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.
肿瘤细胞治疗研究
英文原题:A Clinical Study of Humanized CD19 CAR-T Cells With TLR2 for the Treatment of Adult Patients With Naive B-Cell Acute Lymphoblastic Leukemia/Lymphoma Who Are Intolerant to Intensive Chemotherapy
A Clinical Study of Humanized CD19 CAR-T Cells With TLR2 for the Treatment of Adult Patients With Naive B-Cell Acute Lymphoblastic Leukemia/Lymphoma Who Are Intolerant to Intensive Chemotherapy
分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。
这是一项早期 I 期注册临床试验,评估人源 CAR-T 细胞治疗淋巴瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 60 例。登记号:NCT07335094。
不限性别 · ≥ 18 Years 且 ≤ 80 Years
纳入标准: 1. 新诊断急性B淋巴细胞白血病/淋巴瘤,临床判断无法耐受强化化疗; 2. 年龄18–80岁(含界值),男女均可; 3. ECOG体能状态评分0–2分; 4. 流式细胞术和/或组织病理学证实CD19阳性; 5. 自签署知情同意书之日起预期生存期>3个月; 6. 育龄女性筛查时人绒毛膜促性腺激素(HCG)检测须阴性,并同意输注后至少1年内避孕;伴侣有生育能力的男性须同意输注后至少1年内使用有效屏障避孕; 7. 主要组织和器官功能良好:①肝功能:ALT/AST<3倍ULN,总胆红素≤34.2 μmol/L;②肾功能:Cockcroft-Gault法计算的肌酐清除率≥60 mL/min;③肺功能:血氧饱和度≥95%,无活动性肺部感染;④心功能:LVEF≥50%,无大量心包积液及有临床意义的心电图异常。 排除标准: 1. 严重心功能不全,LVEF<50%; 2. 有严重肺功能损害史; 3. 合并其他晚期恶性肿瘤; 4. 入组前4周内发生严重感染且未能有效控制; 5. 患有严重自身免疫性疾病或免疫缺陷病; 6. 活动性肝炎(HBV DNA定量>500 IU/mL或HCV RNA检测阳性); 7. HIV感染、已知AIDS或梅毒感染; 8. 对生物制品(包括抗生素)有严重过敏史,或对抗体、细胞因子等大分子生物药物过敏; 9. 异基因造血干细胞移植患者停用免疫抑制剂1个月后仍有急性移植物抗宿主病(GvHD); 10. 妊娠期或哺乳期,或计划在1年内妊娠;无法保证入组后1年内采取有效避孕措施(如避孕套或避孕药); 11. 有临床意义的中枢神经系统疾病史,如癫痫、轻瘫、失语、卒中、严重脑损伤、痴呆、帕金森病、小脑疾病或器质性脑综合征; 12. 患有精神疾病; 13. 有物质滥用/成瘾; 14. 使用禁用药物:①白细胞采集前7天内或CD19 CAR-T 给药前72小时内使用治疗剂量类固醇(泼尼松或等效剂量>20 mg/日);生理替代、局部和吸入性类固醇允许;②白细胞采集前2周内接受挽救化疗;③白细胞采集前4周内接受供者淋巴细胞输注;④CD19 CAR-T 输注前4周内接受GVHD治疗;⑤白细胞采集前6个月内使用阿仑单抗,或前3个月内使用氯法拉滨或克拉屈滨。
Inclusion Criteria: 1. Newly treated patients with acute B-lymphocytic leukaemia/lymphoma who are clinically determined to be unable to tolerate strong chemotherapy; 2. age 18-80 years old (including boundary value), both men and women can; 3. The physical status of the American Eastern Cancer Collaboration Group (ECOG) was 0\~2 points; 4. Positive CD19 confirmed by flow cytometry and/or histopathology; 5. The expected survival period from the date of signing the informed consent form is more than 3 months.; 6. women of childbearing age screening period human chorionic gonadotropin (HCG) test negative, and Consent to use contraception for at least 1 year after the infusion; A man whose partner is fertile Subjects must agree to use an effective barrier contraceptive method for at least 1 year after the infusion; 7. the patient's main tissues and organs function well: (1) Liver function: ALT/AST\<3 times the upper limit of normal (ULN) and total bilirubin ≤34.2μmol/L; (2) Renal function: creatinine clearance (Cockcroft-Gault method) ≥60mL/min; (3) Lung function: blood oxygen saturation ≥95%, and no active lung infection; (4) Cardiac function: left ventricular ejection fraction (LVEF) ≥50%; No large number of pericardium was found Fluid accumulation, no clinically significant electrocardiogram abnormalities; Exclusion Criteria: 1. severe cardiac insufficiency, left ventricular ejection fraction \<50%; 2. have a history of severe lung function impairment; 3. Combined with other advanced malignant tumors; 4. Had severe