant cardiovascular diseases, including but not limited to:

  1. Congestive heart failure (NYHA classification \> Class 2);
  2. Unstable angina pectoris;
  3. Myocardial infarction occurring within the past 3 months;
  4. Any supraventricular or ventricular arrhythmias requiring treatment or intervention.
* 7\. Subjects with ≥3 untreated central nervous system (CNS) metastases at screening.

(Enrollment is permitted if subjects have ≤3 CNS metastases, with the largest diameter \<1 cm, no peritumoral edema on brain imaging (MRI or CT), and no evidence of progressive CNS disease on brain imaging for at least 3 months after treatment.)

* 8\. A history of autoimmune diseases, or active autoimmune diseases requiring treatment with systemic corticosteroids or immunosuppressive agents (\>10 mg/day of prednisone or equivalent).
* 9\. Presence of refractory or intractable epilepsy, massive pleural effusion, ascites, pericardial effusion uncontrolled by medication, active gastrointestinal bleeding, or contraindications to IL-2 administration.
* 10\. A history of malignant tumors other than the target indication within 5 years prior to screening (excluding adequately treated basal cell or squamous cell skin cancer, surgically resected ductal carcinoma in situ of the breast, etc.), unless the investigator determines that the potential benefits to the subject outweigh the risks.
* 11\. A history of infectious diseases within 1 year prior to screening, such as HIV, syphilis, active viral hepatitis, active tuberculosis, active EBV and/or CMV infection; or a history of active tuberculosis infection for more than 1 year without standard treatment. Subjects with active hepatitis B or C are excluded.

HBsAg- or HBcAb-positive subjects may participate in the study if their HBV DNA test result is below the lower limit of normal (LLN) of the testing laboratory at the study site.

HCV antibody-positive subjects may participate if their HCV RNA test result is below the LLN of the testing laboratory at the study site.

For carriers enrolled in the study, antiviral treatment should be arranged as appropriate, and regular nucleic acid copy number quantitative testing should be performed during the study period.

* 12\. Subjects with a history of prior allogeneic bone marrow transplantation or solid organ transplantation.
* 13\. Use of anti-angiogenic agents (e.g., bevacizumab, a VEGF inhibitor) within 4 weeks prior to sampling.
* 14\. Receipt of systemic anti-tumor therapy within 4 weeks prior to lymphodepletion conditioning, except for the following circumstances:

  * Bridge therapy;
  * If prior treatment included nitrosourea or mitomycin chemotherapy, the interval between the end of chemotherapy and the expected first study treatment administration must be at least 6 weeks for enrollment;
  * If prior treatment included small-molecule targeted therapy, the interval between the end of treatment and the expected first study treatment administration must be at least 5 half-lives of the drug for enrollment.
* 15\. Prior receipt of genetically modified or edited cell therapy products (excluding autologous immune cell therapy products without genetic modification or editing that were administered more than 1 year before the date of cell infusion).
* 16\. A history of hypersensitivity reactions to any component of the drugs intended for use in the study, including but not limited to autologous tumor-infiltrating lymphocytes (TILs), cyclophosphamide, fludarabine, interleukin-2 (IL-2), dimethyl sulfoxide (DMSO), human serum albumin (HSA), dextran-40, and antibiotics (β-lactam antibiotics, gentamicin).
* 17\. A known history of mental illness, alcoholism, drug addiction, or substance abuse, etc.
* 18\. A history of grade 3 or higher adverse reactions from prior immunotherapy that failed to resolve to CTCAE Grade 1 or lower within 28 days; any disease or condition (including other illnesses, metabolic disorders, physical examination findings, or abnormal laboratory test results) that would reasonably raise suspicion of contraindicating the use of study drugs, interfere with the interpretation of study results, or place the subject at high risk of treatment-related complications.
* 19\. Pregnant or lactating women; or women planning to become pregnant, lactate, or conceive within 1 year after cell infusion.
* 20\. Receipt of other investigational drugs/study treatments within 4 weeks prior to screening, or plans to participate in other investigational drugs/study treatments during the study period.
* 21\. Other circumstances deemed unsuitable for enrollment by the investigator.

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

  • 主要终点根据CTCAE 5.0标准的不良事件发生率和严重程度3年
  • 次要终点客观缓解率
核对登记原文(英文)

主要终点:Incidence and severity of adcersed events per CTCAE 5.0 · To characterize the safety profile of autologous TIL injection(GT307) in patients with relapsed/metastatic advanced solid tumor as measured by the incidence and severity of adcersed events per CTCAE 5.0 · 3 years
次要终点:Objective response rate

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)
  • GT307注射液治疗组试验组
核对分组登记原文(英文)
  • GT307 injection treatment group · EXPERIMENTAL

关键日期

开始日期
2024-04-18
主要完成日期
2027-04-18
全部完成日期
2027-04-18
登记状态核实于
2026-01

联系与责任方公示信息

申办方
Grit Biotechnology
合作方
The Affiliated Hospital of Xuzhou Medical University、Beijing GoBroad Hospital、Beijing Arion Cancer Center
联系邮箱
cnhzxyq@163.com
联系电话
+86 18052268612

以上邮箱 / 电话是登记库里的申办方联系方式(+86,中国),通常不直达某家医院。中国中心的联系方式请以医院或登记平台最新公示为准。

登记简述

本研究为单臂、开放设计,旨在评估自体TIL(肿瘤浸润淋巴细胞)(GT307注射液)治疗实体瘤患者的安全性和耐受性,同时评估药代动力学特征和疗效,以确定最佳生物剂量(OBD)。

核对登记原文(英文)

This study is a single arm, open design aimed at evaluating the safety and tolerability of Autologous Tumor-Infiltrating Lymphocyte (GT307 injection ) for treatment of patients with solid tumours,while evaluating pharmacokinetic characteristics and efficacy assessment to determine the optimal biological dose (OBD).

登记原文与核验信息

试验登记号
NCT06397963
试验期别
NA
试验状态
招募中
中国试验中心(3 个)
北京 ×2 · 徐州
适应症(原文)
Solid Tumor, Adult
干预方式(原文)
GT307 injection