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:PA3-17 Injection in Adult Patients With CD7-positive Relapsed/Refractory T-lymphoblastic Leukemia/Lymphoma
这是一项 II 期注册临床试验,评估 T 细胞治疗淋巴瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 100 例。试验地点:中国 · 合肥、北京、广州、哈尔滨(共 16 个中心,其中中国 16 个)。登记号:NCT07188610。
不限性别 · ≥ 18 Years
纳入标准: 1. 年龄≥18岁,性别不限; 2. 预期生存期≥3个月; 3. ECOG评分0–1分; 4. 按WHO第五版《造血和淋巴肿瘤分类》确诊急性T细胞淋巴细胞白血病/淋巴瘤(T-ALL/LBL),包括早期T细胞前体(ETP); 5. 复发/难治性T-ALL/LBL(包括ETP-ALL/LBL); 6. 筛查时异常细胞CD7表达阳性; 7. 仅存在髓外病灶的受试者须有可评估病灶; 8. 肝、肾、心、肺功能符合要求; 9. 无严重精神障碍; 10. 能够理解试验内容并签署知情同意书。 排除标准: 1. 已知活动性或未控制的自身免疫性疾病; 2. 存在GVHD; 3. 过去5年内有T-ALL/LBL以外恶性肿瘤史,但充分治疗的宫颈上皮内瘤变、皮肤基底细胞癌/鳞状细胞癌、局部治疗的前列腺癌及根治术后的乳腺导管原位癌除外; 4. 乙肝、丙肝、梅毒等检测阳性; 5. 严重心脏病; 6. 研究者判断存在不稳定的全身性疾病; 7. 有活动性或未控制感染,且需要全身治疗; 8. 妊娠或哺乳期女性;女性受试者计划在细胞输注后2年内妊娠,或男性受试者的伴侣计划在细胞输注后2年内妊娠; 9. 筛查前接受过CAR-T或其他基因修饰细胞治疗; 10. 筛查前1个月内参加其他临床研究(自末次使用未获批研究药物之日起计算); 11. 筛查时有中枢神经系统受累证据; 12. 研究者判断不适合细胞制备的情况; 13. 研究者认为不适合入组的其他情况。
Inclusion Criteria: 1. Age and Gender: ≥18 years old (inclusive), regardless of gender. 2. Survival Expectancy: ≥3 months. 3. Performance Status: ECOG score 0-1. 4. Diagnosis: Confirmed acute T-cell lymphoblastic leukemia/lymphoma (T-ALL/LBL) according to the WHO fifth edition of the "Classification of Hematopoietic and Lymphoid Tumors," including early T-cell precursor (ETP). 5. Recurrent or Refractory Disease: Subjects with recurrent/refractory T-ALL/LBL (including ETP-ALL/LBL). 6. Screening: Abnormal cells CD7 expression positive. 7. Lesion Assessment: If the subject has only extramedullary lesions, they must have evaluable lesions. 8. Meet the requirements of liver, kidney, heart, and lung functions. 9. No Severe Mental Disorders. 10. Informed Consent: Ability to understand the trial and signed informed consent form. Exclusion Criteria: 1. Known to have active or uncontrolled autoimmune diseases; 2. Presence of GvHD; 3. History of malignant tumors other than T-ALL/LBL within the past 5 years, except for adequately treated cervical intraepithelial neoplasia, basal cell or squamous cell skin cancer, locally treated prostate cancer, and ductal carcinoma in situ of the breast after radical surgery; 4. Positive test results for hepatitis B, hepatitis C, syphilis, etc.; 5. Severe heart disease; 6. Unstable systemic diseases as judged by the investigator; 7. Presence of active infection or uncontrollable infection requiring systemic treatment; 8. Pregnant or breastfeeding women, and female subjects planning to conceive within 2 years after cell infusion, or male subjects whose partners plan to conceive within 2 years after cell infusion; 9. Subjects who have received CAR-T therapy or other gene-modified cell therapy before screening; 10. Participation in other clinical studies within 1 month before screening (end date of the last application of unapproved innovative drugs); 11. Evidence of central nervous system involvement at the time of subject screening; 12. Situations judged by the investigator as not suitable for cell preparation; 13. Other circumstances deemed unsuitable for enrollment by the investigator.
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:Efficacy · Three-month Objective Response Rate (ORR): Proportion of Composite Complete Response Rate (CRc: CR, CRh, CRi, MLFS) and PR · Three months
这是一项单臂、开放标签、多中心研究。受试者签署知情同意书后,符合条件者进行一次有核细胞采集以制备CAR-T细胞。淋巴细胞清除预处理后,单次输注PA3-17。输注前后采集血样,进行药代动力学、药效学、免疫原性及安全性评估。治疗期在基线后于4周、2个月、3个月及此后每3个月进行疗效评估,直至细胞输注后24个月。持续评估肿瘤,直至疾病进展、新抗肿瘤治疗开始、死亡、不可接受的毒性、研究者决定或受试者自愿退出,以先发生者为准。
\*\*Translation:\*\* This clinical trial is designed as a single-arm, open-label, multicenter study. After signing the informed consent form, eligible subjects will undergo a single nucleated cell collection for the preparation of CAR-T cells. Following lymphodepletion pretreatment, a single infusion of PA3-17 injection will be administered. Blood samples will be collected from the subjects before and after the infusion for pharmacokinetic, pharmacodynamic, immunogenicity, and safety evaluations. In addition to the baseline period, the treatment phase will involve efficacy assessments at 4 weeks, 2 months, 3 months, and every 3 months thereafter, up to 24 months post-cell infusion. Tumor assessments will continue until disease progression (PD), initiation of new antitumor treatment, death, unacceptable toxicity, investigator decision, or subject's voluntary withdrawal, whichever occurs first.
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