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CEA CAR-T 细胞治疗结直肠癌、胃癌:I 期临床试验(Weijia Fang, MD)

英文原题:Study of CEA Targeting CAR-T (PTC13) in the Treatment of CEA-Positive Advanced Malignant Solid Tumors

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Study of CEA Targeting CAR-T (PTC13) in the Treatment of CEA-Positive Advanced Malignant Solid Tumors

ClinicalTrials.gov 2025/02/11(首次登记) I 期注册临床试验 · 招募中

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

简要介绍

这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗结直肠癌、胃癌、胰腺癌的安全性、可行性及初步疗效。当前状态:招募中。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:NCT06821048。

入组条件决定能不能参加

不限性别 · ≥ 18 Years

纳入标准:

受试者必须符合以下所有标准才能入选本研究:

1. 年龄≥18岁,性别不限。
2. 经组织学或病理学确诊的晚期、转移性或复发性恶性肿瘤,主要包括结直肠癌、食管癌、胃癌、胰腺癌、肺癌或胆管癌。
3. 至少二线标准治疗失败(因疾病进展或不耐受,如手术、化疗、放疗等)或缺乏有效治疗手段。
4. 3个月内肿瘤样本免疫组化染色证实CEA阳性(明确的膜染色,阳性率≥10%);若筛选时肿瘤样本免疫组化结果超过3个月(明确的膜染色,阳性率≥10%),则患者血清CEA必须超过10µg/L。
5. 根据RECIST 1.1标准至少有一个可评估病灶。
6. ECOG评分0-2分(附录2)。
7. 无严重精神疾病。
8. 除非另有特别说明,受试者主要器官功能必须符合以下条件:

1. 血常规:WBC>2.0×109/L,中性粒细胞>0.8×109/L,淋巴细胞>0.5×109/L,血小板>50×109/L,血红蛋白>90g/L;
2. 心功能:超声心动图提示左心室射血分数≥50%,心电图无明显异常;
3. 肾功能:血清肌酐≤2.0×ULN;
4. 肝功能:ALT和AST≤3.0×ULN(若存在肝脏肿瘤浸润可放宽至≤5.0×ULN);
5. 总胆红素≤2.0×ULN;
6. 不吸氧情况下血氧饱和度>92%。 9. 适合进行单采或静脉采血,无细胞采集禁忌症。

10. 受试者同意自签署知情同意书起至接受CAR-T 细胞输注后1年内采用可靠有效的避孕方法(不包括自然避孕法)。

11. 患者或其监护人同意参加本临床试验并签署ICF,表明了解试验目的和程序并愿意参加。

排除标准:

符合以下任一标准的受试者将被排除出本研究:

1. 筛选时存在临床上有症状的中枢神经系统或软脑膜转移,或其他证据提示中枢神经系统或软脑膜转移未得到控制,经研究者判断不适合入选。
2. 筛选前1个月内参加过其他临床研究。
3. 筛选前4周内接种过减毒活疫苗。
4. 筛选前接受过以下抗肿瘤治疗:14天内或至少5个半衰期(以较短者为准)内接受过化疗、靶向治疗或其他试验性药物治疗。
5. 存在需要全身治疗的活跃或未控制的感染。
6. 患有肠梗阻、活动性胃肠道出血、3个月内有重大胃肠道出血史、严重胃十二指肠溃疡,或严重胃肠道炎症如溃疡性结肠炎的患者。
7. 既往抗肿瘤治疗引起的毒性未恢复至基线水平或≤1级,脱发或周围神经病变除外。
8. 存在以下任何心脏状况:

1. 纽约心脏协会(NYHA)III级或IV级充血性心力衰竭;
2. 入组前6个月内发生心肌梗死或接受冠状动脉旁路移植术(CABG);
3. 有临床意义的室性心律失常或不明原因晕厥史(血管迷走性或脱水相关原因除外);
4. 严重非缺血性心肌病病史。
9. 存在活动性自身免疫性疾病或其他需要长期免疫抑制治疗的情况。
10. 过去3年内诊断出另一种未经治疗的恶性肿瘤,原位宫颈癌或皮肤基底细胞癌除外。
11. 乙型肝炎表面抗原(HBsAg)或乙型肝炎核心抗体(HBcAb)阳性且外周血乙型肝炎病毒(HBV)DNA水平超过正常范围;丙型肝炎病毒(HCV)抗体阳性且外周血HCV RNA水平超过正常范围;人类免疫缺陷病毒(HIV)抗体阳性;或梅毒检测阳性。
12. 妊娠或哺乳期女性。
13. 研究者认为存在任何其他不适合参加本研究的情况。
核对登记原文(英文)
Inclusion Criteria:

Subjects must meet all the following criteria to be eligible for the study:

1. Age≥18 years, regardless of gender.
2. Diagnosed with advanced, metastatic, or recurrent malignant tumors confirmed by histology or pathology, primarily including colorectal cancer, esophageal cancer, gastric cancer, pancreatic cancer, lung cancer, or cholangiocarcinoma.
3. Failure of at least second-line standard therapy (due to disease progression or intolerance, such as surgery, chemotherapy, radiotherapy, etc.) or a lack of effective treatment options.
4. Immunohistochemical staining of tumor samples within 3 months confirming CEA positivity (distinct membrane staining with a positivity rate of≥10%); if the immunohistochemical result of the tumor sample is more than 3 months old at the time of screening (distinct membrane staining with a positivity rate of≥10%), the patient's serum CEA must exceed 10µg/L.
5. At least one evaluable lesion according to RECIST 1.1 criteria.
6. ECOG score of 0-2 (Appendix 2).
7. No severe psychiatric disorders.
8. Unless specifically stated otherwise, subjects' major organ functions must meet the following conditions:

   1. Blood routine: WBC\>2.0×109/L, neutrophils\>0.8×109/L, lymphocytes\>0.5×109/L, platelets\>50×109/L, hemoglobin\>90g/L;
   2. Cardiac function: Echocardiography indicating a left ventricular ejection fraction≥50%, and no significant abnormalities on electrocardiogram;
   3. Renal function: Serum creatinine≤2.0×ULN;
   4. Liver function: ALT and AST ≤3.0×ULN (may be relaxed to≤5.0×ULN if liver tumor infiltration is present);
   5. Total bilirubin≤2.0×ULN;
   6. Oxygen saturation\>92% without supplemental oxygen. 9. Eligible for apheresis or venous blood collection, with no contraindications for cell collection.

      10\. Subjects agree to use reliable and effective contraceptive methods from signing the informed consent form until 1 year after receiving CAR-T cell infusion (excluding natural family planning methods).

      11\. The patient or their guardian agree to participate in this clinical trial and signs the ICF, indicating an understanding of the trial's purpose and procedures and willingness to participate.

Exclusion Criteria:

Subjects meeting any of the following criteria will be excluded from the study:

1. Clinically symptomatic central nervous system or leptomeningeal metastasis at the time of screening, or other evidence suggesting that central nervous system or leptomeningeal metastases are not controlled, as judged unsuitable for inclusion by the investigator.
2. Participation in another clinical study within 1 month prior to screening.
3. Receipt of live attenuated vaccines within 4 weeks prior to screening.
4. Receipt of the following anti-tumor treatments before screening: Chemotherapy, targeted therapy, or other experimental drug treatments within 14 days or at least 5 half-lives (whichever is shorter).
5. Presence of active or uncontrolled infections requiring systemic treatment.
6. Patients with intestinal obstruction, active gastrointestinal bleeding, a history of major gastrointestinal bleeding within 3 months, severe gastroduodenal ulcers, or severe gastrointestinal inflammation such as ulcerative colitis.
7. Toxicity from previous anti-tumor therapy that has not improved to baseline levels or≤Grade 1, except for alopecia or peripheral neuropathy.
8. Presence of any of the following cardiac conditions:

