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Anti-CD5 CAR NK(NK 细胞)治疗淋巴瘤:I 期临床试验

英文原题:Clinical Trial of CD5-targeted CAR-NK Therapy for Relapse/Refractory T-Cell Hematologic Malignancies

ClinicalTrials.gov 2025/04/03(首次登记) I 期注册临床试验 · 招募中

⚠ 该试验的登记信息已有 18 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。

简要介绍

这是一项 I 期注册临床试验,评估 NK 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 · 武汉(共 1 个中心,其中中国 1 个)。登记号:NCT06909474。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 75 Years

纳入标准:

1. 年龄18–75岁(含),性别不限。
2. 确诊T细胞急性淋巴细胞白血病(T-ALL)或T细胞淋巴瘤。
   • T-ALL:筛选时骨髓形态学原始/幼稚淋巴细胞≥5%和/或流式细胞术证实MRD阳性,并符合以下之一:至少2个标准诱导化疗周期后难治(未达CR);一线诱导达CR后12个月内复发;至少2线化疗后未达CR或复发;造血干细胞移植后复发。
   • T细胞淋巴瘤:确诊T淋巴母细胞淋巴瘤(T-LBL)或T细胞非霍奇金淋巴瘤,包括PTCL-NOS、AITL、ALCL、结外NK/T细胞淋巴瘤、T-PLL、ATLL、ⅡB期及以上蕈样肉芽肿/Sezary综合征等;按Lugano 2014标准至少有1个双径可测量病灶(淋巴结长径>1.5 cm,结外病灶>1.0 cm),且至少2线化疗后难治、原发耐药或移植后复发。
3. CD5阳性:流式细胞术证实≥80%肿瘤细胞表达CD5且平均荧光强度(MFI)与正常T细胞相当;弱阳性定义为MFI比正常T细胞低≥1个对数;部分阳性为20%–80%肿瘤细胞表达CD5。或免疫组化显示>30%肿瘤细胞表达CD5。
4. ECOG体能状态0–2分;预期生存期≥12周。
5. 器官功能符合:超声心动图LVEF≥50%、心电图无显著异常;肌酐≤ULN的2倍;ALT/AST≤ULN的3倍(肝受累时≤5倍)、总胆红素≤ULN的2倍;室内空气血氧≥92%。
6. 无白细胞单采、静脉穿刺或细胞采集禁忌;无严重精神疾病。
7. 有生育能力者同意自知情同意至CAR-NK输注后1年内有效避孕。
8. 患者或法定监护人签署知情同意书,确认理解试验目的及程序。

排除标准:

1. 既往接受CAR-NK或基因修饰细胞治疗。
2. 筛选时活动性中枢神经系统受累;既往受累但治疗后已缓解者可入组。
3. 近期抗癌治疗:筛选前2周或5个半衰期(取较长者)内接受化疗、靶向治疗或试验药物;筛选前2周内接受放疗。
4. 筛选前1周内有活动性/未控制感染。
5. 筛选前6个月内发生脑血管事件或癫痫发作。
6. 病毒感染:HBsAg或HBcAb阳性者HBV DNA>ULN;HCV抗体阳性者HCV RNA>ULN;HIV、梅毒阳性或活动性结核。
7. 心脏病:NYHAⅢ/Ⅳ级心力衰竭;6个月内心肌梗死或冠状动脉旁路移植术;有临床意义的室性心律失常或无法解释的晕厥(血管迷走性/脱水相关除外);严重心肌病。
8. 活动性或未控制的自身免疫病。
9. 过去5年内有其他恶性肿瘤;已治愈的宫颈原位癌、基底/鳞状细胞皮肤癌、局限性前列腺癌或乳腺导管原位癌除外。
10. 筛选前4周内接种活疫苗。
11. 妊娠、哺乳期或计划在CAR-NK输注后1年内妊娠。
12. 研究者判定不适合参加研究的其他原因。
核对登记原文(英文)
Inclusion Criteria:

