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CEA-targeted CAR-T(CAR-T 细胞)治疗结直肠癌:I 期临床试验

英文原题:CEA CAR-T Therapy After Cytoreduction in Colorectal Cancer Patients With Peritoneal Metastases

ClinicalTrials.gov 2025/11/25(首次登记) I 期注册临床试验 · 招募中

简要介绍

这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗结直肠癌的安全性、可行性及初步疗效。当前状态:招募中。计划入组 12 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT07247396。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 75 Years

纳入标准:

1. 在签署知情同意书时年龄≥18岁且≤75岁。
2. 经病理学确诊的结直肠癌伴腹膜转移。
3. 标准治疗失败(疾病进展或不耐受,如奥沙利铂、伊立替康、氟尿嘧啶等治疗失败)或无可用的有效治疗方案的受试者。
4. 接受过结直肠癌腹膜转移的肿瘤细胞减灭术,肿瘤细胞减灭程度(CC)评分为CC-0至CC-2。术后恢复良好,无严重术后并发症。基线增强全腹部CT扫描(术后1个月内或术前1周内)显示腹膜外无远处转移(如肝、肺、骨、脑)。
5. 肿瘤细胞减灭术中切除的肿瘤样本经免疫组化确认为CEA阳性(明确的膜染色,阳性率≥10%)。
6. 无论同时性还是异时性腹膜转移,腹膜外无转移灶,且原发肿瘤已切除。
7. 预期生存时间至少3个月。
8. ECOG(美国东部肿瘤协作组)体能状态评分为0或1。
9. 除非另有说明,受试者必须具备以下足够的器官功能:

   1. 血液学:白细胞(WBC)计数≥3.5×10⁹/L,中性粒细胞计数≥1.8×10⁹/L,淋巴细胞计数>0.5×10⁹/L,血小板计数≥80×10⁹/L,血红蛋白≥90g/L。
   2. 心功能:超声心动图显示左心室射血分数(LVEF)>50%,心电图(ECG)无明显异常。
   3. 肾功能:血清肌酐≤2.0×ULN,血尿素氮(BUN)≤1.5×ULN。
   4. 肝功能:ALT和AST≤3.0×ULN;总胆红素≤2.0×ULN(Gilbert综合征≤3.0×ULN)。
   5. 不吸氧情况下血氧饱和度>92%。
10. 有生育能力的女性在入组前7天内妊娠试验阴性,近期无妊娠计划,并同意在试验前及试验期间采取避孕措施(或其他生育控制方法)。
11. 男性患者同意采取适当的避孕措施。
12. 能够遵守研究方案和随访程序。

排除标准:

1. 不愿意签署知情同意书。
2. 入组前2周内接受过或正在接受抗肿瘤药物治疗,但围手术期腹腔热灌注化疗除外。
3. 临床确诊的活动性或未控制的细菌、真菌或病毒感染。
4. 有其他未治愈的恶性肿瘤,但肺原位癌、宫颈原位癌或皮肤基底细胞癌除外。
5. 有严重哮喘、活动性自身免疫性疾病、免疫缺陷病史,或需要长期免疫抑制药物治疗;例外情况包括白癜风、1型糖尿病、需要激素治疗的自身免疫相关甲状腺功能减退症,以及不需要全身治疗的白癜风。
6. 有精神疾病史。
7. 有未控制的合并症,包括但不限于症状性充血性心力衰竭、不稳定型心绞痛、心律失常;严重冠状动脉疾病或脑血管疾病,或研究者认为不适合入组的其他疾病。
8. 乙型肝炎表面抗原(HBsAg)阳性或乙型肝炎核心抗体(HBcAb)阳性且HBV DNA滴度高于正常范围;丙型肝炎病毒(HCV)抗体阳性且HCV RNA高于正常范围;人类免疫缺陷病毒(HIV)抗体阳性;梅毒阳性。
9. 已知对研究产品的任何成分过敏,或研究者认为对免疫治疗存在其他潜在过敏反应。
10. 妊娠或哺乳期妇女。
11. 研究者判断患者存在可能影响随访和短期生存的其他严重疾病。
12. 研究者认为不适合入组的其他情况。
核对登记原文(英文)
Inclusion Criteria:

