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:Clinical Trial of Autologous GPC3 CAR-T Cells (CBG166) Therapy for Advanced Hepatocellular Carcinoma
⚠ 该试验的登记信息已有 23 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 期注册临床试验,评估 CAR-T 细胞治疗肝细胞癌的安全性、可行性及初步疗效。当前状态:招募中。计划入组 15 例。试验地点:中国 · 杭州(共 2 个中心,其中中国 2 个)。登记号:NCT06461624。
不限性别 · ≥ 18 Years 且 ≤ 70 Years
纳入标准: * 年龄18至70岁,男性或女性; * 受试者自愿参加研究,并由本人或监护人签署知情同意书(ICF); * 根据巴塞罗那临床肝癌(BCLC)分期,不可切除的B期或C期HCC。对于B期,受试者必须在手术或局部治疗后出现疾病进展,或不适合手术或局部治疗; * 受试者既往至少接受过一种全身治疗方案(包括但不限于靶向治疗、免疫治疗或化疗),且在治疗期间或治疗后经影像学确定疾病进展; * 肝硬化状态Child-Pugh评分:≤7; * 治疗开始前28天内经影像学检查(动脉期强化)确认肝内病灶。根据RECIST1.1,至少有一个可稳定评估的目标病灶; * 预期生存时间> 12周; * 经免疫组织化学(IHC)证实GPC3表达 * ECOG体能状态评分:0至1分; * 受试者应具有足够的器官功能; * 受试者应为HBsAg阴性。HBsAg阳性或HBcAb阳性的受试者要求HBV-DNA <2000 IU/ml; * 育龄期女性受试者在细胞治疗前7天内血妊娠试验应为阴性,且不在哺乳期;育龄期女性或男性受试者需要在整个研究过程中或CAR-T细胞输注后一年内采取高效工具或药物避孕措施(以后续发生情况为准); 排除标准: * 肝脏肿瘤完全可切除或符合肝移植条件的受试者; * 妊娠或哺乳期女性; * 淋病清除前72小时内有活动性细菌或真菌感染(排除无活动性感染证据且抗生素不在禁用药物清单上,并继续使用预防性抗生素、抗真菌药物或抗病毒药物的受试者); * 在单采前2周内接受过相当于> 15 mg/天泼尼松的全身性类固醇的患者,但近期使用或目前正在使用吸入性类固醇的患者除外; * 单采前,Hb < 80 g/L,ANC < 1.0 × 109 /L或PLT < 60 × 109 /L; * 当前有临床意义的腹水,定义为体格检查阳性或需要干预(如穿刺或药物)控制的腹水(影像学结果显示腹水无需干预者可纳入); * 影像学结果:≥50%的肝脏被肿瘤替代或门静脉主干癌栓,或癌栓侵犯肠系膜静脉/下腔静脉; * 既往或目前存在肝性脑病; * 活动性脑转移; * 有器官移植史或等待器官移植(包括肝移植)的受试者; * 存在以下任一情况:乙型肝炎核心抗体(HBcAb)阳性且外周血乙型肝炎病毒(HBV)DNA ≥ 2000 IU/mL。丙型肝炎病毒(HCV)抗体阳性且HCV RNA阳性。人类免疫缺陷病毒(HIV)抗体阳性。梅毒检测阳性。 * 其他可能限制患者参加本试验的严重医学状况; * 在单采前2周内接受过抗肿瘤治疗,或在签署知情同意书前28天内(或药物的5个半衰期,以研究者判断更合适者为准)接受过任何研究性药物或全身性抗肿瘤治疗; * 既往接受过任何靶向GPC3的治疗; * 签署知情同意书时,既往PD-1/PD-L1治疗引起的毒性未恢复至1级或基线水平,脱发和色素沉着除外; * 过去5年内或同时存在其他未治愈的恶性肿瘤,宫颈原位癌和皮肤基底细胞癌除外; * 根据研究者的评估,患者无法或不愿意遵守研究方案的要求。
Inclusion Criteria: * Aged 18 to 70 years, male or female; * Subjects voluntarily participated in the research and signed the Informed Consent Form (ICF) by themselves or their guardians; * Unresectable stage B or C HCC according to the Barcelona Clinic Liver Cancer (BCLC) staging. In case of stage B, the subject must have disease progression following surgery or local treatment, or be unsuitable for surgery or local treatment; * Subjects have previously received at least one systemic treatment regimen (including but not limited to targeted therapy, immunotherapy or chemotherapy) with disease progression determined by imaging during or after treatment; * Cirrhosis status Child-Pugh score:≤7; * Intrahepatic lesions were confirmed by imaging examination (arterial phase enhancement) within 28 days before the start of treatment. According to the RECIST1.1, there was at least one target lesion that could be stably evaluated; * Expected survival time \> 12 weeks; * Expression of GPC3 demonstrated by immunohistochemistry (IHC) * ECOG Performance Status score: 0 to 1 point; * Subjects should have adequate organ function; * Subjects should be HBsAg negative. Subjects with positive HBsAg or positive HBcAb are required to have HBV-DNA \<2000 IU/ml; * The blood pregnancy test of female subjects of childbearing age should be negative within 7 days before cell therapy and not during lactation; Female or male subjects of childbearing age need to take efficient tools or drug contraceptive measures during the whole research process or within one year after CAR-T cell transfusion (What happens later shall prevail); Exclusion Criteria: * Subjects with completely resectable liver tumors or who are eligible for liver transplantation; * Pregnant or lactating women; * Active bacterial or fungal infections within 72 hours prior to gonorrhea clearance (excluding subjects who have no evidence of active infections and antibiotics are not on the prohibited drug list, and continue to use prophylactic antibiotics, antifungal drugs, or antiviral drugs); * Patients who had received systemic steroids equivalent to \> 15 mg/day prednisone within 2 weeks before apheresis, except those who had recently used or are currently using inhaled steroids; * Before apheresis, Hb \< 80 g/L, ANC \< 1.0 × 109 /L or PLT \< 60 × 109 /L; * Current clinically significant ascites, which is defined as ascites that are physically positive or require intervention (e.g., puncture or medication) for control (those whose imaging result shows ascites requiring no intervention may be included); * Imaging results:≥50% of the liver is replaced by tumor or portal vein main tumor thrombus, or tumor thrombus invasion of mesenteric vein / inferior vena cava; * Previous or present hepatic encephalopathy; * Active brain metastasis; * Subjects with a history of organ transplantation or waiting for organ transplantation (including liver transplantation); * Any of the following situations exist: Hepatitis B core antibody (HBcAb) positive and hepatitis B virus (HBV) DNA in peripheral blood isperipheral blood hepatitis B virus (HBV) DNA ≥ 2000 IU/mL. Hepatitis C virus (HCV) antibody positive and HCV RNA positive. Human immunodeficiency virus (HIV) antibody positive. Syphilis test positive. * Other serious medical conditions that may limit the patient's participation in this trial; * Subjects who received anti-tumor therapy within 2 weeks prior to apheresis, or who received any investigational drug or systemic anti-tumor therapy within 28 days (or 5 half-lives of the drug, whichever is more appropriate in the judgment of the investigator) prior to signing the informed consent form; * Prior treatment with any therapy that is targeted to GPC3; * At the time of signing the informed consent, toxicity caused by previous PD-1/PD-L1 treatment had not returned to grade 1 or baseline levels, except for hair loss and pigmentation; * Other uncured malignant tumors in the past 5 years or at the same time, except for cervical cancer in situ and basal cell carcinoma of the skin; * According to the investigators' evaluation, patients are unable or unwilling to comply with the requirements of the study protocol.
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:Dose limiting toxicity (DLT) · Describe the adverse events of limiting further increases in the dose of CBG166. · Within 28 days of CAG166 infusion;Adverse events · Describe adverse events (AEs) and serious adverse events (SAEs) that are "likely" or "definitely" related to the study treatment that occur at any time of 24 months after treatment. · Within 24 months after the treatment;Maximum tolerated dose · Determine the optimal agent for CBG166 CAR-T at maximum tolerated dose. · From enrollment of the first subject to completion of follow-up of the last subject (up to 3 years)
次要终点:Effectiveness evaluation;Effectiveness evaluation;Effectiveness evaluation;Effectiveness evaluation;Effectiveness evaluation;Pharmacokinetic evaluation;Pharmacodynamic evaluation;Pharmacodynamic evaluation
靶向磷脂酰肌醇蛋白聚糖3(GPC3)的第四代嵌合抗原受体T细胞(CAR-GPC3 T细胞)治疗晚期肝细胞癌患者的I期临床研究。
A phase I clinical study of 4th generation chimeric antigen receptor T Cells targeting glypican-3 ( CAR-GPC3 T Cells) in patients with advanced hepatocellular carcinoma.
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