\-

1.Gender and Age: No gender restriction; age 18-75 years (inclusive). 2.Diagnosis: Confirmed diagnosis of T-cell acute lymphoblastic leukemia (T-ALL) or T-cell lymphoma, including:

1. T-ALL Patients: Bone marrow morphology during screening shows ≥5% blasts/immature lymphocytes and/or flow cytometry confirms minimal residual disease (MRD)+, and meets any of the following:

   1. Refractory to ≥2 cycles of standard induction chemotherapy (failure to achieve CR).
   2. Relapsed within 12 months after achieving CR with first-line induction therapy.
   3. Failure to achieve CR or relapse after ≥2 lines of chemotherapy.
   4. Relapse after hematopoietic stem cell transplantation (HSCT).
2. T-cell Lymphoma Patients: Confirmed diagnosis of T-lymphoblastic lymphoma (T-LBL) or T-cell non-Hodgkin lymphoma (including but not limited to: peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), extranodal NK/T-cell lymphoma (ENKL), T-cell prolymphocytic leukemia (T-PLL), adult T-cell leukemia/lymphoma (ATLL), mycosis fungoides/Sézary syndrome (MF/SS) stage IIB or higher), and meets both:

   1. At least one bidimensionally measurable lesion per Lugano 2014 criteria: nodal lesions \>1.5 cm in long axis; extranodal lesions \>1.0 cm in long axis.
   2. Refractory to ≥2 lines of chemotherapy, primary resistance, or relapse post-HSCT.

      3.CD5 Positivity: Confirmed by flow cytometry (≥80% tumor cells express CD5 with mean fluorescence intensity \[MFI\] equivalent to normal T cells; Dim defined as MFI ≥1 log lower than normal T cells; partial positivity defined as 20-80% tumor cells expressing CD5) or immunohistochemistry (\>30% tumor cells express CD5).

      4.ECOG Performance Status: 0-2 . 5.Life Expectancy: ≥12 weeks. 6.Organ Function:

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   1. Cardiac: Left ventricular ejection fraction (LVEF) ≥50% by echocardiography; no significant ECG abnormalities.
   2. Renal: Serum creatinine ≤2.0×ULN.
   3. Hepatic: ALT/AST ≤3.0×ULN (≤5.0×ULN if liver involvement); total bilirubin ≤2.0×ULN.
   4. Pulmonary: Oxygen saturation ≥92% (room air). 7.No Contraindications: To leukapheresis, venipuncture, or cell collection. 8.No Severe Psychiatric Disorders. 9.Contraception: Agreement to use effective contraception from informed consent until 1 year post-CAR-NK infusion (for patients of childbearing potential).

      10.Informed Consent: Signed by the patient or legal guardian, confirming understanding of the trial's purpose and procedures.

Exclusion Criteria:

1. Prior CAR-NK therapy or genetically modified cell therapy.
2. Active CNS involvement at screening (prior CNS involvement with resolved status post-treatment is allowed).
3. Recent Anticancer Therapy:

   1. Chemotherapy, targeted therapy, or investigational drugs within 2 weeks or 5 half-lives prior to screening.
   2. Radiotherapy within 2 weeks prior to screening.
4. Active/Uncontrolled Infection: Within 1 week prior to screening.
5. Cerebrovascular Event or Seizure: Within 6 months prior to screening.
6. Viral Infections:

   1. HBV DNA \> ULN (if HBsAg+ or HBcAb+).
   2. HCV RNA \> ULN (if HCV Ab+).
   3. HIV+, syphilis+, or active tuberculosis.
7. Cardiac Disease:

   1. NYHA Class III/IV congestive heart failure.
   2. Myocardial infarction or CABG ≤6 months prior.
   3. Clinically significant ventricular arrhythmia or unexplained syncope (excluding vasovagal/dehydration-related).
   4. Severe cardiomyopathy.
8. Active/Uncontrolled Autoimmune Disease.
9. Prior Malignancy: Within 5 years, except for cured cervical carcinoma in situ, basal/squamous skin cancer, localized prostate cancer, or ductal carcinoma in situ.
10. Live Vaccination: Within 4 weeks prior to screening.
11. Pregnancy/Lactation: Pregnant, breastfeeding, or planning pregnancy within 1 year post-CAR-NK infusion.
12. Other: Investigator-determined ineligibility.

