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.
英文原题:Clinical Study on the Safety and Efficacy of Autologous CD84 Chimeric Antigen Receptor T-Cell Therapy for Adult Relapsed/Refractory Acute Myeloid Leukemia.
Clinical Study on the Safety and Efficacy of Autologous CD84 Chimeric Antigen Receptor T-Cell Therapy for Adult Relapsed/Refractory Acute Myeloid Leukemia.
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⚠ 该试验的登记信息已有 20 个月未更新, 页面上显示的「尚未开始招募」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,评估细胞治疗用于急性髓系白血病的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 18 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT06786299。
不限性别 · ≥ 18 Years 且 ≤ 70 Years
纳入标准: 1. 年龄18-70岁(含边界值),性别不限。 2. 自愿参加本临床研究,签署知情同意书,依从性好,能配合随访。 3. 诊断为复发/难治性急性髓系白血病(AML),复发/难治性AML患者需满足以下条件之一:两个标准疗程未缓解的患者;完全缓解后12个月内复发;12个月后复发但一个标准治疗未缓解;第二次或以上复发的患者。复发定义为达到AML完全缓解(CR)后外周血中白血病细胞重新出现或骨髓中原始细胞≥5%(排除巩固化疗后骨髓再生等其他原因)或髓外部位白血病细胞浸润,排除上述情况发生在粒细胞集落刺激因子(G-CSF)治疗后。 4. 流式细胞术确认存在CD84阳性原始细胞。 5. ECOG(美国东部肿瘤协作组)评分为0-1。 6. 能够采集符合要求规格的T细胞。 7. 肝功能:丙氨酸氨基转移酶(ALT)≤ 3 × 正常值上限(ULN);天冬氨酸氨基转移酶(AST)≤ 3 × ULN;总胆红素(TBIL)≤ 1.5 × ULN(Gilbert综合征除外)。 8. 肾功能:肌酐清除率(CrCl)≥ 60 ml/分钟(Cockcroft/Gault公式)。 9. 凝血功能:国际标准化比值(INR)≤ 1.5 × 正常值上限(ULN),凝血酶原时间(PT)≤ 1.5 × ULN。 10. 心功能:血流动力学稳定良好,左心室射血分数(LVEF)≥ 50%。 11. 肺功能:无临床显著胸腔积液,基线血氧饱和度 >92%。 12. 有生育能力的女性受试者和有生育能力伴侣的男性受试者必须在研究治疗期间及研究治疗结束后至少6个月内采用医学认可的避孕措施或禁欲。有生育能力的女性受试者必须在研究入组前7天内血清人绒毛膜促性腺激素(HCG)检测为阴性,且不得处于哺乳期。 排除标准: 1. 有严重药物过敏史或过敏体质者; 2. 存在未控制的活跃性感染者; 3. 有严重心脏疾病者,如心绞痛、心肌梗死、心力衰竭和心律失常; 4. 先天性免疫球蛋白缺陷的受试者; 5. 患有其他恶性肿瘤的患者(非黑色素瘤皮肤癌、宫颈原位癌、膀胱癌和乳腺癌无病生存期超过5年者除外); 6. 终末期肾衰竭的受试者; 7. 乙型肝炎表面抗原(HBsAg)阳性或乙型肝炎核心抗体(HBcAb)阳性且外周血HBV DNA水平高于检测下限者;丙型肝炎病毒(HCV)抗体阳性且外周血HCV RNA阳性者;人类免疫缺陷病毒(HIV)抗体阳性者;梅毒检测阳性者; 8. 患有精神疾病及严重认知障碍者; 9. 近一个月内参加过其他临床试验者; 10. 妊娠或哺乳期妇女; 11. 研究者认为不适合本研究或因其他原因不适合纳入本研究者; 12. 异基因移植后三个月内复发或移植三个月后仍有移植物抗宿主病(GVHD)反应者; 13. 中枢神经系统白血病浸润。
Inclusion Criteria: 1. Ages 18-70 years (inclusive of boundary values), gender unrestricted. 2. Voluntarily participate in this clinical study, sign the informed consent form, have good compliance, and cooperate with follow-up visits. 3. Diagnosed with relapsed/refractory acute myeloid leukemia (AML), patients with relapsed/refractory AML must meet one of the following conditions: patients who have not achieved remission after two standard treatment courses; relapse within 12 months after complete remission; relapse after 12 months but have not achieved remission after one standard treatment; patients with second or subsequent relapses. Relapse is defined as the reappearance of leukemia cells in the peripheral blood or the presence of ≥5% blasts in the bone marrow (excluding other causes such as bone marrow regeneration after consolidation chemotherapy) or the infiltration of leukemia cells in extramedullary sites after achieving complete remission (CR) of AML, excluding cases where the above conditions occur after granulocyte colony-stimulating Factor (G-CSF) treatment. 4. Flow cytometry confirms the presence of CD84-positive blasts. 5. ECOG (Eastern Cooperative Oncology Group) score of 0-1. 6. Able to collect T cells that meet the required specifications. 7. Liver Function: Alanine Aminotransferase (ALT) ≤ 3 × Upper Limit of Normal (ULN); Aspartate Aminotransferase (AST) ≤ 3 × ULN; Total Bilirubin (TBIL) ≤ 1.5 × ULN (except in cases of Gilbert's syndrome). 8. Renal Function: Creatinine Clearance Rate (CrCl) ≥ 60 ml/minute (Cockcroft/Gault formula). 9. Coagulation Function: International Normalized Ratio (INR) ≤ 1.5 × Upper Limit of Normal (ULN), Prothrombin Time (PT) ≤ 1.5 × ULN. 10. Cardiac Function: Hemodynamic stability is good, with a Left Ventricular Ejection Fraction (LVEF) ≥ 50%. 11. Pulmonary Function: No clinically significant pleural effusion, baseline oxygen saturation \>92%. 