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Memory-Like NK(NK 细胞)治疗恶性肿瘤:I/II 期临床试验

英文原题:Exploratory Clinical Study on Memory NK Cell Therapy for Advanced Metastatic Solid Tumors

ClinicalTrials.gov 2025/12/10(首次登记) I/II 期注册临床试验 · 进行中(不再招募)

简要介绍

这是一项 I/II 期注册临床试验,评估 NK 细胞治疗恶性肿瘤的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 6 例。试验地点:中国 · 南京(共 1 个中心,其中中国 1 个)。登记号:NCT07274449。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 75 Years

纳入标准:能够理解知情同意、自愿参加并签署知情同意书;签署时年龄18–75岁;ECOG 0–3(多数时间可卧床,但仍能完成最低限度日常自理);预计生存期≥8周。结直肠癌、胃癌、肺癌、卵巢癌、神经内分泌肿瘤等实体瘤患者,一线指南推荐标准治疗失败(进展或毒性不耐受)且至少有1个可测量病灶以评估疗效。尽可能提供签署知情同意前2年内的存档或新鲜肿瘤组织,或5张未染色组织切片,优先采用新鲜标本;肿瘤免疫组化须显示整合素αVβ3、CLDN6、KKLC-1、DLL3或间皮素至少一种靶点在≥40%肿瘤细胞膜呈2/3级染色。骨髓及器官功能充分:白细胞≥2.0×10⁹/L、中性粒细胞≥1.0×10⁹/L、血红蛋白≥7.0 g/dL、血小板≥75×10⁹/L;总胆红素≤1.5×ULN,无肝转移者ALT/AST≤2.5×ULN,有肝转移者≤5×ULN;血清肌酐≤1.5×ULN。凝血功能:INR≤1.5或PT≤1.5×ULN;接受抗凝治疗者PT在该抗凝药目标范围内即可。有生育能力者同意入组前及试验期间采取适当避孕。签署知情同意并能遵守方案规定的访视和相关程序。

排除标准:首次给药前2周内针对病灶接受姑息性局部治疗;2周内接受全身非特异性免疫调节治疗(如白细胞介素、干扰素、胸腺肽)或有抗肿瘤适应证的草药/中药。其他恶性肿瘤史,但宫颈原位癌、已治疗鳞状细胞癌或膀胱尿路上皮肿瘤(Ta、Tis),以及入组前至少5年已根治的其他恶性肿瘤除外。未控制的合并症,包括活动性细菌/真菌感染、有症状充血性心衰、不稳定型心绞痛或心律失常;HIV感染、活动性乙肝(HBV DNA≥500 IU/mL)或丙肝;未控制的冠状动脉疾病、哮喘、脑血管病或研究者判定不适合的其他疾病;合并症控制不佳,包括活动性感染、心衰、不稳定型心绞痛、心律失常或先天性长QT综合征,或筛查校正QTc(Fridericia公式)>500 ms。自身免疫病或免疫缺陷;首次给药前4周内使用免疫抑制药物,以下除外:鼻用/吸入糖皮质激素或局部激素注射(如关节腔注射);泼尼松等效剂量≤10 mg/日的全身激素;过敏预处理用糖皮质激素(如CT造影前)。需要长期全身糖皮质激素或其他免疫抑制剂(吸入激素除外);首次给药前4周内接种减毒活疫苗或研究期间计划接种;首次给药前4周内重大手术(如开颅、开胸、开腹)或研究期间预计需要重大手术。入组前6个月内胃肠穿孔/瘘、肠梗阻(包括需肠外营养的不完全梗阻)、广泛肠切除(部分结肠切除或大范围小肠切除并伴慢性腹泻)、克罗恩病、溃疡性结肠炎或慢性腹泻;入组前2周内胃肠道出血或高出血风险;需临床干预的有症状CNS转移;妊娠或哺乳;对试验药或辅料已知过敏;社会或地理因素导致无法接受免疫治疗;以及任何未解决且可能影响安全或依从性的状况。
核对登记原文(英文)
Inclusion Criteria:

