下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:An Open-label, Phase I Clinical Trial of Super1 TCR-T in NY-ESO-1-positive Patients With Advanced Solid Tumors
⚠ 该试验的登记信息已有 13 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 I 期注册临床试验,评估 TCR-T 细胞治疗肉瘤、肺癌、黑色素瘤的安全性、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 · 广州(共 1 个中心,其中中国 1 个)。登记号:NCT06942143。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准:
1. 在进行任何试验相关活动前签署知情同意书;
2. 年龄18-75岁,男性或女性;
3. 一线治疗失败的患者;
4. 根据RECIST1.1标准存在可测量病灶。
5. 在试验筛选期间,必须满足以下两项筛选标准(由申办方进行):
* HLA-A*02阳性;
* NYESO-1免疫组化染色阳性率≥20%。
6. ECOG评分0-1;
7. 预期生存时间超过3个月;
8. TCR-T细胞输注前4周内不允许使用抗肿瘤药物和治疗;
9. 超声心动图显示左心室射血分数≥50%;
10. 实验室检查结果至少应满足以下指定指标:
* WBC ≥3.0×109/L;
* 中性粒细胞绝对计数(ANC)≥1.5×109/L;
* 淋巴细胞绝对计数(ALC)≥1.0×109/L;
* 血小板(PLT)≥75×109/L;
* 血红蛋白≥10g/dL(过去7天内未输血);
* 凝血酶原时间或INR≤1.5倍正常值上限,除非正在接受抗凝治疗;
* 部分凝血酶原时间(APTT)≤1.5倍正常值上限,除非正在接受抗凝治疗;
* 24小时肌酐清除率≥60mL/min;
* 天冬氨酸氨基转移酶(AST/SGOT)≤2.5×ULN;
* 丙氨酸氨基转移酶(ALT/SGPT)≤2.5×ULN;
* 总胆红素(TBIL)≤1.5×ULN
11. 有生育能力的女性在研究治疗前妊娠试验阴性;必须同意在治疗期间使用有效的避孕措施。
12. 在整个试验期间,能够定期前往入组研究机构进行相关检测、评估和管理。
排除标准:
1. 进入试验前4周内接受过大手术、常规化疗、大面积放疗、免疫治疗或生物治疗的患者;
2. 已知对试验治疗的任何成分产生过敏反应;
3. 既往手术或治疗相关不良事件未恢复至≤2级CTCAE;
4. 高血压控制不佳(收缩压>160mmHg和/或舒张压>90mmHg)或具有临床意义(如活动性)的心脑血管疾病;脑血管意外(签署知情同意书前6个月内)、心肌梗死(签署知情同意书前6个月内)、不稳定型心绞痛、纽约心脏病协会II级或以上充血性心力衰竭(附录),或无法用药物控制或可能影响研究治疗的严重心律失常;心电图(ECG)显著异常或连续三次平均QTc间期≥450毫秒。
5. 合并其他严重器质性疾病和精神障碍;
6. 有需要治疗的活跃性全身感染,包括活动性结核、已知HIV阳性或临床活动性甲型、乙型或丙型肝炎;(病毒携带者应排除)
7. 自身免疫性疾病患者:有炎症性肠病史或研究者判断不适合本研究的自身免疫性疾病史(如系统性红斑狼疮、血管炎和侵袭性肺病)的患者应排除;(白癜风患者不排除)。
8. 细胞治疗前4周内给予慢性全身性可的松类固醇、羟基脲和免疫调节剂(如白细胞介素-2、干扰素-α或γ、GM-CSF、mTOR抑制剂、环孢素、胸腺素等)。
9. 器官移植、自体/异体干细胞移植和肾脏替代治疗史;
10. 已知未控制的糖尿病、肺纤维化、间质性肺病、急性肺病或肝衰竭;
11. 已知酒精和/或药物滥用;
12. 妊娠或哺乳期妇女;
13. 研究者判断可能影响试验进行的任何共存医学状况或疾病的试验参与者;
14. 无法律行为能力/限制行为能力。
Inclusion Criteria:
1. Sign informed consent before conducting any trial-related activities;
2. Age of 18-75 years old, male or female;
3. Patients with first-line treatment failure;
4. Measurable lesions according to RECIST1.1 criteria.
5. During the trial screening period, the following two screening criteria must be met (by the sponsor) :
* HLA-A\*02 positive;
* The positive rate of NYESO-1 immunohistochemical staining was ≥20%.
