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:A Clinical Study of CHT102 in Mesothelin Positive Advanced Solid Tumors
⚠ 该试验的登记信息已有 22 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。
这是一项分期未标注的注册临床试验,评估异体 CAR-T 细胞治疗相关疾病的安全性、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 · 天津(共 1 个中心,其中中国 1 个)。登记号:NCT06717022。
不限性别 · ≥ 18 Years
纳入标准: * 能够理解并签署书面知情同意书; * 年龄≥18岁,男女均可; * 组织病理学确诊晚期或转移性实体瘤,一线标准治疗失败;或初诊晚期实体瘤且NCCN指南无推荐的一线标准治疗; * 组织病理学或细胞学(石蜡切片或新鲜活检肿瘤组织)确诊晚期/转移性实体瘤,组织学或病理学证实MSLN表达阳性(IHC 2+); * 基线时按RECIST 1.1至少有一个可测量病灶; * 预期生存期>12周; * ECOG评分0–1分; * 重要器官功能基本正常; * 研究者判断既往治疗毒性已恢复至≤1级,以下情况除外:脱发;色素沉着;研究者认为无法恢复的放疗长期毒性;铂类药物引起的≤2级神经毒性(CTCAE 5.0); * 受试者同意自签署知情同意书起至CAR-T输注后6个月内采取可靠有效的避孕方法(节律避孕除外)。 排除标准: * 28天内接受过任何试验药物或使用过研究器械; * 4周内接受过化疗、靶向治疗等抗肿瘤治疗; * 1个月内接受过MSLN靶向以外的细胞治疗产品; * 既往接受其他细胞治疗产品者,筛查期间须进行复制型逆转录病毒(RCL)检测;如任一检测结果阳性则排除; * CHT102输注前14天内接受过淋巴细胞清除化疗以外的化疗; * 2周内接受泼尼松>10 mg/日或其他等效剂量全身性糖皮质激素治疗; * CHT102细胞输注前7天内接受口服或静脉抗凝治疗; * 既往接受过异基因器官移植或异基因造血干细胞移植; * 免疫缺陷、自身免疫性疾病或需要使用免疫抑制剂; * 入组前14天内接种疫苗,或研究期间需要接种活疫苗; * 筛查时存在活动性/有症状的中枢神经系统转移或脑膜转移;脑转移经治疗者须在治疗结束≥4周后影像学证实未进展方可入组; * 严重或未控制的全身性疾病或任何不稳定全身疾病,包括但不限于未控制的高血压、高血糖、肝肾功能不全或代谢性疾病、中枢神经系统疾病等; * 存在以下任一心脏疾病:NYHA III或IV级充血性心力衰竭;入组前6个月内心肌梗死或冠状动脉旁路移植术(CABG);有临床意义的室性心律失常;超声心动图显示射血分数<50%;男性QTc>450 ms或女性QTc>470 ms; * 妊娠期、哺乳期或正在哺乳的女性; * 胸腔或腹腔积液控制不佳; * 研究者认为不适合参加研究的其他情况。
Inclusion Criteria: * Ability to understand and sign a written informed consent document; * Age ≥18 years old, male or female; * Histopathological confirmed advanced or metastatic solid tumors failed to at least standard first-line therapy or initially diagnosed advanced solid tumors that have no National Comprehensive Cancer Network (NCCN )guideline recommended standard first-line therapy; * Histopathology or cytology (paraffin section or fresh biopsy tumor tissue specimen) diagnosed as advanced/metastatic solid tumor (positive tumor MSLN expression (tumor MSLN positive (IHC 2+) confirmed by histology or pathology)); * At least one measurable lesion at baseline per RECIST version 1.1; * The expected survival time is more than 12 weeks; * ECOG(American Eastern Oncology Consortium) 0-1 points; * The function of important organs is basically normal; * The investigator determines that the patient must have fully recovered from previous treatment toxicity to ≤ grade 1, except in the following cases: a. Hair loss; b. Pigmentation; c. Long-term toxicity caused by radiotherapy, which could not be recovered according to the investigators; d. Platinum induced grade 2 or lower neurotoxicity (CTCAE 5.0); * Subjects agree to use reliable and effective contraceptive methods for contraception within * 6 months after signing the informed consent form to receiving CAR-T cell infusion (excluding rhythm contraception). Exclusion Criteria: * Received any experimental drug treatment or used experimental devices within 28 days; * Received anti-tumor therapy such as chemotherapy and targeted therapy within 4 weeks; * Received cell therapy products other than MSLN targets within 1 month; * Patients who have previously received other cell therapy products should be tested for RCL(Replication Competent Retrovirus ) during the screening period if any test result is positive; * Received chemotherapy other than lymphocyte clearance chemotherapy within 14 days prior to CHT102 infusion; * Received systemic corticosteroid therapy at doses greater than 10 mg/day prednisone (or equivalent doses of other corticosteroids) within 2 weeks; * Patients receiving oral or intravenous anticoagulant therapy within 7 days prior to CHT102 cell infusion; * Prior organ allograft transplantations or allogeneic hematopoietic stem cell transplantation; * Patients with immune deficiency or autoimmune diseases, or who require immunosuppressants; * Vaccination within 14 days of study enrollment, or who required live vaccine immunization during the study period; * Active/symptomatic central nervous system metastases or meningeal metastases at the time of screening; subjects with brain metastases who have been treated must be confirmed to have no imaging evidence of progression ≥ 4 weeks after the end of treatment before they can be enrolled; * Serious or uncontrollable systemic disease or any unstable systemic disease, including but not limited to uncontrolled hypertension, uncontrolled hyperglycemia, liver and kidney insufficiency or metabolic disease, central nervous system disease, etc; * Have any of the following heart conditions: * New York Heart Association (NYHA) stage III or IV congestive heart failure; * Myocardial infarction or coronary artery bypass grafting (CABG) within 6 months before enrollment; * Clinically significant ventricular arrhythmia, * echocardiography showed cardiac ejection fraction\<50%, QTc (male)\>450 ms,QTc (female)\>470 ms;; * Pregnant, lactating, or breastfeeding females; * Patients with poor control of thoracoabdominal water; * Other investigators deem it inappropriate to participate 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。
主要终点:Dose Limiting Toxicities (DLTs) occurence · Adverse events assessed according to NCI-CTCAE v5.0 criteria · Baseline up to 28 days after U CAR-T infusion
次要终点:Objective Response Rate;Progression-free survival
剂量递增阶段计划设置一个备选剂量及4个剂量组(按CAR阳性T细胞数计算),每个治疗周期28天;分别在第1、5、9天输注U CAR-T细胞。各组内单次剂量固定,各组之间递增。每次输注剂量依次为2.5×10⁶/kg(可选)、5×10⁶/kg、1×10⁷/kg、2×10⁷/kg和3×10⁷/kg,允许±20%的剂量误差。
研究目的:评估靶向间皮素(MSLN)的通用型嵌合抗原受体T细胞(U CAR-T)免疫治疗MSLN阳性晚期实体瘤的安全性和有效性。
Objectives of Study:In this study investigators plan to evaluate the safety and efficacy of MSLN-targeting Universal Chimeric Antigen Receptor T-Cell Immunotherapy(U CAR-T) in the treatment of MSLN-positive advanced solid tumors.
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