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CD7 自体造血干细胞治疗淋巴瘤:I/II 期临床试验(Zhengzhou)

英文原题:CD7 CAR-T Combined With Autologous Hematopoietic Stem Cell Transplantation

ClinicalTrials.gov 2025/08/12(首次登记) I/II 期注册临床试验 · 尚未开始招募

⚠ 该试验的登记信息已有 14 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。

简要介绍

这是一项 I/II 期注册临床试验,评估自体造血干细胞治疗淋巴瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 38 例。试验地点:中国 · 郑州(共 1 个中心,其中中国 1 个)。登记号:NCT07117305。

入组条件决定能不能参加

不限性别 · ≥ 14 Years 且 ≤ 65 Years

纳入标准:

1. 患者知情同意并签署知情同意书后,愿意且能够遵守计划的访视、研究治疗、实验室检查及其他试验程序;
2. 年龄范围:14至65岁。男女均可;
3. 根据世界卫生组织造血和淋巴组织肿瘤分类(2022年)诊断的所有类型的CD7+ T细胞非霍奇金淋巴瘤(T淋巴母细胞淋巴瘤除外);
4. 对于一线化疗方案难治,或至少经过二线化疗方案后复发耐药的T细胞淋巴瘤患者。需满足以下标准:a. 对于既往仅接受过一线治疗的患者,若至少4个周期的一线方案未达到PR,或至少6个周期的一线方案未达到CR;b. 完全缓解后早期(< 12个月)复发者;或晚期(≥ 12个月)复发且经过一个疗程标准诱导化疗未缓解者;c. 经过二线或以上化疗方案治疗未缓解者;
5. 入组筛选过程中,受试者经病理组织学和/或细胞学确诊为CD7+(CD7表达≥ 10%);
6. 具有可测量或可评估的病灶:靶病灶定义为淋巴结内长径≥15mm的病灶,或结外病灶大于10mm(依据Lugano 2014标准);既往接受过放疗的病灶,仅当完成放疗后出现明确进展时才视为可测量;或根据Lugano标准判定的PET阳性病灶;
7. 美国东部肿瘤协作组(ECOG)体能状态评分为0至2分,且预计生存期大于3个月;
8. 具有适当的器官功能:a. 丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)水平应≤正常值上限(ULN)的3倍。若ALT和AST异常被判定为疾病所致(如肝脏浸润或胆管梗阻),阈值可放宽至≤5倍ULN;b. 血清总胆红素≤2倍ULN,但Gilbert综合征患者除外;Gilbert综合征患者总胆红素≤3倍ULN且直接胆红素≤1.5倍ULN可入选;c. 血清肌酐≤正常值上限的1.5倍,或肌酐清除率≥60 mL/min;d. 国际标准化比值(INR)不超过正常值上限(ULN)的1.5倍,活化部分凝血活酶时间(aPTT)不超过ULN的1.5倍;e. 具有最低水平的肺储备,定义为≤1级呼吸困难(CTCAE v5.0)且在不吸氧情况下血氧饱和度≥92%;f. 超声心动图左心室射血分数≥50%;无临床显著异常心电图发现;无临床显著心包积液或胸腔积液。
9. 有生育能力的女性参与者必须在输注前7天内进行血/尿妊娠试验且结果为阴性。所有有生殖能力的性活跃男性和女性必须同意在整个研究期间以及研究性治疗给药后至少2年内使用高效避孕措施。

排除标准:

1. 严重心功能不全,左心室射血分数(LVEF)<50%;
2. 有严重肺功能损害记录;
3. 有器官移植史或活动性移植物抗宿主病(GVHD);
4. 合并其他进展性恶性肿瘤;
5. 未控制的严重感染;
6. 严重自身免疫性疾病或原发性免疫缺陷病;
7. 以下任何一项阳性:乙型肝炎表面抗原(HBsAg)和/或乙型肝炎e抗原(HBeAg);乙型肝炎e抗体(HBe-Ab)和/或乙型肝炎核心抗体(HBc-Ab)且HBV-DNA水平高于正常值上限(ULN);丙型肝炎病毒抗体(HCV-Ab)且HCV RNA可检测到;人类免疫缺陷病毒抗体(HIV-Ab);梅毒螺旋体抗体(TP-Ab);巨细胞病毒(CMV)DNA高于ULN;EB病毒(EBV)DNA高于ULN;
8. 对生物制品(包括抗生素)有严重过敏史;
9. 既往存在中枢神经系统疾病,包括但不限于:

