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XW-LTH-03(CD73 CAR-T)治疗胃癌:I/II 期临床试验

英文原题:A Hypoxia-Inducible CAR-T Cell Targeting AXL and CD73 for Advanced Gastric Cancer

ClinicalTrials.gov 2026/01/12(首次登记) I/II 期注册临床试验 · 尚未开始招募

简要介绍

这是一项 I/II 期注册临床试验,评估细胞治疗用于胃癌的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 42 例。试验地点:中国 · 上海(共 1 个中心,其中中国 1 个)。登记号:NCT07333573。

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. 年龄18–75岁,男女均可;
2. 临床判断为不可切除IV期胃癌,标准治疗后进展或不耐受,或患者自愿放弃标准治疗;
3. 患者须提供肿瘤组织样本,中央实验室免疫组化(IHC)确认AXL和CD73阳性:AXL阳性率≥50%且染色强度≥2+;CD73阳性率≥30%且染色强度≥1+;
4. ECOG体能状态评分≤1分;
5. 预期生存期≥3个月;
6. 至少有一个可测量病灶(≥1 cm);
7. 末次失败治疗后已超过4周,且既往治疗毒性已恢复至≤1级;
8. 器官功能和骨髓储备充分,按方案规定时间窗内实验室指标:血红蛋白≥90 g/L;ANC≥1.0×10⁹/L;淋巴细胞绝对计数≥0.5×10⁹/L;血小板≥100×10⁹/L;ALT和AST≤3×ULN;血清淀粉酶和脂肪酶≤1.0×ULN;总胆红素≤1.5×ULN;肌酐≤1.5×ULN或按Cockcroft-Gault公式计算的肌酐清除率≥50 mL/min;PT/INR及PTT<1.5×ULN(使用华法林或肝素抗凝者,如无基础凝血异常可入组,但须至少每周密切监测至INR稳定);
9. 心肺功能充分;
10. 有生育能力女性治疗开始前7天内妊娠检测须阴性,所有受试者同意治疗期间及之后1年采取有效避孕措施;
11. 自愿签署书面知情同意书,依从性良好并愿意配合随访。

排除标准:

1. 活动性、已知或高度疑似自身免疫性疾病;
2. 有活动性中枢神经系统症状的脑转移患者。注:入组前至少3个月已完成脑转移放疗且CNS疾病无症状者可符合条件;
3. 活动性、未控制的全身感染;
4. 入组前14天内接受大剂量皮质类固醇(甲泼尼龙>10 mg/日或其他等效剂量)或其他免疫抑制治疗;
5. 有对其他单克隆抗体严重过敏史;
6. 对研究药物不耐受或过敏;
7. 有间质性肺病史;
8. 有器官衰竭证据:心脏NYHA III或IV级心力衰竭;肝脏Child-Pugh C级;肾衰竭或尿毒症;肺部严重呼吸衰竭症状;神经系统意识障碍;
9. 活动性乙肝(HBsAg阳性且HBV DNA可检出)、活动性丙肝(HCV RNA阳性)或HIV抗体阳性;
10. 有器官移植史;
11. 活动性胃肠道出血,或过去1个月内有胃肠道出血史;
12. 有药物滥用史,或可能影响研究依从性的心理/精神障碍;
13. 任何可能危及患者安全或影响研究依从性的不稳定情况;
14. 甲状腺功能障碍;
15. 既往接受过任何形式的过继T细胞治疗;
16. 目前接受抗凝或抗血小板治疗;
17. 入组前4周内接受过大手术或遭受严重创伤;
18. 过去3年内有其他恶性肿瘤史;
19. 研究者判断不适合接受细胞治疗。
核对登记原文(英文)
Inclusion Criteria:

1. Aged 18 to 75 years, male or female.
2. Clinically judged as unresectable Stage IV gastric cancer that has progressed on or is intolerant to standard therapy, or patients who voluntarily forego standard therapy.
3. Patients must provide tumor tissue samples, with positive AXL and CD73 confirmed by immunohistochemical (IHC) staining at a central laboratory: AXL positivity rate ≥50% with staining intensity ≥++, and CD73 positivity rate ≥30% with staining intensity ≥+.
4. ECOG Performance Status score of ≤ 1.
5. Life expectancy of ≥ 3 months.
6. At least one measurable lesion (≥ 1 cm).
7. More than 4 weeks since the last failed treatment, and any toxicities from previous treatments must have recovered to Grade ≤ 1.
8. Adequate organ function and bone marrow reserve, as defined by the following laboratory values within a specified period before enrollment:

1\. Hemoglobin (Hb) ≥ 90 g/L. 2. Absolute Neutrophil Count (ANC) ≥ 1.0 × 10\^9/L. 3. Absolute Lymphocyte Count ≥ 0.5 × 10\^9/L. 4. Platelet count ≥ 100 × 10\^9/L. 5. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 × upper limit of normal (ULN).

6\. Serum amylase and lipase ≤ 1.0 × ULN. 7. Total bilirubin ≤ 1.5 × ULN. 8. Serum creatinine ≤ 1.5 × ULN or creatinine clearance ≥ 50 mL/min (calculated by the Cockcroft-Gault formula).

