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:Postoperative Adjuvant Therapy for CT041 Gastric or Gastroesophageal Junction (G/GEJ) Adenocarcinoma Patients
⚠ 该试验的登记信息已有 19 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 I 期注册临床试验,评估自体 CAR-T 细胞治疗胃食管结合部癌、胃癌的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 48 例。试验地点:中国 · 北京、南京(共 3 个中心,其中中国 3 个)。登记号:NCT06857786。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准:
* 1. 必须自愿签署知情同意书(ICF)并愿意遵守所有试验程序。
2. 年龄必须为18-75岁(含),男性或女性。3. 经病理学确诊为胃/胃食管交界部(G/GEJ)腺癌。
4. 必须经免疫组织化学(IHC)检测确认为CLDN18.2阳性肿瘤表达,定义为至少70%的肿瘤细胞CLDN18.2染色强度≥1+。
5. 必须已接受D2胃切除术并达到R0切除。6. 必须符合美国癌症联合委员会(AJCC)TNM分期标准(第8版,2017年)的病理分期(y)pT4aN+或(y)pT4bNany)。
7. 必须已按照治疗指南完成全部周期的标准辅助化疗。本试验允许的标准辅助化疗包括FLOT(多西他赛+奥沙利铂+氟尿嘧啶)、CapeOX(奥沙利铂+卡培他滨)和FOLFOX(奥沙利铂+氟尿嘧啶)。
1. 允许接受过新辅助化疗。
2. 经研究者判定为无法耐受或在医学上不适合完成全部周期的辅助化疗、或辅助化疗无获益的受试者,在与医学监查员讨论后可能有入组资格。
8. 必须无复发性或转移性G/GEJ腺癌的证据。9. 美国东部肿瘤协作组(ECOG)体能状态为0或1(在白细胞单采术前7天内)。
10. 有足够的静脉通路用于白细胞单采采集,且无其他白细胞单采禁忌症。
11. 白细胞单采术前7天内的实验室检查结果必须符合以下标准(允许在一周内复测一次。如果复测仍不符合标准,则将被视为筛选失败):12. 有生育潜力的女性(WOCBP)必须在筛选时接受血清妊娠试验且结果为阴性,并且必须愿意在最后一次satri-cel输注后至少12个月内使用有效且可靠的避孕方法。应在12个月内避免捐卵。
13. 男性部分
排除标准:
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1. 白细胞单采术与辅助化疗结束之间的时间间隔超过12周。
2. 存在出血、穿孔或梗阻高风险的受试者,包括但不限于深大溃疡、不稳定/活动性溃疡、三个月内有活动性消化道出血/穿孔/梗阻或有消化道出血/穿孔/梗阻病史。
3. 曾针对G/GEJ腺癌接受本试验允许的治疗以外的任何非标准辅助抗肿瘤治疗的受试者,包括方案未规定的任何全身抗肿瘤药物、任何放疗或介入治疗等。
4. 在白细胞单采术前2周内(或药物的5个半衰期内,以较短者为准)曾接受针对G/GEJ腺癌的全身抗肿瘤治疗的受试者。
5. 在白细胞单采术前4周内接受过大手术(不包括白内障手术及其他需局部麻醉的手术)或遭受严重创伤,且尚未从毒性和/或并发症中充分恢复的受试者。预期在试验期间需要接受大手术的受试者也将被排除。
6. 既往接受过任何基因工程改造细胞治疗(如 CAR T 细胞、TCR T 细胞等)的受试者。
7. 既往治疗出现的不良事件(AE)尚未恢复至常见不良事件评价标准(CTCAE)v5.0 规定的 ≤ 1 级的受试者,但脱发、神经病变以及经研究者判定不太可能因试验治疗累积毒性的其他事件、以及本试验允许的实验室检查异常除外。
8. 血清学检测人类免疫缺陷病毒(HIV)、梅毒和丙型肝炎病毒(HCV)阳性的受试者。HCV 抗体阳性但 HCV RNA 阴性者可入组。
Inclusion Criteria:
* 1\. Must have voluntarily signed the informed consent form (ICF) and be willing to comply with all trial procedures.
2\. Must be 18 -75 years old (inclusive), male or female. 3. Pathologically confirmed diagnosis of gastric/gastroesophageal junction (G/GEJ) adenocarcinoma.
