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anti-CD19 IL10/IL15 CAR-NK(抗 CD19CAR-NK 细胞)治疗非霍奇金淋巴瘤:I 期临床试验

英文原题:Clinical Study of Cord Blood-derived IL-10/IL-15 CD19-CAR NK in the Treatment of Refractory/Relapsed B-cell NHL

ClinicalTrials.gov 2024/11/27(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,评估抗 CD19CAR-NK 细胞治疗非霍奇金淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 24 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT06707259。

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. 自愿参加研究并签署知情同意书;年龄18–75岁,性别不限。
2. 组织学确诊弥漫大B细胞淋巴瘤(DLBCL)、转化型滤泡性淋巴瘤(TFL)、原发纵隔B细胞淋巴瘤(PMBCL)、套细胞淋巴瘤(MCL)或其他惰性B细胞淋巴瘤转化类型。复发/难治DLBCL包括:两线治疗后未达完全缓解;治疗期间疾病进展或疾病稳定期≤6个月;或自体造血干细胞移植后12个月内进展/复发。复发/难治MCL须对BTK抑制剂耐药或不耐受;惰性B细胞淋巴瘤须三线治疗失败/复发。既往治疗须包括抗CD20单克隆抗体(CD20阴性者除外)及蒽环类药物。
3. 至少1个最长径≥1.5 cm的可测量病灶;肿瘤穿刺组织CD19表达阳性。
4. 预期生存期≥12周;ECOG体能状态0–2分。
5. 器官功能储备充分:ALT/AST≤ULN的2.5倍;按Cockcroft-Gault公式计算的肌酐清除率≥60 mL/min;总胆红素及碱性磷酸酶≤ULN的1.5倍;GFR>50 mL/min;心脏射血分数≥50%;室内空气下基础血氧>92%。允许既往接受造血干细胞移植。
6. 已获批的抗B细胞淋巴瘤治疗(如系统化疗、放疗及免疫治疗)须在研究用药前至少3周结束。既往CAR-T治疗失败或经评估3个月后复发者可入组。
7. 有生育能力女性妊娠试验阴性并同意试验期间有效避孕;新冠病毒检测两次阴性。

排除标准:

1. 对细胞产品任一成分过敏;有其他肿瘤史。
2. 既往发生Glucksberg标准Ⅱ–Ⅳ级急性GVHD或广泛慢性GVHD,或正在接受抗GVHD治疗。
3. 过去3个月内接受基因治疗。
4. 存在需治疗的活动性感染(单纯尿路感染或细菌性咽炎除外);允许预防性抗生素、抗病毒及抗真菌治疗。
5. 乙肝(HBsAg阳性,但HBV DNA<10³者不排除)、丙肝(包括病毒携带)、梅毒或其他获得性/先天性免疫缺陷(包括HIV)。
6. NYHA心功能Ⅲ/Ⅳ级。
7. 既往抗肿瘤治疗毒性尚未恢复至CTCAE 5.0版≤1级;疲劳、食欲减退、脱发除外。
8. 癫痫或其他中枢神经系统疾病史;头部增强CT/MRI提示中枢神经系统淋巴瘤。
9. 既往接受其他CD19靶向药物。
10. 哺乳期且不愿停止哺乳。
11. 研究者认为可能增加受试者风险或干扰研究结果的其他情况。
核对登记原文(英文)
Inclusion Criteria:

1. Volunteer to participate in this study and sign an informed consent form;
2. Age 18-75 years old, no gender limit;
3. Histologically diagnosed as diffuse large B-cell lymphoma (DLBCL), transforming follicular lymphoma (TFL), primary mediastinal B-cell lymphoma (PMBCL), mantle cell lymphoma (MCL) and other inert B-cells NHL conversion type:(1) Refractory or relapsed DLBCL refers to the failure to achieve complete remission after 2-line treatment; disease progression during any treatment, or disease stable time equal to or less than 6 months; or disease progression or recurrence within 12 months after autologous hematopoietic stem cell transplantation ; (2) Refractory or relapsed MCL must be resistant to or intolerable to BTK inhibitors; (3) Refractory or relapsed indolent B-cell NHL is the failure or recurrence of third-line treatment; (4) Previous treatment must include CD20 monoclonal antibody treatment (unless the subject is CD20 negative) and anthracyclines;
4. At least one measurable lesion with the longest diameter ≥ 1.5 cm exists;
5. The expected survival period is ≥12 weeks;
6. The puncture section of the tumor tissue was positive for CD19 expression; 7, ECOG score 0-2 points;
7. Sufficient organ function reserve: (1) Alanine aminotransferase, aspartate aminotransferase ≤ 2.5× UNL (upper limit of normal value); (2) Creatinine clearance rate (Cockcroft-Gault method) ≥60 mL/min; (3) Serum total bilirubin and alkaline phosphatase ≤1.5× UNL; (4)Glomerular filtration rate\>50Ml/min Cardiac ejection fraction (EF) ≥50%; (5) Under natural indoor air environment, basic oxygen saturation\>92% .
8. Allow a previous stem cell transplantation.
9. The approved anti-B-cell lymphoma treatments, such as systemic chemotherapy, systemic radiotherapy, and immunotherapy, have been completed for at least 3 weeks before the study medication;
10. Allow patients who have previously received CAR-T cell therapy and have failed or relapsed after 3 months of evaluation;
11. Female subjects of childbearing age must have a negative pregnancy test and agree to take effective contraceptive measures during the trial.
12. Two tests for the new coronavirus were negative.

