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:CD5 CAR T-Cell Therapy for r/r T-cell Lymphomas
这是一项 I/II 期注册临床试验,评估 CAR-T 细胞治疗非霍奇金淋巴瘤、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 36 例。试验地点:中国 · 北京、上海(共 3 个中心,其中中国 3 个)。登记号:NCT07022964。
不限性别 · ≥ 14 Years 且 ≤ 70 Years
纳入标准(符合所有纳入标准者方可入组): • 复发或难治性CD7阳性T细胞淋巴瘤患者,标准化疗后预后不佳,现有治疗效果有限且无可用治疗选择(如HSCT或化疗)。 • 男性或女性,年龄14至70岁。 • ECOG体能状态评分0至2。 • 预期生存期至少60天。 • 受试者须能够理解并在任何筛查程序前签署知情同意书;愿意遵守方案规定的访视计划及相关研究程序。19至70岁候选者须能够理解并签署知情同意书;14至18岁未成年候选者须充分理解知情同意内容,并由其法定监护人另行签署知情同意书。 排除标准(符合以下任一标准者不得入组): • 既往接受异基因HSCT,但无法获得移植供者的外周血单个核细胞(PBMNC)用于制备CAR-T细胞,且外周血肿瘤负荷>30%;或无异基因HSCT史且外周血肿瘤负荷>30%。 • 颅内压增高或脑功能障碍导致意识受损。 • 有症状的心力衰竭或严重心律失常。 • 有严重呼吸衰竭症状。 • 合并其他类型恶性肿瘤。 • 弥散性血管内凝血。 • 血清肌酐和/或尿素氮≥正常值的1.5倍。 • 存在败血症或其他未控制感染。 • 患有未控制的糖尿病。 • 存在严重精神障碍。 • 颅脑MRI显示明显颅内病灶。 • 有器官移植史(造血干细胞移植除外)。 • 有生育能力女性血HCG阳性。 • 患有肝炎(包括乙型和丙型肝炎),或艾滋病、梅毒筛查阳性。
Inclusion Criteria (Patients who met all the inclusion criteria were eligible for enrolment): * Relapsed or refractory CD7-positive T-cell lymphomas that were treated with with standard chemotherapy, with poor prognosis from currently available treatments at and no available treatment options (e.g., HSCT or chemotherapy); * Male or female, age 14-70; * Eastern Cooperative Oncology Group (ECOG) Physical Status Score 0-2; * life expectancy is at least 60 days; * Subjects should be capable of understanding and signing the informed consent form prior to any screening procedures. Subjects are willing to follow the study visit schedule and associated study procedures as specified in the protocol. Candidates between the ages of 19-70 years old will need to be sufficiently aware of and capable of signing the informed consent form; underage candidates between the ages of 14-18 years old will need to be sufficiently aware of the informed consent form and their legal guardian will also need to sign the informed consent form separately. Exclusion Criteria (Patients who fulfil any of the following criteria may not be enrolled): * Patients with history of allogeneic HSCT but PBMNC is not available from prior- transplant donor for preparation of CAR T cells and peripheral blood tumour load \>30%; patients without history of allogeneic HSCT and peripheral blood tumour load \>30%; * Intracranial hypertension or cerebral impaired consciousness; * Symptomatic heart failure or severe arrhythmia; * Symptoms of severe respiratory failure; * With other types of malignancy; * Diffuse intravascular coagulation; * Serum creatinine and/or urea nitrogen ≥ 1.5 times the normal value; * With sepsis or other uncontrollable infection; * Suffering from uncontrollable diabetes mellitus; * Severe mental disorders; * Have significant intracranial lesions on cranial MRI; * Organ transplantation (excluding haematopoietic stem cell transplantation) history; * Female patients (patients of childbearing potential) with positive blood HCG test; * Hepatitis (including hepatitis B and C) and positive screening for AIDS and syphilis.
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:Dose-limiting toxicity (DLT) · Incidence and type of dose-limiting toxicity(DLT) within 21 days of CD5CAR-T infusion. · 21 days;Adverse events (AEs) · Total number, incidence and severity of adverse events (AEs) within 21 days of CD5 CAR-T infusion. · 21 days
次要终点:Objective Response Rate (ORR);Duration of response (DOR)
入组患者接受抗CD5 CAR-T细胞治疗,可采用或不采用异基因HSCT桥接。
这是一项多中心、开放标签、非随机、单臂临床试验。复发/难治性T细胞非霍奇金淋巴瘤(T-NHL)患者接受自体或异基因CD5 CAR-T细胞治疗。主要目标是前瞻性评估CD5 CAR-T细胞桥接HSCT治疗复发/难治性T-NHL的安全性。主要终点为CD5 CAR-T细胞输注后21天内剂量限制性毒性(DLT)的类型和发生率。预计共入组36例受试者。
This is a multi-center, open-label, non-randomized, single-arm clinical trial. Refractory/relapse T-NHL patients are treated with autologous and allogeneic CD5 CAR T-cell therapy. The primary objective is to prospectively evaluate the safety of CD5 CAR T cell bridging to HSCT in the treatment of r/r T-NHL. The primary endpoint is the type and incidence of dose limiting toxicity (DLT) within 21 days after CD5 CAR-T cell infusion. A total of 36 subjects is estimated to be enrolled.
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