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:Phase I/II Study of SENL103 for Relapsed or Refractory Multiple Myeloma: A Multicenter, Open-Label, Single-Arm Trial.
Phase I/II Study of SENL103 for Relapsed or Refractory Multiple Myeloma: A Multicenter, Open-Label, Single-Arm Trial.
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 I/II 期注册临床试验,评估自体 CAR-T 细胞治疗多发性骨髓瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 24 例。登记号:NCT07421856。
不限性别 · ≥ 18 Years 且 ≤ 70 Years
纳入标准: 1. 受试者理解并自愿签署知情同意书,且在任何研究评估/程序前签署。 2. 签署知情同意时年龄18–70岁(含)。 3. 预期生存期≥12周;ECOG体能状态0–1分。 4. 按国际骨髓瘤工作组(IMWG)诊断标准确诊复发/难治性多发性骨髓瘤,既往至少3线治疗,包括蛋白酶体抑制剂、免疫调节剂及抗CD38单克隆抗体方案;最近一次抗骨髓瘤治疗后12个月内有影像学进展证据。 5. 有可测量疾病,符合至少一项:骨髓细胞学、活检或流式细胞术显示克隆性/未成熟浆细胞≥5%;血清M蛋白:IgG型≥10 g/L,或IgA/IgD/IgE/IgM型≥5 g/L;24小时尿M蛋白≥200 mg;无可测量血清/尿病灶的轻链型骨髓瘤,血清游离轻链≥100 mg/L且κ/λ比值异常。 排除标准: 1. 无症状(冒烟型)多发性骨髓瘤。 2. 有髓外病灶的多发性骨髓瘤;最大横截径≤3 cm的孤立髓外病灶除外。 3. 筛选时患活动性浆细胞白血病(外周血浆细胞>5%)、Waldenström巨球蛋白血症、POEMS综合征或原发性淀粉样变。 4. 有临床意义的心血管疾病,包括QTc>470 ms(Fridericia校正)、NYHA心功能≥Ⅱ级、签署同意书前6个月内不稳定型心绞痛或急性心肌梗死、LVEF<50%、控制不佳的高血压(收缩压≥160和/或舒张压≥100 mmHg),或有临床意义/需抗心律失常治疗的心律失常(如持续性室速、室颤、尖端扭转型室速、完全性左束支传导阻滞)。 5. 既往接受BCMA靶向治疗、BCMA CAR-T 或其他细胞治疗。 6. 既往抗肿瘤治疗的洗脱期不足:自体干细胞采集前21天内接受多发性骨髓瘤单克隆抗体治疗;前14天内接受细胞毒化疗或蛋白酶体抑制剂;前7天内接受免疫调节剂;或前14天/5个半衰期(取较长者)内接受其他抗肿瘤治疗。 7. 签署知情同意时有间质性肺病或间质性肺炎。 8. 筛选时有活动性自身免疫病(如系统性红斑狼疮、类风湿关节炎、炎症性肠病、银屑病)或其他需免疫抑制治疗的情况;低剂量糖皮质激素除外。 9. 签署知情同意前28天内接种活疫苗或灭活疫苗。
Inclusion Criteria: * 1.The subject must understand and voluntarily sign the informed consent form (ICF) before any study-related assessments/procedures.; 2.Male or female subjects aged 18 to 70 years (inclusive) at the time of signing the informed consent form; 3.Life expectancy of no less than 12 weeks; 4.ECOG performance status of 0 to 1; 5.Diagnosis of relapsed/refractory multiple myeloma (RRMM) according to the International Myeloma Working Group (IMWG) diagnostic criteria, with at least 3 prior lines of therapy, including regimens based on proteasome inhibitors, immunomodulatory agents, and CD38 monoclonal antibodies; disease progression documented by radiographic evidence within 12 months following the most recent anti-myeloma therapy.; 6.The subject must have measurable multiple myeloma disease, which must meet at least one of the following criteria: 1. Bone marrow cytology, bone marrow biopsy tissue, or flow cytometry showing ≥5% clonal plasma cells or immature plasma cells; 2. Serum M-protein levels: IgG type M-protein ≥10 g/L; or IgA, IgD, IgE, IgM type M-protein ≥5 g/L; 3. 24-hour urine M-protein level ≥200 mg; 4. For light chain multiple myeloma without measurable serum or urine lesions: serum free light chain (sFLC) ≥100 mg/L and abnormal serum κ/λ free light chain ratio; Exclusion Criteria: * 1.Subjects with asymptomatic (smoldering) multiple myeloma; 2.Subjects with multiple myeloma with extramedullary lesions (excluding isolated extramedullary lesions with a maximum cross-sectional diameter ≤3 cm); 3.Subjects with active plasma cell leukemia (defined as peripheral blood plasma cells \>5%), Waldenström's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes), or primary amyloidosis at screening; 4.Subjects with clinically significant cardiovascular disease, including any of the following: 1. QTc interval \>470 ms (QTc interval corrected using the Fridericia formula); 2. New York Heart Association (NYHA) Class II or higher heart failure; 3. Unstable angina or acute myocardial infarction within 6 months prior to signing the informed consent form (ICF); 4. Left ventricular ejection fraction (LVEF) \<50%; 5. Poorly controlled hypertension (systolic blood pressure ≥160 mm Hg and/or diastolic blood pressure ≥100 mm Hg); Arrhythmia that is either clinically significant or requires antiarrhythmic therapy (e.g., persistent ventricular tachycardia, ventricular fibrillation, torsades de pointes, or complete left bundle branch block); 5.Subjects who have previously received BCMA-targeted therapies, BCMA CAR-T therapy, or other cellular therapies 6.Subjects who have previously received the following antineoplastic therapies: monoclonal antibody treatment for multiple myeloma within 21 days prior to autologous stem cell collection, cytotoxic chemotherapy or proteasome inhibitors within 14 days prior to autologous stem cell collection, immunomodulatory agents within 7 days prior to autologous stem cell collection, or any other antineoplastic therapies within 14 days or at least 5 half-lives (whichever is longer) prior to autologous stem cell collection; 7.Subjects with interstitial lung disease or interstitial pneumonia at the time of signing the ICF; 8.Subjects with active autoimmune diseases (such as systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, and psoriasis) or other conditions requiring immunosuppressive therapy (except for low-dose corticosteroids) at screening; 9.Subjects who have received live or inactivated vaccines within 28 days prior to signing the ICF;
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:Maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) after S103 infusion · Safety · 28 days;Incidence, severity, and relationship of DLTs, AEs and SAEs. · Safety. To evaluate the possible adverse events occurred within 2 years after S103 infusion, including the incidence and severity of symptoms such as cytokine release syndrome and neurotoxicity · 2 years
次要终点:Pharmacokinetic data parameters.Analysis using CAR DNA copy number measured by qPCR; the highest concentration of S103 cells expanded in peripheral blood after administration;Pharmacodynamics data parameters. Proportion of BCMA-positive cells and Cytokine release.;Objective response rate after S103 infusion;Best overall response after S103 infusion;Duration of Response after S103 infusion;Progression-Free Survival after S103 infusion;Overall survival after S103 infusion;Time to Response after S103 infusion
自体BCMA靶向CAR-T 细胞,经静脉输注;输注细胞前给予氟达拉滨和环磷酰胺。
以上邮箱 / 电话是登记库里的申办方联系方式(中国内地手机),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。
本研究旨在评估S103治疗复发/难治性多发性骨髓瘤的安全性和疗效。
To Evaluate Safety and Efficacy of S103 for Treating Relapsed or Refractory Multiple Myeloma
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