6. ECOG score 0-1;
7. The expected survival time is more than 3 months;
8. Antineoplastic drugs and treatments were not allowed for 4 weeks before TCR-T cell infusion;
9. Echocardiography showed left ventricular ejection fraction ≥50%;
10. Laboratory test results should at least meet the following specified indicators:
* WBC ≥3.0×109/L;
* Absolute neutrophil count (ANC) ≥1.5×109/L;
* Absolute lymphocyte count (ALC) ≥1.0×109/L;
* platelet (PLT) ≥75×109/L;
* hemoglobin ≥10g/dL (no blood transfusion in the past 7 days);
* Prothrombin time or INR≤1.5x upper limit of normal unless receiving anticoagulant therapy;
* Partial prothrombin time (APTT) ≤1.5x upper limit of normal time, unless receiving anticoagulant therapy;
* 24-hour creatinine clearance ≥60mL/ min;
* Aspartate aminotransferase (AST/SGOT) ≤2.5×ULN;
* alanine aminotransferase (ALT/SGPT) ≤2.5×ULN;
* Total bilirubin (TBIL) ≤1.5×ULN
11. Negative pregnancy tests in women of childbearing potential prior to study treatment; Consent must be given to use effective contraception during treatment.
12. During the whole period of the trial, I can regularly visit the enrolled research institutions for relevant testing, evaluation and management.
Exclusion Criteria:
1. Patients who received major surgery, conventional chemotherapy, large area radiotherapy, immunotherapy or biological therapy within 4 weeks before entering the trial;
2. Known to produce allergic reactions to any component of the trial treatment;
3. no recovery from previous surgery or treatment-related adverse events to ≤ grade 2 CTCAE;
4. Poorly controlled hypertension (systolic blood pressure \> 160mmHg and/or diastolic blood pressure \> 90mmHg) or clinically significant (e.g., active) cardio-cerebrovascular disease; Cerebrovascular accident (within 6 months before the signing of informed consent), myocardial infarction (within 6 months before the signing of informed consent), unstable angina, congestive heart failure of New York Heart Association class II or higher (Appendix), or severe arrhythmia that could not be controlled with medications or that had the potential to affect study treatment; Electrocardiogram (ECG) was significantly abnormal or the mean QTc interval was ≥450 msec on three consecutive occasions.
5. Combined with other serious organic diseases and mental disorders;
6. Have active systemic infection requiring treatment, including active tuberculosis, known HIV positivity, or clinically active hepatitis A, B, or C; (Virus carriers should be excluded)
7. Patients with autoimmune diseases: those with a history of inflammatory bowel disease or a history of autoimmune diseases (such as systemic lupus erythematosus, vasculitis, and invasive lung disease) judged by the investigators to be not suitable for this study should be excluded; (Patients with vitiligo are not excluded).
8. Administration of chronic systemic cortisone steroids, hydroxyurea, and immunomodulatory agents (e.g., interleukin-2, interferon-α or γ, GM-CSF, mTOR inhibitors, cyclosporine, thymosin, etc.) within 4 weeks prior to cell therapy."
9. History of organ transplantation, autologous/allogeneic stem cell transplantation and renal replacement therapy;
10. Known uncontrolled diabetes mellitus, pulmonary fibrosis, interstitial lung disease, acute lung disease or liver failure;
11. Known alcohol and/or drug abuse;
12. Pregnant or lactating women;
13. Trial participants with any coexisting medical conditions or diseases judged by the investigators to be likely to impair the conduct of the trial;
14. No legal capacity/limited capacity.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:DLT · Determining the dose-limiting toxicity (DLT) of Super1 TCR-T adoptive Immunotherapy · Up to 28 Days;MDT · Determining the maximum Tolerated dose (MTD) of Super1 TCR-T adoptive Immunotherapy · Up to 28 Days
次要终点:ORR;OS;PFS
Super1 TCR-T剂量毒性试验按以下剂量(阳性细胞)递增方案进行递增: 水平1 水平2 水平3
本研究是一项在单中心开展的、开放标签、3+3设计、剂量递增的I期安全性和耐受性临床试验。
This study was a phase I safety and tolerability clinical trial conducted in a single-center, open-label, 3+3 design with dose escalation.
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