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:Safety and Efficacy of CMD03 CAR T Cell in Children With Relapse or Refractory Solid Tumors
这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗恶性肿瘤、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 9 例。试验地点:亚太其他 · 曼谷(共 1 个中心)。登记号:NCT06612645。
不限性别 · ≥ 1 Year 且 ≤ 25 Years
纳入标准: 1. 患有B7-H3阳性且可测量的实体瘤。使用既往取得的样本,通过标准免疫组化(IHC)或流式细胞术评估B7-H3表达。 2. 标准一线治疗后有疾病复发或难治的证据。 3. 年龄1–25岁。 4. 男性或女性。 5. Lansky或Karnofsky体能状态评分≥50。 6. 预期生存期≥12周。 7. 器官功能正常:AST和ALT均<年龄对应ULN的5倍;总胆红素<ULN的3倍;肌酐<ULN的5倍;室内空气下SpO2≥90%。 8. 计划白细胞单采前符合既往治疗洗脱期:末次化疗/生物治疗后至少7天;末次抗肿瘤抗体治疗后至少3个半衰期或30天(取较短者);末次细胞输注后至少30天。入组前1周内全身皮质类固醇剂量须稳定或递减,甲泼尼龙剂量最高0.5 mg/kg/日;允许生理性替代治疗。 9. 参与者和/或法定监护人能够理解并愿意签署书面知情同意和/或同意参与文件。 排除标准: 1. ≥3级心功能不全,或需要干预的症状性心律失常。 2. 原发性免疫缺陷或骨髓衰竭综合征。 3. 未控制的并发疾病,包括活动性感染、有症状的充血性心力衰竭、不稳定型心绞痛、心律失常、肺部异常,或可能妨碍遵守研究要求的精神疾病/社会状况。 4. 妊娠或哺乳期。CAR-T治疗可能具有致畸或导致流产的风险;有生育能力女性的血清妊娠检测须为阴性。由于母亲接受CAR-T治疗后对哺乳婴儿的风险尚不明确但可能存在,应停止哺乳;研究使用的其他药物也可能有此类风险。有生育能力的参与者须同意从入组起至CAR-T细胞输注后4个月采取避孕措施。 5. 血清学检查提示活动性HIV、乙肝或丙肝感染。乙肝核心抗体、乙肝表面抗原或丙肝抗体阳性者,入组前PCR检测须为阴性。
Inclusion Criteria: 1. Participants must have B7-H3 positive solid tumor with measurable disease. \- B7-H3 expression will be evaluated by standard immunohistochemistry (IHC) or flow cytometry using a previously obtained sample. 2. Evidence of relapsed or refractory disease after standard first-line therapy 3. Age 1 - 25 years 4. Sex: Male or female 5. Performance status: Lansky or Karnofsky score not less than 50 6. Life expectancy not less than 12 weeks 7. Normal organ function * AST (SGOT) below 5 times the upper limit of normal (ULN) * ALT (SGPT) below 5 times the upper limit of normal (ULN) * Total bilirubin below 3 times the upper limit of normal (ULN) * Creatinine below 5 times the upper limit of normal (ULN) * SpO2 room air not less than 90% 8. Prior therapy wash-out before planned leukapheresis * Not less than 7 days post last chemotherapy/biologic therapy administration * 3 half-lives or 30 days, whichever is shorter after the last dose of antitumor antibody therapy * At least 30 days from most recent cellular infusion * All systemically administered corticosteroid treatment therapy must be stable or decreasing within 1 week prior to enrollment with a maximum of 0.5 mg/kg/day dose of methylprednisolone. Corticosteroid physiologic replacement therapy is allowed 9. Participants and/or legal guardians must have the ability to understand and willingness to sign a written informed consent and/or assent document Exclusion Criteria: 1. Presence of greater than or equal to grade 3 cardiac dysfunction or symptomatic arrythmia requiring intervention 2. Presence of primary immunodeficiency or bone marrow failure syndrome 3. Presence of uncontrolled intercurrent illness including but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, pulmonary abnormalities, or psychiatric illness/social situations that would limit compliance with study requirements 4. Pregnant or breastfeeding women were excluded from this study because CAR-T cell therapy may be associated with the potential for teratogenic or abortifacient effects. Women of childbearing potential must have a negative serum pregnancy test. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with CAR-T cells, breastfeeding should be discontinued. These potential risks may also apply to other agents used in this study. Participants of childbearing or child-fathering potential must be willing to practice birth control from the time of enrollment in this study and for four months after receiving CAR-T-cell infusion. 5. Serologic status reflecting active HIV, hepatitis B or C infection. Participants who are positive for hepatitis B core antibody, hepatitis B surface antigen or hepatitis C antibody must have negative PCR prior to enrollment.
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:Safety and tolerability of B7H3-IL7Ra CAR T cells infusion in solid tumors patients. · The incidence of adverse events assessed by the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 5.0 · 7 days, 14 days, 21 days, 30 days, 60 days, 90 days, 6 months and 12 months after B7H3-IL7Ra CAR-T cell infusion
次要终点:The overall response rate of solid tumors
靶向B7H3的嵌合抗原受体(CAR)T细胞,并加入IL-7Ra信号结构域。剂量水平:1×10⁶、3×10⁶或10×10⁶个细胞/kg。
这是一项Ⅰ期临床试验,旨在评估靶向B7-H3并带有IL-7受体α(IL-7Ra)信号的CAR-T细胞,在完成标准治疗后的儿童实体瘤患者中的安全性和初步疗效。
A Phase 1 clinical trial to evaluate the safety and early efficacy of CAR T-cells with IL-7Ra signal targeting B7H3 in children with solid tumors patients after complete standard treatments.
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