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GF-CART01(CD20 CAR-T)治疗弥漫大 B 细胞淋巴瘤、滤泡性淋巴瘤:I 期临床试验

英文原题:A Study to Evaluate the Safety and Clinical Activity of GF- CART01 (CD20/19 CAR T Cell) in Subjects With Relapsed or Refractory B-Cell Hematological Malignancies

ClinicalTrials.gov 2024/11/25(首次登记) I 期注册临床试验 · 招募中

简要介绍

这是一项 I 期注册临床试验,评估细胞治疗用于弥漫大 B 细胞淋巴瘤、滤泡性淋巴瘤、大 B 细胞淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 18 例。试验地点:中国 · 台北(共 1 个中心,其中中国 1 个)。登记号:NCT06703892。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 70 Years

纳入标准:

1. 受试者年龄必须≥18岁且≤70岁
2. 受试者或其法定监护人必须自愿参加研究并签署知情同意书
3. 根据世界卫生组织(WHO)淋巴瘤分类标准(2022),组织学确诊为弥漫性大B细胞淋巴瘤-非特指型(DLBCL-NOS)、滤泡性淋巴瘤(FL)、原发性纵隔大B细胞淋巴瘤(PMBCL)或高级别B细胞淋巴瘤(HGBCL)
4. 通过流式细胞术或免疫组织化学染色检测,肿瘤细胞表面表达CD19(+)和/或CD20(+)
5. 接受≥两线系统性治疗(包括抗CD20抗体和蒽环类药物)后复发、进展或难治性疾病(定义为未达到完全缓解),或自体HSCT后复发、进展或难治性疾病(定义为未达到完全缓解)
6. 根据Lugano 2014标准,受试者有任何可及PET阳性病灶或可测量CT阳性病灶
7. 充分的血液学功能:绝对中性粒细胞计数(ANC)> 1,000/μL,绝对淋巴细胞计数(ALC)> 300/μL,血小板计数≥ 75,000/μL,血红蛋白≥ 8.0 g/dL
8. 充分的肝功能:丙氨酸氨基转移酶(ALT)≤ 5倍正常上限(ULN),天冬氨酸转氨酶(AST)≤ 5倍ULN,总胆红素≤ 1.5倍ULN
9. 充分的肾功能:血估计肾小球滤过率(eGFR)≥ 60 mL/min/1.73m2(通过肾脏病饮食改良(MDRD)公式计算)
10. 充分的心脏功能:超声心动图或门控血池分析(MUGA)显示左心室射血分数(LVEF)≥ 50%;且无临床显著心电图(ECG)发现
11. 充分的肺功能:肺部无活动性感染,室内空气血氧饱和度≥ 92%
12. 研究者确定无临床显著胸腔积液
13. 估计生存时间≥ 3个月
14. 东部肿瘤协作组(ECOG)体能状态0至2
15. 根据研究者判断,愿意且能够遵守方案规定的要求、指示和限制

排除标准:

1. 既往接受过任何CAR T细胞产品或异基因造血干细胞移植(HSCT)
2. 已知或怀疑对研究产品(IP)任何成分过敏、超敏或不耐受
3. 已知病史或可能存在接受正电子发射断层扫描(PET)和/或计算机断层扫描(CT)造影剂的风险
4. 在白细胞分离术前12周内接受过任何其他研究产品、细胞治疗或基因治疗
5. 在白细胞分离术前2周内接受过任何酪氨酸激酶抑制剂
6. 在白细胞分离术前4周内接受过任何全身性类固醇、免疫治疗(如免疫检查点抑制剂、T细胞转移疗法、单克隆抗体)或化疗
7. 在白细胞分离术前2周内接种过任何活疫苗
8. 人类免疫缺陷病毒(HIV)、梅毒、乙型或丙型肝炎感染受试者:HIV-1和HIV-2抗体阳性、梅毒抗体阳性、乙型肝炎病毒(HBV)DNA和乙型肝炎核心(HBc)抗体均阳性,或丙型肝炎病毒(HCV)抗体阳性
9. B细胞恶性肿瘤累及心房或心室的受试者
10. 在白细胞分离术前8周内需要紧急治疗的肿瘤肿块受试者,如肠梗阻、肿瘤溶解综合征或血管压迫
11. 患有严重疾病或其他未控制疾病的受试者,如冠心病、心绞痛、心肌梗死、心律失常(需紧急干预、危及生命后果或血流动力学受损)、心脏血管成形术或支架植入术、不稳定型心绞痛、脑血栓形成、脑出血、高血压(收缩压≥ 140 mmHg和/或舒张压≥ 90 mmHg)
12. 在白细胞分离术前6周内发生的不稳定肺栓塞、深静脉栓塞或其他主要动脉/静脉血栓栓塞事件。如果受试者接受抗凝治疗,则在白细胞分离术前治疗剂量和频率必须稳定超过14周
13. 颅脑外伤、意识障碍、癫痫、脑血管缺血、脑血管出血性疾病、痴呆、小脑疾病或任何累及中枢神经系统(CNS)的自身免疫性疾病史
14. 有生育能力的女性受试者:a. 妊娠试验结果阳性;或 b. 正在哺乳
15. 有生育能力的女性受试者,或配偶/伴侣为有生育能力女性的男性受试者,拒绝自签署知情同意书之日起至GF-CART01输注后12个月内采取至少一种避孕措施。可接受的避孕方式包括:a. 已确定使用口服、注射或植入激素避孕方法 b. 放置宫内节育器(IUD)或宫内节育系统(IUS) c. 屏障避孕法:避孕套或封闭式帽(隔膜或宫颈/穹窿帽)
16. 研究者认为不适合本试验和/或可能增加受试者风险或干扰研究结果的任何以下情况 a. 伴有严重活动性感染(单纯尿路感染和细菌性咽炎除外) b. 伴有淋巴瘤活动性中枢神经系统受累、脑脊液中恶性细胞 c. 脑转移史 d. 伴有未控制的恶性肿瘤 e. 既往治疗引起的任何毒性 f. 伴有任何未控制的疾病或任何疾病史
核对登记原文(英文)
Inclusion Criteria:

1. Subjects must be of age ≥ 18 years and ≤ 70 years
2. Subjects or their legal guardians must volunteer to participate in the study and sign the informed consent
3. Histologically confirmed diagnosis of Diffuse Large B-Cell Lymphoma - Not Otherwise Specified (DLBCL-NOS), follicular lymphoma (FL), Primary Mediastinal Large B-cell Lymphoma (PMBCL), or High-Grade B-Cell Lymphoma (HGBCL) per the world health organization (WHO) Classification Criteria for Lymphoma (2022)
4. Tumor cell surface expression of CD19 (+) and/or CD20 (+) by flow cytometry or immunohistochemistry staining
5. Relapsed, progressive or refractory disease (defined as have not achieved a complete response) after ≥ two lines of systemic therapy, including anti-CD20 antibody and anthracycline and/or Relapsed, progressive or refractory disease ( defined as have not achieved a complete response) after auto-HSCT
6. Subjects have any accessible PET-positive lesion or measurable CT-positive lesion per Lugano 2014 criteria
7. Adequate hematologic function: absolute neutrophil count (ANC) \> 1,000/μL, absolute lymphocyte count (ALC) \> 300/μL, platelet count ≥ 75,000/μL, hemoglobin ≥ 8.0 g/dL
8. Adequate hepatic function: alanine aminotransferase (ALT) ≤ 5 times upper limit of normal (ULN), aspartate transaminase (AST) ≤ 5 times ULN, total bilirubin ≤ 1.5 times ULN
9. Adequate renal function: blood estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m2 (calculated by Modification of Diet in Renal Disease (MDRD) equation)
10. Adequate cardiac function: echocardiogram or multigated blood pool analysis (MUGA) shows left ventricular ejection fraction (LVEF) ≥ 50%; and no clinically significant electrocardiogram (ECG) findings
11. Adequate pulmonary function: no active infection in the lungs, blood oxygen saturation in indoor air ≥ 92%
12. No clinically significant pleural effusion determined by the investigators
13. Estimated survival time ≥ 3 months
14. Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2
15. Willingness and ability to comply with protocol-stated requirements, instructions, and restrictions in the investigator's judgement