Exclusion Criteria:

1. Those who have a history of allergies to any of the ingredients in cell products;
2. History of other tumors;
3. Previously presented with II-IV degree (Glucksberg criteria) acute GvHD or extensive chronic GvHD; or are receiving anti-GvHD treatment;
4. Have received gene therapy in the past 3 months;
5. Active infections that require treatment (except for simple urinary tract infections and bacterial pharyngitis), but preventive antibiotics, antiviral and antifungal infection treatments are allowed;
6. Hepatitis B (HBsAg positive, but HBV-DNA \<103 is not an exclusion criterion) or hepatitis C virus infection (including virus carriers), syphilis and other subjects with acquired and congenital immunodeficiency diseases, including but not limited to people living with HIV;
7. According to the New York Heart Association's Heart Function Classification Standard, it is classified as Grade III or Grade IV impaired subjects;
8. Those who have received anti-tumor therapy in the early stage but the toxic reaction has not recovered (the CTCAE 5.0 toxic reaction has not recovered to ≤1, except for fatigue, anorexia, and hair loss);
9. Subjects with a history of epilepsy or other central nervous system diseases; 10. Enhanced CT or MRI of the head showed evidence of central nervous system lymphoma;

11\. Have any other drugs that target CD19; 12. Women who are breastfeeding and unwilling to stop breastfeeding; 13. Any other situation that the investigator believes may increase the subject's risk or interfere with the test results.

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

  • 主要终点剂量限制性毒性(DLT)发生率最长28天
  • 次要终点完全缓解率(CR)
  • 次要终点无进展生存期(PFS)
  • 次要终点缓解持续时间(DOR)
  • 次要终点总生存期(OS)
  • 次要终点部分缓解率(PR)
  • 次要终点客观缓解率(ORR)
核对登记原文(英文)

主要终点:Incidence of dose limiting toxicity (DLTs) · To evaluate the safety, and tolerability, and determine the recommended dosage of cord blood-derived Anti-CD19 IL10/IL15-CAR-NK Cell Therapy for B-cell Non-Hodgkin Lymphoma · Up to 28 days
次要终点:Complete response rate (CR);Progression free survival (PFS);Duration of response (DOR);Overall survival (OS);Partial response rate (PR);Overall response rate (ORR)

研究设计怎么做的

研究类型
干预性研究
入组人数
24 人(预计)
分组方式
不适用(单臂)
  • 脐带血IL-10/IL-15-CD19 CAR-NK组试验组

    所有受试者均接受IL-10/IL-15 CD19 CAR-NK细胞静脉输注。

核对分组登记原文(英文)
  • CB IL-10/IL-15-CD19-CAR NK · EXPERIMENTAL · All subjects were intravenously administrated with IL-10/IL-15 CD19-CAR NK

关键日期

开始日期
2024-12-01
主要完成日期
2026-12-01
全部完成日期
2027-12-01
登记状态核实于
2024-11

联系与责任方

申办方
Second Affiliated Hospital, Zhejiang University, School of Medicine
联系邮箱
qianwb@zju.edu.cn
联系电话
+8613605801032

登记简述

本研究旨在评估脐带血来源IL-10/IL-15共表达CD19 CAR-NK细胞治疗B细胞非霍奇金淋巴瘤患者的安全性和疗效。

核对登记原文(英文)

To study the safety and effectiveness of cord blood-derived IL-10/IL-15 CD19-CAR NK in patients with B-cell non-Hodgkin's lymphoma

登记原文与核验信息

试验登记号
NCT06707259
试验期别
I 期
试验状态
招募中
中国试验中心(1 个)
the Second Affiliated Hospital, College of Medicine, Zhejiang University · 杭州 · 中国
适应症(原文)
B-cell Non Hodgkin Lymphoma
干预方式(原文)
anti-CD19 IL10/IL15 CAR-NK