下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:Study of Autologous Tumor-Infiltrating Lymphocytes in Pediatric, Adolescent, and Young Adult Participants
这是一项 I 期注册临床试验,评估细胞治疗用于软组织肉瘤、黑色素瘤、肉瘤的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 40 例。试验地点:美国 · 奥罗拉、圣彼得堡、新不伦瑞克、布法罗(共 5 个中心)。登记号:NCT06566092。
不限性别 · ≥ 6 Months 且 ≤ 21 Years
纳入标准: 1. 签署知情同意/同意书时体重≥8 kg且年龄≤21岁。 2. 标准治疗后复发或难治性实体瘤经组织学或细胞学确认,包括横纹肌肉瘤、尤文肉瘤、原发性中枢神经系统恶性肿瘤或黑色素瘤,且所有可用根治性治疗均已失败。 3. 体能状态可接受,预计生存期>6个月。 4. 至少有1个可切除病灶(单个或多个病灶),可用于制备TIL。 5. 切除用于制备TIL的肿瘤后,至少保留1个可测量病灶用于疗效评估。 6. 计划中的手术须在肿瘤切除前至少14天进行(重大手术)。 7. 既往抗癌治疗相关不良事件均已恢复;周围神经病变、脱发、白癜风或经药物控制的内分泌功能障碍除外。 8. 按照方案和当地法规,参与者同意采取避孕措施;根据儿童、青少年和青年参与者的年龄及性生活情况,适用时不得捐献精子或卵子。 9. 已签署知情同意书;适用时已签署同意书。 10. 已书面授权使用和披露受保护的健康信息。 11. 能遵守研究访视计划及其他方案要求。 12. 血液学指标符合要求。 13. 器官功能符合要求。 14. 改良Ross心功能分级为1级,且左室缩短分数(LVFS)>25%或左室射血分数(LVEF)≥50%。 15. 肺功能符合要求。 16. 参与者和/或签署同意的法定监护人愿意为参与者提供最佳支持治疗。 17. 须有法定监护人或主要照护者协助研究中心人员确保随访,并按照评估计划陪同参与者每次到研究中心。 排除标准: 1. 非中枢神经系统肿瘤患者存在有症状且未经治疗的脑转移和/或癌性脑膜炎。 2. 有活动性或未控制的并发疾病,可能增加参加研究的风险。 3. 癫痫发作未受控制。 4. 有颅内出血或脊髓出血史。 5. 活动性葡萄膜炎且需要积极治疗。 6. 研究者认为存在会妨碍充分知情同意的严重精神疾病或物质滥用。 7. 存在任何原发性或获得性免疫缺陷。 8. 有临床显著慢性阻塞性肺病、哮喘、间质性肺病或其他慢性肺病史。 9. 对研究干预措施的任何成分有超敏反应史。 10. 研究者判断会显著增加参与风险的其他任何情况。 11. 切除手术后出现研究者认为会增加参与风险的并发症或愈合延迟。 12. 过去3年内有其他原发恶性肿瘤。 13. 有异基因细胞或器官移植史。 14. 需要使用超过生理替代剂量的全身性类固醇治疗。 15. 非清髓性淋巴清除(NMA-LD)开始前28天内接种过或计划接种活疫苗/减毒疫苗。 16. 存在需要持续全身治疗的活动性病毒、细菌或真菌感染。
Inclusion Criteria: 1. Participant is ≥ 8 kg and ≤ 21 years of age at the time of informed consent and assent. 2. Histologically or cytologically confirmed recurrent or refractory solid tumor (Rhabdomyosarcoma, Ewing sarcoma, primary CNS malignancies, melanoma) after standard therapy which has failed all available curative therapy. 3. Acceptable performance status and an estimated life expectancy of \> 6 months. 4. At least one resectable lesion (solitary or aggregate lesions) for TIL generation. 5. Following tumor resection for TIL generation, the participant will have at least one remaining measurable lesion for response assessment. 6. Preplanned surgical procedure(s) will take place at least 14 days (for major operative procedures) prior to the tumor resection. 7. All prior anticancer treatment-related AEs should be recovered, exceptions are peripheral neuropathy, alopecia, vitiligo, or medically controlled endocrine dysfunction. 8. Agreement to abide by the protocol indicated contraception use, including refraining from donating sperm or eggs (ova, oocytes), as appropriate for the age and sexual activity of pediatric, adolescent, and young adult participants and as required by local regulations. 9. Signed informed consent and assent when applicable. 10. Written authorization for use and disclosure of protected health information. 11. Ability to adhere to the study visit schedule and other protocol requirements. 12. Acceptable hematologic parameters. 13. Adequate organ function. 14. Modified Ross criteria class 1 and an LVFS \> 25% or an LVEF ≥ 50%. 15. Adequate pulmonary function. 16. Participant and/or the legal guardian who provided consent is willing for the participant to receive optimal supportive care. 17. A legal guardian or primary caregiver must be available to help the study-site personnel ensure follow-up and accompany the participant to the study site on each assessment day according to the SoA. Exclusion Criteria: 1. Participant with a non-CNS tumor has symptomatic untreated brain metastases and/or carcinomatous meningitis. 2. Participant has an active or uncontrolled intercurrent illness(es) that would pose increased risks for study participation. 3. Participants are not eligible if they experience uncontrolled seizures. 4. Participants with history of intracranial hemorrhage/spinal cord hemorrhage. 5. Participant has active uveitis that requires active treatment. 6. Participant has significant psychiatric disease or substance abuse in the investigator's opinion that would prevent adequate informed consent. 7. Participant has any form of primary or acquired immunodeficiency. 8. History of clinically significant chronic obstructive pulmonary disease, asthma, interstitial lung disease, or other chronic lung disease. 9. History of hypersensitivity reaction to any components of the study intervention. 10. Any other condition that in the investigator's judgment would significantly increase the risks of participation. 11. Any complication or delayed healing from an excisional procedure that in the investigator's opinion would increase the risks of participation. 12. Another primary malignancy within the previous 3 years. 13. History of allogeneic cell or organ transplant. 14. Requiring systemic steroid therapy higher than the physiologic replacement dose. 15. Received or will receive a live or attenuated vaccination within 28 days prior to the start of the NMA-LD. 16. Any active viral, bacterial, or fungal infection requiring ongoing systemic treatment.
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:Incidence rate of Treatment-Emergent Adverse Events · To evaluate the safety and tolerability of the TIL regimen that occurs from the start of TIL infusion and up to 30 days after TIL infusion per CTCAE. · Up to 24 months
次要终点:Objective Response Rate;Duration of Response;Disease Control Rate;Progression-Free Survival;Overall Survival
本研究拟评估TIL方案的安全性和耐受性,并考察TIL抗肿瘤效果。研究对象为患有复发/难治性实体瘤、现有标准治疗无有效选择的儿童、青少年和青年患者。每位参与者在TIL输注(第0天)后随访最长2年;治疗最长10天;第42天前每2周访视一次,至第6个月每6周访视一次,之后至第2年每3个月访视一次。
This study is planned to test the safety and tolerability of the TIL regimen. The study will also test how well TIL fights cancer. The study will enroll children, teenagers, and young adults with solid tumors that have returned or are not responding to treatment for whom no effective standard-of-care treatment options exist. Study details include: * The study will last up to 2 years after the TIL infusion (Day 0) for each person. * The treatment will last up to 10 days for each person. * Study visits will be every 2 weeks until Day 42, every 6 weeks until Month 6, and every 3 months until Year 2.
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