infection within 4 weeks before enrollment and could not be effectively controlled; 5. suffering from serious autoimmune diseases or immune deficiency diseases; 6. active hepatitis (HBV DNA quantitative \> 500IU/ml\] or HCV ribose Nucleic acid \[HCVRNA\] test positive); 7. human immunodeficiency virus (HIV) infection or known to have acquired immunodeficiency syndrome Co-syndrom (AIDS), or syphilis infection; 8. Have a history of severe allergy to biological products (including antibiotics), antibodies or cytokines Allergy to macromolecular biological drugs; 9. Acute graft-versus-host reactions were still present one month after immunosuppressant discontinuation Patients with allogeneic hematopoietic stem cell transplantation (GvHD); 10. in the pregnancy period (urine/blood pregnancy test positive) or breastfeeding women; nearly Men or women who plan to conceive within 1 year; Not guaranteed to be taken within 1 year after enrollment Effective contraception (condoms or contraceptives, etc.); 11. History of clinically significant central nervous system diseases, such as epilepsy, paresis, and loss Speech, stroke, severe brain injury, dementia, Parkinson's disease, cerebellar disease, organic Cerebral syndrome; 12. Suffering from mental illness; 13. The patient has substance abuse/addiction; 14. Use of banned drugs. (1). Hormones: within 7 days before leukocyte collection, or within 72 hours before CD19CAR-T administration A past therapeutic dose of corticosteroid (defined as prednisone or equivalent \> 20mg/day) Days). However, the use of physiological substitutes, topical and inhaled steroids is permitted. (2) Chemotherapy: rescue chemotherapy was received within 2 weeks before white blood cell collection. (3) Allogeneic cell therapy: donor lymphocytes were received within 4 weeks before white blood cell collection Infusion. (4).GVHD treatment: Anti-GVHD received within 4 weeks prior to CD19CAR T cell infusion Heal. (5) Alenzumab was used within 6 months before white blood cell collection, or chlorine was used within 3 months Farabine or cladobine.
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:ORR · Objective response rates (ORR), including CR and PR, were analyzed by Clopper-Pearson distribution with bilateral 95% confidence intervals. For progression-free survival (PFS), Kaplan-Meier method was used to estimate the survival curve. Overall survival: the time from cell retransfusion until death from any cause. · 3 years
经氟达拉滨联合环磷酰胺(F+C)淋巴清除治疗后,单次输注联合TLR2的人源化CD19 CAR-T 细胞;输注后3年内按访视计划在规定时间点进行随访评估。
以上邮箱 / 电话是登记库里的申办方联系方式(+86,中国),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。
本临床试验旨在评估联合TLR2的人源化CD19 CAR-T 疗法对初治时无法耐受强化化疗的成人急性B淋巴细胞白血病/淋巴瘤患者的耐受性和安全性。受试者接受一次CD19 CAR-T 细胞输注,并在随后3年按计划完成随访。
The purpose of this clinical trial is to tolerability and safety of humanized CD19 CAR-T therapy with TLR2 in adult patients with acute B lymphoblastic leukemia/lymphoma who cannot tolerate intense chemotherapy at initial treatment. Participants will receive a single infusion of CD19 CAR-T and complete follow-ups over the next three years.
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