12. Female subjects of childbearing potential and male subjects with partners of childbearing potential must use medically recognized contraceptive measures or abstain from sexual activity during the study treatment period and for at least 6 months after the study treatment ends. Female subjects of childbearing potential must have a negative serum human chorionic gonadotropin (HCG) test within 7 days prior to study enrollment and must not be breastfeeding. Exclusion Criteria: 1. Individuals with a history of severe drug allergies or allergic constitution; 2. Those with uncontrolled active infections; 3. Individuals with severe cardiac diseases, such as angina, myocardial infarction, heart failure, and arrhythmias; 4. Subjects with congenital immunoglobulin deficiencies; 5. Patients with other malignant tumors (except for non-melanoma skin cancer, carcinoma in situ of the cervix, bladder cancer, and breast cancer with more than 5 years of disease-free survival); 6. Subjects with end-stage renal failure; 7. Subjects who are positive for Hepatitis B surface antigen (HBsAg) or Hepatitis B core antibody (HBcAb) with peripheral blood HBV DNA levels above the detection limit; those positive for Hepatitis C virus (HCV) antibody with peripheral blood HCV RNA positivity; individuals positive for Human Immunodeficiency Virus (HIV) antibody; and those with positive syphilis tests; 8. Individuals with mental illnesses and severe cognitive impairments; 9. Those who have participated in other clinical trials within the last month; 10. Pregnant or breastfeeding women; 11. Subjects deemed inappropriate for the study by the investigator or for other reasons not suitable for inclusion in this study; 12. Recipients of allogeneic transplants who relapsed within three months or still have graft-versus-host disease (GVHD) reactions more than three months after the transplant; 13. Central nervous system leukemia involvement.
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:Maximal tolerable dose (MTD); Recommended phase II dose (RP2D); Dose limiting toxicity (DLT) · Dose limiting toxicity (DLT) is defined as an adverse event that is judged to be definitely or possibly related to RD-IIT-001, occurring from the first infusion of RD-IIT-001 up to Day 28 (±3 days). Safety evaluations are conducted using the NCI-CTCAE 5.0 criteria. Maximal tolerable dose (MTD):Three dose levels (1.0×10\^6 cells/kg;3.0×10\^6 cells/kg;6.0×10\^6 cells/kg)are preset, with the observation period for dose-limiting toxicity (DLT) from the first infusion of RD-IIT-001 up to Day 28 (±3 days). Dose escalation follows the "3+3" design principle. Recommended phase II dose (RP2D):After completing dose escalation, 3-6 additional subjects may be enrolled at the MTD dose level to determine the RP2D. If the MTD dose level has not been reached, the investigator may decide, based on PK and efficacy data, whether to increase to a higher dose or expand with 3-6 3-6 additional subjects at the current highest dose level to determine the RP2D. · 28 days ±3 days
以上邮箱 / 电话是登记库里的申办方联系方式(+86,中国),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。
急性髓系白血病(AML)是一种侵袭性白血病,成人患者复发率高、长期生存率差。传统治疗方案主要包括化疗和造血干细胞移植。过去十年,随着分子靶向药物和免疫治疗的应用,AML患者的生存率显著提高。复发/难治性(R/R)-AML是AML治疗失败后的状态,治疗更为复杂,预后更差,需要更多临床试验和新的治疗方法来改善患者的生存和生活质量。在本研究中,我们提出一种包括自体CD84CAR-T 细胞治疗的治疗方法。我们的研究旨在回答该治疗方案的安全性和有效性,并进一步改善这些参与者的生存。
Acute Myeloid Leukemia (AML) is an aggressive type of leukemia, with high relapse rate and poor long term survival in adults. Traditional treatment regimens mainly include chemotherapy and hematopoietic stem cell transplantation. In the past decade, with the application of molecular targeted drugs and immunotherapy, the survival of AML patients has significantly improved. Relapsed/refractory (R/R)-AML is a state following the failure of AML treatment, with more complex therapy and poorer prognosis, necessitating more clinical trials and new treatment methods to improve patients' survival and quality of life. In this study, we propose a treatment approach that include therapying with autologous CD84 chimeric antigen receptor T-cell. Our study aims to answer the safety and efficacy of this treatment regimen, and further improve the survival for those participants.
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