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:Chimeric Antigen Receptor Natural Killer Cell Therapy for High-risk Lymphoma Patients With Primary Sjogren's Syndrome
⚠ 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。
这是一项 I/II 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 6 例。试验地点:中国 · 上海(共 1 个中心,其中中国 1 个)。登记号:NCT06967038。
不限性别 · ≥ 18 Years 且 ≤ 70 Years
纳入标准: 1. 年龄18至70岁,性别不限。 2. 确诊原发性干燥综合征,符合2016年ACR/EULAR分类标准。 3. 唾液腺、淋巴结、肝脏或脾脏持续肿大(影像学/病理学检查),且符合以下4项中的至少2项:①冷球蛋白血症;②C4降低;③白细胞减少;④抗SSA或抗SSB阳性。 4. 肝肾功能符合以下标准:血清谷丙转氨酶(GPT)<正常值上限的3倍;血清胆红素和碱性磷酸酶<正常值上限的2倍;血清肌酐≤2 mg/dL。 5. 认知功能正常,自愿参加本临床试验并签署书面知情同意书;能够配合并完成所有试验程序。 排除标准: 1. 妊娠或哺乳期女性。 2. 乙型肝炎、丙型肝炎、HIV或其他病毒感染。 3. 高度过敏体质或有严重过敏史。 4. 有其他自身免疫性疾病史。 5. 患有严重心力衰竭、呼吸衰竭、肝功能障碍、肾功能衰竭、持续性出血、恶性肿瘤或尿崩症。 6. 研究者认为不适合参加本临床研究的其他情况。
Inclusion Criteria: 1. Age range of 18-70 years old, gender not limited; 2. Diagnosed with primary Sjogren's syndrome, meeting the 2016 ACR/EULAR classification criteria; 3. Persistent enlargement of salivary glands, lymph nodes, liver, or spleen (imaging/or pathology), and at least 2 of the following 4 conditions are met: ① Cryoglobulinemia; ② Low C4; ③ Decreased white blood cells; ④ Positive for anti SSA or anti SSB; 4. Liver and kidney function, defined as S serum GPT\<3 times the upper limit of normal; Serum bilirubin and alkaline phosphatase are less than twice the upper limit of normal, and serum creatinine is ≤ 2mg/dl; 5. Normal cognitive function and voluntarily participate in this clinical trial. Signing a written informed consent form. Can follow and complete all trial procedures. Exclusion Criteria: 1. Pregnant and lactating women; 2. Patients with hepatitis B, hepatitis C, HIV and other virus infections; 3. Highly allergic constitution or history of severe allergies; 4. Patients with a history of other autoimmune diseases; 5. Patients with severe heart failure, respiratory failure, liver dysfunction, kidney failure, persistent bleeding, malignant tumors, and diabetes insipidus; 6. There are other situations where the researcher deems it inappropriate to participate in this clinical 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。
主要终点:Safety: Incidence of Dose limiting toxicity (DLT) · The dose escalation method adopts the i3+3 design, and CAR-NK cells are tentatively given three doses based on literature: 5×10\^6/kg body weight, 1×10\^7/kg body weight, and 5×10\^7/kg body weight. Plan to enroll 6-12 subjects. Researchers can together decide whether to increase it to a higher dose to determine the possible therapeutic dose. During the experiment, dosage adjustments can be made based on the safety and tolerability data of the subjects, including limiting toxicity type, incidence, and severity of dose limiting toxicity (DLT). · 45 days;Safety: Incidence and severity of adverse events (AEs) · One or more adverse events are related to CAR-NK cell therapy occurring in a subject within 45 days after the first infusion of CAR-NK cells. (1) Inflammatory cytokine release syndrome of grade ≥ 3 within 2 weeks. (2) Allergic reactions of grade 3 or higher within 2 weeks. (3) Organ damage of grade≥3 within 2 weeks (nerve, cardiovascular, lung, genitourinary, gastrointestinal, liver, skin, etc.). (4) Grade≥3 graft-versus-host disease within 45 days. (5) Deaths related to treatment within 45 days. · 45 days
次要终点:cell treatment efficacy;cell treatment efficacy;cell treatment efficacy;cell treatment efficacy
CAR-NK细胞治疗。
这是一项I/II期CAR-NK细胞治疗试验,纳入原发性干燥综合征(pSS)合并高危淋巴瘤患者。研究旨在确定CAR-NK细胞的最佳剂量,并评估递增剂量的iC9/CAR19/IL15 CB-NK细胞治疗的安全性和疗效。研究采用i3+3剂量递增设计。剂量限制性毒性(DLT)定义为:细胞输注后2周内发生需转入重症监护病房的细胞因子释放综合征;输注后40天内发生III至IV级急性移植物抗宿主病;或与CAR-NK细胞输注相关的3至5级过敏反应。i3+3设计中疗效定义为:CAR-NK细胞输注后第30天pSS患者淋巴瘤高危情况减轻,且口干和眼干症状至少部分缓解。
This study is a phase I-II clinical trial of CAR-NK cell therapy for high-risk lymphoma patients with primary Sjogren's syndrome (pSS). The aim is to determine the optimal dose of CAR-NK cells and evaluate the safety and efficacy of increasing doses of iC9/CAR19/IL15 CB-NK cell therapy. Use i3+3 based design to increase dosage. Dose limiting toxicity (DLT) is defined as the occurrence of CRS within 2 weeks after cell infusion, requiring transfer to the intensive care unit, or grade III-IV acute graft-versus-host disease within 40 days after infusion, or grade 3-5 allergic reactions related to CAR-NK cell infusion. For the purpose of i3+3 design, efficacy is defined as a reduction in the high-risk of lymphoma in pSS patients and at least partial relief of dry mouth and eye symptoms on the 30th day after CAR-NK cell infusion.
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