肿瘤细胞治疗研究
英文原题:MT027 in Patients With Advanced Peritoneal Malignancies or Abdominal Metastatic Solid Tumors
MT027 in Patients With Advanced Peritoneal Malignancies or Abdominal Metastatic Solid Tumors
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这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗实体瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 12 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT06912152。
不限性别 · ≥ 18 Years 且 ≤ 70 Years
纳入标准: * 患者必须满足以下所有入组标准方可参加本研究: 1. 自愿参加本研究,并在接受任何研究特定程序、采样或分析前提供签署并注明日期的书面知情同意书; 2. 年龄18-70岁(含),性别不限; 3. 经病理学和/或组织学确诊的原发恶性肿瘤(提供完整病理报告),包括:既往标准治疗失败≥2线的晚期实体瘤;无标准治疗可用,或可及治疗失败,或研究者基于综合风险-获益评估认为患者对可及治疗不耐受(不耐受定义为治疗后发生≥3级不良反应,或低于3级但持续或反复发生、影响继续治疗)的晚期实体瘤(如胃癌、结直肠癌、铂耐药晚期卵巢癌、输卵管癌等)。所有相关不良反应必须在筛选或首次给药前恢复至≤1级或恢复至基线。经病理学和/或组织学确诊的原发性恶性腹膜肿瘤,包括原发性腹膜癌、腹膜间皮瘤等,标准治疗失败或不耐受;研究者判断缺乏标准治疗选择的其他伴腹膜转移的实体瘤。 4. 对原发和转移病灶有明确的全身治疗方案,且预计研究期间不会变更; 5. 经活检、细胞学、CT或既往证据证实腹膜转移; 6. 增强CT显示腹腔内占位性病变,具有≥1个可测量病灶(按iRECIST标准);或经超声评估有可评估的恶性腹腔积液(按WHO标准); 7. 愿意提供近期FFPE组织样本、病理切片(8张连续未染色切片)或腹水肿瘤细胞用于B7-H3表达检测,且确认B7-H3阳性; 8. 签署知情同意前1个月内未接受腹腔内药物注射(包括腹腔热灌注化疗),诊断性腹腔穿刺除外; 9. 预期生存期≥3个月; 10. ECOG体能状态(PS)评分为0-2; 11. 筛选期实验室检查结果符合以下标准: 血液学检查(14天内): WBC ≥3.0×10^9/L;ANC ≥1.5×10^9/L;淋巴细胞 ≥0.8×10^9/L;血小板 ≥90×10^9/L;血红蛋白 ≥90 g/L(允许输血或使用促红细胞生成素)。因活动性出血或慢性疾病需要反复输血的患者必须与申办方讨论。 肝功能(7天内): 总胆红素 ≤1.5×ULN;ALT/AST ≤2.5×ULN(如存在肝转移则 ≤5×ULN)。 肾功能(7天内): 血清肌酐 ≤1.5×ULN;或CrCL ≥30 mL/min(Cockcroft-Gault公式)。 凝血功能(7天内): INR/PT ≤1.3×ULN;APTT ≤1.5×ULN。 12. 既往全身治疗毒性恢复至≤1级或基线水平(脱发除外); 13. 有生育能力的男性和女性必须同意自签署知情同意书起至末次MT027细胞输注后180天内采取避孕措施。 排除标准: * 1. 已知对研究药物或其辅料过敏;2. 腹膜穿刺禁忌或被认为不太可能从腹腔内治疗中获益;3. 既往未接受过免疫治疗的MSI-H/dMMR结直肠癌患者;4. 广泛肝转移(肝脏受累>70%);5. 确诊门静脉血栓;6. 给药前4周内发生肠梗阻;7. 限制药物扩散的情况(如分隔性或胶冻状腹水);8. 首次给药前4周内接受手术或放疗;9. 治疗前1周内使用全身性类固醇(替代治疗除外)或免疫抑制剂;10. 筛选前4周内参加其他药物试验;11. 既往接受过B7-H3靶向治疗(抗体/ADC/细胞治疗)且未经活检确认B7-H3阳性;12. 对研究药物或生物制剂的任何成分严重过敏;13. 合并恶性肿瘤(已治愈的宫颈原位癌或基底细胞癌除外);14. 严重自身免疫性疾病;15. 既往接受过同种异体组织/器官移植;16. 细胞治疗前2周内接种活疫苗或计划在研究期间接种;17. 活动性HBV、HCV(除非RNA阴性)、HIV、梅毒、EBV或CMV感染;18. 活动性全身感染或凝血功能障碍;19. 严重心脏(NYHA III级及以上)、肝脏(Child-Pugh C级及以上)、肾脏(CKD ≥4期)或肺功能不全;20. 妊娠或哺乳期;21. 研究者认为不适合的任何情况
Inclusion Criteria:
* Patients must meet all of the following inclusion criteria to be enrolled in this study:
1. Voluntarily participate in this study and provide a signed and dated written informed consent form before undergoing any study-specific procedures, sampling, or analyses;
2. Aged 18-70 years (inclusive), regardless of gender;
