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:CD30 CAR-T in the Treatment of CD30 Positive Lymphoma
这是一项早期 I 期注册临床试验,评估 T 细胞治疗淋巴瘤、B 细胞淋巴瘤、外周 T 细胞淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 15 例。试验地点:中国 · 武汉(共 1 个中心,其中中国 1 个)。登记号:NCT07048353。
不限性别 · ≥ 18 Years 且 ≤ 65 Years
纳入标准: * 年龄≥18岁且≤65岁,女性及男性; * CD30+复发/难治性恶性血液肿瘤,经≥2线全身治疗后出现复发(治疗缓解后疾病进展)或难治(既往全身治疗未达到CR); * 免疫组化CD30表达>10%; * 根据Lugano 2014评估标准至少存在1个可测量病灶; * 预计生存时间≥3个月; * ECOG体能状态0-2,KPS>60%; * 器官功能充分:ALT、AST≤2.5×ULN,肝脏侵犯患者可放宽至≤5×ULN;血清总胆红素<34 μmol/L;肌酐清除率>30 mL/min;EF≥40%;无心包积液及明显心律失常;SpO2≥92%; * ALC≥0.5×109/L,PLT>30×109/L,Hb>80 g/L,且受试者具有单采静脉通路且无血细胞分离禁忌症; * MRI显示无淋巴瘤中枢侵犯; * 有生育能力的患者必须愿意能够采用可靠的避孕措施; * 受试者或法定监护人能够理解并自愿签署书面知情同意书。 排除标准: * 淋巴瘤相关噬血细胞综合征; * 妊娠或哺乳期女性,以及六个月内计划妊娠的女性; * 乙型肝炎(HBsAg、HBsAb、HBeAg、HBeAb、HBcAb)、丙型肝炎(Anti-HCV)、Anti-HIV Ⅰ/Ⅱ及anti-TP阳性(乙型肝炎DNA检测阴性者除外); * 患有其他恶性肿瘤,但接受过根治性治疗的皮肤基底细胞癌、皮肤鳞状细胞癌及宫颈原位癌除外; * 入组前4周内接受过Anti-CD30 Ab治疗; * 与任何既往治疗相关的未缓解的>1级非血液学毒性; * 活动性未控制出血或已知出血素质; * 6周内接受过自体造血干细胞移植; * 不可控制的活动性细菌或真菌感染; * 已知对研究药物及其成分过敏; * 患有需要全身治疗的活动性自身免疫性疾病; * 无法配合治疗和疗效评估的精神或精神疾病患者; * 本研究前1个月内参加过其他临床研究; * 异基因造血干细胞移植史; * 研究者或治疗医师认为任何会干扰试验或受试者安全的情况。
Inclusion Criteria: * Age≥18 years and ≤65years,female and male; * CD30+ recurrent/refractory malignant hematological malignancies, experienced recurrence (disease progression after treatment remission) or refractory (previous systemic treatment did not achieve CR) after ≥ 2-line systemic treatment; * CD30 expression \>10% by immunohistochemistry; * At least 1 measurable lesion can be measured according to theLugano 2014 evaluation criteria; * The estimated survival time ≥3 months; * ECOG performance status 0-2,KPS\>60%; * Sufficient organ function:ALT,AST≤2.5×ULN,patients with liver invasion can be relaxed to ≤ 5 x ULN;serum total bilirubin\<34 μmol/L;creatinine clearance rate\>30 mL/min;EF≥40%;No pericardial effusion and obvious arrhythmia;SpO2≥92%; * ALC ≥0.5×109/L,PLT\>30×109/L,Hb\>80 g/L and subjects had apheresis venous access and no contraindications for blood cell separation; * MRI showed no central involvement of lymphoma; * Patients with fertility must be willing to be able to use reliable contraceptive measures ; * The subject or legal guardian can understand and voluntarily sign the written informed consent. Exclusion Criteria: * Lymphoma-associated hemophagic cell syndrome; * Pregnant or lactating women, and women who have a pregnancy plan within six months; * Hepatitis B(HBsAg、HBsAb、HBeAg、HBeAb、HBcAb),Hepatitis C(Anti-HCV),Anti-HIV Ⅰ/Ⅱ and anti-TP positive(Hepatitis B DNA test is negative except); * Suffered from other malignant tumors, except for for skin basal cell carcinoma, skin squamous cell carcinoma and cervical carcinoma in situ undergoing the radical treatment; * Received Anti-CD30 Ab therapy within 4 weeks before enrollment; * Unresolved \> Grade 1 non-hematologic toxicity associated with any prior treatments; * Active uncontrolled bleeding or a known bleeding diathesis; * Autologous hematopoietic stem cell transplantation was performed within 6 weeks; * Uncontrollable active bacterial or fungal infection; * Known allergy to the study drug and its components; * Suffer from active autoimmune diseases that require systemic treatment ; * Persons with mental or mental illness who cannot cooperate with treatment and efficacy evaluation; * Participated in other clinical studies within 1 months prior to this study; * History of allogeneic hematopoietic stem cell transplantation; * patients with any condition which the investigator or treating physician feels would interfere with the trial or the safety of the subject.
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:Incidence of Treatment-Emergent Adverse Events · Incidence of DLTs and occurrence of study related adverse events · 28 days
次要终点:Overall response rate;Overall Survival;Progression-free survival
受试者接受单次低剂量CD30 CAR-T治疗
受试者接受单次中剂量CD30 CAR-T治疗
受试者接受单次高剂量CD30 CAR-T治疗
这是一项前瞻性、开放标签、剂量爬坡的多中心临床研究,评估CD30 CAR-T治疗r/r CD30+淋巴瘤的有效性和安全性。计划入组15例r/r CD30+淋巴瘤受试者。
The is a prospective, open-label, dose-climbing multicenter clinical study assessing the efficacy and safety of CD30 CAR-T in the treatment of r/r CD30+ lymphoma. Plan to recruit 15 subjects with r/r CD30+ lymphoma。
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