简要介绍
这是一项 I 期注册临床试验,评估 NK 细胞治疗急性髓系白血病、肿瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 30 例。试验地点:中国 · 武汉(共 1 个中心,其中中国 1 个)。登记号:NCT06690827。
入组条件决定能不能参加
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准:
1. 性别不限,年龄18至75岁(含边界值);
2. 流式细胞术检测肿瘤细胞CD123表达阳性;
3. 确诊为CD123阳性的复发/难治性AML或BPDCN:
(1)对于AML患者:
* 复发指完全缓解(CR)后外周血再次出现白血病细胞,或骨髓中原始细胞≥5%(排除巩固化疗后骨髓再生等其他原因),或髓外出现白血病细胞浸润;
* 难治指标准方案治疗两疗程未缓解者;CR后经巩固/强化治疗后12个月内复发者;12个月后复发但常规化疗无效者;两次及以上复发者;持续性髓外白血病者;
(2)对于BPDCN患者:按指南推荐挽救治疗无效或不耐受,且在外周血、骨髓、淋巴结、脾脏、皮肤病变或其他部位任一存在持续或复发病灶者。
4. 预期生存时间超过12周;
5. ECOG评分0-2分(附录2);
6. 无严重精神障碍;
7. 重要脏器功能基本正常:
1. 血常规:白细胞>1.0×109/L,中性粒细胞>0.5×109/L,淋巴细胞>0.5×109/L,血小板>50×109/L;
2. 心功能:超声心动图提示左心室射血分数≥50%,心电图无明显异常;
3. 肾功能:血清肌酐≤2.0×ULN;
4. 肝功能:ALT和AST≤3.0×ULN(肝脏浸润患者
* 5.0×ULN);
5. 总胆红素≤2.0×ULN(Gilbert综合征患者≤3.0×ULN);
6. 血氧饱和度>92%。8. 患者或其法定监护人同意参加本临床试验并签署ICF,表明其理解临床试验的目的和程序并愿意参加研究。
排除标准:
1. 筛选期存在活动性中枢神经系统侵犯;
2. 筛选前接受过抗肿瘤治疗,包括14天内或至少5个半衰期内(以较短者为准)的化疗、靶向治疗或其他试验性药物治疗,但治疗后确认疾病进展者除外;
3. 筛选前6个月内发生脑血管意外或癫痫发作;
4. 筛选前1周内存在需要全身治疗的活动性或未控制的感染;
5. 存在以下任一心脏疾病:
1. 纽约心脏协会(NYHA)III级或IV级充血性心力衰竭;
2. 入组前6个月内发生心肌梗死或接受冠状动脉旁路移植术(CABG);
3. 具有临床意义的室性心律失常,或不明原因晕厥史(血管迷走性或脱水所致者除外);
4. 严重非缺血性心肌病病史;
6. 合并需要长期免疫抑制治疗的自身免疫性疾病;
7. 存在其他恶性肿瘤,但已充分治疗的宫颈原位癌、皮肤基底细胞癌或鳞状细胞癌、根治术后的局限性前列腺癌、根治术后的导管原位癌除外。
8. 筛选前4周内接种过减毒活疫苗;
9. 妊娠或哺乳期女性,以及接受CAR-NK细胞输注后1年内计划生育的男性或女性受试者;
10. 研究者认为不适合参加研究的其他情况。
核对登记原文(英文)
Inclusion Criteria:
1. Patients of any gender, aged between 18 and 75 years (inclusive);
2. Positive expression of CD123 on tumor cells detected by flow cytometry;
3. Patients with a confirmed diagnosis of CD123-positive relapsed/refractory AML or BPDCN:
(1) For AML patients:
* Relapsed refers to the reappearance of leukemic cells in peripheral blood after complete remission (CR), or ≥5% blasts in bone marrow (excluding other reasons such as bone marrow regeneration after consolidation chemotherapy), or the presence of leukemic cell infiltration outside the marrow;
* Refractory refers to patients who have not responded to two courses of standard treatment; patients who have relapsed within 12 months after CR and consolidation/intensification therapy; patients who have relapsed after 12 months but have not responded to conventional chemotherapy; patients with two or more relapses; patients with persistent extramedullary leukemia;
(2) For BPDCN patients: Patients who have not responded to or cannot tolerate the recommended salvage treatment according to guidelines, and have persistent or recurrent disease in any of the following: peripheral blood, bone marrow, lymph nodes, spleen, skin lesions, or other sites.
4\. Expected survival time of more than 12 weeks;
5\. ECOG score of 0-2 (Appendix 2);
6\. No severe mental disorders;
7\. Basic normal function of important organs:
1. Blood routine: white blood cells \>1.0×109/L, neutrophils \>0.5×109/L, lymphocytes \>0.5×109/L, platelets \>50×109/L;
2. Cardiac function: echocardiography indicates a left ventricular ejection fraction ≥50%, and no significant abnormalities on electrocardiogram;
3. Renal function: serum creatinine ≤2.0×ULN;
4. Liver function: ALT and AST ≤3.0×ULN (for patients with liver invasion
* 5.0×ULN);
5. Total bilirubin ≤2.0×ULN (for patients with Gilbert's syndrome ≤3.0×ULN);
6. Blood oxygen saturation \>92%. 8. The patient or their legal guardian agrees to participate in this clinical trial and signs the ICF, indicating their understanding of the purpose and procedures of the clinical trial and willingness to participate in the study.
