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:CD30 CAR-T in the Treatment of CD30 Positive Relapsed/Refractory Lymphoma
⚠ 该试验的登记信息已有 19 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。
这是一项分期未标注的注册临床试验,评估 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 15 例。试验地点:中国 · 太原(共 1 个中心,其中中国 1 个)。登记号:NCT06850285。
不限性别 · ≥ 15 Years 且 ≤ 80 Years
纳入标准: • 年龄≥15岁且≤80岁,男女不限。 • 患有CD30阳性淋巴细胞恶性肿瘤。 • 免疫组化检测CD30表达>10%。 • 按2014年Lugano评估标准至少有1个可测量病灶。 • 不适合接受自体造血干细胞移植,或自体造血干细胞移植后复发。 • 不适合接受BV治疗,或BV治疗后复发;组织学检查证实CD30表达。 • 预计生存期≥3个月。 • ECOG体能状态评分0~2分,Karnofsky体能状态评分>60%。 • 器官功能充足:ALT、AST≤正常值上限(ULN)的2.5倍;存在肝脏受累者可放宽至≤ULN的5倍;血清总胆红素<34 μmol/L;肌酐清除率>30 mL/min;射血分数≥40%;无心包积液和明显心律失常;SpO₂≥92%。 • 淋巴细胞绝对计数(ALC)≥0.5×10⁹/L,血小板>30×10⁹/L,血红蛋白>80 g/L;有适合单采的静脉通路,且无血细胞分离禁忌证。 • MRI未显示淋巴瘤累及中枢神经系统。 • 有生育能力者愿意采取可靠的避孕措施。 • 受试者或法定监护人能够理解并自愿签署书面知情同意书。 排除标准: • 淋巴瘤相关噬血细胞综合征。 • 妊娠期或哺乳期女性,或计划在6个月内妊娠者。 • 乙型肝炎(HBsAg、HBsAb、HBeAg、HBeAb、HBcAb)、丙型肝炎(抗HCV)、抗HIV-Ⅰ/Ⅱ或抗梅毒螺旋体抗体阳性;乙型肝炎DNA检测阴性者除外。 • 患有其他恶性肿瘤者除外;已接受根治性治疗的皮肤基底细胞癌、皮肤鳞状细胞癌和宫颈原位癌不在此限。 • 入组前4周内接受过抗CD30抗体治疗。 • 既往任何治疗相关的非血液学毒性尚未恢复至≤1级。 • 活动性、未控制的出血或已知出血倾向。 • 入组前6周内接受过自体造血干细胞移植。 • 未控制的活动性细菌或真菌感染。 • 已知对研究药物或其成分过敏。 • 患有需要全身治疗的活动性自身免疫性疾病。 • 患有精神或心理疾病,无法配合治疗及疗效评估。 • 参加本研究前1个月内参加过其他临床研究。 • 有异基因造血干细胞移植史。 • 研究者或主管医生认为可能影响试验实施或受试者安全的任何状况。
Inclusion Criteria: * Age≥15 years and ≤80years,female and male; * CD30+ lymphocyte malignancies; * CD30 expression \>10% by immunohistochemistry; * At least 1 measurable lesion can be measured according to theLugano 2014 evaluation criteria; * Not suitable for autologous hematopoietic stem cell transplantation or recurrence after autologous hematopoietic stem cell transplantation; * Not suitable for BV treatment or relapse after BV treatment, and the expression of CD30 was confirmed by histology; * The estimated survival time ≥3 months; * ECOG performance status 0-2,KPS\>60%; * Sufficient organ function:ALT,AST≤2.5×ULN,patients with liver invasion can be relaxed to ≤ 5 x ULN;serum total bilirubin\<34 μmol/L;creatinine clearance rate\>30 mL/min;EF≥40%;No pericardial effusion and obvious arrhythmia;SpO2≥92%; * ALC ≥0.5×109/L,PLT\>30×109/L,Hb\>80 g/L and subjects had apheresis venous access and no contraindications for blood cell separation; * MRI showed no central involvement of lymphoma; * Patients with fertility must be willing to be able to use reliable contraceptive measures ; * The subject or legal guardian can understand and voluntarily sign the written informed consent. Exclusion Criteria: * Lymphoma-associated hemophagic cell syndrome; * Pregnant or lactating women, and women who have a pregnancy plan within six months; * Hepatitis B(HBsAg、HBsAb、HBeAg、HBeAb、HBcAb),Hepatitis C(Anti-HCV),Anti-HIV Ⅰ/Ⅱ and anti-TP positive(Hepatitis B DNA test is negative except); * Suffered from other malignant tumors, except for for skin basal cell carcinoma, skin squamous cell carcinoma and cervical carcinoma in situ undergoing the radical treatment; * Received Anti-CD30 Ab therapy within 4 weeks before enrollment; * Unresolved \> Grade 1 non-hematologic toxicity associated with any prior treatments; * Active uncontrolled bleeding or a known bleeding diathesis; * Autologous hematopoietic stem cell transplantation was performed within 6 weeks; * Uncontrollable active bacterial or fungal infection; * Known allergy to the study drug and its components; * Suffer from active autoimmune diseases that require systemic treatment ; * Persons with mental or mental illness who cannot cooperate with treatment and efficacy evaluation; * Participated in other clinical studies within 1 months prior to this study; * History of allogeneic hematopoietic stem cell transplantation; * patients with any condition which the investigator or treating physician feels would interfere with the trial or the safety of the subject.
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 · Including complete remission (CR) and partial remission (PR) · 6 months;To evaluate safety and dose limiting toxicities (DLT) of autologous CD30 CAR-T and establish the recommended Phase dose · Incidence of DLTs and occurrence of study related adverse events · 28 days
次要终点:Disease-free survival;Overall Survival
受试者接受一次低剂量CD30 CAR-T治疗(1×10⁶个CAR阳性T细胞/kg)。
受试者接受一次低剂量CD30 CAR-T治疗(2×10⁶个CAR阳性T细胞/kg)。
受试者接受一次低剂量CD30 CAR-T治疗(5×10⁶个CAR阳性T细胞/kg)。
这是一项前瞻性、开放标签、剂量递增临床研究,旨在评估CD30 CAR-T治疗复发/难治性CD30阳性淋巴瘤的疗效和安全性。计划招募15例复发/难治性CD30阳性淋巴瘤患者。
The is a prospective, open-label, dose-climbing clinical study assessing the efficacy and safety of CD30 CAR-T in the treatment of r/r CD30+ lymphoma. Plan to recruit 15 subjects with r/r CD30+ lymphoma。
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