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Claudin18.2-targeted CAR-T(Claudin18.2CAR-T 细胞)治疗 Colorectal Neoplasia:I 期临床试验

英文原题:Exploratory Clinical Study of Claudin18.2-Targeted CAR-DC and CAR-T Therapy in Advanced Colorectal Cancer

ClinicalTrials.gov 2025/04/27(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 17 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 Claudin18.2CAR-T 细胞治疗相关疾病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 18 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT06946615。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 70 Years

纳入标准:
1. 组织学或细胞学确诊结肠或直肠腺癌,且至少有1个符合RECIST 1.1的可测量病灶(螺旋CT靶病灶最长径≥10 mm,或淋巴结短径≥15 mm)。
2. 免疫组化(IHC)证实肿瘤组织Claudin18.2表达阳性。
3. 标准治疗后疾病进展;既往治疗须包括氟嘧啶类、伊立替康和奥沙利铂。疾病可在治疗期间或治疗后进展;允许既往接受分子靶向治疗。
4. ECOG体能状态评分0–1分。
5. 预期生存期至少6个月。
6. 既往抗肿瘤治疗毒性已恢复至基线或≤1级(残留脱发除外);周围神经毒性≤2级可接受。化疗和免疫治疗的最短洗脱期为4周,靶向治疗为2周。
7. 器官功能充分:血液学:ANC≥1.5×10⁹/L、血小板≥75×10⁹/L、血红蛋白≥9 g/dL;血液学检查前14天内不得输血或使用G-CSF、TPO或EPO。肝功能:总胆红素<1.5倍ULN,AST和ALT<2.5倍ULN;Gilbert综合征患者总胆红素<2倍ULN;有肝转移者AST和ALT<5倍ULN。肾功能:血清肌酐≤1.5倍ULN;若>1.5倍ULN,则按Cockcroft-Gault公式计算的肌酐清除率(CrCl)须≥60 mL/min。凝血功能:PT和APTT<1.5倍ULN;INR<1.5,或接受抗凝治疗者处于治疗范围内。
8. 有生育能力者须同意在研究期间有效避孕。
9. 能充分理解研究并自愿签署知情同意书。
10. 愿意遵守所有研究程序,包括计划访视、用药、实验室检查及其他方案要求。

排除标准:
1. 存在需立即干预的肿瘤急症,如恶性心包积液或心包填塞、上腔静脉综合征或脊髓压迫。
2. 临床显著心血管疾病,包括过去6个月内心肌梗死、心绞痛、心力衰竭、严重心律失常、血管成形术、支架置入或冠状动脉旁路移植术史;或具有临床意义的QT/QTcF间期延长(女性>470 ms,男性>450 ms)。
3. 临床显著出血性疾病或凝血障碍,如血友病。
4. 活动性感染,包括HIV、梅毒或活动性乙肝/丙肝:乙肝HBV DNA≥1000 IU/mL;丙肝HCV RNA阳性且肝功能异常。
5. 因精神疾病或其他精神障碍曾被非自愿住院,或研究者认为不适合治疗。
6. 患有自身免疫性疾病,或长期使用免疫抑制剂/皮质类固醇。
7. 用药依从性差或无法遵守治疗方案。
8. 研究者认为应排除的其他情况。
核对登记原文(英文)
Inclusion Criteria:

1. Participants must have a histologically or cytologically confirmed diagnosis of colonic or rectal adenocarcinoma, with at least one measurable lesion meeting RECIST v1.1 criteria (i.e., a target lesion with a longest diameter ≥10 mm on spiral CT scan, or a lymph node with a short axis ≥15 mm).
2. Claudin18.2 expression must be confirmed as positive in tumor tissue by immunohistochemistry (IHC).
3. Disease progression following standard treatments, including prior administration of fluoropyrimidines, irinotecan, and oxaliplatin. Disease progression may occur during or after treatment. Prior molecular targeted therapies are allowed.
4. ECOG performance status of 0 to 1.
5. Expected survival of at least 6 months.
6. Toxicities related to prior antitumor treatments must have resolved to baseline or ≤ Grade 1 (except for residual alopecia); peripheral neurotoxicity ≤ Grade 2 is acceptable. The minimum washout period is 4 weeks for chemotherapy and immunotherapy, and 2 weeks for targeted therapy.
7. Adequate organ function, defined as follows:

   * Hematologic function: Absolute neutrophil count (ANC) ≥ 1.5 × 10\^9/L, platelet count ≥ 75 × 10\^9/L, and hemoglobin ≥ 9 g/dL. No blood transfusions, granulocyte colony-stimulating factor (G-CSF), thrombopoietin (TPO), or erythropoietin (EPO) allowed within 14 days prior to hematology testing.
   * Hepatic function: Total bilirubin (TBIL) \< 1.5 × upper limit of normal (ULN); AST and ALT \< 2.5 × ULN. For patients with Gilbert's syndrome, TBIL \< 2 × ULN. For patients with liver metastases, AST and ALT must be \< 5 × ULN.
   * Renal function: Serum creatinine ≤ 1.5 × ULN; or if \> 1.5 × ULN, creatinine clearance (CrCl) ≥ 60 mL/min as calculated by the Cockcroft-Gault formula.
   * Coagulation function: Prothrombin time (PT) and activated partial thromboplastin time (APTT) \< 1.5 × ULN; international normalized ratio (INR) \< 1.5 or within the therapeutic range if on anticoagulation therapy.
8. Participants of childbearing potential must agree to use effective contraception during the study period.
9. Participants must have adequate comprehension and voluntarily sign the informed consent form.
10. Willingness to comply with all study-related procedures, including scheduled visits, drug administration, laboratory assessments, and other protocol requirements.

