CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:A Clinical Study to Explore the Safety and Efficacy of CD33 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
A Clinical Study to Explore the Safety and Efficacy of CD33 CAR-T Cell in Relapsed/Refractory Acute Myeloid Leukemia
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⚠ 该试验的登记信息已有 21 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。
这是一项早期 I 期注册临床试验,评估 CAR-T 细胞治疗急性髓系白血病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 27 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT06762132。
不限性别 · ≥ 18 Years
纳入标准: 1. 男性或女性,年龄≥18岁。 2. CAR-T 细胞可正常制备,或自体CAR-T 细胞制备失败(包括自体淋巴细胞<1×10⁹、制备过程中扩增不足或无法回输)。 3. 组织学或免疫学检查确诊CD33阳性急性髓系白血病(AML),且CD33阳性表达率>80%。 4. 符合2016年WHO AML分类及《中国复发难治性急性髓系白血病诊断和治疗指南(2017年版)》的复发/难治诊断标准,且目前无有临床意义的治疗方案或适合入组的临床试验。复发AML定义:完全缓解(CR)后外周血再次出现白血病细胞、骨髓原始细胞>5%(排除巩固化疗后骨髓再生等其他原因),或骨髓外出现白血病细胞浸润。难治AML包括:初治患者经2个疗程标准方案治疗无效;CR后巩固强化治疗后12个月内复发;12个月后复发但常规化疗失败;复发≥2次;持续性髓外白血病。 5. 骨髓原始细胞(原粒细胞和/或早幼粒细胞)形态学比例>5%,和/或流式细胞术检测>1%。 6. 总胆红素≤51 μmol/L,ALT和AST≤ULN的3倍,血清肌酐≤176.8 μmol/L。 7. 超声心动图显示LVEF≥50%。 8. 无活动性肺部感染,室内空气下血氧饱和度>92%。 9. 预期生存期>3个月。 10. ECOG评分0–2。 11. 妊娠/哺乳期女性不得入组;有生育能力的男性或女性同意在研究期间及末次细胞输注后至少6个月采取有效避孕措施。 12. 自愿参加试验并签署知情同意书。 排除标准: 1. 有癫痫或其他中枢神经系统疾病史。 2. QT间期延长或严重心脏病。 3. 未治愈的活动性感染。 4. 活动性乙肝或丙肝感染。 5. 既往使用过任何基因治疗产品。 6. 对CD3/CD28共刺激信号的增殖反应不足5倍。 7. 研究者认为不适合参加的其他未控制疾病。 8. HIV感染。 9. 研究者认为可能增加受试者风险或干扰试验结果的任何情况。
Inclusion Criteria: * 1\. Male or female, age ≥ 18 years old; * 2\. CAR-T cells can be prepared normally, or who have failed to prepare autologous CAR-T cells (including the number of autologous lymphocytes \<1×10\^9 or the expansion during the preparation process is insufficient or cannot reinfusion); * 3\. Patients diagnosed with CD33 positive acute myeloid leukemia (AML) through histological or immunological examination,and CD33 positive expression rate \>80%; * 4\. Complies with the 2016 WHO classification for AML diagnosis and meets the diagnostic criteria for recurrence and refractory acute myeloid leukemia in the "Chinese Guidelines for the Diagnosis and Treatment of relapsed and refractory acute myeloid leukemia (2017 edition)", and currently there are no clinically relevant treatments or suitable clinical trials for registration: * a) Diagnostic criteria for recurrent AML: After complete remission (CR), leukemia cells reappear in peripheral blood or primitive cells in bone marrow\>0.050 (excluding other reasons such as bone marrow regeneration after consolidation chemotherapy) or leukemia cell infiltration appears outside the bone marrow; * b) Diagnostic criteria for refractory AML: initial treatment cases that have failed to respond to two courses of standard protocol treatment; Patients who relapse within 12 months after consolidation and intensive treatment after CR; Patients who relapse after 12 months but fail conventional chemotherapy; Patients with 2 or more relapses; Persistent extramedullary leukemia; * 5\. The number of primitive cells (promyelocytes and/or promyelocytes) in the bone marrow \> 5% (morphology) and/or \> 1% (flow cytometry detection); * 6\. Total bilirubin ≤ 51 μmol / L, ALT and AST ≤ 3 times of the upper limit of normal value, serum creatinine ≤ 176.8 μmol / L; * 7\. Echocardiography shows left ventricular ejection fraction (LVEF) ≥ 50%; * 8\. There is no active pulmonary infection, and the oxygen saturation during air inhalation is more than 92%; * 9\. The estimated survival time is more than 3 months; * 10\. ECOG score was 0-2; * 11\. Pregnant/lactating women, or male or female patients who have fertility and are willing to take effective contraceptive measures at least 6 months after the last cell infusion during the study period; * 12\. Those who voluntarily participated in this trial and provided informed consent; Exclusion Criteria: * 1\. Patients with the history of epilepsy or other CNS disease; * 2\. Patients with prolonged QT interval time or severe heart disease; * 3\. Active infection with no cure; * 4\. Active infection of hepatitis B virus or C virus ; * 5\. Before using any gene therapy products; * 6\. The proiferation rate is less than 5 times response to CD3/CD28 co-stimulation signal; * 7\. Suffering from other uncontrolled diseases that the researchers consider unsuitable for joining; * 8\. Infected with AIDS virus; * 9\. Any situation that researchers believe may increase the risk to the subjects or interfere with the trial 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。
主要终点:Dose-limiting toxicity (DLT) · Adverse events assessed according to NCI-CTCAE v5.0 criteria · Up to 28 days after Treatment;Incidence of treatment-emergent adverse events (TEAEs) · Incidence of treatment-emergent adverse events \[Safety and Tolerability\] · Up to 2 years after Treatment
次要终点:Complete response (CR), and complete response with incomplete hematologic recovery (CRi);Duration of remission ,DOR;Overall survival, OS;Leukemia-Free Survival, LFS
按标准3+3设计进行剂量递增,共设置3个剂量水平。
以上邮箱 / 电话是登记库里的申办方联系方式(中国内地座机),通常不直达某家医院。中国中心的联系方式请以医院或登记平台最新公示为准。
本临床研究旨在评估靶向CD33的CAR-T 细胞治疗复发/难治性急性髓系白血病的安全性和疗效。
A Clinical Study on the Safety and Effectiveness of targeting CD33 CAR-T Cell in the treatment of Relapsed/Refractory Acute Myeloid Leukemia
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