CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Clinical Study of LILRA6 CAR-T for the Treatment of R/R Acute Myeloid Leukemia
Clinical Study of LILRA6 CAR-T for the Treatment of R/R Acute Myeloid Leukemia
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这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗急性髓系白血病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 48 例。试验地点:中国 · 杭州(共 1 个中心,其中中国 1 个)。登记号:NCT07263906。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 自愿参加研究并签署知情同意书。 2. 年龄18–75岁,性别不限。 3. 复发/难治性AML,符合以下任一情况:难治性疾病包括新诊断患者接受2个标准治疗疗程后未达完全缓解;CR后巩固/强化治疗结束12个月内复发;超过12个月复发且挽救化疗无效;复发≥2次;持续髓外白血病。复发还包括AML完全缓解后外周血再次出现白血病细胞;骨髓原始细胞≥5%(不包括巩固化疗后骨髓再生等其他原因);或白血病细胞浸润骨髓以外部位(中枢神经系统除外)。 4. 预期生存期≥12周。 5. 骨髓/肿瘤细胞LILRA6表达阳性率≥20%。 6. ECOG体能状态0–2分。 7. 器官功能储备充分:ALT/AST≤ULN的2.5倍;按Cockcroft-Gault公式计算肌酐清除率≥45 mL/min;总胆红素≤ULN的1.5倍;LVEF≥45%;室内空气下基线血氧>92%;ANC≥0.5×10⁹/L、血小板≥30×10⁹/L、血红蛋白≥7.0 g/dL。 8. 允许既往接受过一次自体造血干细胞移植。 9. 有生育能力女性妊娠试验阴性,并同意在研究期间有效避孕。 10. 无未控制活动性感染(包括肺部感染);既往抗肿瘤治疗后全身化疗/放疗/免疫治疗至少间隔3周,靶向药至少间隔2周。 11. 无活动性新冠病毒或流感感染。 排除标准: 1. 对细胞制剂任何成分或预处理化疗药有严重过敏史。 2. 有其他活动性恶性肿瘤。 3. 有需治疗的活动性感染(单纯尿路感染和细菌性咽炎除外);允许预防性使用抗生素、抗病毒药及抗真菌药。 4. 活动性乙肝(HBsAg阳性且HBV DNA≥10³ copies/mL)、丙肝、梅毒或其他获得性/先天性免疫缺陷(包括HIV)。 5. 按NYHA标准心功能Ⅲ/Ⅳ级。 6. 既往抗肿瘤治疗相关毒性尚未恢复至CTCAE 5.0版≤1级;疲劳、食欲减退和脱发除外。 7. 有可能影响研究评估的癫痫或其他中枢神经系统疾病史。 8. 既往接受任何其他LILRA6靶向药物治疗。 9. 哺乳期女性且不愿停止哺乳。 10. 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. Voluntarily participate in this study and sign the informed consent form. 2. Age range: 18 - 75 years old. Gender is not restricted. 3. Refractory/Recurrent AML: Meeting any one of the following criteria for refractory or recurrent cases is sufficient. 1) Refractory: (1) In the case of a newly diagnosed patient, treatment with the standard regimen for two courses fails to achieve complete remission (CR); (2) Recurrence within 12 months after consolidation and intensification therapy following CR; (3) Recurrence after 12 months with no response to salvage chemotherapy; (4) ≥ 2 recurrences; (5) Persistent extramedullary leukemia; 2) Recurrence: (1) Leukemia cells reappear in the peripheral blood after complete remission (CR) of AML; (2) The percentage of blasts in the bone marrow is ≥ 5% (excluding other reasons such as bone marrow regeneration after consolidation chemotherapy); (3) Infiltration of leukemia cells in sites other than the bone marrow (excluding the central nervous system). 4. Expected survival period ≥ 12 weeks. 5. The positive rate of LILRA6 expression in bone marrow/tumor cells is ≥ 20% 6. ECOG score ranging from 0 to 2 points. 7. Sufficient organ function reserve: Alanine aminotransferase and Aspartate aminotransferase ≤ 2.5× UNL (upper limit of normal value); Creatinine clearance rate (Cockcroft-Gault method) ≥ 45 mL/min; Serum total bilirubin ≤ 1.5× UNL; Ejection fraction of the heart (EF) ≥ 45%; In an indoor natural air environment, baseline oxygen saturation \> 92%; Blood routine: All of the following criteria are met: Absolute number of neutrophils ≥ 0.5×10\^9 /L, Platelet count ≥ 30×10\^9 /L, Hemoglobin ≥ 7.0 g/dl. 8. Allow those who have previously undergone a single autologous hematopoietic stem cell transplantationAllowing previous recipients of a single autologous hematopoietic stem cell transplantation. 9. Pregnancy tests for the female subjects of childbearing age must be negative, and they must also agree to take effective contraceptive measures during the trial. 10. There are no uncontrollable infectious activities (including lung infections). 11. Distance from the last anti-tumor treatment: Systemic chemotherapy / systemic radiotherapy / immunotherapy ≥ 3 weeks, targeted drug elution period ≥ 2 weeks. 12. No active infection of the novel coronavirus or influenza. Exclusion Criteria: 1. Those who have a severe history of allergic reaction to any component of the cell preparation or the pre-treatment chemotherapy drugs. 2. Those with a history of other active malignant tumors. 3. There are active infections that require treatment (excluding simple urinary tract infections and bacterial pharyngitis); the use of prophylactic antibiotics, antiviral drugs, and antifungal drugs is permitted. 4. Active hepatitis B (with HBsAg positive and HBV-DNA ≥ 10³ copies/mL), hepatitis C infection, syphilis, or other acquired/innate immune deficiency disorders (including HIV infection). 5. According to the New York Heart Association (NYHA) classification of cardiac function, those with cardiac function at grade III or IV. 6. Previous anti-tumor treatment-related toxic reactions have not yet recovered to a grade ≤ 1 (according to CTCAE 5.0), except for fatigue, anorexia and hair loss. 7. Those with a history of epilepsy or other central nervous system diseases that may affect the research assessment. 8: Those who have received any other targeted LILRA6 drug treatment before. 9.Breastfeeding women who do not wish to stop breastfeeding. 10.The researchers believe that there may be any other circumstances that could increase the risks for the subjects or interfere with the test 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:Incidence of dose limiting toxicity (DLTs) · To evaluate the safety, tolerability, and determine the recommended dosage of peripheral blood-derived Anti-LILRA6 CAR-T Cell Therapy for refractory/relapsed peripheral T-cell lymphoma. · Up to 28 days
次要终点:Complete response rate (CR)
以上邮箱 / 电话是登记库里的申办方联系方式(中国内地手机),通常不直达某家医院。中国中心的联系方式请以医院或登记平台最新公示为准。
本研究旨在评估LILRA6靶向CAR-T 细胞(LILRA6 CAR-T)治疗复发/难治性急性髓系白血病(AML)患者的安全性和疗效。
This study aims to evaluate the safety and efficacy of LILRA6-directed chimeric antigen receptor T cells (LILRA6 CAR-T cells) in patients with refractory or relapsed acute myeloid leukemia(AML).
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