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 Multicenter Study of CAR-T Cells in Primary Ph+All
A Multicenter Study of CAR-T Cells in Primary Ph+All
这是一项 II 期注册临床试验,评估 CD19CAR-T 细胞治疗急性淋巴细胞白血病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 50 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT07252336。
不限性别 · ≥ 18 Years
纳入标准:年龄≥18岁,性别不限;按WHO 2016急性白血病分类确诊B细胞急性淋巴细胞白血病(B-ALL);免疫表型显示异常B细胞CD19及CD22阳性;染色体及相应遗传学检测证实费城染色体(Ph)阳性和BCR/ABL1融合基因阳性;新诊断B-ALL,尚未接受标准化疗方案;血清总胆红素≤51 μmol/L,血清ALT和AST均≤正常值上限3倍,血清肌酐≤176.8 μmol/L;超声心动图左心室射血分数≥50%;无活动性肺部感染且不吸氧时血氧饱和度≥92%;预计生存期≥3个月;ECOG 0-2分;有生育能力的女性和男性同意入组前、研究期间及输注后6个月采取适当避孕措施;自愿参加并签署知情同意书。排除标准:癫痫或其他中枢神经系统疾病史;QT间期延长史或严重心脏病;妊娠或哺乳(治疗对胎儿的安全性未知);未经治疗的活动性感染;慢性HBV感染血清学证据且不能或不愿接受标准预防性抗病毒治疗,或可检出HBV病毒载量;有HCV感染血清学证据但未完成治愈性治疗,或可检出HCV病毒载量;HIV抗体阳性;梅毒抗体阳性;既往接受任何基因治疗产品;研究者判断不适合入组的其他未控制疾病;研究者认为可能增加受试者风险或干扰结果的其他情况。
Inclusion Criteria: 1. Age ≥ 18 years old, gender not restricted; 2. Subjects diagnosed with B-cell acute lymphoblastic leukemia (B-ALL) in accordance with the 2016 WHO Classification of Acute Leukemias; 3. Abnormal B cells positive for CD19 and CD22 by immunophenotyping; 4. Subjects positive for Philadelphia chromosome (Ph chromosome) and BCR/ABL1 fusion gene by chromosomal and corresponding genetic testing; 5. Newly diagnosed B-ALL patients who have not received treatment with standard chemotherapy regimens; 6. Serum total bilirubin ≤ 51 μmol/L, serum ALT and AST both ≤ 3 times the upper limit of the normal reference range, and serum creatinine ≤ 176.8 μmol/L; 7. Left ventricular ejection fraction (LVEF) ≥ 50% as assessed by echocardiography; 8. Subjects with no active pulmonary infection and oxygen saturation ≥ 92% without oxygen supplementation; 9. Estimated survival time ≥ 3 months; 10. ECOG performance status score 0-2; 11. Females and males of childbearing potential must agree to use appropriate contraceptive measures before enrollment, during study participation, and within 6 months after infusion; 12. Subjects voluntarily participate in this study and sign the informed consent form. Exclusion Criteria: * Subjects meeting any of the following exclusion criteria are ineligible for enrollment in this study: 1. Subjects with a history of epilepsy or other central nervous system diseases; 2. Subjects with a prior history of QT interval prolongation or severe cardiac diseases; 3. Pregnant or lactating women (the safety of this therapy for unborn children is unknown); 4. Subjects with untreated active infections; 5. Subjects with serological evidence of chronic hepatitis B virus (HBV) infection who are unable or unwilling to receive standard prophylactic antiviral treatment, or have a detectable HBV viral DNA load; subjects with serological evidence of hepatitis C virus (HCV) infection who have not completed curative treatment or have a detectable HCV viral load; 6. Human immunodeficiency virus (HIV) antibody positive; 7. Syphilis antibody positive; 8. Subjects who have previously received any gene therapy products; 9. Subjects with other uncontrolled diseases who, in the investigator's judgment, are unsuitable for enrollment; 10. Any other conditions that, in the investigator's judgment, may increase the risk to the subject or interfere with the study results.
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:Complete Molecular Response Rate after CD19 CAR-T Cell Therapy · Laboratory tests · 28 days after infusion
次要终点:Leukemia-Free Survival;Overall survival;Cumulative Incidence of Relapse;Complete Molecular Response Rate after CD22 CAR-T Cell Therapy
CD19 CAR-T,2×10^6个CAR阳性T细胞/kg。
多中心研究评估CD19 CAR-T细胞治疗成人原发性费城染色体阳性急性淋巴细胞白血病患者的疗效和安全性。
A Multicenter Study of CD19 CAR-T Cells in the Treatment of Adult Patients With Primary Ph Chromosome Positive Acute Lymphoblastic Leukemia
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