Exclusion Criteria:

1. Previously treated with any CAR T cell product or allogenic hematopoietic stem cell transplant (HSCT)
2. Known or suspected allergy, hypersensitivity, or intolerance to any ingredients of the investigational product (IP)
3. Known medical history or possible risk for taking contrast agent(s) for positron emission tomography (PET) and/or computed tomography (CT) scan
4. Received any other investigational product, cell therapy, or gene therapy within 12 weeks prior to the leukapheresis
5. Received any tyrosine kinase inhibitor within 2 weeks prior to the leukapheresis
6. Received any systemic steroid, immunotherapy (such as immune checkpoint inhibitors, T- cell transfer therapies, monoclonal antibodies), or chemotherapy within 4 weeks prior to the leukapheresis
7. Received any live vaccine from 2 weeks prior to the leukapheresis
8. Subjects with human immunodeficiency virus (HIV), syphilis, Hepatitis B or C infection: HIV-1 and HIV-2 antibody positive, syphilis antibody positive, both hepatitis B virus (HBV) DNA and hepatitis B core (HBc) antibody positive, or hepatitis C virus (HCV) antibody positive
9. Subjects with atrial or ventricular involvement by B-cell malignancies
10. Subjects with tumor mass requiring urgent treatment within 8 weeks prior to the leukapheresis, such as ileus, tumor lysis syndrome, or vascular compression
11. Subjects with severe disease or other uncontrolled diseases, such as coronary heart disease, angina pectoris, myocardial infarction, arrhythmia (urgent intervention indicated, life- threatening consequences, or hemodynamic compromise), cardiac angioplasty or stenting, unstable angina, cerebral thrombosis, cerebral hemorrhage, hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg)
12. Unstable pulmonary embolism, deep venous embolism, or other major arterial/venous thromboembolism events that occurred within 6 weeks prior to the leukapheresis. If subjects receive anticoagulant therapy, the treatment dose and frequency must be stable for more than 14 weeks prior to the leukapheresis
13. History of craniocerebral trauma, disturbance of consciousness, epilepsy, cerebrovascular ischemia, cerebrovascular hemorrhagic diseases, dementia, cerebellar disease, or any autoimmune disease with central nervous system (CNS) involvement
14. Female subject of childbearing potential who: a. Has positive pregnancy test result; or b. Is lactating
15. Female subjects of childbearing potential, or male subject with female spouse/partner of childbearing potential, who refuses to adopt at least one form of birth control from the date of signing informed consent to 12 months after GF-CART01 infusion. Acceptable forms of birth control include: a. Established use of oral, injected or implanted hormonal methods of contraception b. Placement of an intrauterine device (IUD) or intrauterine system (IUS) c. Barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps)
16. Any following situations that the investigators believe are not suitable for this trial and/or may increase the risk for subjects or interfere with the results of the study a. With severe active infections (except simple urinary tract infection and bacterial pharyngitis) b. With active central nervous system involvement by lymphoma, malignant cells in cerebrospinal fluid c. History of brain metastasis d. With uncontrolled malignancies e. Any toxicities due to prior therapy f. With any uncontrolled illness or a history of any illness