   未控制的癫痫;脑缺血/出血;痴呆;小脑疾病;
10. 既往接受过自体或异基因造血干细胞移植;
11. 任何其他可能增加研究参与风险、干扰研究结果解读、被研究者认为使患者不适合参与研究的严重躯体或精神疾病或显著实验室异常;
12. 筛选时存在因肿瘤肿块阻塞或压迫而需要立即干预的淋巴瘤相关临床急症(如肠梗阻、血管压迫等)。
核对登记原文(英文)
Inclusion Criteria:

1. With the patient's explicit consent and after signing the informed consent form, the patient is willing and capable of complying with the planned visits, research treatments, laboratory tests and other trial procedures;
2. Age range: 14 to 65 years old. Both men and women are eligible;
3. All types of CD7+ T-cell non-Hodgkin's lymphomas (except T-lymphoblastic lymphoma) diagnosed according to the World Health Organization's classification of hematopoietic and lymphoid tissue tumors (2022);
4. For patients with T-cell lymphoma who are refractory to the first-line chemotherapy regimen or who experience recurrence and resistance after at least the second-line chemotherapy regimen. The following criteria must be met: a. For those patients who had only received first-line treatment previously, if they did not achieve PR after at least 4 cycles of the first-line regimen, or if they did not achieve CR after at least 6 cycles of the first-line regimen; b. Those who experienced recurrence in the early stage (\< 12 months) after complete remission; or those who experienced recurrence in the late stage (≥ 12 months) and did not achieve remission after one course of standard induction chemotherapy; c. Those who have not achieved remission after treatment with second-line or more chemotherapy regimens;
5. During the enrollment screening process, the subjects were confirmed to have CD7+ (with CD7 expression ≥ 10%) through pathological histology and/or cytology;
6. Having measurable or evaluable lesions: The target lesion is defined as a lesion within lymph nodes with a long diameter of ≥ 15mm, or an extranodal lesion larger than 10mm (in accordance with the Lugano 2014 criteria); Lesions that have received prior radiotherapy are considered measurable only if there is a clear progression after completing radiotherapy; or PET-positive lesions determined according to the Lugano criteria;
7. The Eastern Cooperative Oncology Group (ECOG) performance status score is 0 to 2, and the estimated survival period is greater than 3 months;
8. Having appropriate organ functions: a. The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) should be ≤ 3 times the upper limit of normal (ULN). If the abnormality of ALT and AST is judged to be caused by the disease (such as liver infiltration or bile duct obstruction), the thresholds can be relaxed to ≤ 5 times ULN; b. Total serum bilirubin ≤ 2 times ULN, except in cases where Gilbert syndrome is present; patients with Gilbert syndrome whose total bilirubin is ≤ 3 times ULN and direct bilirubin is ≤ 1.5 times ULN can be included; c. Serum creatinine ≤ 1.5 times the upper limit of normal, or creatinine clearance rate ≥ 60 mL/min; d. The international normalized ratio (INR) is no more than 1.5 times the upper limit of normal (ULN), and the activated partial thromboplastin time (aPTT) is no more than 1.5 times the ULN; e. Having the lowest level of lung reserve, defined as ≤ grade 1 dyspnea (CTCAE v5.0) and a blood oxygen saturation of ≥ 92% in the absence of oxygen supplementation; f. Left ventricular ejection fraction in echocardiography is ≥ 50%; no clinically significant abnormal electrocardiogram findings; no clinically significant pericardial effusion or pleural effusion.
9. Female participants of childbearing potential must have negative blood/urine pregnancy tests within 7 days prior to infusion. All sexually active males and females with reproductive capacity must agree to use highly effective contraception throughout the study and for at least 2 years after administration of the investigational treatment.

Exclusion Criteria:

1. Severe cardiac insufficiency with left ventricular ejection fraction (LVEF) \<50%;
2. Documented history of severe pulmonary impairment;
3. History of organ transplantation or active graft-versus-host disease (GVHD);
4. Concurrent other progressive malignancies;
5. Uncontrolled severe infections;
6. Severe autoimmune diseases or primary immunodeficiency disorders;
7. Positive for any of the following: Hepatitis B surface antigen (HBsAg) and/or hepatitis B e antigen (HBeAg); Hepatitis B e antibody (HBe-Ab) and/or hepatitis B core antibody (HBc-Ab) with HBV-DNA levels above the upper limit of normal (ULN); Hepatitis C virus antibody (HCV-Ab) with detectable HCV RNA; Human immunodeficiency virus antibody (HIV-Ab); Treponema pallidum antibody (TP-Ab); Cytomegalovirus (CMV) DNA above ULN; Epstein-Barr virus (EBV) DNA above ULN;
8. History of severe hypersensitivity to biological products (including antibiotics);
9. Pre-existing central nervous system disorders, including but not limited to:

   Uncontrolled epilepsy;Cerebral ischemia/hemorrhage;Dementia;Cerebellar disorders;
10. Previous recipients of autologous or allogeneic hematopoietic stem cell transplantation;
11. Any other severe physical or psychiatric conditions or significant laboratory abnormalities that may: Increase study participation risks;Interfere with study results interpretation; Be deemed by investigators to render the patient unsuitable for study participation;
12. Presence of lymphoma-related clinical emergencies requiring immediate intervention at screening due to tumor mass obstruction or compression (e.g., intestinal obstruction, vascular compression, etc.).

