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:CD19 & CD22 Bispecific CAR T Cells in the Treatment of Relapsed/Refractory B Cell Hematologic 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 I/II 期注册临床试验,评估 CD19CAR-T 细胞治疗淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 80 例。试验地点:中国 · 武汉(共 1 个中心,其中中国 1 个)。登记号:NCT06735495。
不限性别 · ≥ 3 Years 且 ≤ 75 Years
纳入标准: 1. 病理组织学检查证实CD19和CD22双阳性B细胞血液系统肿瘤,且符合复发/难治性标准: 复发/难治性B细胞白血病符合以下任一项:首次缓解后6个月内复发;接受2个周期标准化疗后仍未达到完全缓解的原发难治;一线或多线挽救化疗后未达完全缓解或复发;因条件限制不适合或放弃HSCT,或HSCT后复发。 复发/难治性B细胞淋巴瘤须符合前四项之一,并且既往接受充分治疗,包括至少一种抗CD20单克隆抗体及含蒽环类药物的联合化疗:按标准方案化疗4个周期后肿瘤缩小不足50%或疾病进展;标准化疗后达到CR但6个月内复发;CR后复发≥2次;不适合或因条件限制放弃HSCT,或HSCT后复发。 2. 流式细胞术(FCM)或免疫组化检测肿瘤抗原CD19/CD22阳性。 3. 自签署知情同意书起预期生存期>3个月。 4. 器官功能良好:血红蛋白≥70 g/L(可输血);肌酐≤ULN的1.5倍,总胆红素≤ULN的1.5倍,ALT和AST≤ULN的2.5倍;LVEF>50%,血氧饱和度>90%。 5. ECOG体能状态0–2。 排除标准(符合任一项者不得入组): 1. 严重心功能不全,LVEF<50%。 2. 有严重肺功能损害病史。 3. 其他晚期恶性肿瘤。 4. 严重感染或持续感染且无法有效控制。 5. 合并严重自身免疫病或先天性免疫缺陷。 6. 活动性肝炎:乙肝病毒DNA(HBV-DNA)≥500 IU/mL且肝功能异常,或丙肝抗体(HCV-Ab)阳性、HCV-RNA高于检测下限且肝功能异常。 7. HIV感染或梅毒感染。 8. 对生物制品(包括抗生素)有严重过敏史。 9. 异基因造血干细胞移植后急性GVHD,停用免疫抑制剂后未满1个月。 10. 有其他严重躯体或精神疾病或实验室异常,可能增加临床试验风险或干扰结果,且研究者判定不适合参加。
Inclusion Criteria: 1.CD 19 + / CD 22 + B cell hematological tumor was confirmed by pathological and histological examination, and the patient met the following criteria for relapsed or refractory B cell hematological tumor: 1. Refractory / relapsed B lymphocytic leukemia (1 of the following 4 items can be met): i . Recurrence within 6 months of first remission; ii. Primary refractory without complete remission after 2 cycles of standard chemotherapy regimen; iii. No complete remission or recurrence after first-line or multiline salvage chemotherapy; iv. Not eligible for HSCT conditions, abandonment of HSCT, or relapse after HSCT due to conditional limitations. 2. Refractory / relapsed B-cell lymphoma (meet the following item 1 of the first 4 items plus item 5): i . After four courses of chemotherapy with a standard regimen, tumor shrinkage was less than 50% or disease progression; ii . CR after standard regimen chemotherapy, but relapsed within 6 months; iii.2 or more recurrences after CR; iv . Not suitable for hematopoietic stem cell transplantation, or abandoning HSCT due to conditional restrictions or relapse after hematopoietic stem cell transplantation; v . Subject must have received prior adequate treatment, including at least: a monoclonal antibody against CD 20 and combination chemotherapy containing an anthracycline drug agent. 2.The results of FCM or immunohistochemical detection of tumor antigen (CD 19 / CD 22) were positive. 3.The estimated survival period is more than 3 months starting from the signing of the informed consent form. 4.Good organ function,Meet the following requirements: 1. HGB≥70g/L(transfusible) 2. Liver and kidney function: creatinine ≤1.5XULN: total bilirubin ≤1.5XULN:ALT and AST≤2.5X ULN 3. Cardiopulmonary function: left ventricular ejection fraction \>50%; Blood oxygen saturation \>90%; 5.Subjects with the Eastern Cooperative Oncology Group (ECOG) fitness scores of 0 to 2. Exclusion Criteria:(If meet any of the following criteria, patients will not be included) 1. Serious heart insufficiency,LVEF \<50% 2. History of severe pulmonary function impairment disease. 3. Other malignant tumors in the advanced stage. 