Exclusion Criteria:
1. Presence of active central nervous system invasion during screening;
2. Receipt of anti-tumor therapies prior to screening, including chemotherapy, targeted therapy, or other experimental drug treatments within 14 days or at least 5 half-lives (whichever is shorter), except for those who have confirmed disease progression after treatment;
3. Occurrence of cerebrovascular accident or epileptic seizure within 6 months prior to screening;
4. Presence of active or uncontrolled infection requiring systemic treatment within 1 week prior to screening;
5. Presence of any of the following cardiac diseases:
1. Congestive heart failure at New York Heart Association (NYHA) class III or IV;
2. Myocardial infarction or coronary artery bypass grafting (CABG) within 6 months prior to enrollment;
3. Clinically significant ventricular arrhythmia, or history of unexplained syncope (excluding cases caused by vasovagal or dehydration);
4. History of severe non-ischemic cardiomyopathy;
6. Combination with active autoimmune diseases requiring long-term immunosuppressive therapy;
7. Presence of other malignancies, except for adequately treated carcinoma in situ of the cervix, basal cell or squamous cell carcinoma of the skin, localized prostate cancer after radical surgery, and ductal carcinoma in situ after radical surgery.
8. Receipt of live attenuated vaccines within 4 weeks prior to screening;
9. Pregnant or breastfeeding women, as well as male or female subjects who plan to have children within 1 year after receiving CAR-NK cell infusion;
10. Other conditions that the investigator deems unsuitable for participation in the study.
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。
研究终点衡量什么算有效
- 主要终点治疗中出现的不良事件发生率[安全性和耐受性]28 dyas
- 主要终点CAR-NK 输注后的客观缓解率(ORR),包括完全缓解(CR)和部分缓解(PR)1month, 2 months, 3 months
- 主要终点CAR-NK 输注后的总生存期(OS)2 years
- 主要终点CAR-NK 输注后的缓解持续时间(DOR)2 years
- 主要终点CAR-NK 输注后的无复发生存期(RFS)2 years
- 主要终点CAR-NK 细胞输注后的无事件生存期(EFS)2 years
- 次要终点CAR-NK 输注后的剂量限制性毒性(DLT)发生率
- 次要终点抗 CD123 CAR-NK 细胞在人体中的 Cmax
- 次要终点抗 CD123 CAR-NK 治疗复发/难治性 AML 和 BPDCN 患者后的总体缓解率(ORR)
- 次要终点抗 CD123 CAR-NK 细胞的 Tmax [细胞动力学]
- 次要终点抗 CD123 CAR-NK 细胞的 AUCs [细胞动力学]
- 次要终点抗 CD123 CAR-NK 输注后 r/r AML 和 BPDCN 患者的总生存期(OS)
- 次要终点抗 CD123 CAR-NK 细胞输注后 r/r AML 和 BPDCN 患者的缓解持续时间(DOR)
- 次要终点抗 CD123 CAR-NK 细胞输注后 r/r AML 和 BPDCN 患者的无复发生存期(RFS)
核对登记原文(英文)
主要终点:Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] · The incidence of adverse events after CAR-NK cell infusion was assessed by CTCAE, version 5.0. · 28 dyas;Objective response rate (ORR), including complete response (CR) and partial response (PR), after CAR-NK infusion · 1month, 2 months, 3 months;overall survival (OS) after CAR-NK infusion · 2 years;Duration of response (DOR) after CAR-NK infusion · 2 years;recurrence free survival (RFS) after CAR-NK infusion · 2 years;event free survival (EFS) after CAR-NK cells infusion · 2 years
次要终点:Dose limited toxicity (DLT) rate after CAR-NK infusion;Cmax of anti-CD123 CAR-NK cells in humans;Overall response rate (ORR) after anti-CD123 CAR-NK therapy in relapsed/refractory AML and BPDCN patients;Tmax of anti-CD123 CAR-NK cells [Cell dynamics];AUCs of anti-CD123 CAR-NK cells [Cell dynamics];overall survival (OS) after anti-CD123 CAR-NK infusion in r/r AML and BPDCN patients;duration of response (DOR) after anti-CD123 CAR-NK cells infusion in r/r AML and BPDCN patients;Recurrence free survival (RFS) after anti-CD123 CAR-NK cells infusion in r/r AML and BPDCN patients
研究设计怎么做的
- 研究类型
- 干预性研究
- 入组人数
- 30 人(预计)
- 分组方式
- 不适用(单臂)
核对分组登记原文(英文)
- CD123 CAR-NK cells · EXPERIMENTAL
关键日期
- 开始日期
- 2024-12-12
- 主要完成日期
- 2027-06-30
- 全部完成日期
- 2028-10-31
- 登记状态核实于
- 2026-08
联系与责任方
- 申办方
- Chongqing Precision Biotech Co., Ltd
- 联系邮箱
- jiawei@tjh.tjmu.edu.cn
- 联系电话
- +86 13986102084
登记简述
这是一项由研究者发起的临床试验,旨在评估抗CD123 CAR-NK治疗复发/难治性急性髓系白血病或母细胞性浆细胞样树突状细胞肿瘤患者的安全性和有效性。
核对登记原文(英文)
This is a clincal trial initiated by investigator to evaluate the safety and efficacy of anti-CD123 CAR-NK in the treatment of patients with relapsed/refractory acute myeloid leukemia or blastic plasma cell like dendritic cell tumors.