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.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Clinical Study of Oncolytic Vaccinia VIrus Delivering Targeted CD19 in Vivo CAR-T/M Therapy for Refractory/Relapsed B-cell Lymphoma
这是一项 I 期注册临床试验,评估 CD19 细胞治疗用于 B 细胞淋巴瘤的安全性、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:NCT07398963。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 男性或女性,年龄18–75岁。 2. ECOG评分0–2。 3. 组织学确诊非霍奇金B细胞淋巴瘤(按WHO 2008诊断标准),包括非特指型弥漫大B细胞淋巴瘤(DLBCL)、原发纵隔大B细胞淋巴瘤(PMBCL)、套细胞淋巴瘤(MCL)、转化型滤泡性淋巴瘤及其他转化型惰性B细胞非霍奇金淋巴瘤。 4. CD19阳性(免疫组化或流式细胞术检测)。 5. DLBCL复发/难治定义为:接受2线治疗后达到完全缓解;任何治疗期间疾病进展或疾病稳定持续时间≤6个月;或自体造血干细胞移植后12个月内疾病进展或复发。 6. MCL:接受2线治疗(包括BTK抑制剂)后达到完全缓解;任何治疗期间疾病进展或疾病稳定持续时间≤6个月;或自体造血干细胞移植后12个月内疾病进展或复发。 7. 至少有一个可测量的浅表病灶:淋巴结病灶任一径>1.5 cm,或结外病灶任一径>1.0 cm;PET-CT显示病灶摄取高于肝脏血池(SUV)。 8. 外周血中性粒细胞绝对计数≥1,000/mm³,血小板≥50,000/mm³。 9. 心、肝、肾功能达标:肌酐<1.5 mg/dL;ALT和AST均<ULN的2.5倍;总胆红素<1.5 mg/dL;心脏射血分数≥50%。 10. 能充分理解研究内容并自愿签署知情同意书。 11. 有生育能力的女性血清妊娠检测须为阴性,并同意在治疗期间及最后一次溶瘤病毒给药后60天内采取有效避孕措施。 12. 男性患者同意在研究期间及末次病毒治疗后60天内采取有效避孕措施。 排除标准: 1. 有其他肿瘤史。 2. 研究治疗前3个月内或研究期间接种天花疫苗。 3. 研究治疗前3个月内接受基因治疗或任何类型的溶瘤病毒治疗。 4. 有其他开放性伤口。 5. 活动性自身免疫病。 6. 未控制的活动性感染。 7. HIV感染,或未控制的乙肝、丙肝或梅毒感染。 8. 已知中枢神经系统淋巴瘤。 9. 有临床意义的心脏病。 10. 对白蛋白或蛋制品过敏。 11. 有器官移植或类似手术史。 12. 皮肤病需要全身治疗。 13. 接种天花疫苗后有严重全身反应或副作用史。 14. 已知酒精依赖或病毒依赖。 15. 妊娠或哺乳期女性。
Inclusion Criteria: 1. Age≥ 18 years old, up to 75 years old, male or female; 2. ECOG score 0-2; 3. Histologically confirmed non-Hodgkin B-cell lymphoma (NHL) \[diagnostic criteria are WHO2008\], including diffuse large B-cell lymphoma (DLBCL) non-specific, primary mediastinal large B-cell lymphoma (PMBCL), mantle cell lymphoma (MCL), transformed follicular cell lymphoma (TFL) and other indolent B-cell NHL transformed types; 4. CD19 positive (immunohistochemistry or flow cytometry); 5. DLBCL refractory or relapse is defined as: complete remission after 2 lines of therapy; Disease progression during any course of treatment, or disease stabilization time equal to and less than 6 months; or disease progression or recurrence within 12 months after autologous hematopoietic stem cell transplantation; 6. MCL: Complete remission after 2 lines of treatment (including BTK inhibitors); Disease progression during any course of treatment, or disease stabilization time equal to and less than 6 months; or disease progression or recurrence within 12 months after autologous hematopoietic stem cell transplantation; 7. At least one measurable superficial lesion, requiring any length diameter of lymph node lesion greater than 1.5cm or any length diameter of extranodal lesion greater than 1.0cm, and uptake of the lesion on PET-CT scan (SUV greater than hepatic blood pool); 8. Absolute peripheral blood neutrophil ≥ 1000/mm3, platelet ≥ 50,000/mm3; 9. Heart, liver and kidney function: creatinine \<1.5mg/dL; ALT (alanine aminotransferase)/AST (aspartate aminotransferase) less than 2.5 times the upper limit of normal; Total bilirubin \< 1.5 mg/dL; Cardiac ejection fraction (EF) ≥ 50%; 10. Have sufficient understanding ability and voluntarily sign the informed consent form; 11. Women of childbearing potential must have a negative serum pregnancy test and agree to practice effective birth control during the treatment phase and for 60 days after the last application of oncolytic virus; 12. Male patients must agree to practice effective birth control during the study and for 60 days after the last viral treatment. Exclusion Criteria: 1. History of other tumors; 2. Vaccination with the smallpox vaccine within 3 months before or during the study treatment; 3. Receiving gene therapy or any type of oncolytic virus therapy within 3 months before the study treatment; 4. Other open wounds; 5. Active autoimmune diseases; 6. Uncontrolled active infections; 7. HIV infection, uncontrolled HBV, HCV, or syphilis infection; 8. Known central nervous system lymphoma; 9. Clinically significant heart disease; 10. Allergy to albumin or egg products; 11. History of organ transplantation or similar surgeries; 12. Need for systemic treatment for skin diseases; 13. History of severe systemic reactions or side effects after smallpox vaccination; 14. Known alcohol or viral dependence; 15. Pregnant or breastfeeding women.
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, and tolerability, and determine the recommended dosage of the CD19-CAR novel oncolytic vaccinia virus · Up to 28 days
次要终点:Complete response rate (CR);Progression free survival (PFS);Duration of response (DOR);Overall survival (OS);Partial response rate (PR);Overall response rate (ORR)
受试者接受CD19-CAR溶瘤痘苗病毒(RGV005)瘤内注射。
本研究旨在评估溶瘤痘苗病毒递送靶向CD19的体内CAR-T/M疗法治疗复发/难治性B细胞淋巴瘤的安全性和有效性。
To study the safety and effectiveness of oncolytic Vaccinia VIrus-Delivered Targeted CD19 In Vivo CAR-T/M Therapy for Refractory/Relapsed B-Cell Lymphoma
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