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:A Study of CTD402 in T-ALL/LBL Patients
这是一项 I/II 期注册临床试验,评估 CAR-T 细胞治疗白血病、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 118 例。试验地点:美国 · 帕洛阿尔托、丹佛、芝加哥、罗切斯特(共 9 个中心)。登记号:NCT07070219。
不限性别 · ≥ 1 Year
关键纳入标准: 1. 男性或女性,年龄≥1岁。 2. 体重≥40 kg。 3. A)复发/难治性或MRD阳性T-ALL/LBL,符合以下任一情形:既往接受≥2线全身治疗后复发/难治;首次复发发生于首次缓解后12个月内;异基因HSCT后复发且筛查前距移植至少100天。 B)MRD阳性T-ALL/LBL定义为有MRD证据:骨髓原始细胞<5%,但经NGS ClonoSEQ®和/或其他地区认可方法(如EuroMRD指南)检测到每1,000个细胞中至少1个癌细胞。 4. 形态学评估骨髓淋巴母细胞≥5%,或筛查时存在髓外病变。 5. 器官功能充分。 6. 筛查时ECOG评分≤2;或年龄≥16岁的参加者Karnofsky评分≥60,年龄<16岁的参加者Lansky评分≥60。 关键排除标准: 1. 合并与骨髓衰竭相关的遗传综合征或其他已知骨髓衰竭综合征。 2. 活动性中枢神经系统(CNS)受累。 3. 存在以下心脏疾病:纽约心脏协会(NYHA)III或IV级心力衰竭史;或入组前12个月内心肌梗死、心血管成形术/支架置入、不稳定型心绞痛或其他严重心脏病史。 4. 原发性免疫缺陷。 5. 存在未控制感染。 6. 已知HIV、HCV或梅毒感染史。 7. 活动性或潜伏性HBV感染。 8. 筛查时EBV或CMV DNA或IgM阳性。
Key Inclusion Criteria: 1. Male or female, ≥ 1 year of age. 2. Participants with body weight ≥ 40 kilogram. 3. A) Relapsed or refractory T-ALL/LBL or MRD positive defined as one of the following: * Relapsed or refractory disease after two or more lines of systemic therapy; * The first relapse occurs within 12 months after first remission; * Relapse after allogeneic HSCT and must be ≥100 days from HSCT prior to screening period. B) Minimal Residual Disease (MRD) positive T-ALL/LBL is defined as evidence of MRD, defined as \< 5% blasts in bone marrow but ≥ 1 cancer cell in 1,000 cells determined by NGS ClonoSEQ® and/or other regionally acceptable methodologies (e.g., EuroMRD guidelines). 4. The presence of bone marrow lymphoblasts is ≥ 5% as determined by morphologic evaluation or evidence of extramedullary disease at screening. 5. Adequate organ function 6. ECOG of 2 or less or Karnofsky PS ≥ 60 (for participants age ≥ 16) or Lansky PS ≥ 60 (for participants \< 16) at screening. Key Exclusion Criteria: 1. Participants with concomitant genetic syndromes associated with bone marrow failure states or any other known bone marrow failure syndrome. 2. Active central nervous system (CNS) involvement 3. Participants with following cardiac conditions will be excluded: 1. History of heart failure New York Heart Association (NYHA) class III or IV; 2. History of myocardial infarction, cardiovascular angioplasty or stenting, unstable angina, or other serious heart diseases within 12 months of enrollment. 4. Primary immune deficiency. 5. Presence of uncontrolled infections. 6. Known history of infection with the human immunodeficiency virus (HIV); hepatitis C virus and syphilis. 7. Active or latent hepatitis B virus infection 8. Epstein-Barr virus (EBV), Cytomegalovirus (CMV) DNA or IgM positive at screening.
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 Profile · Incidence of dose limiting toxicities including incidence of adverse events and graft vs host disease · 24 months;Response Evaluation · Percentage of participants who achieve overall complete remission (OCR) assess by an independent review committee · 24 months
次要终点:Characterize the cPK profile of CTD402
TENACITY-01临床试验旨在了解CTD402 UCART治疗复发/难治性T细胞急性淋巴细胞白血病/淋巴母细胞淋巴瘤(T-ALL/LBL)的安全性和疗效。 年龄>1岁的复发/难治性T-ALL/LBL患者可参加研究。 参加者将在第0天接受一次CTD402输注。独立审查委员会将根据T-ALL的NCCN标准和T-LBL的Lugano 2014标准评估抗肿瘤活性。 受试者将在本研究中随访最长24个月,并须另行参加长期随访方案,随访最长15年。
The goal of the TENACITY-01 clinical trial is to learn if CTD402 UCART is safe and effective for relapsed/refractory T-ALL/LBL patients. Participants with relapsed/refractory T-ALL/LBL over the age of 1 year will be eligible to participate. Participants will receive one infusion of CTD402 on Day 0 and will be evaluated for anti-tumor activity by an independent review committee based on the NCCN criteria for T-ALL and the Lugano 2014 criteria for T-LBL. Patients will be followed for up to 24 months in this study and will be required to enroll under a separate long term follow up protocol to be followed for up to 15 years.
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