为肝细胞癌武装 GPC3 CAR T 细胞:多少才足够,下一步是什么?
Armouring GPC3 CAR T cells for hepatocellular carcinoma: how much is enough and what comes next?
英文原题:HRYZ-T102 TCR-T Cell for AFP Positive Advanced HCC and Other Solid Tumors
这是一项 I 期注册临床试验,评估 T 细胞治疗相关疾病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 12 例。试验地点:中国 · 上海(共 1 个中心,其中中国 1 个)。登记号:NCT06515314。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 患者愿意签署知情同意书。 2. 年龄≥18岁且≤75岁。 3. HLA-A*02:03等位基因阳性。 4. 组织学确诊为AFP阳性肝细胞癌(HCC)或其他实体瘤;研究者判断无法从根治性手术或其他局部治疗获益,且筛选时至少接受过1线系统治疗。 5. 新鲜或福尔马林固定石蜡包埋(FFPE)样本免疫组化(IHC)显示AFP阳性,或血清AFP≥400 ng/mL。 6. 巴塞罗那临床肝癌(BCLC)分期B或C期,Child-Pugh评分≤7分。 7. ECOG体能状态评分≤1分。 8. 预计生存期≥4个月。 9. 根据RECIST 1.1至少有1个可测量病灶。 10. 器官功能符合以下标准:白细胞≥3.0×10⁹/L;血小板≥75×10⁹/L;血红蛋白≥85 g/L;淋巴细胞绝对计数≥0.8×10⁹/L;血清白蛋白≥30 g/L;总胆红素≤ULN的3倍;ALT/AST≤ULN的3倍;肌酐清除率≥50 mL/min或血清肌酐≤ULN的1.5倍;INR≤ULN的1.5倍;APTT≤ULN的1.5倍;LVEF≥50%;SpO₂≥92%。 11. 有生育能力者须同意在整个试验期间及接受HRYZ-T102细胞输注后至少1年内采取有效避孕措施。有生育能力的女性须在单采前7天内HCG检测阴性。 排除标准: 1. 既往治疗毒性在筛选时尚未缓解或未降至≤1级。 2. 过去5年内患有其他原发恶性肿瘤(已完全切除的早期肿瘤等部分情况除外)。 3. 筛选前6个月内患有严重心血管疾病或有临床相关的中枢神经系统(CNS)疾病。 4. 患有需要长期全身免疫抑制治疗的自身免疫性疾病。 5. 对环磷酰胺或氟达拉滨有超敏反应史,或已知对本研究使用的任何药物成分会发生过敏反应。 6. 目前存在或既往有肝性脑病。 7. 器官移植或异基因细胞移植受者。 8. 筛选前3个月内有胃肠道出血史或明确的胃肠道出血倾向。 9. 存在遗传性或获得性出血(如凝血功能障碍)或血栓倾向。 10. 筛选期间或细胞输注前存在活动性感染或不明原因发热。 11. 有症状的中枢神经系统转移。 12. 已知HIV或梅毒感染和/或活动性丙型肝炎病毒感染。 13. HBV感染且HBV-DNA≥2000 IU/mL。 14. 妊娠或哺乳期女性,或入组前HCG检测阳性。 15. 患有未控制的糖尿病、肺纤维化、间质性肺病、急性肺病或肝功能衰竭。
Inclusion Criteria:
1. The patient must be willing to sign the informed consent form.
2. Age ≥18 years and ≤75 years.
3. HLA-A 02:03 allele positive
4. Histologically-confirmed AFP positive hepatocellular carcinoma (HCC) or other solid tumor, No benefits from curative surgery or other local therapies are expected ,at least one prior line of systematic treatment at screening, judged by investigators.
5. Fresh samples or formalin-fixed paraffin-embedded (FFPE) samples, immunohistochemistry (IHC)-stained AFP positive or serum AFP ≥400ng/ml.
6. Barcelona Clinic Liver Cancer (BCLC) stage C or B and Child-Pugh ≤7
7. ECOG performance status ≤1.
8. Estimated life expectancy ≥4 months.
9. Patients must have at least one measurable lesion defined by RECIST 1.1.
10. Patients with any organ dysfunction as defined below:
Leukocytes≥3.0 x 10\^9/L; blood platelets ≥75 x 10\^9/L; hemoglobin≥85g/L; Absolute lymphocyte count≥0.8 x 10\^9/L Serum albumin ≥ 30g/L; total bilirubin≤3×ULN; ALT/AST≤3×ULN ; Creatinine clearance ≥50mL/min; or serum creatinine ≤1.5×ULN; INR≤1.5×ULN; APTT≤1.5×ULN; LVEF≥50%; SpO2≥92%.
11. Subjects with potential fertility must agree to use effective contraceptive methods during the whole trials period and at least 1 year after receiving HRYZ-T102 cell transfusion treatment. HCG test for female with potential fertility must be negative within 7 days before apheresis.
Exclusion Criteria:
1. Toxicity of previous treatment has not been mitigated or ≤ Grade 1 at screening.
2. Another primary malignancy within 5 years (with some exceptions for completely-resected early-stage tumors)
3. With severe cardiovascular disease or presence of clinically-relevant central nervous system (CNS) disorders in six months before screening.
4. Systematic autoimmune disorders requiring long-term systematic immunosuppression
5. Have a history of hypersensitivity to cyclophosphamide or fludarabine, and it is known that any ingredient used in the treatment of this study will produce allergic reactions.
6. Current presence of or previously with hepatic encephalopathy
7. Organ transplanters and allogeneic cell transplanters.
8. Have a history of gastrointestinal bleeding or a definite tendency to gastrointestinal bleeding within 3 months before screening
9. Hereditary or acquired bleeding (e.g. coagulation dysfunction) or a tendency to clot
10. Subject has active infection or unexplained fever during screening and prior to cell transfusion
11. Have central nervous system metastasis with symptoms
12. Known HIV or syphilis infection, and/or active hepatitis C virus infection.
13. HBV infect subjects with HBV-DNA≥2000IU/ml
14. Pregnant or lactating female, or those whose HCG test is positive before enrollment.
15. Known uncontrolled diabetes, pulmonary fibrosis, interstitial lung disease, acute lung disease or liver failure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:Adverse events and serious adverse events · Incidence of adverse events and serious adverse events · 2 years;DLT · Dose-limiting toxicity · 2 years
次要终点:Objective Response Rate(ORR);Disease Control Rate (DCR);Duration of response (DoR);Time to response (TTR);Progression-Free Survival(PFS);Overall Survival (OS);Duration of TCR T cells in-vivo persistence;Concentration of Cytokines (IL-2、IL-6、IL-10、TNFα、IFNγ)
患者接受淋巴细胞单采,随后接受HRYZ-T102 TCR-T细胞治疗。
这是一项单臂、开放标签、剂量递增临床研究,旨在评估HRYZ-T102 TCR-T细胞用于既往系统治疗无效的甲胎蛋白(AFP)阳性晚期肝细胞癌及其他实体瘤患者的安全性和疗效。
This is a single arm, open-label, dose escalation clinical study to evaluate the safety and efficacy of HRYZ-T102 TCR-T Cell in patients with AFP positive advanced hepatocellular carcinoma and other solid tumors refractory to prior systematic treatments.
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