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:UCAR T-cell Therapy Targeting CD19/ BCMA in Patients With Relapse/ Refractory Autoimmune Diseases
⚠ 该试验的登记信息已有 17 个月未更新, 页面上显示的「尚未开始招募」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,评估异体 CAR-T 细胞治疗系统性红斑狼疮、多发性骨髓瘤、重症肌无力的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 18 例。试验地点:中国 · 常州(共 1 个中心,其中中国 1 个)。登记号:NCT06978738。
不限性别 · ≥ 18 Years
纳入标准: 1. 年龄≥18岁(含),性别不限。 2. 流式细胞术确认外周血B细胞CD19阳性。 3. 重要器官功能要求:骨髓功能为中性粒细胞≥0.5×10⁹/L(检查前2周未用集落刺激因子)、血红蛋白≥60 g/L、血小板≥30×10⁹/L;肝功能为ALT和AST≤ULN的3倍(炎性肌病导致的升高除外)、总胆红素≤ULN的1.5倍(Gilbert综合征患者≤3倍);肾功能为肌酐清除率≥30 mL/min(按Cockcroft-Gault公式计算;靶疾病导致的急性肌酐清除率下降除外,狼疮性肾炎除外)。 4. ECOG评分0–1。 5. 有生育能力的女性及伴侣有生育能力的男性须在治疗期间和治疗结束后至少6个月内采取医学认可的避孕措施或禁欲。有生育能力女性须在入组前7天内HCG检测阴性且未哺乳。 6. 愿意参加研究、签署知情同意书、依从性良好并配合随访。 7. 患有复发/难治性自身免疫病,包括自身免疫性溶血性贫血、系统性红斑狼疮、系统性硬化症、炎性肌病、ANCA相关性血管炎、IgG4相关疾病或重症肌无力。 排除标准: 1. 有严重药物过敏史或过敏体质。 2. 存在或疑似存在未控制/需治疗的真菌、细菌、病毒或其他感染。 3. 心功能不全。 4. 先天性免疫球蛋白缺乏。 5. 过去5年内有恶性肿瘤史,但以下情况除外:非黑色素瘤皮肤癌;完全切除后复发概率低的Ⅰ期肿瘤;治疗后的临床局限性前列腺癌;活检证实的宫颈原位癌或涂片显示鳞状上皮内病变;稳定的甲状腺乳头状癌或滤泡状癌。 6. HBsAg阳性,或HBcAb阳性且外周血HBV-DNA>ULN;HCV抗体阳性且外周血HCV-RNA阳性;HIV抗体阳性;梅毒检测阳性。 7. 有精神疾病或严重认知功能障碍。 8. 妊娠或计划妊娠。 9. 研究者认为不适合入组的其他原因。
Inclusion Criteria: * 1.Age ≥ 18 years old (inclusive), regardless of gender. * 2.Positive expression of CD19 on peripheral blood B cells confirmed by flow cytometry. * 3.Functional requirements for major organs are as follows: 1. Bone marrow function must meet: A. Neutrophil count ≥ 0.5×10 \^ 9/L (no colony-stimulating factor treatment within 2 weeks before examination); B. Hemoglobin ≥ 60g/L; C. Platelets ≥ 30 × 10 \^ 9/L. 2. Liver function: Alanine aminotransferase (ALT) ≤ 3×ULN (excluding ALT elevation due to inflammatory myopathy), aspartate aminotransferase (AST)≤3×Upper limit of normal (ULN) (excluding AST elevation due to inflammatory myopathy), TBIL≤1.5×ULN (or ≤ 3.0×ULN for subjects with Gilbert syndrome); 3. Renal function: creatinine clearance rate (CrCl) ≥ 30ml/minute (calculated by Cockcroft/Gault formula, acute CrCl decrease due to the target disease is excluded; LN is exluded); * 4.ECOG score 0-1. * 5.Female subjects of childbearing potential and male subjects with partners of childbearing potential must use medically approved contraception or abstinence during the study treatment period and for at least 6 months after the end of the study treatment; Female subjects of childbearing potential must have a negative Human chorionic gonadotropin (HCG) test within 7 days before study enrollment and not be lactating. * 6.Willing to participate in this clinical study, sign an informed consent form, have good compliance, and cooperate with follow-up. * 7.Subjects with relapsed or refractory autoimmune diseases, Including relapsed or refractory Autoimmune Hemolytic Anemia, relapsed or refractory Systemic Lupus Erythematosus, relapsed or refractory or Progressive Systemic Sclerosis, relapsed or refractory or Progressive Inflammatory Myopathy, relapsed or refractory ANCA-Associated Vasculitis, relapsed or refractory Immunoglobulin-G4 related disease and relapsed or refractory Myasthenia Gravis. Exclusion Criteria: * 1.Subjects with a history of severe drug allergies or allergic constitutions; * 2\. Presence or suspicion of uncontrolled or treatment-required fungal, bacterial, viral, or other infections; * 3\. Subjects with insufficient cardiac function; * 4\. Subjects with congenital immunoglobulin deficiencies; * 5\. Subjects with a history of malignant tumors within the past five years, except for the following conditions: non-melanoma skin cancer, stage I tumors with a low recurrence probability after complete resection, clinically localized prostate cancer after treatment, cervical carcinoma in situ confirmed by biopsy or squamous intraepithelial lesion shown by smear, and stable papillary thyroid carcinoma or follicular thyroid carcinoma. * 6\. Subjects who are positive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) with peripheral blood HBV DNA \>ULN; subjects positive for hepatitis C virus (HCV) antibody and peripheral blood HCV RNA; individuals positive for human immunodeficiency virus (HIV) antibody; individuals positive for syphilis testing; * 7\. Subjects with mental illness and severe cognitive dysfunction; * 8\. Pregnant women or women planning to conceive; * 9.Subjects whom the investigator believes have other reasons that make them unsuitable for inclusion in this 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:The number and severity of dose-limiting toxicity (DLT) events · DLT will be graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0, and the ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. · Within 28 Days After UCAR T-cell Infusion;The total number, incidence, and severity of AEs · Up to 90 days After UCAR T-cell Infusion
次要终点:AIHA:Rates of CR, CRi, PR, ORR;SLE:SLE Response Index 4 (SRI-4);SLE: Change in the Systemic Lupus Erythematosus Disease Activity Index(SLEDAI) from baseline;SSc:Change in the modified Rodnan Skin Score (mRSS) from baseline;IIM:The ACR-EULAR Myositis Response Criteria [Total Improvement Score (TIS)];AAV: Change in disease activity as measured by Birmingham Vasculitis Activity Score (BVAS);IgG4-RD:IgG4-Related Disease Responder Index (IgG4-RD RI);MG:Changes of Myasthenia Gravis Activities of Daily Living (MG-ADL) Score
单次输注UCAR T细胞,即通用型异基因抗CD19/BCMA CAR-T细胞。
这是一项研究者发起的临床试验,旨在评估通用型异基因抗CD19/BCMA CAR-T细胞治疗复发/难治性自身免疫病的安全性和疗效。
This is an investigator-initiated trial to evaluate the safety and efficacy of universal allogeneic anti-CD19/BCMA CAR T-cells in With Relapse/Refractory Autoimmune Diseases.
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