   1. New York Heart Association (NYHA) Stage III or IV congestive heart failure;
   2. Myocardial infarction or coronary artery bypass graft (CABG) within 6 months prior to enrollment;
   3. Clinically significant ventricular arrhythmia or history of unexplained syncope (excluding vasovagal or dehydration-related causes);
   4. History of severe non-ischemic cardiomyopathy.
9. Presence of active autoimmune diseases or other conditions requiring long-term immunosuppressive therapy.
10. Diagnosis of another untreated malignancy within the past 3 years, except for in situ cervical cancer or basal cell carcinoma of the skin.
11. Positive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) with peripheral blood hepatitis B virus (HBV) DNA levels exceeding the normal range; positive for hepatitis C virus (HCV) antibodies with peripheral blood HCV RNA levels exceeding the normal range; positive for human immunodeficiency virus (HIV) antibodies; or positive syphilis test.
12. Pregnant or breastfeeding women.
13. Any other conditions deemed unsuitable for participation in the study 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。

研究终点衡量什么算有效

  • 主要终点CEA-CAR-T 细胞输注后不良事件的发生率28天
  • 主要终点获得CEA-CAR-T 细胞的最大耐受剂量28天
  • 次要终点CAR-T 细胞制剂在CEA阳性晚期恶性肿瘤中的疾病控制率
  • 次要终点CAR-T 细胞制剂在CEA阳性晚期恶性肿瘤中血清肿瘤标志物的变化
  • 次要终点CAR-T 细胞的药代动力学(Cmax)
  • 次要终点CAR-T 细胞的药代动力学(Tmax)
  • 次要终点CAR-T 细胞的药代动力学(AUC28d/90d)
  • 次要终点CAR-T 细胞的药效动力学
核对登记原文(英文)

主要终点:Incidence of Adverse events after CEA-CAR-T cells infusion · Incidence and proportion of adverse events during the trial (evaluated per Common Terminology Criteria for Adverse Events, Version 5.0 (CTCAE 5.0) and ASTCT criteria) · 28 days;Obtain the maximum tolerated dose of CEA-CAR-T cells · Dose-limiting toxicity after cell infusion · 28 days
次要终点:Disease control rate of CAR-T cell preparations in CEA-positive advanced malignancies;Changes in serum tumor markers of CAR-T cell preparations in CEA-positive advanced malignancies;Pharmacokinetic of CAR-T cells (Cmax);Pharmacokinetic of CAR-T cells (Tmax);Pharmacokinetic of CAR-T cells (AUC28d/90d);Pharmacodynamic of CAR-T cells

研究设计怎么做的

研究类型
干预性研究
入组人数
18 人(预计)
分组方式
不适用(单臂)
  • 腹腔灌注FAST CEA靶向CAR-T(PTC13)试验组

    通过4个剂量水平腹腔灌注FAST CEA靶向CAR-T 细胞(PTC13)

核对分组登记原文(英文)
  • Intraperitoneal infusion of FAST CEA-targeted CAR-T (PTC13) · EXPERIMENTAL · Intraperitoneal infusion of FAST CEA-targeted CAR-T cells (PTC13) by 4 dose levels

关键日期

开始日期
2024-07-24
主要完成日期
2026-06-01
全部完成日期
2027-12-01
登记状态核实于
2026-01

联系与责任方公示信息

主要研究者
Weijia Fang, MD
申办方
Weijia Fang, MD
合作方
Chongqing Precision Biotech Co., Ltd
联系电话
86-0571-87237587

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。

登记简述

这是一项I期临床研究,旨在评估FAST靶向嵌合抗原受体(CAR)-T细胞(PTC13)在癌胚抗原(CEA)阳性晚期恶性实体瘤患者中的安全性和耐受性,并获得FAST CAR-T(PTC13)的最大耐受剂量和II期推荐剂量。

核对登记原文(英文)

This is a phase I clinical study to evaluate the safety and tolerability of FAST targeted chimeric antigen receptor (CAR)-T cells (PTC13) in patients with carcinoembryonic antigen (CEA)-positive advanced malignant solid tumors, and to obtain the maximum tolerated dose of FAST CAR-T (PTC13) and phase II Recommended dose.

登记原文与核验信息

试验登记号
NCT06821048
试验期别
I 期
试验状态
招募中
中国试验中心(1 个)
杭州
适应症(原文)
Colorectal Cancer; Stomach Cancer; Pancreatic Cancer; Metastatic Cancer
干预方式(原文)
Intraperitoneal infusion of FAST CEA-targeted CAR-T