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B 细胞治疗 B 细胞恶性肿瘤:注册临床试验(分期未知)(Donghua Zhang)

英文原题:Clinical Study Evaluating the Safety and Efficacy of BAFFR CAR-T Therapy for Relapsed/Refractory B-cell Malignancies

ClinicalTrials.gov 2026/01/16(首次登记) 注册临床试验(分期未标注) · 招募中

简要介绍

这是一项分期未标注的注册临床试验,评估 B 细胞治疗 B 细胞恶性肿瘤的安全性、可行性及初步疗效。当前状态:招募中。计划入组 28 例。试验地点:中国 · 武汉(共 1 个中心,其中中国 1 个)。登记号:NCT07345728。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 78 Years

纳入标准:

• 受试者或监护人理解研究内容并自愿签署知情同意书,预计能够完成随访检查和治疗程序。
• 年龄18–85岁(含),性别不限。
• 复发/难治性B细胞淋巴瘤;既往接受过包括抗CD20靶向药物(除非有记录证实CD20阴性)及含蒽环类方案在内的治疗。
• 筛选时肿瘤病理免疫组化证实BAFFR靶点表达阳性。
• 既往治疗毒性已恢复至CTCAE<2级;肿瘤相关异常或研究者判断稳定且不会显著影响安全性/疗效者除外。
• ECOG体能状态0–2,预期生存期>3个月。
• 器官功能充分:ALT≤3×ULN、AST≤3×ULN、总胆红素≤1.5×ULN、血清肌酐≤1.5×ULN或肌酐清除率≥60 mL/min;血红蛋白≥60 g/L或输血后可维持该水平;室内空气血氧饱和度≥92%;LVEF≥45%。
• 有适合单采的静脉通路,且无白细胞单采禁忌。

排除标准:

• 筛选前3年内有其他恶性肿瘤史;充分治疗的宫颈原位癌、乳头状甲状腺癌、基底细胞或鳞状细胞皮肤癌、根治治疗后的局限性前列腺癌及乳腺导管原位癌除外。
• HBsAg阳性,或HBcAb阳性且外周血HBV DNA高于研究机构检测下限;HCV抗体阳性且外周血HCV RNA阳性;HIV抗体阳性。
• 有严重过敏史(定义为≥2级且出现气道阻塞、心动过速、低血压、心律失常、胃肠道症状、失禁、喉头水肿、支气管痉挛、发绀、休克或呼吸/心搏骤停),或已知对本研究任何活性成分、辅料、小鼠来源成分或异种蛋白(包括淋巴清除方案)过敏。
• 严重心脏病,包括严重心律失常、不稳定型心绞痛、大面积心肌梗死、NYHAⅢ–Ⅳ级心衰、筛选前≤6个月心肌梗死或冠状动脉旁路移植术(CABG)、非迷走神经反射或脱水所致不明原因晕厥、严重非缺血性心肌病;或难治性高血压(调整生活方式并接受>1个月合理、可耐受、足量的≥3种降压药〔含利尿剂〕后仍未控制,或需≥4种降压药方能控制)。
• 研究者判定不稳定的全身性疾病,包括需药物治疗的严重肝、肾或代谢疾病;既往器官移植或计划器官移植(造血干细胞移植除外)。
• 活动性自身免疫病或炎症性神经系统疾病(如格林-巴利综合征、肌萎缩侧索硬化症),或有临床意义的活动性脑血管病(如脑水肿、可逆性后部脑病综合征)。
• 筛选时或输注前存在需紧急治疗的肿瘤急症,如脊髓压迫、肠梗阻、白细胞淤滞或肿瘤溶解综合征。
• 未控制且需抗生素治疗的细菌、真菌、病毒或其他感染。
• 计划CAR-T制备单采前1周内使用影响血细胞计数的短效造血生长因子,或前2周内使用长效造血生长因子,且研究者判断会影响细胞制备。
• 计划CAR-T制备单采前2周内使用糖皮质激素或免疫抑制药且研究者判断会影响细胞制备;包括单采前2周内需长期全身激素治疗者(吸入或局部用药除外)、细胞输注前72小时内使用全身激素者(吸入或局部用药除外),以及单采前2周内使用免疫抑制剂者。
• 淋巴清除前4周内接受重大手术(诊断性操作和活检除外),研究期间计划重大手术,或入组前手术伤口未愈合。
• 筛选前4周内接种减毒活疫苗。
• 有严重精神疾病史、酗酒或物质滥用史。
• 妊娠或哺乳期;女性受试者计划在细胞输注后2年内怀孕,或男性受试者的伴侣计划在其细胞输注后2年内怀孕。
• 存在研究者和/或临床标准认为会造成不可接受风险的研究程序禁忌或其他医学状况。
核对登记原文(英文)
Inclusion Criteria:

Patients or their guardians understand and voluntarily sign the informed consent form, and are expected to complete the follow-up examinations and treatment procedures of the study; Age 18-85 years (inclusive), gender not restricted; Patients with relapsed/refractory B-cell lymphoma who have received prior treatment including anti-CD20 targeted agents (unless documented CD20 negative) and anthracycline-containing regimens; Pathological immunohistochemistry of tumor confirms positive BAFFR target expression at screening; Patients have recovered from the toxicities of previous treatments, i.e., CTCAE toxicity grade \< 2 (unless abnormalities are tumor-related or judged by the investigator to be stable and not significantly affecting safety or efficacy); ECOG performance status 0-2 and life expectancy \> 3 months;

Adequate organ function:

1. Alanine transaminase (ALT) ≤ 3 × upper limit of normal (ULN);
2. Aspartate transaminase (AST) ≤ 3 × ULN;
3. Total bilirubin ≤ 1.5 × ULN;
4. Serum creatinine ≤ 1.5 × ULN, or creatinine clearance ≥ 60 mL/min;
5. Hemoglobin ≥ 60 g/L or maintained at this level after transfusion;
6. Room air oxygen saturation ≥ 92%;
7. Left ventricular ejection fraction (LVEF) ≥ 45%; Accessible venous access for apheresis and no contraindications to leukapheresis.

Exclusion Criteria:History of other malignancies within 3 years prior to screening, except for adequately treated carcinoma in situ of the cervix, papillary thyroid cancer, basal or squamous cell skin cancer, localized prostate cancer after radical therapy, and ductal carcinoma in situ after radical therapy; Positive for hepatitis B surface antigen (HBsAg), or positive for hepatitis B core antibody (HBcAb) with peripheral blood HBV DNA titer above the lower limit of detection of the research institution; positive for hepatitis C virus (HCV) antibody with positive peripheral blood HCV-RNA; positive for human immunodeficiency virus (HIV) antibody; History of severe allergies \[severe allergy is defined as grade 2 or higher allergic reaction with any of the following clinical manifestations: airway obstruction (runny nose, cough, wheezing, dyspnea), tachycardia, hypotension, arrhythmia, gastrointestinal symptoms (nausea, vomiting), incontinence, laryngeal edema, bronchospasm, cyanosis, shock, respiratory or cardiac arrest\] or known hypersensitivity to any active ingredients, excipients, murine products, or xenogeneic proteins contained in this study (including lymphodepletion regimen); History of severe cardiac disease, including but not limited to severe arrhythmia, unstable angina, massive myocardial infarction, New York Heart Association class III or IV cardiac insufficiency, myocardial infarction or coronary artery bypass grafting (CABG) within ≤ 6 months prior to screening, history of unexplained syncope not due to vasovagal reaction or dehydration, history of severe non-ischemic cardiomyopathy, refractory hypertension (refractory hypertension is defined as: despite lifestyle modifications, blood pressure remains uncontrolled after \> 1 month of treatment with reasonable, tolerable, and adequate doses of ≥ 3 antihypertensive drugs (including diuretics), or requires ≥ 4 antihypertensive drugs to achieve effective blood pressure control); Unstable systemic disease as judged by the investigator: including but not limited to severe liver, kidney, or metabolic diseases requiring medical treatment; Previous organ transplantation or planned organ transplantation (except hematopoietic stem cell transplantation); Active autoimmune or inflammatory neurological diseases (e.g., Guillain-Barré syndrome (GBS), amyotrophic lateral sclerosis (ALS)) and clinically significant active cerebrovascular disease (e.g., cerebral edema, posterior reversible encephalopathy syndrome (PRES)); Presence of tumor emergencies (e.g., spinal cord compression, bowel obstruction, leukostasis, tumor lysis syndrome, etc.) requiring urgent treatment at screening or before infusion; Uncontrolled bacterial, fungal, viral, or other infections requiring antibiotic treatment; Use of short-acting hematopoietic growth factors affecting blood counts within 1 week, or long-acting hematopoietic growth factors within 2 weeks prior to planned CAR-T manufacturing apheresis, and judged by the investigator to affect cell manufacturing;