* The study participants are able to understand the informed consent form, voluntarily participate and sign the informed consent form.
* The study participant is 18 \~ 75 years old on the day of signing the informed consent.
* The Eastern Cooperative Oncology Group (ECOG) performance status score (ECOG) is 0-3, which allows bed rest most of the time, but can still maintain the minimum daily self-care ability.
* Estimated survival time\>=8 weeks.
* Patients with solid tumors such as colorectal cancer, gastric cancer, lung cancer, ovarian cancer, and neuroendocrine tumors who have failed first-line standard therapy recommended by the guidelines (disease progression after treatment or intolerable toxic side effects of treatment) should have at least one measurable lesion for efficacy evaluation.
* All research participants should provide archived or freshly obtained tumor tissue samples or 5 unstained tumor tissue section samples within 2 years before signing the informed information as much as possible, and newly obtained tumor tissue samples are preferred. The patient's tumor tissue was stained by immunohistochemistry, and 40% of the tumor cell membrane was stained with (2/3) at least one of the targets of integrin aVβ3, CLDN6, KKLC-1, DLL3, and mesothelin.
* The patient has adequate organ and bone marrow function, defined as follows: Complete blood count: white blood cell count \>=2.0×10\^9/L, neutrophil count \>=1.0×10\^9/L, hemoglobin \>=7.0g/dL, platelet count \>=75×10\^9/L; Liver function: total bilirubin \<=1.5× upper limit of normal (ULN), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in study participants without liver metastases\<=2.5×ULN. There are liver metastases study participants requested: ALT and AST \<=5×ULN. Renal function: serum creatinine (Scr) \<=1.5×ULN. Adequate coagulation: defined as international normalized ratio (INR) \<=1.5 or prothrombin time (PT) \<=1.5 times ULN; If the study participant is receiving anticoagulant therapy, as long as the PT is within the intended range of the anticoagulant medication.
* Patients of childbearing age need to take appropriate protective measures (contraceptive measures or) before enrollment and during the test other methods of birth control).
* Have signed the informed consent form and be able to comply with the visit and related procedures specified in the program.

Exclusion Criteria:

* Palliative local therapy targeting lesions within 2 weeks prior to the first dose; systemic non-specific immunomodulatory therapy (e.g., interleukin, interferon, thymosin) within 2 weeks prior to the first dose; use of herbal or traditional Chinese medicines with anti-tumor indications within 2 weeks prior to the first dose.
* History of other malignancies, except for carcinoma in situ of the cervix, treated squamous cell carcinoma or urothelial bladder tumors (Ta and TIS), or other malignancies that have undergone curative therapy (at least 5 years prior to enrollment).
* Uncontrolled comorbid conditions, including but not limited to active bacterial/fungal infections, symptomatic congestive heart failure, unstable angina, or arrhythmias.
* Concurrent HIV infection, active hepatitis B (HBV DNA \>=500 IU/mL), or hepatitis C.
* Uncontrolled coronary artery disease, asthma, cerebrovascular disease, or other conditions deemed ineligible by the investigator.
* Poorly controlled comorbidities, including active infections, congestive heart failure, unstable angina, arrhythmias, or congenital long QT syndrome; corrected QTc interval \>500 ms (Fridericia's formula) at screening.
* Subjects with autoimmune diseases or immunodeficiency disorders.
* Use of immunosuppressive drugs within 4 weeks prior to the first dose, excluding: a) Intranasal inhaled corticosteroids or local steroid injections (e.g., intra-articular); b) Systemic corticosteroids ≤10 mg/day prednisone equivalents; c) Corticosteroids as premedication for hypersensitivity (e.g., pre-CT contrast).
* Subjects requiring chronic systemic corticosteroids or other immunosuppressive agents (excluding inhaled corticosteroids).
* Administration of live attenuated vaccines within 4 weeks prior to the first dose or planned during the study.
* Major surgery (e.g., craniotomy, thoracotomy, laparotomy) within 4 weeks prior to the first dose or anticipated need for major surgery during the study.
* History of gastrointestinal perforation/fistula, bowel obstruction (including incomplete obstruction requiring parenteral nutrition), extensive bowel resection (partial colectomy or extensive small bowel resection with chronic diarrhea), Crohn's disease, ulcerative colitis, or chronic diarrhea within 6 months prior to enrollment.
* Gastrointestinal bleeding or high bleeding risk within 2 weeks prior to enrollment.
* Symptomatic central nervous system metastases requiring clinical intervention.
* Pregnancy or lactation.
* Known hypersensitivity to the investigational drug or its excipients.
* Subjects unable to undergo immunotherapy due to social or geographical factors.
* Any unresolved condition that may compromise safety or compliance.