3. Diagnosed with primary malignancy confirmed by pathology and/or histology (with complete pathological report provided), including:Advanced solid tumors that have failed ≥2 lines of prior standard therapy;Advanced solid tumors (e.g., gastric cancer, colorectal cancer, platinum-resistant advanced ovarian cancer, fallopian tube cancer, etc.) with no standard treatment available, or for which accessible treatments have failed, or for which the investigator deems the patient intolerant to accessible treatments based on comprehensive risk-benefit assessments (intolerance defined as ≥Grade 3 adverse reactions post-treatment, or reactions below Grade 3 but persistent or recurrent, impacting continued treatment). All related adverse reactions must resolve to ≤Grade 1 or return to baseline before screening or the first dose.Primary malignant peritoneal tumors confirmed by pathology and/or histology, including primary peritoneal cancer, peritoneal mesothelioma, etc., with failed or intolerable standard therapy;Other solid tumors with peritoneal metastasis judged by the investigator to lack standard treatment options.
4. Clear systemic treatment plan for primary and metastatic lesions, with no anticipated changes during the study;
5. Confirmed peritoneal metastasis via biopsy, cytology, CT, or prior evidence;
6. Enhanced CT shows intraperitoneal space-occupying lesions with ≥1 measurable lesion (per iRECIST criteria); or evaluable malignant peritoneal effusion via ultrasound (per WHO criteria);
7. Willingness to provide recent FFPE tissue samples, pathological slides (8 consecutive unstained slides), or ascites tumor cells for B7-H3 expression testing, with confirmed B7-H3 positivity;
8. No intraperitoneal drug injections (including hyperthermic intraperitoneal chemotherapy) within 1 month before signing the informed consent, except diagnostic paracentesis;
9. Expected survival ≥3 months;
10. ECOG performance status (PS) score of 0-2;
11. Laboratory results during screening meeting the following criteria:
Blood tests (within 14 days):
WBC ≥3.0×10\^9/L; ANC ≥1.5×10\^9/L; Lymphocytes ≥0.8×10\^9/L; Platelets ≥90×10\^9/L; Hemoglobin ≥90 g/L (transfusions or erythropoietin allowed). Patients requiring repeated transfusions due to active bleeding or chronic conditions must be discussed with the sponsor.
Liver function (within 7 days):
Total bilirubin ≤1.5×ULN; ALT/AST ≤2.5×ULN (≤5×ULN if liver metastases present).
Renal function (within 7 days):
Serum creatinine ≤1.5×ULN; or CrCL ≥30 mL/min (Cockcroft-Gault formula).
Coagulation (within 7 days):
INR/PT ≤1.3×ULN; APTT ≤1.5×ULN.
12. Recovery of prior systemic treatment toxicity to ≤Grade 1 or baseline (except alopecia);
13. Fertile males and females must agree to use contraception from informed consent until 180 days post-last MT027 cell infusion.
