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:Immunotherapy for Solid Tumor Malignancies in Pediatrics Using Interleukin-15 and -21 Armored Glypican-3-specific Chimeric Antigen Receptor T Cells
这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗实体瘤、肉瘤、软组织肉瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 21 例。试验地点:美国 · 西雅图(共 1 个中心)。登记号:NCT07148050。
不限性别 · ≥ 1 Year 且 ≤ 26 Years
1. 细胞采集资格 纳入标准: * 确诊GPC3表达阳性的实体瘤; * Lansky或Karnofsky评分≥60%; * 预期生存期>16周; * 患者/监护人已获知、理解并签署知情同意书。 仅针对肝细胞癌患者: * 巴塞罗那肝癌分期A、B或C期; * Child-Pugh-Turcotte评分<7。 排除标准: * 对含鼠源蛋白制品有超敏反应史;或既往接受鼠源抗体治疗者在入组前存在人抗鼠抗体(HAMA); * 有器官移植史; * 已知HIV阳性; * 活动性细菌、真菌或病毒感染(乙型或丙型肝炎病毒感染除外)。 2. 治疗资格 纳入标准: * Lansky或Karnofsky评分≥60%; * 预期生存期>16周; * 患者/监护人已获知、理解并签署知情同意书; * 器官功能充分; * 实验室检查指标符合要求; * 经一线治疗及至少一个挽救治疗周期后,疾病仍为难治或复发; * 入组前既往化疗和研究药物的急性毒性已恢复; * 有性生活的患者须愿意在T细胞输注后12个月内采用一种高效避孕方法; * 患者/监护人已获知、理解并签署知情同意书。 仅针对肝细胞癌患者: * 巴塞罗那肝癌分期A、B或C期; * Child-Pugh-Turcotte评分<7。 排除标准: * 对含鼠源蛋白制品有超敏反应史;或既往接受鼠源抗体治疗者在入组前存在HAMA; * 有器官移植史; * 已知HIV阳性; * 活动性自身免疫性疾病或炎症性疾病; * 入组前30天内接种活疫苗; * 活动性细菌、真菌或病毒感染(乙型或丙型肝炎病毒感染除外); * 妊娠期或哺乳期; * 未控制的感染; * 接受全身性类固醇治疗(泼尼松等效剂量≥0.5 mg/kg/日);调整剂量或停药须在CAR-T输注前至少24小时完成; * 充血性心力衰竭(NYHA心功能分级III或IV级)、不稳定型心绞痛、严重且未控制的心律失常、入组前6个月内心肌梗死或心肌炎病史。
1. Procurement Eligibility
Inclusion Criteria:
* Diagnosis of a solid tumor expressing GPC3
* Lansky or Karnofsky score of \>=60%
* Life expectancy of \>16 weeks
* Informed consent explained to, understood by and signed by patient/guardian.
For patients with hepatocellular carcinoma only:
* Barcelona Liver Cancer Stage A, B or C
* Child-Pugh Turcotte Score \<7
Exclusion Criteria:
* History of hypersensitivity reactions to murine protein-containing products OR presence of human anti-mouse antibody (HAMA) prior to enrollment for patients who have received prior therapy with murine antibodies.
* History of organ transplantation
* Known HIV positivity
* Active bacterial, fungal, or viral infection (except Hepatitis B or Hepatitis C virus infections)
2. Treatment eligibility
Inclusion Criteria:
* Lansky or Karnofsky score of \>=60%
* Life expectancy of \>16 weeks
* Informed consent explained to, understood by and signed by patient/guardian.
* Adequate organ function
* Adequate laboratory values
* Refractory or relapsed disease after treatment with up- front therapy and at least one salvage treatment cycle
* Recovered from acute toxic effects of all prior chemotherapy and investigational agents before entering this study
* Sexually active patients must be willing to utilize one of the more effective birth control methods for 12 months after the T-cell infusion.
* Informed consent explained to, understood by and signed by patient/guardian.
For patients with hepatocellular carcinoma only:
* Barcelona Liver Cancer Stage A, B or C
* Child-Pugh Turcotte Score \<7
Exclusion Criteria:
* History of hypersensitivity reactions to murine protein-containing products OR presence of human anti-mouse antibody (HAMA) prior to enrollment for patients who have received prior therapy with murine antibodies.
* History of organ transplantation
* Known HIV positivity
* Active autoimmune or inflammatory disorder
* Live vaccines within 30 days prior to enrollment
• Active bacterial, fungal, or viral infection (except Hepatitis B or Hepatitis C virus infections)
* Pregnancy or lactation
* Uncontrolled infection
* Systemic steroid treatment (≥ 0.5 mg prednisone equivalent/kg/day, dose adjustment or discontinuation of medication must occur at least 24hrs prior to CAR T cell infusion)
* Congestive heart failure (as defined by New York Heart Association Functional Classification III or IV), unstable angina, serious uncontrolled cardiac arrhythmia, a myocardial infarction within 6 months prior to study entry or a history of myocarditis.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:The number of successfully manufactured SC-CAR.GPC3xIL15.21 T cell products will be assessed · The number of successfully manufactured products will be measured · 28 days;Establish the safety, defined by adverse events of SC-CAR.GPC3xIL15.21 T cells. · Type, frequency, severity, and duration of adverse events will be tabulated and summarized · 28 days
次要终点:Estimate the maximum tolerated dose (MTD) or biologically effective dose and dose limiting toxicities (DLT), and describe the full toxicity profile of SC-CAR.GPC3xIL15.21 T cells.;To estimate anti-tumor responses by measuring changes in tumor burden using disease-specific evaluations following SC-CAR.GPC3xIL15.21 T cells.
单次输注自体SC-CAR.GPC3xIL15.21 T细胞产品。
这是一项I期、开放标签、非随机研究,纳入GPC3阳性的复发/难治性非中枢神经系统实体恶性肿瘤儿童及青年患者,评估SC-CAR.GPC3xIL15.21 T细胞的安全性、可行性和疗效。该产品由外周血单个核细胞制备,经基因改造后共同表达GPC3特异性嵌合抗原受体、白细胞介素-15(IL-15)、IL-21及诱导型半胱天冬酶9(iC9)自杀基因。符合全部入选条件且不符合任何排除条件的儿童或青年将采集血样,用于制备靶向其肿瘤的CAR-T细胞。
This Phase 1, open-label, non-randomized study will enroll pediatric and young adult subjects with relapsed or refractory non-central nervous system (CNS) malignant solid tumors expressing glypican-3 (GPC3) to examine the safety, feasibility, and efficacy of administering T cell products derived from peripheral blood mononuclear cells (PBMC) that have been genetically modified to co-express a GPC3-specific chimeric antigen receptor (CAR), interleukin (IL)-15 and IL-21 as well as the inducible caspase 9 (iC9) suicide gene (SC-CAR.GPC3xIL15.21 T cells). A child or young adult meeting all eligibility criteria and meeting none of the exclusion criteria will have a blood sample collected, which will be used to bioengineer the CAR T cells targeting their tumor.
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