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CD7 CAR-T 细胞治疗血液系统恶性肿瘤:I/II 期临床试验(Union Hospital, Tongji)

英文原题:CD7-specific CAR-T Cell in the Treatment of CD7-positive Relapsed/Refractory Hematologic Tumors

ClinicalTrials.gov 2024/12/06(首次登记) I/II 期注册临床试验 · 招募中

⚠ 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。

简要介绍

这是一项 I/II 期注册临床试验,评估 CAR-T 细胞治疗血液系统恶性肿瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 80 例。试验地点:中国 · 武汉(共 1 个中心,其中中国 1 个)。登记号:NCT06720324。

入组条件决定能不能参加

不限性别 · ≥ 3 Years 且 ≤ 75 Years

纳入标准:

• 复发/难治性血液系统恶性肿瘤,符合以下之一:复发:既往标准治疗达到完全缓解后,外周血或骨髓原始细胞>5%,或出现髓外疾病;包括12个月内早期复发、12个月后复发但一疗程标准诱导化疗后仍未缓解,或自体/异基因造血干细胞移植后复发。难治:至少2个疗程标准诱导治疗后未达到完全缓解,或一线及以上挽救治疗后未达完全缓解。
• 入组筛选时骨髓流式细胞术检测肿瘤细胞表达CD7,和/或髓外病灶病理免疫组化证实CD7表达。若筛选时外周血检测到肿瘤细胞,其流式免疫表型须为CD4和CD8双阴性;若非双阴性,则外周血肿瘤细胞比例须≤1%。
• ECOG体能状态0–2。
• 预期生存期>3个月。
• 肝、肾及心肺功能达标:血清肌酐≤ULN的1.5倍;LVEF≥50%;基线外周血氧饱和度>90%;总胆红素≤ULN的1.5倍,ALT和AST≤ULN的2.5倍。
• 患者或法定监护人自愿参加并签署知情同意书。

排除标准:

• 存在以下心脏情况之一:房颤;过去12个月内心肌梗死;研究者判定的长QT综合征或继发性QT延长;超声心动图显示左心室短轴缩短率<30%或LVEF<50%;有临床意义的心包积液;NYHAⅢ或Ⅳ级心功能不全(治疗前12个月内超声心动图证实)。
• 活动性GVHD。
• 有严重肺功能损害病史。
• 其他晚期恶性肿瘤。
• 严重感染或持续感染且无法有效控制。
• 合并严重自身免疫病或先天性免疫缺陷。
• 活动性肝炎(HBV-DNA≥500 IU/mL且肝功能异常,或HCV抗体阳性、HCV-RNA高于检测方法下限且肝功能异常)。
• HIV感染或梅毒感染。
• 对生物制品(包括抗生素)有严重过敏史。
• 中枢神经系统疾病,如未控制的癫痫、脑血管缺血/出血、痴呆或小脑疾病等。
• 女性妊娠或哺乳,或计划在12个月内妊娠。
• 研究者认为可能增加风险或干扰试验结果的其他情况。
核对登记原文(英文)
Inclusion Criteria:

* Subjects with a diagnosis of relapsed/refractory hematologic malignancies that meet any of the following criteria:

  1. Recurrence: peripheral blood or bone marrow blasts (proportion\>5%) after achieving complete remission after previous standard treatment regimens, or extramedullary disease, including:

     i) Early recurrence within 12 months; ii) Late recurrence of 12 months or more with no remission after one course of standard induction chemotherapy; iii) Relapse after autologous or allogeneic hematopoietic stem cell transplantation.
  2. Refractory: complete remission is not achieved after at least two courses of standard induction therapy, or complete remission is not achieved after first-line or above salvage therapy
* At the time of enrollment screening, bone marrow flow cytometry detected tumor cells as CD7 expression and/or pathological immunohistochemistry of extramedullary lesions was confirmed that tumor cells expressed CD7.
* If tumor cells are detected in peripheral blood during enrollment screening, the immunophenotype of tumor cell surface at the time of flow cytometry detection should be CD4 and CD8 negative. If the surface immunophenotype of peripheral blood tumor cells is not CD4 and CD8 negative, the condition of ≤1% proportion of peripheral blood tumor cells must be met.
* Subjects with the Eastern Cooperative Oncology Group (ECOG) fitness scores of 0 to 2.
* Expected survival over 3 months;
* Liver, kidney and cardiopulmonary functions meet the following requirements:

  1. Serum creatinine ≤ 1.5× ULN;
  2. Left ventricular ejection fraction (LVEF) ≥50%;
  3. Baseline peripheral oxygen saturation \> 90%;
  4. Total bilirubin ≤ 1.5×ULN; ALT and AST ≤2.5×ULN.
* Patient or his or her legal guardian voluntarily participates in and signs an informed consent form.