Exclusion Criteria:
* 1\. Known allergy to the investigational drug or its excipients; 2. Contraindications to peritoneal puncture or deemed unlikely to benefit from intraperitoneal therapy; 3. MSI-H/dMMR colorectal cancer patients not previously treated with immunotherapy; 4. Extensive liver metastases (\>70% liver involvement); 5. Confirmed portal vein thrombosis; 6. Bowel obstruction within 4 weeks before dosing; 7. Conditions limiting drug diffusion (e.g., compartmentalized or gelatinous ascites); 8. Surgery or radiotherapy within 4 weeks before the first dose; 9. Systemic steroids (excluding replacement therapy) or immunosuppressants within 1 week before treatment; 10. Participation in other drug trials within 4 weeks before screening; 11. Prior B7-H3-targeted therapy (antibody/ADC/cell therapy) without confirmed B7-H3 positivity via biopsy; 12. Severe allergy to any component of the investigational drug or biologics; 13. Concurrent malignancies (except cured cervical carcinoma in situ or basal cell carcinoma); 14. Severe autoimmune diseases; 15. Prior allogeneic tissue/organ transplant; 16. Live vaccines within 2 weeks before cell therapy or planned during the study; 17. Active HBV, HCV (unless RNA-negative), HIV, syphilis, EBV, or CMV infection; 18. Active systemic infection or coagulation disorders; 19. Severe cardiac (NYHA Class III+), hepatic (Child-Pugh C+), renal (CKD ≥Stage 4), or pulmonary insufficiency; 20. Pregnancy or lactation; 21. Any condition deemed unsuitable 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。
主要终点:Incidence of Adverse events after MT027 cells infusion · Incidence and proportion of adverse events during the trial (NCI-CTCAE v5.0 criteria ) · 28 days
次要终点:Obtain the maximum tolerated dose of MT027 cells;Objective Response Rate (ORR);Disease Control Rate (DCR);Duration of Overall Response (DOR);Progression-Free Survival (PFS);RP2D;Overall Survival (OS);Overall Survival Rate (OSR)
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这是一项开放标签、单臂I期剂量递增研究,旨在评估MT027在晚期原发性腹膜恶性肿瘤或继发于恶性实体瘤的腹部转移患者中的安全性、耐受性、药代动力学特征和初步疗效。该研究主要侧重于通过序贯队列剂量递增确定最大耐受剂量和推荐的II期剂量,次要目的是表征药代动力学参数并收集关于肿瘤反应的初步疗效数据。 本研究通过三个主要目标全面评估MT027细胞疗法的药效学和药代动力学特征:(1)系统监测治疗中出现的不良事件和具有临床意义的实验室参数偏差;(2)评估抗肿瘤活性并进行相关生物标志物分析;(3)表征细胞动力学,包括生物分布模式、治疗活性的机制通路,以及全面的免疫原性评估,测量针对MT027细胞的细胞/体液免疫反应。该方案进一步通过纵向监测供者特异性抗体和细胞因子释放谱来研究潜在的宿主抗产物免疫反应,同时采用先进的分子追踪方法来阐明肿瘤微环境中的细胞持久性和功能调节。
This is an open-label, single-arm phase I dose-escalation study designed to evaluate the safety, tolerability, pharmacokinetic profile, and preliminary efficacy of MT027 in patients with advanced primary peritoneal malignancies or abdominal metastases secondary to malignant solid tumors. The study primarily focuses on determining the maximum tolerated dose and recommended phase II dose through sequential cohort dose escalation, while secondarily characterizing the pharmacokinetic parameters and collecting initial efficacy data regarding tumor response. This investigation comprehensively evaluates the pharmacodynamic and pharmacokinetic profile of MT027 cellular therapy through three primary objectives: (1) systematic monitoring of treatment-emergent adverse events and clinically significant laboratory parameter deviations; (2) assessment of antitumor activity with correlative biomarker analysis; and (3) characterization of cellular kinetics including biodistribution patterns, mechanistic pathways of therapeutic activity, and comprehensive immunogenicity assessment measuring both cellular/humoral immune responses against MT027 cells. The protocol further investigates potential host-versus-product immune reactions through longitudinal monitoring of donor-specific antibodies and cytokine release profiles, while employing advanced molecular tracking methodologies to elucidate cellular persistence and functional modulation within the tumor microenvironment.
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