Exclusion Criteria:

1. Tumor-related emergencies requiring immediate intervention, such as malignant pericardial effusion or cardiac tamponade, superior vena cava syndrome, or spinal cord compression.
2. Clinically significant cardiovascular disease, including:

   * Documented cardiovascular events within the past 6 months, such as myocardial infarction, angina, heart failure, severe arrhythmias, or history of angioplasty, stent implantation, or coronary artery bypass grafting (CABG);
   * Prolonged QT/QTcF interval with clinical significance (QT/QTcF \> 470 ms in females or \> 450 ms in males).
3. Clinically significant bleeding disorders or coagulopathies, such as hemophilia.
4. Active infections including HIV, syphilis, or active hepatitis B or C:

   * Hepatitis B: HBV-DNA ≥ 1000 IU/mL;
   * Hepatitis C: Positive HCV RNA with abnormal liver function.
5. History of involuntary psychiatric hospitalization due to mental illness or other psychiatric disorders deemed unsuitable for treatment by the investigator.
6. Presence of autoimmune diseases or chronic use of immunosuppressive agents or corticosteroids.
7. Poor medication compliance or inability to adhere to the treatment protocol.
8. Any other condition that, in the opinion of the investigator, warrants exclusion from the study.

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

  • 主要终点安全性:不良事件的发生率和严重程度CAR-T细胞和CAR-DC输注后首3个月
  • 主要终点疗效:缓解率CAR-T细胞和CAR-DC输注后3个月
  • 次要终点无进展生存期
  • 次要终点总生存期
  • 次要终点复发率
  • 次要终点缓解持续时间
  • 次要终点体内CAR-T细胞和CAR-DC持续存在情况及细胞因子谱监测
  • 次要终点接受不同CAR-DC剂量参与者的客观缓解率
  • 次要终点接受不同CAR-DC剂量参与者治疗相关不良事件的发生率和严重程度
核对登记原文(英文)

主要终点:Safety: Incidence and severity of adverse events · To evaluate adverse events occurring within the first three months following infusion of Claudin18.2-targeted CAR-T cells and CAR-DCs. The assessment includes incidence and severity of treatment-related symptoms such as neurological toxicity, hematological abnormalities, infections, autoimmune reactions, and secondary malignancies. · First 3 month post CAR-T cells and CAR-DCs infusion;Efficacy: Remission Rate · To evaluate the proportion of participants who achieve an objective tumor response, including complete remission (CR) and partial remission (PR) · 3 months post CAR-T cells and CAR-DCs infusion
次要终点:Progression-Free Survival;Overall Survival;Relapse Rate;Duration of Response;In Vivo Persistence of CAR-T cells and CAR-DCs and Cytokine Profile Monitoring;Objective Response Rate in Participants Receiving Different Doses of CAR-DCs;Incidence and Severity of Treatment-Related Adverse Events in Participants Receiving Different Doses of CAR-DCs

研究设计怎么做的

研究类型
干预性研究
入组人数
18 人(预计)
分组方式
不适用(单臂)
  • CAR-T与CAR-DC联合治疗组试验组

    依次给予两种生物学干预:先给予Claudin18.2靶向CAR-DC,再给予Claudin18.2靶向CAR-T细胞。

核对分组登记原文(英文)
  • CAR-T and CAR-DC Combination Therapy · EXPERIMENTAL · This arm involves the sequential administration of two biological interventions, with Claudin18.2-targeted CAR-DCs administered first, followed by Claudin18.2-targeted CAR-T cells.

关键日期

开始日期
2025-04-08
主要完成日期
2026-04
全部完成日期
2027-04
登记状态核实于
2025-04

联系与责任方

申办方
Second Affiliated Hospital, Zhejiang University, School of Medicine
联系邮箱
yuanying1999@zju.edu.cn
联系电话
+86-13858193601

登记简述

这是一项开放标签、单臂临床研究,旨在评估Claudin18.2靶向CAR-DC联合CAR-T细胞疗法治疗晚期结直肠癌患者的安全性和初步疗效。

核对登记原文(英文)

This is an open-label, single-arm clinical study designed to evaluate the safety and preliminary efficacy of Claudin18.2-targeted CAR-DC combined with CAR-T cell therapy in patients with advanced colorectal cancer.

登记原文与核验信息

试验登记号
NCT06946615
试验期别
I 期
试验状态
招募中
中国试验中心(1 个)
Second Affiliated Hospital, School of Medicine, Zhejiang University · 杭州 · 中国
适应症(原文)
Colorectal Neoplasia
干预方式(原文)
Claudin18.2-targeted CAR-T Cells; Claudin18.2-targeted CAR-DCs