Receiving corticosteroids or immunosuppressive drugs within 2 weeks prior to planned CAR-T manufacturing apheresis, and judged by the investigator to affect cell manufacturing:

1. Corticosteroids: Subjects receiving systemic steroid therapy within 2 weeks prior to planned CAR-T manufacturing apheresis and judged by the investigator to require long-term systemic steroid therapy during treatment (except inhaled or topical use); and subjects receiving systemic steroid therapy within 72 hours before cell infusion (except inhaled or topical use);
2. Immunosuppressants: Subjects receiving immunosuppressive agents within 2 weeks prior to planned CAR-T manufacturing apheresis; Major surgery (except diagnostic procedures and biopsies) within 4 weeks prior to lymphodepletion or planned major surgery during the study, or incompletely healed surgical wounds before enrollment; Vaccination with (live-attenuated) viral vaccines within 4 weeks prior to screening; History of severe mental illness; History of alcoholism or substance abuse; Pregnant or lactating women, and female subjects planning pregnancy within 2 years after cell infusion or male subjects whose partners plan pregnancy within 2 years after their cell infusion; Subjects with contraindications to any study procedures or other medical conditions that may pose unacceptable risks according to the investigator's judgment and/or clinical standards.

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

  • 主要终点总生存期(OS)治疗后第1、3、6、12、18和24个月
核对登记原文(英文)

主要终点:overall survival · 1,3,6,12,18,24 months after treatment

研究设计怎么做的

研究类型
干预性研究
入组人数
28 人(预计)
分组方式
不适用(单臂)
  • 试验组试验组
核对分组登记原文(英文)
  • Experimental:Experimental group · EXPERIMENTAL

关键日期

开始日期
2026-01-01
主要完成日期
2029-06-01
全部完成日期
2029-06-01
登记状态核实于
2026-01

联系与责任方

主要研究者
Donghua Zhang
申办方
Donghua Zhang

登记简述

本前瞻性、多中心、单臂研究拟纳入30例受试者,评估BAFFR CAR-T治疗复发/难治性B细胞恶性肿瘤的安全性和疗效。

核对登记原文(英文)

This is a prospective, single-arm, multi-center, randomized controlled clinical study designed to evaluate the safety and efficacy of BAFFR CAR-T therapy for relapsed/refractory B-cell malignancies. A total of 30 subjects are planned to be enrolled.

登记原文与核验信息

试验登记号
NCT07345728
试验期别
NA
试验状态
招募中
中国试验中心(1 个)
Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology · 武汉 · 中国
适应症(原文)
Relapsed/Refractory B-cell Malignancies
干预方式(原文)
Infusion of BAFFR CAR-T therapy for relapsed/refractory B-cell malignancies