4. Severe infection or persistent infection that cannot be effectively controlled. 5. Combined with severe autoimmune disease or innate immune deficiency. 6. 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). 7. Human immunodeficiency virus (HIV) infection or syphilis infection. 8. History of severe allergies to biological products (including antibiotics). 9. Acute graft-versus-host response (GVHD) allogeneic hematopoietic stem remained one month after immunosuppressant discontinuation. 10. Patients who have other serious physical or mental illnesses or abnormalities in laboratory tests that may increase the risk of participating in the clinical trial or interfere with the study results, and who are deemed unsuitable for participation in the clinical trial by the investigator
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:Overall response rate (ORR) of administering CD19&CD22 dual-target CAR-T cells In the treatment of relapsed/refractory B-cell 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;Complete response rate (CR) of administering CD19&CD22 dual-target CAR-T cells In the treatment of relapsed/refractory B-cell hematologic tumors · CR will be assessed from CAR-T cell infusion to death or last follow-up (censored). · within 3 years after infusion;Complete response with incomplete blood recovery rate (CRi) of administering CD19&CD22 dual-target CAR-T cells In the treatment of relapsed/refractory B-cell hematologic tumors · CRi will be assessed from CAR-T cell infusion to death or last follow-up (censored). · within 3 years after infusion;Partial response rate (PR) of administering CD19&CD22 dual-target CAR-T cells In the treatment of relapsed/refractory B-cell hematologic tumors · PR will be assessed from CAR-T cell infusion to death or last follow-up. · within 3 years after infusion
次要终点:Duration of Response (DOS) of administering CD19&CD22 dual-target CAR-T cells in the treatment of relapsed/refractory B-cell hematologic tumors;Progress-free survival (PFS) of administering CD19&CD22 dual-target CAR-T cells in the treatment of relapsed/refractory B-cell hematologic tumors;Overall survival (OS) of administering CD19&CD22 dual-target CAR-T cells in the treatment of relapsed/refractory B-cell hematologic tumors;The Peripheral blood vector copy number of patients of CD19&CD22 dual-target CAR-T cell therapy in relapsed/refractory B-cell hematological malignancies;The Cmax of CAR T cells of CD19&CD22 dual-target CAR-T cell therapy in relapsed/refractory B-cell hematological malignancies;The Tmax of CAR T cells of CD19&CD22 dual-target CAR-T cell therapy in relapsed/refractory B-cell hematological malignancies;The AUC28D of CAR T cells of CD19&CD22 dual-target CAR-T cell therapy in relapsed/refractory B-cell hematological malignancies
本试验建议的CAR-T细胞输注剂量范围为1–2×10⁶个细胞/kg。
这是一项多中心、开放、前瞻性单臂临床研究,旨在评估CD19和CD22双特异性CAR-T细胞治疗复发/难治性B细胞血液系统肿瘤的安全性和疗效,同时收集CAR-T细胞的药代动力学和药效学指标。
This study is a multi-center, open, prospective single-arm clinical study of patients with relapsed / refractory B cell hematological tumors to evaluate the safety and efficacy of CD19 \& CD22 bispecific CAR-T cells in relapsed / refractory B cell hematological tumors while collecting pharmacokinetics and pharmacodynamics indicators of CAR-T cells.
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