9\. Prothrombin Time (PT) or International Normalized Ratio (INR), and Partial Thromboplastin Time (PTT) \< 1.5 × ULN. (Patients receiving warfarin or heparin anticoagulation therapy may be enrolled if no underlying abnormality in these parameters is suspected, but require close monitoring with at least weekly testing until INR is stable).

9\. Adequate cardiac and pulmonary function. 10. Women of childbearing potential must have a negative pregnancy test within 7 days before treatment initiation. All subjects must agree to use effective contraception during the treatment period and for 1 year thereafter.

11\. Voluntary signing of a written informed consent form, good compliance, and willingness to cooperate with follow-up.

Exclusion Criteria:

1. Active, known, or highly suspected autoimmune disease.
2. Patients with brain metastases who have active central nervous system symptoms. (Note: Patients with brain metastases who completed radiotherapy at least 3 months prior to enrollment and remain asymptomatic from CNS disease may be eligible).
3. Active, uncontrolled systemic infection.
4. Receiving high-dose corticosteroids (\>10 mg/day of methylprednisolone or equivalent doses of other corticosteroids) or other immunosuppressive therapy within 14 days prior to enrollment.
5. History of severe allergy to other monoclonal antibodies.
6. Intolerance or allergy to the investigational drug.
7. History of interstitial lung disease.
8. Evidence of organ failure:

   * Cardiac: Class III or IV heart failure (per NYHA or other applicable criteria).
   * Hepatic: Class C liver function as per Child-Pugh score.
   * Renal: Renal failure or uremia stage.
   * Pulmonary: Symptoms of severe respiratory failure.
   * Neurological: Impaired consciousness.
9. Active Hepatitis B (HBsAg positive with detectable HBV DNA), active Hepatitis C (HCV RNA positive), or HIV antibody positive.
10. History of organ transplantation.
11. Active gastrointestinal bleeding, or history of gastrointestinal bleeding within the past month.
12. History of drug abuse, or psychological/psychiatric disorders that may compromise compliance with the study.
13. Any unstable condition or situation that may jeopardize the patient's safety or compliance in the study.
14. Thyroid dysfunction.
15. Prior treatment with any form of adoptive T-cell therapy.
16. Currently receiving anticoagulant or antiplatelet therapy.
17. Major surgery or significant trauma within 4 weeks prior to enrollment.
18. History of other malignant tumors within the past 3 years.
19. Judged by the investigator as unsuitable for cell therapy.

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

  • 主要终点不良事件(AE)和严重不良事件(SAE)发生率3个月
  • 主要终点剂量限制性毒性(DLT)发生率3个月
  • 主要终点最大耐受剂量(MTD)或II期推荐剂量(RP2D)3个月
核对登记原文(英文)

主要终点:Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs) · 3 months;Incidence of Dose-Limiting Toxicities (DLTs) · 3 months;Maximum Tolerated Dose (MTD) or Recommended Phase II Dose (RP2D) · 3 months

研究设计怎么做的

研究类型
干预性研究
入组人数
42 人(预计)
分组方式
不适用(单臂)
  • XW-LTH-03输注组试验组
核对分组登记原文(英文)
  • XW-LTH-03 Infusion · EXPERIMENTAL

关键日期

开始日期
2026-01-01
主要完成日期
2027-06-30
全部完成日期
2027-06-30
登记状态核实于
2025-12

联系与责任方

申办方
Shanghai Zhongshan Hospital
合作方
SHANGHAI SINOBAY BIOTECHNOLOGY CO., LTD
联系邮箱
wang.zhaoming@zs-hospital.sh.cn
联系电话
021-64041990

登记简述

这是一项单臂、开放标签临床研究,评估一种新型缺氧诱导型双特异性CD73/AXL靶向CAR-T产品XW-LTH-03治疗IV期胃癌患者的安全性和初步疗效。主要目标是评估XW-LTH-03输注的安全性和耐受性;次要目标是评估抗肿瘤疗效,并通过测量CAR-T细胞在体内扩增及持续存在情况描述其药代动力学特征。探索性分析旨在识别与临床反应和毒性相关的潜在生物标志物,并研究潜在治疗耐药的细胞和分子机制。

核对登记原文(英文)

This is a single-arm, open-label clinical study evaluating the safety and preliminary efficacy of a novel hypoxia-inducible, bispecific CD73/AXL-targeting CAR-T cell product, XW-LTH-03, in patients with stage IV gastric cancer (GC). The primary objective is to assess the safety and tolerability of XW-LTH-03 infusions. Secondary objectives include the evaluation of its antitumor efficacy and the characterization of its pharmacokinetic profile by measuring the in vivo expansion and persistence of the CAR-T cells. Exploratory analyses aim to identify potential biomarkers associated with clinical response and toxicity, as well as to investigate the cellular and molecular mechanisms underlying potential treatment resistance.

登记原文与核验信息

试验登记号
NCT07333573
试验期别
I 期 / II 期
试验状态
尚未开始招募
中国试验中心(1 个)
Fudan University Zhongshan Hospital · 上海 · 中国
适应症(原文)
Stage IV Gastric Cancer
干预方式(原文)
XW-LTH-03 Infusion