Exclusion Criteria:

* Appearance of one of the following cardiac criteria: atrial fibrillation; myocardial infarction in the last 12 months; prolonged QT syndrome or secondary QT extension, as judged by the investigator.

Echocardiography LVSF \<30% or LVEF \<50%; clinically significant pericardial effusion; cardiac insufficiency NYHA (New York Heart Association) III or IV (confirmed by echocardiography within 12 months of treatment).

* Active GVHD.
* History of severe pulmonary function impairment disease.
* Other malignant tumors in the advanced stage.
* Severe infection or persistent infection that cannot be effectively controlled.
* Combined with severe autoimmune disease or innate immune deficiency.
* Active hepatitis (hepatitis B virus deoxyribonucleic acid \[HBV-DNA 500 IU / ml and abnormal liver function\] or hepatitis C antibody \[HCV-Ab\] positive, HCV-RNA above the lower limit of detection of the analytical method and abnormal liver function).
* Human immunodeficiency virus (HIV) infection or syphilis infection.
* History of severe allergies to biological products (including antibiotics).
* Central nervous system disorders, such as uncontrolled epilepsy, cerebrovascular ischemia/hemorrhage, dementia, cerebellar diseases, etc..
* Female patients are in pregnancy and lactation, or have a pregnancy plan within 12 months.
* Situations where the investigator may increase the 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CD7特异性CAR-T细胞治疗复发/难治性血液系统肿瘤的总缓解率(ORR)输注后3年内
  • 主要终点治疗相关不良事件发生率CD19/CD20 CAR-T输注后3个月内
  • 次要终点CD7特异性CAR-T细胞在复发/难治性血液系统恶性肿瘤患者体内的扩增和存活
核对登记原文(英文)

主要终点:Overall response rate (ORR) of administering CD7-specific CAR-T Cells In the treatment of relapsed/refractory hematologic tumors · Disease overall response rate (ORR) will be assessed from CAR-T cell infusion to death or last follow-up (censored). · within 3 years after infusion;Incidence of Treatment-related Adverse Events · Therapy-related adverse events (AE), including severe adverse events (SAE) and laboratory outliers with clinical significance, will be recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0). · Within 3 month after CD19&CD20 CAR-T infusion
次要终点:In vivo expansion and survival of CD7-specific CAR-T Cells in relapsed/refractory hematological malignancies

研究设计怎么做的

研究类型
干预性研究
入组人数
80 人(预计)
分组方式
不适用(单臂)
  • 氟达拉滨+环磷酰胺+CD7特异性CAR-T细胞试验组

    第-5、-4和-3天给予氟达拉滨(30 mg/kg)和环磷酰胺(300 mg/kg)进行淋巴细胞清除,随后输注CD7特异性CAR-T细胞,剂量为1–3×10⁶个细胞/kg。

核对分组登记原文(英文)
  • Fludarabine + Cyclophosphamide +CD7-specific CAR-T Cells · EXPERIMENTAL · Patients will received lymphodepletion with fludarabine (30 mg/kg) and cyclophosphamide (300 mg/kg) on day -5, -4, and -3, followed by the infusion of CD7-specific CAR-T Cells with the dose of 1-3×10\^6/kg.

关键日期

开始日期
2024-12-31
主要完成日期
2027-12-31
全部完成日期
2027-12-31
登记状态核实于
2024-12

联系与责任方

主要研究者
MEI HENG
申办方
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
合作方
Hebei Taihe Chunyu Biotechnology Co., Ltd
联系邮箱
hmei@hust.edu.cn
联系电话
027-8572600

登记简述

这是一项单中心、开放、前瞻性单臂临床研究,旨在评估CD7特异性CAR-T细胞治疗CD7阳性复发/难治性血液系统肿瘤的安全性和疗效,同时收集CAR-T细胞的药代动力学及药效学指标。

核对登记原文(英文)

This study is a single-center, open, prospective single-arm clinical study of patients with CD7 postive relapsed / refractoryhematological tumors to evaluate the safety and efficacy of CD7-specific CAR-T cells in relapsed / refractory hematological tumors while collecting pharmacokinetics and pharmacodynamics indicators of CAR-T cells.

登记原文与核验信息

试验登记号
NCT06720324
试验期别
I 期 / II 期
试验状态
招募中
中国试验中心(1 个)
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology · 武汉 · 中国
适应症(原文)
Hematologic Malignancy
干预方式(原文)
Fludarabine + Cyclophosphamide + CD7-specific CAR-T Cells