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

  • 主要终点最大耐受剂量(MTD)细胞输注后第1天至28天
  • 主要终点GF-CART01的安全性和耐受性细胞输注后第1天至1年
  • 次要终点GF-CART01的初步疗效-ORR
  • 次要终点GF-CART01的初步疗效-DOR
  • 次要终点GF-CART01的药代动力学-Cmax
  • 次要终点GF-CART01的药代动力学-Tmax
  • 次要终点GF-CART01的药代动力学-pAUC
  • 次要终点GF-CART01的药代动力学-Clast
  • 次要终点GF-CART01的药代动力学-T1/2
  • 次要终点GF-CART01的持续性
核对登记原文(英文)

主要终点:Maximum tolerated dose (MTD) · Percentage of subjects with dose-limiting toxicity (DLT) from Visit 4 (Day 1) to Visit 9 (Day 29) after GF-CART01 cell infusion · From Day 1 to 28 days after cell infusion;Safety and tolerability of GF-CART01 · Percentage of subjects with treatment-emergent adverse events (TEAEs), ≥ grade 3 TEAEs, serious adverse events (SAEs), adverse events of special interest (AESIs) · From Day 1 to 1 year after cell infusion
次要终点:Preliminary efficacy of GF-CART01-ORR;Preliminary efficacy of GF-CART01-DOR;Pharmacokinetics of GF- CART01-Cmax;Pharmacokinetics of GF- CART01-Tmax;Pharmacokinetics of GF- CART01-pAUC;Pharmacokinetics of GF- CART01-Clast;Pharmacokinetics of GF- CART01-T1/2;GF-CART01 persistence

研究设计怎么做的

研究类型
干预性研究
入组人数
18 人(预计)
分组方式
不适用(单臂)
  • GF-CART01试验组

    CAR阳性存活T细胞

核对分组登记原文(英文)
  • GF-CART01 · EXPERIMENTAL · CAR-positive viable T cells

关键日期

开始日期
2025-06-09
主要完成日期
2027-03
全部完成日期
2027-12
登记状态核实于
2025-12

联系与责任方

申办方
GenomeFrontier Therapeutics TW Co., Ltd.
联系邮箱
howardcheng@genomefrontier.com
联系电话
+886-2-2655-8766

登记简述

这是一项I期、前瞻性、剂量探索研究,旨在评估GF-CART01在18-70岁、复发或难治性(R/R)B细胞血液系统恶性肿瘤且两线或以上标准化疗或自体造血干细胞移植(HSCT)失败受试者中的安全性、持久性和临床活性。本研究采用传统的3+3剂量递增设计,观察剂量限制性毒性(DLT),确定GF-CART01的最大耐受剂量(MTD)/推荐II期剂量(RP2D)及初步疗效。RP2D可能等于或低于MTD

核对登记原文(英文)

This is a Phase I, prospective, dose-finding study to evaluate the safety, persistence, and clinical activity of GF-CART01 in subjects aged 18-70 with relapsed or refractory (R/R) B-cell hematological malignancies and failure of two-line or more standard chemotherapies or auto-hematopoietic stem cell transplantation (HSCT).This study is a traditional 3+3 dose-escalation design to observe dose-limiting toxicity (DLT), establish the maximum tolerated dose(MTD)/recommended phase 2 doses (RP2D), and preliminary efficacy of GF-CART01. RP2D may equal to or lower than MTD

登记原文与核验信息

试验登记号
NCT06703892
试验期别
I 期
试验状态
招募中
中国试验中心(1 个)
National Taiwan University Hospital · 台北 · 中国台湾
适应症(原文)
Diffuse Large B Cell Lymphoma Relapsed; Diffuse Large B Cell Lymphoma Refractory; Follicular Lymphoma ( FL); Primary Mediastinal Large B-Cell Lymphoma-Refractory; Primary Mediastinal Large B-Cell Lymphoma-Recurrent; High-grade B-cell Lymphoma (HGBCL)
干预方式(原文)
GF-CART01; GF-CART01; GF-CART01