4\. Must have CLDN18.2-positive tumor expression as determined by immunohistochemistry (IHC), defined as CLDN18.2 staining intensity ≥ 1+ in at least 70% of tumor cells.
5\. Must have undergone D2 gastrectomy and achieved R0 resection. 6. Must have pathological stage (y)pT4aN+ or (y)pT4bNany) according to the American Joint Committee on Cancer (AJCC) TNM Staging Classification (8th ed., 2017).
7\. Must have received full cycles of standard adjuvant chemotherapy according to treatment guidelines. Standard adjuvant chemotherapy allowed in this trial includes FLOT(docetaxel + oxaliplatin + fluorouracil), CapeOX (oxaliplatin + capecitabine), and FOLFOX(oxaliplatin + fluorouracil).
1. Neoadjuvant chemotherapy is allowed.
2. Participants who are deemed intolerable or medically improper to complete the full cycles of adjuvant chemotherapy or not beneficial as determined by the investigator could be eligible after discussing with the medical monitor.
8\. Must have no evidence of recurrent or metastatic G/GEJ adenocarcinoma. 9. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 (within 7 days before leukapheresis).
10\. Sufficient venous access for leukapheresis collection and no other contraindications to leukapheresis.
11\. Laboratory results within 7 days before leukapheresis must meet the following criteria (Retesting once within one week is permitted. it will be considered a screening failure if retest still not meets the criteria): 12. Women of childbearing potential (WOCBP) must undergo a serum pregnancy test with negative result at screening and must be willing to use effective and reliable method of contraception for at least 12 months after the last satri-cel infusion. Egg donation should be refrained for 12 months.
13\. Male part
Exclusion Criteria:
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1. The time interval between leukapheresis and completion of adjuvant chemotherapy is more than 12 weeks.
2. Participants with high risk of bleeding, perforation or obstruction, including but not limited to deep or large ulcer, unstable/active ulcer, active or history of digestive tract bleeding/perforation/obstruction within three months.
3. Participants who have received any non-standard adjuvant anti-tumor treatment for G/GEJ adenocarcinoma allowed in this trial, including any systemic anti-tumor drugs not specified in the protocol, any radiotherapy or interventional therapy, etc.
4. Participants who have received systemic anti-tumor treatment for G/GEJ adenocarcinoma within 2 weeks (or within 5 half-lives of the drug, whichever is shorter) prior to leukapheresis.
5. Participants who have received major surgery (excluding cataract surgery and others requiring local anesthesia) within 4 weeks prior to leukapheresis or significant traumatic injury and have not recovered adequately from the toxicity and/or complications. Participants who are anticipated to need major surgery during the trial will also be excluded.
6. Participants who have received any prior genetic engineering modified cellular therapy (such as CAR T-cell, TCR T-cell, etc.).
7. Participants with AEs from previous treatment who have not recovered to Grade ≤ 1 per Common Terminology Criteria for Adverse Events (CTCAE) v5.0, excluding hair loss, neuropathy, other events that are unlikely to cumulate toxicity from trial treatment as determined by the investigator, and laboratory abnormalities allowed in this trial.
8. Participants with serologically positive human immunodeficiency virus (HIV), Syphilis, and hepatitis C virus (HCV). HCV antibody positive but HCV RNA negative can be enrolled.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:Incidence, type, and severity of adverse events · ncidence, type, and severity of adverse events, including
* Adverse Events (AEs)
* Adverse Events of Special Interest (AESIs)
* Serious Adverse Events (SAEs) · Signed ICF to 15 years after CT041 infusion
次要终点:Disease-free survival (M12-DFS);Disease-free survival (DFS) after surgery;Distant metastasis-free survival (DMFS) after surgery;Overall Survival (OS);To evaluate the cellular metabolism kinetics of satri-celrea under the curve (AUC) and sustained cell survival (Tlast) after satri-cel infusion;To evaluate the immunogenicity of satri-cel
药物:CT041自体CAR T细胞注射液
评估satri-cel作为术后辅助治疗后巩固治疗在已切除胃或胃食管交界处(G/GEJ)腺癌患者中的安全性和耐受性
To evaluate the safety and tolerability of satri-cel as consolidation therapy after postoperative adjuvant therapy in patients with resected gastric or gastroesophageal junction (G/GEJ) adenocarcinoma
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