1. Aged ≥18 years and ≤75 years at the time of informed consent signing.
2. Pathologically confirmed colorectal cancer with peritoneal metastases.
3. Patients who have failed standard treatments (disease progression or intolerance, e.g., failure of oxaliplatin, irinotecan, fluorouracil, etc.) or have no effective treatment options.
4. Underwent cytoreductive surgery for peritoneal metastases from colorectal cancer, with cytoreduction completeness (CC) score of CC-0 to CC-2. Postoperative recovery is good, without severe postoperative complications. A baseline enhanced whole-abdominal CT scan (within 1 week before or after 1 month post-surgery) shows no distant metastases outside the peritoneum (e.g., liver, lung, bone, brain).
5. Tumor samples resected during cytoreductive surgery are confirmed CEA-positive by immunohistochemistry (distinct membranous staining, positive rate ≥10%).
6. Regardless of synchronous or metachronous peritoneal metastases, there are no metastatic sites outside the peritoneum, and the primary tumor has been resected.
7. Expected survival time of at least 3 months.
8. ECOG (Eastern Cooperative Oncology Group) performance status of 0 or 1.
9. Unless otherwise specified, subjects must have adequate organ function as follows:

   1. Hematology: White blood cell (WBC) count ≥3.5×10⁹/L, neutrophil count ≥1.8×10⁹/L, lymphocyte count \>0.5×10⁹/L, platelet count ≥80×10⁹/L, hemoglobin ≥90g/L.
   2. Cardiac function: Echocardiography shows left ventricular ejection fraction (LVEF) \>50%, and electrocardiogram (ECG) shows no significant abnormalities.
   3. Renal function: Serum creatinine ≤2.0×ULN, blood urea nitrogen (BUN) ≤1.5×ULN.
   4. Liver function: ALT and AST ≤3.0×ULN; total bilirubin ≤2.0×ULN (≤3.0×ULN for Gilbert's syndrome).
   5. Oxygen saturation \>92% without oxygen supplementation.
10. Women of childbearing potential have a negative pregnancy test within 7 days prior to enrollment, have no immediate plans for pregnancy, and agree to use contraceptive measures (or other fertility control methods) before and during the trial.
11. Male patients agree to use appropriate contraceptive methods.
12. Able to comply with the study protocol and follow-up procedures.

Exclusion Criteria:

1. Unwilling to sign the informed consent form.
2. Received or are currently receiving anti-tumor drug therapy within 2 weeks prior to enrollment, except for perioperative hyperthermic intraperitoneal chemotherapy.
3. Clinically confirmed active or uncontrolled bacterial, fungal, or viral infections.
4. Have other uncured malignant tumors, except for carcinoma in situ of the lung, carcinoma in situ of the cervix, or basal cell carcinoma of the skin.
5. Have a history of severe asthma, active autoimmune disease, immunodeficiency, or require long-term immunosuppressive drug therapy; exceptions include vitiligo, type 1 diabetes, autoimmune-related hypothyroidism requiring hormonal therapy, and psoriasis not requiring systemic treatment.
6. Have a history of mental illness.
7. Have uncontrolled comorbidities, including but not limited to symptomatic congestive heart failure, unstable angina, arrhythmia; severe coronary artery disease or cerebrovascular disease, or other diseases deemed ineligible by the investigator.
8. Positive for hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) with HBV DNA titer above the normal range; positive for hepatitis C virus (HCV) antibody with HCV RNA above the normal range; positive for human immunodeficiency virus (HIV) antibody; positive for syphilis.
9. Known hypersensitivity to any component of the study product, or other potential hypersensitivity to immunotherapy as deemed by the investigator.
10. Pregnant or lactating women.
11. The investigator judges that the patient has other serious diseases that may affect follow-up and short-term survival.
12. Other situations deemed ineligible 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。