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

  • 主要终点剂量限制性毒性(DLT)从临床试验入组至首次记录疾病进展或任何原因死亡,以先发生者为准,最长评估1年
  • 次要终点总生存期
  • 次要终点疾病控制率
  • 次要终点疾病控制持续时间
  • 次要终点客观缓解率
  • 次要终点无进展生存期
核对登记原文(英文)

主要终点:Dose-limiting toxicities (DLT) · From clinical trial enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to one year.
次要终点:Overall Survival;Disease control rate;Duration of control;Objective response rate;Progression free survival

研究设计怎么做的

研究类型
干预性研究
入组人数
6 人(预计)
分组方式
不适用(单臂)
  • 试验组试验组

    记忆NK细胞治疗。

核对分组登记原文(英文)
  • Experimental Group · EXPERIMENTAL · Memory NK Cell Therapy

关键日期

开始日期
2025-05-08
主要完成日期
2027-12-31
全部完成日期
2028-12-31
登记状态核实于
2025-05

联系与责任方

申办方
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

登记简述

这是一项单中心、前瞻性Ib/II期临床试验,评估细胞膜修饰记忆NK细胞联合标准治疗用于晚期转移性实体瘤患者的安全性和疗效。主要目标是在意向治疗(ITT)人群中评价联合治疗的安全性和耐受性,包括剂量限制性毒性(DLT)发生率、不良事件频率/严重程度,以及实验室检查、体格检查和生命体征的临床显著异常。次要目标是评估初步疗效(ORR、DOR、PFS、OS及肿瘤标志物动态变化)和联合标准治疗时记忆NK细胞的药代动力学。先入组6例先导队列评价安全性,并在末次NK输注后观察21天评估DLT;若安全性可接受,将向伦理委员会提交方案修订以扩展队列。

核对登记原文(英文)

This study is a single-center, prospective, Phase Ib/II clinical trial designed to evaluate the safety and efficacy of cell membrane-modified memory NK cells in treating patients with advanced metastatic solid tumors. The primary objective of this study is to evaluate the safety and tolerability profile of memory NK cells administered in combination with standard therapy in the Intent-to-Treat (ITT) population. The assessment will be based on the following endpoints: 1)Incidence of dose-limiting toxicities (DLTs); 2) Frequency and severity of adverse events; 3) Occurrence of clinically significant abnormalities in laboratory parameters, physical examinations, and vital signs. The secondary Study Objectives: 1) To evaluate the preliminary efficacy of the combination regimen by assessing the objective response rate (ORR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and serial changes in tumor markers; 2) To characterize the pharmacokinetic profile of memory NK cells when used in combination with standard therapy within the ITT population. A pilot cohort of 6 patients will first be enrolled to assess the safety of NK cell therapy, with dose-limiting toxicities (DLT) evaluated over a 21-day observation period following the last NK cell infusion. If safety is confirmed, a protocol amendment for cohort expansion will be submitted to the Ethics Committee.

登记原文与核验信息

试验登记号
NCT07274449
试验期别
I 期 / II 期
试验状态
进行中(不再招募)
中国试验中心(1 个)
Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University · 南京 · 中国
适应症(原文)
Advanced Solid Cancers
干预方式(原文)
Memory-Like NK Cells