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。

研究终点衡量什么算有效

  • 主要终点CD7 CAR-T细胞注射液联合自体造血干细胞移植的安全性治疗后第28天
  • 次要终点疗效指标
  • 次要终点疗效指标
  • 次要终点疗效指标
  • 次要终点疗效指标
  • 次要终点疗效指标
  • 次要终点疗效指标
  • 次要终点CAR-T细胞动力学
核对登记原文(英文)

主要终点:The safety of CD7 CAR-T cell injection combined with autologous hematopoietic stem cell transplantation · The possible adverse reactions recorded in each item were evaluated. · Day 28 after treatment
次要终点:Efficacy indicators;Efficacy indicators;Efficacy indicators;Efficacy indicators;Efficacy indicators;Efficacy indicators;kinetics of CAR-T cells

研究设计怎么做的

研究类型
干预性研究
入组人数
38 人(预计)
分组方式
不适用(单臂)
  • CD7+ T细胞淋巴瘤试验组
核对分组登记原文(英文)
  • CD7+ T cell lymphoma · EXPERIMENTAL

关键日期

开始日期
2025-09-01
主要完成日期
2027-09-30
全部完成日期
2027-12-01
登记状态核实于
2025-08

联系与责任方

主要研究者
Mingzhi Zhang
申办方
Zhengzhou University
合作方
Hebei Taihe Chunyu Biotechnology Co., Ltd
联系邮箱
fcczhangxd@zzu.edu.cn
联系电话
86-0371-66279567

登记简述

这是一项由研究者发起的单臂、开放标签、I/II期临床试验,旨在评估靶向CD7的嵌合抗原受体T细胞(CD7 CAR-T)联合自体干细胞移植(ASCT)治疗复发或难治性CD7阳性T细胞淋巴瘤患者的安全性、耐受性和初步疗效。I期采用标准3+3剂量递增设计,确定最大耐受剂量(MTD)和推荐II期剂量(RP2D)。II期在RP2D剂量下扩展,进一步评估疗效。研究包括淋巴细胞清除化疗、ASCT和序贯输注CD7 CAR-T细胞。主要目的包括:(1)评估CD7 CAR-T + auto-HSCT在复发或难治性CD7阳性T细胞淋巴瘤中的安全性/耐受性。(2)确定MTD和RP2D。次要目的包括:(1)评估疗效(总缓解率、完全缓解、缓解持续时间、无进展生存期和总生存期)。(2)表征PK/PD特征。(3)探究抗肿瘤机制。

核对登记原文(英文)

This is a single-arm, open-label, phase I/II clinical trial initiated by investigators to evaluate the safety, tolerability, and preliminary efficacy of CD7-targeted chimeric antigen receptor T cells (CD7 CAR-T) combined with autologous stem cell transplantation (ASCT) in patients with relapsed or refractory CD7-positive T-cell lymphomas. Phase I adopts a standard 3+3 dose-escalation design to determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D). Phase II expands at the RP2D to further assess efficacy. The study includes lymphodepletion chemotherapy, ASCT, and sequential infusion of CD7 CAR-T cells. The primary objectives include: (1) Evaluate safety/tolerability of CD7 CAR-T + auto-HSCT in relapsed or refractory CD7-positive T-cell lymphomas. (2) Determine MTD and RP2D. The secondary objectives include: (1) Assess efficacy (overall response rate, complete response, duration of response, progression-free survival and overall survival. (2)Characterize PK/PD profiles. (3)Investigate anti-tumor mechanisms.

登记原文与核验信息

试验登记号
NCT07117305
试验期别
I 期 / II 期
试验状态
尚未开始招募
中国试验中心(1 个)
The First Affiliated Hospital of Zhengzhou University, Department of Oncology · 郑州 · 中国
适应症(原文)
CD7+ Lymphoma; T Cell Lymphoma
干预方式(原文)
CD7 CAR-T combined with autologous hematopoietic stem cell transplantation