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:EX02 CAR-T Cells for Relapsed and Refractory Acute Myeloid Leukemia
EX02 CAR-T Cells for Relapsed and Refractory Acute Myeloid Leukemia
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⚠ 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 细胞治疗急性髓系白血病的安全性、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:中国 · 合肥(共 1 个中心,其中中国 1 个)。登记号:NCT06642025。
不限性别 · ≥ 18 Years 且 ≤ 70 Years
纳入标准: 1. 按《中国成人急性髓系白血病(AML)诊断与治疗指南》(2023版/既往版本)确诊AML且符合难治性AML诊断标准,包括:初治者接受2个标准治疗疗程后无应答;首次CR后12个月内复发且巩固治疗失败;12个月后复发且常规化疗无应答;复发≥2次;或存在髓外白血病; 2. 外周血、骨髓或髓外病灶标本显示白血病细胞表面EX02表达阳性; 3. ECOG体能状态评分0–2分; 4. 年龄18–70岁(含),性别不限; 5. 血细胞检查符合:血红蛋白>60 g/L;T淋巴细胞(CD3+)正常且>0.5×10⁹/L;血小板>30×10⁹/L; 6. 有生育能力女性在试验开始前妊娠检测阴性,并同意在试验期间至末次随访采取有效避孕措施;有生育能力男性同意在试验期间至末次随访采取有效避孕措施; 7. 自愿参加临床研究,充分理解研究内容后自愿签署知情同意书,并承诺完成所有试验程序和活动。 排除标准: 1. 活动性甲型、乙型或丙型肝炎、HIV感染,或其他尚未控制的严重活动性感染; 2. 有AIDS病史,或因其他疾病长期使用免疫抑制剂(包括泼尼松等效剂量>15 mg/日的类固醇); 3. 心功能情况:a. NYHA III或IV级心力衰竭;b. 入组前6个月内发生心肌梗死或接受冠状动脉旁路手术;c. 有临床意义的室性心律失常或不明原因晕厥;d. 严重非缺血性心肌病史;e. 入组前8周内有心功能障碍史(左心室射血分数<45%); 4. 妊娠期或哺乳期女性;男女受试者均不愿避孕; 5. 严重肝肾功能障碍:AST/ALT>正常值上限3倍、胆红素>正常值上限3倍,或血清肌酐≥178 μmol/L(失代偿期); 6. 对本研究计划使用的任何药物有严重过敏反应史; 7. 造血干细胞移植受者入组前须停用免疫抑制剂至少6周,且无GVHD迹象; 8. 研究者认为不适合参加本试验的其他情况。
Inclusion Criteria: 1. According to the Chinese Adult Acute Myeloid Leukemia (AML) Diagnosis and Treatment Guidelines (2023 edition/previous edition), patients diagnosed with acute myeloid leukemia (AML) and meeting the diagnostic criteria for refractory AML are eligible, including: initial treatment cases with no response after two courses of standard therapy; relapse within 12 months after achieving complete remission (CR) and failure of consolidation therapy; relapse after 12 months with no response to conventional chemotherapy; two or more relapses; and presence of extramedullary leukemia. 2. Peripheral blood, bone marrow, or extramedullary lesion specimens showing leukemia cells with positive surface expression of EX02; 3. ECOG performance status score of 0-2; 4. Age ≥18 and ≤70 years, any gender; 5. Blood cell examination meeting the following conditions: hemoglobin \> 60g/L, normal T lymphocyte count (CD3+) \> 0.5×10\^9/L, platelet count \> 30×10\^9/L; 6. Negative pregnancy test for women of childbearing potential before the start of the trial, and agreement to use effective contraception measures during the trial until the final follow-up; male participants of reproductive potential agreeing to use effective contraception measures during the trial until the final follow-up; 7. Voluntary participation in this clinical study: after fully understanding the study content, voluntary signing of the informed consent form, and commitment to complete all trial procedures and activities. Exclusion Criteria: 1. Active hepatitis A, B, C, HIV infection, or other severe active infections that are not yet controlled; 2. History of acquired immune deficiency syndrome (AIDS) or long-term use of immunosuppressants due to other diseases (including steroids, equivalent to prednisone \>15mg/day); 3. Conditions of the heart function: a. New York Heart Association (NYHA) class III or IV heart failure; b. Myocardial infarction or coronary artery bypass surgery within the six months prior to enrollment; c. Clinically significant ventricular arrhythmia or unexplained syncope; d. History of severe non-ischemic cardiomyopathy; e. History of cardiac dysfunction (left ventricular ejection fraction \<45%) within 8 weeks before enrollment; 4. Pregnant or lactating women; participants (both male and female) unwilling to use contraception; 5. Severe liver or kidney dysfunction: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels exceeding 3 times the upper limit of normal, bilirubin exceeding 3 times the upper limit of normal; serum creatinine ≥ 178 μmol/L (decompensated phase); 6. History of severe allergic reactions to any drugs planned for use in this study; 7. Recipients of hematopoietic stem cell transplantation must have discontinued immunosuppressants for at least 6 weeks before enrollment and have no signs of graft-versus-host disease; 8. Other conditions deemed unsuitable for participation in this trial by the investigator.
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:Treatment-Emergent Adverse Events (TEAE) · TEAE is defined as any adverse event that occurs within 90 days after the first injection of EX02 CAR-T, or that existed before treatment and worsened after treatment. All adverse events are graded according to CTCAE v4.0, classified, and then the incidence rate is calculated. In addition, according to the definition of this study, the occurrence of CAR-T cell therapy-specific CRS and ICANS, as well as their grading, management, and prognosis are evaluated, and the incidence rates are calculated separately, with specific patient details recorded. · From the infusion (Day 0) to 3 months;Overall Response Rate (ORR) · Overall response rate=number of complete remission(CR) (including incomplete hematologic recovery (CRi)) + number of partial remission (PR) / total number of treated cases, determined by the investigator according to the 2023 Chinese Diagnosis and Treatment Guidelines for Adult Acute Myeloid Leukemia (non-acute promyelocytic leukemia). · From the infusion (Day 0) to Day 60
次要终点:PFS;OS;ECOG scoring
以上邮箱 / 电话是登记库里的申办方联系方式(+86,中国),通常不直达某家医院。中国中心的联系方式请以医院或登记平台最新公示为准。
这是一项早期I期、开放标签、单臂临床研究,评估EX02 CAR-T 细胞治疗复发/难治性急性髓系白血病。入组后每位受试者接受白细胞单采,随后接受环磷酰胺和氟达拉滨预处理化疗及CAR-T 细胞静脉输注。研究程序包括筛查、入组/白细胞单采、预处理化疗、CAR-T 治疗、治疗后评估及长期随访。
This is a early Phase 1 open-label, single-arm clinical study of EX02 CAR-T therapy for relapsed and refractory acute myeloid leukemia. Each participant will undergo leukapheresis after enrolment, receive treatment of the conditioning chemotherapy of cyclophosphamide and fludarabine, and an an intravenous infusion of CAR-T cells. Each participant will proceed through the following study procedures: * Screening * Enrollment/Leukapheresis * Conditioning chemotherapy * CAR T treatment * Post-treatment assessment * Long-term follow-up
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