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:CAR19BCMA CAR-T Cells for the Treatment of R/R Plasma Cell Neoplasms and Lymphomas/Leukemias With Plasmacytic Differentiation
CAR19BCMA CAR-T Cells for the Treatment of R/R Plasma Cell Neoplasms and Lymphomas/Leukemias With Plasmacytic Differentiation
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这是一项早期 I 期注册临床试验,评估 BCMAT 细胞治疗浆细胞肿瘤、淋巴瘤的疗效与安全性。当前状态:尚未开始招募。计划入组 20 例。试验地点:中国 · 北京(共 1 个中心,其中中国 1 个)。登记号:NCT06986434。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 确诊复发/难治性CD19/BCMA阳性浆细胞肿瘤或伴浆细胞分化的淋巴瘤/白血病,并符合以下全部条件: * 免疫组化或流式细胞术证实BCMA或CD19阳性; * 多发性骨髓瘤、浆细胞癌、浆细胞白血病或伴浆细胞分化的淋巴瘤/白血病患者,既往至少接受3线治疗(包括抗CD38单克隆抗体、蛋白酶体抑制剂、免疫调节剂等),但治疗失败或复发; * 系统性轻链淀粉样变患者既往至少接受2线治疗(抗CD38单克隆抗体、蛋白酶体抑制剂[PI]或免疫调节药物[IMiD]),但治疗失败或复发。 2. 年龄18–80岁,性别不限。 3. ECOG评分≤2分。 4. 预期生存期不少于3个月。 5. 血红蛋白(HGB)≥60 g/L。 6. 肝功能及心肺功能符合以下要求:左心室射血分数≥50%;血氧饱和度>90%;总胆红素≤1.5×正常值上限(ULN),ALT和AST≤2.5×ULN。 7. 受试者同意自签署知情同意书起至CAR-T 细胞输注后1年内采取避孕措施。 排除标准: * 左心室射血分数<50%的严重心力衰竭; * 有严重肺功能损害史; * 合并其他晚期恶性肿瘤; * 合并严重且无法有效控制的感染; * 严重自身免疫性疾病或先天性免疫缺陷; * 活动性肝炎(乙型肝炎病毒DNA[HBV-DNA]或丙型肝炎病毒RNA[HCV-RNA]检测结果高于检测下限); * HIV感染、已知获得性免疫缺陷综合征(AIDS)或梅毒感染; * 有对生物制品(包括抗生素)严重过敏史; * 患有其他严重躯体或精神疾病,或存在可能增加研究参与风险、干扰研究结果的实验室异常,或研究者认为不适合参加研究; * 有生育能力的女性处于妊娠期或哺乳期。
Inclusion Criteria: 1. Relapsed/refractory CD19BCMA positive plasma cell neoplasms and lymphomas/leukemias with plasmacytic differentiation must be assured and meet all of the following conditions: * Confirmation for either BCMA or CD19 positivity using immunohistochemistry or flow cytometry * Patients with multiple myeloma, plasma cell carcinoma, plasma cell leukemia and lymphomas/leukemias with plasmacytic differentiation who have received at least three 3 lines treatment (including anti-CD38 monoclonal antibodies, protease inhibitors, immunosuppressants, etc.) but have failed or experienced relapse * Patients with system light chain amyloidosis who have received at least 2 lines treatments in the past \[anti-CD38 monoclonal antibody, proteasome inhibitor (PI), or immunomodulatory drug (IMiD)\], but have failed or experienced relapse 2. Age 18-80 years, no gender restrictions 3. ECOG score ≤ 2 points 4. Expected survival period is not less than 3 months 5. HGB≥60g/L 6. Liver function and cardiopulmonary function meet the following requirements: * left ventricular ejection fraction≥50% * Oxygen saturation \>90% * Total bilirubin ≤1.5×ULN, ALT and AST≤2.5×ULN 7. Participants agreed to use contraception from the time of informed consent until 1 year after CAR-T cell infusion Exclusion Criteria: * Severe heart failure with left ventricular ejection fraction \<50% * A history of severe lung function impairment * Combined with other advanced malignant tumors * Complicated with severe infection that could not be effectively controlled * Severe autoimmune disease or congenital immune deficiency * Active hepatitis (hepatitis B virus DNA \[HBV-DNA\] or hepatitis C virus RNA \[HCV-RNA\] test results above the lower limit of detection) * Human immunodeficiency virus (HIV) infection or known acquired immunodeficiency syndrome (AIDS), or syphilis infection * History of severe allergy to biological products (including antibiotics) * Patients with other serious physical or mental illnesses or laboratory abnormalities that could increase the risk of participating in the study or interfere with the results of the study, and those who were deemed by the investigator to be unsuitable for participation in the study * Female patients (those with fertility) are in pregnancy or lactation
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:According to the incidence of treatment-related adverse events (AEs) to evaluate the safetyof CAR19BCMA CAR-T cells in the treatment of relapsed/refractory CD19+BCMA+plasma cell neoplasms and lymphomas/leukemias with plasmacytic differentiation. · Incidence of treatment-related adverse events (AEs) Description: Number and severity of adverse events graded according to CTCAE v5.0, including cytokine release syndrome (CRS) graded by ASTCT criteria and immune effector cell-associated neurotoxicity syndrome (ICANS) graded by ASBMT criteria · up to 3 years;According to the determine the Maximal Tolerable Dose(MTD) to evaluate the safety of CAR19BCMA CAR-T cells in the treatment of relapsed/refractory CD19+BCMA+ plasma cell neoplasms and lymphomas/leukemias with plasmacytic differentiation. · MTD will be determined based on DLTs observed during the first 28 days of study treatment
次要终点:According to the objective response rate (ORR) to evaluate the efficacy of CAR19BCMA CAR-T cells in the treatment of relapsed/refractory CD19+BCMA+ plasma cell neoplasms and lymphomas/leukemias with plasmacytic differentiation.
研究性产品:CAR19BCMA-T细胞,经静脉注射。输注CD19/BCMA CAR-T 细胞前,采用氟达拉滨联合环磷酰胺进行淋巴细胞清除性化疗。
以上邮箱 / 电话是登记库里的申办方联系方式(+86,中国),通常不直达某家医院。中国中心的联系方式请以医院或登记平台最新公示为准。
本单臂研究旨在评估CAR19BCMA CAR-T 细胞治疗复发/难治性CD19/BCMA阳性浆细胞肿瘤及伴浆细胞分化的淋巴瘤/白血病的安全性和有效性。
This is a single arm study to evaluate the safety and efficacy of CAR19BCMA CAR-T cells in the treatment of relapsed/refractory CD19/BCMA positive plasma cell neoplasms and lymphomas/leukemias with plasmacytic differentiation.
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