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:Genetically Modified T Cells Treating Malignant Tumors
Genetically Modified T Cells Treating Malignant Tumors
⚠ 该试验的登记信息已有 24 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。
这是一项早期 I 期注册临床试验,评估 CAR-T 细胞治疗实体瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 100 例。试验地点:中国 · 郑州(共 1 个中心,其中中国 1 个)。登记号:NCT06515626。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 组织病理学或细胞学确诊恶性肿瘤,包括非小细胞肺癌、食管鳞癌、胃癌、结直肠癌、肝癌、胰腺癌、肾癌、宫颈鳞癌、卵巢癌、乳腺癌、黑色素瘤、脑胶质瘤、淋巴瘤等。 2. 年龄18至75岁,性别不限。 3. 造血功能足够:ANC>1,500个/mm³,血小板>50,000个/mm³,血红蛋白>9.0 g/dL,ALC>9个/mm³。 4. 肝肾功能足够:无肝转移者AST/ALT≤正常值上限(ULN)的2.5倍;有肝转移者≤ULN的5倍;胆红素≤ULN的1.5倍(肝源性高胆红素血症除外);肌酐≤ULN的2倍;肌酐清除率≥40 mL/min。 5. PT/INR<ULN的1.5倍,PTT/aPTT<ULN的1.5倍。 6. 有可用肿瘤组织或组织切片,且至少一种抗原(如间皮素、NKG2D、HER2、CD276、CD19、BCMA等)表达阳性,可供临床试验筛选。 7. ECOG体能状态评分0至2。 8. 预期生存期>6个月。 9. 受试者自愿参加。 排除标准: 1. 本研究免疫细胞治疗前1个月内接受抗PD-1、抗PD-L1或抗PD-L2抗体治疗或其他免疫治疗。 2. 有器官移植史。 3. 妊娠或哺乳期。 4. 基线HBV DNA水平较高(≥2,000 IU/mL),HIV抗体(抗HIV)、HCV抗体(抗HCV)或梅毒螺旋体抗体阳性。 5. 存在活动性感染。 6. 存在活动性脑转移(治疗后无症状或稳定的脑转移除外)。 7. 合并第二种肿瘤;但皮肤基底细胞癌、浅表性膀胱癌、皮肤鳞状细胞癌、宫颈原位癌或乳头状甲状腺癌患者,如第二肿瘤完全缓解已超过5年且研究期间不需治疗,可例外。 8. 患有严重自身免疫性疾病(如溃疡性结肠炎、克罗恩病、类风湿关节炎、系统性红斑狼疮、自身免疫性血管炎或肉芽肿性多血管炎),且需长期(超过2个月)全身免疫抑制治疗。 9. 有过敏体质。 10. NYHA心力衰竭≥II级,或标准治疗后仍无法控制的高血压,有心肌炎史或1年内发生过心肌梗死。 11. 有活动性出血且需治疗的血栓性疾病。 12. 研究者判断存在严重未控制疾病或可能影响本研究治疗的其他情况,不适合参加。
Inclusion Criteria: 1. Subjects with malignant tumors confirmed by histopathology or cytology, including: non-small cell lung cancer, esophageal squamous cell carcinoma, gastric cancer, colorectal cancer, liver cancer, pancreatic cancer, kidney cancer, cervical squamous cell carcinoma, ovarian cancer, breast cancer, melanoma, and brain glia tumor, lymphoma, etc.; 2. Age: 18 \~ 75 years old; Gender: no limitation; 3. Have sufficient hematopoietic capacity: ANC \>1500 cells /mm3, Blood plate count \>50,000 cells /mm3, HGB \>9.0g/dL, ALC \>9 cells /mm3; 4. Adequate liver and kidney function: AST and ALT ≤2.5 ULN in patients without liver metastasis and ≤5 times in patients with liver metastasis. ULN; Bilirubin ≤1.5 ULN (excluding hyperbilirubinemia or hyperbilirubin of non-hepatic origin); Creatinine ≤2.0 ULN. Creatinine clearance and creatinine clearance hormone ≥40 mL/min; 5. PT/INR \<1.5 ULN, and PTT/αPTT \<1.5 ULN; 6. For desirable tumor tissues or tissue white tablets, positive expression of at least one of Mesothelin, NKG2D, HER2, CD276, CD19, BCMA and other antigens can be selected for clinical trials; 7. ECOG physical status score 0 \~ 2 points; 8. Expected survival \>6 months; 9. Subject accepts voluntarily Exclusion Criteria: 1. Received anti-PD1, anti-PD-L1 or anti-PD-L2 antibody therapy or other immunotherapy methods one month before treatment with immune cells in this study; 2. History of organ transplantation; 3. Pregnancy or lactation; 4. Positive for high baseline HBV DNA levels (≥2000 IU/ml), HIV antibodies (anti-HIV), hepatitis C virus antibodies (anti-HCV), or treponema pallidum antibodies; 5. There is active infection; 6. There are active brain metastases (except asymptomatic or stable brain metastases after treatment); 7. Combined with a second tumor; With the exception of patients with basal cell carcinoma of the skin, superficial bladder cancer, squamous cell carcinoma of the skin, cervical carcinoma in situ, or papillary thyroid cancer who achieved complete response to the second tumor for more than 5 years and did not require treatment during the study period; 8. Severe autoimmune diseases such as ulcerative colitis, Crohn's disease, rheumatoid arthritis, systemic lupus erythematosus, autoimmune vasculitis, or Wegener's granulomatosis require long-term (more than 2 months) systemic immunosuppressive therapy; 9. People with allergies; 10. NYHA heart failure grade ≥2 or hypertension can not be controlled after standard treatment, have a history of myocarditis or have a heart attack within one year; 11. Thrombotic diseases with active bleeding that require treatment; 12. Patients who are determined by the researcher to have a serious uncontrollable disease or other conditions that may affect the treatment in this study and are considered unsuitable.
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:PFS · Progression-Free-Survival (PFS) is defined as admission to the group according to imaging specialists based on RECIST 1.1 review when disease progression or death from any cause was first recorded, whichever came first. · up to 36 months
次要终点:OS;ORR;DOR
本研究在中国郑州大学第一附属医院开展,旨在观察基因修饰T细胞治疗恶性肿瘤患者的安全性、耐受性和初步疗效。
To observe the safety, tolerability and initial effectiveness of gene modified T cell therapy in patients with malignant tumors in First Affiliated Hospital of Zhengzhou University, China.
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