研究终点衡量什么算有效

  • 主要终点评价CAR-T细胞制剂在细胞减灭术后治疗伴腹膜转移的晚期结直肠癌中的安全性[安全性和耐受性]从输注至第3个月
  • 主要终点获得CAR-T细胞在细胞减灭术后治疗伴腹膜转移的晚期结直肠癌中的推荐剂量[安全性和耐受性]从输注至第3个月
  • 次要终点CEA CAR-T治疗细胞减灭术后伴腹膜转移的晚期结直肠癌的腹膜无进展生存期(PPFS)[有效性]
  • 次要终点CEA CAR-T治疗细胞减灭术后伴腹膜转移的晚期结直肠癌的无进展生存期(PFS)[有效性]
  • 次要终点CEA CAR-T治疗细胞减灭术后伴腹膜转移的晚期结直肠癌的总生存期(OS)[有效性]
  • 次要终点CEA CAR-T治疗细胞减灭术后伴腹膜转移的晚期结直肠癌的疾病复发/转移率[有效性]
  • 次要终点评价CAR-T细胞制剂在细胞减灭术后治疗伴腹膜转移的晚期结直肠癌中的毒性[安全性]
  • 次要终点评价CAR-T细胞制剂在细胞减灭术后治疗伴腹膜转移的晚期结直肠癌中的长期生物安全性[药代动力学]
  • 次要终点评价CAR-T细胞制剂在细胞减灭术后治疗伴腹膜转移的晚期结直肠癌中的长期生物安全性[药代动力学]
  • 次要终点评价CAR-T细胞制剂在细胞减灭术后治疗伴腹膜转移的晚期结直肠癌中的长期生物安全性[安全性]
核对登记原文(英文)

主要终点:To evaluate the safety of CAR-T cell preparations in the treatment of advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Safety and Tolerability] · Incidence of adverse events during the study, evaluated per the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 and American Society for Transplantation and Cellular Therapy (ASTCT) criteria · From infusion through Month 3;Obtained the recommended dose of CAR-T cells for the treatment of advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Safety and Tolerability] · Dose-limiting toxicity after CEA CAR-T cell infusion · From infusion through Month 3
次要终点:Peritoneal Progression-Free Survival(PPFS) of CEA CAR-T treatment in advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Effectiveness];Progression-Free Survival(PFS) of CEA CAR-T treatment in advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Effectiveness];Overall survival(OS)of CEA CAR-T treatment in advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Effectiveness];Disease Recurrence/Metastasis Rate of CEA CAR-T treatment in advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Effectiveness];To evaluate the toxicity related to CAR-T cell preparations in the treatment of advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Safety];To evaluate the long-term biosafety of CAR-T cell preparations in the treatment of advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Pharmacokinetics];To evaluate the long-term biosafety of CAR-T cell preparations in the treatment of advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Pharmacokinetics];To evaluate the long-term biosafety of CAR-T cell preparations in the treatment of advanced colorectal cancer with peritoneal metastases following cytoreductive surgery [Safety]

研究设计怎么做的

研究类型
干预性研究
入组人数
12 人(预计)
分组方式
不适用(单臂)
  • 腹腔灌注靶向CEA的CAR-T试验组

    按1-5x10^5 cells/kg剂量输注靶向CEA的CAR-T细胞

核对分组登记原文(英文)
  • Intraperitoneal infusion of CEA-targeted CAR-T · EXPERIMENTAL · Infusion of CEA-targeted CAR-T cells by dose of 1-5x10\^5 cells/kg

关键日期

开始日期
2025-11-03
主要完成日期
2027-05-31
全部完成日期
2027-10-31
登记状态核实于
2025-10

联系与责任方

申办方
Second Affiliated Hospital, Zhejiang University, School of Medicine
合作方
Chongqing Precision Biotech Co., Ltd
联系邮箱
sunlifeng@zju.edu.cn
联系电话
0571-87783583

登记简述

这是一项单臂、开放标签、剂量递增试验,旨在评估CEA靶向CAR-T细胞在晚期结直肠癌伴腹膜转移患者接受肿瘤细胞减灭术后的安全性和有效性,并获得其药代动力学特征;随后将根据这些数据推导推荐剂量。

核对登记原文(英文)

This single-arm, open-label, dose-escalation trial aims to evaluate the safety and efficacy of CEA-targeted CAR-T cells and to obtain their pharmacokinetic profile in patients with advanced colorectal cancer and peritoneal metastases after cytoreductive surgery; the recommended dose will then be derived from these data.

登记原文与核验信息

试验登记号
NCT07247396
试验期别
I 期
试验状态
招募中
中国试验中心(1 个)
The Second Affiliated Hospital of Zhejiang University School of Medicine · 杭州 · 中国
适应症(原文)
Peritoneal Metastases From Colorectal Cancer
干预方式(原文)
CEA-targeted CAR-T cells