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

  • 主要终点治疗期间出现的不良事件发生率(安全性及耐受性)原登记注明28天(拼写为“dyas”)
  • 主要终点客观缓解率(ORR)1、2、3个月
  • 主要终点CAR-NK输注后总生存期(OS)2年
  • 主要终点CAR-NK输注后缓解持续时间(DOR)2年
  • 主要终点CAR-NK输注后无进展生存期(PFS)2年
  • 次要终点获取CAR-NK细胞体内动力学数据(药代动力学)
  • 次要终点获取CAR-NK细胞体内动力学数据(药代动力学)
  • 次要终点获取CAR-NK细胞体内动力学数据(药效学)
核对登记原文(英文)

主要终点:Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] · The incidence of adverse events after CAR-NK cell infusion was assessed by CTCAE, version 5.0. · 28 dyas;Objective response rate (ORR) · Objective Response Rate (ORR) within 3 Months: 1. For patients with T-cell lymphoma, ORR includes complete response (CR) and partial response (PR); 2. For patients with T-cell acute lymphoblastic leukemia (T-ALL), ORR includes CR, CR with partial hematologic recovery (CRh), CR with incomplete hematologic recovery (CRi), and morphologic leukemia-free state (MLFS). · 1month, 2 months, 3 months;Overall survival (OS) after CAR-NK infusion · OS is defined as the time from CAR-NK cell infusion to death from any cause, reflecting the long-term survival benefit of the therapy. · 2 years;Duration of response (DOR) after CAR-NK infusion · DOR measures the time from the first achievement of objective response to disease progression or death, evaluating the durability of treatment efficacy in responding patients. · 2 years;Progression-Free-Survival (PFS) after CAR-NK infusion · PFS is the time from CAR-NK cell infusion to disease progression or death from any cause, capturing both tumor control and survival outcomes · 2 years
次要终点:To obtain the cytodynamics data of CAR-NK cells in vivo【pharmacokinetics】;To obtain the cytodynamics data of CAR-NK cells in vivo【pharmacokinetics】;To obtain the cytodynamics data of CAR-NK cells in vivo【pharmacodynamics】

研究设计怎么做的

研究类型
干预性研究
入组人数
15 人(预计)
分组方式
不适用(单臂)
  • CD5 CAR-NK细胞组试验组
核对分组登记原文(英文)
  • CD5 CAR-NK cells · EXPERIMENTAL

关键日期

开始日期
2025-03-27
主要完成日期
2027-03-31
全部完成日期
2028-03-31
登记状态核实于
2025-03

联系与责任方

申办方
Chongqing Precision Biotech Co., Ltd
联系邮箱
jiawei@tjh.tjmu.edu.cn
联系电话
+86 13986102084

登记简述

本研究为研究者发起的临床试验,评估抗CD5 CAR-NK细胞治疗复发/难治性T细胞血液系统恶性肿瘤患者的安全性和疗效。

核对登记原文(英文)

This is a clincal trial initiated by investigator to evaluate the safety and efficacy of anti-CD5 CAR-NK in the treatment of patients with relapsed/refractory T-Cell hematologic malignancies.

登记原文与核验信息

试验登记号
NCT06909474
试验期别
I 期
试验状态
招募中
中国试验中心(1 个)
Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology · 武汉 · 中国
适应症(原文)
T-ALL/Lymphoma
干预方式(原文)
Anti-CD5 CAR NK cells