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:Neurocognitive Assessment in Adults Undergoing CD19 Targeted CAR-T Cell Therapy
这是一项分期未标注的注册临床试验,评估 CAR-T 细胞治疗弥漫大 B 细胞淋巴瘤、B 细胞淋巴瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 100 例。试验地点:欧洲 · 亚历山德里亚、安科纳、布雷西亚、巴勒莫(共 8 个中心)。登记号:NCT07463781。
不限性别 · ≥ 18 Years
纳入标准:既往确诊弥漫性大B细胞淋巴瘤或高级别B细胞淋巴瘤(DLBCL/HGBL),包括新发或由惰性组织学亚型转化(转化性滤泡性淋巴瘤或边缘区淋巴瘤),或原发纵隔B细胞淋巴瘤(PMBCL);依据意大利药品管理局(AIFA)纳入标准接受CD19靶向CAR-T挽救治疗的复发/难治患者;确诊淋巴瘤时年龄>18岁。 排除标准:组织学确诊套细胞淋巴瘤(MCL)或急性淋巴细胞白血病(ALL);中枢神经系统受累;既往接受脑部/神经轴放疗;已有可能影响神经认知评估的严重精神或神经系统合并症。
Inclusion Criteria: * Patients with previous diagnosis of Diffuse Large B Cell Lymphoma or High- Grade B Cell Lymphoma (DLBCL/HGBL), arising de novo or transformed from a previous indolent histotype (transformed Follicular Lymphoma or transformed Marginal Zone Lymphoma), Primary Mediastinal B Cell Lymphoma (PMBCL). * Patients undergoing CD19-targeted CAR-T cell salvage therapy for relapsed/refractory disease according to AIFA inclusion criteria. * Age over 18-years-old at the time of lymphoma diagnosis. Exclusion Criteria: * Patient with histological diagnosis of mantle cell lymphoma (MCL) or acute lymphoblastic leukemia (ALL) * Patients with CNS disease localization. * Patients that received brain/neuroaxis radiotherapy. * Pre-existing severe psychiatric or neurologic comorbidities influencing neurocognitive assessment.
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:Self-assessed neurocognitive performance · Self-assessed neurocognitive performance will be evaluated through Functional Assessment of Cancer Therapy - Cognitive questionnaire (FACT-Cog Version 3). The FACT-Cog (Version 3) is a self-report questionnaire developed within the measurement system of FACIT.org (Functional Assessment of Chronic Illness Therapy) to assess perceived cognitive functioning in individuals with cancer. The instrument includes 37 items in total, although the most commonly reported total score is based on 33 scored items. Each item is rated on a 5-point Likert scale (0-4) (0 = not at all; 4 = very much / very often, depending on the item). Total score (33-item scoring): Minimum: 0, Maximum: 132. Score interpretation: higher scores indicate better perceived cognitive functioning, lower scores indicate greater perceived cognitive impairment. · The endpoint wil be evaluated at screening (before starting CAR-T therapy), at 6, 12 and 24 months after CAR-T infusion (from the beginning of the study at least 24 months after CAR-T infusion);Neurocognitive performance evaluation: Cognitive Status - Mini-Mental State Examination (MMSE) · Cognitive status will be assessed using the Mini-Mental State Examination (MMSE). Unit of Measure: Total score (points) Range: 0 to 30 Interpretation: Higher scores indicate better cognitive performance. · The endpoint wil be evaluated at screening (before starting CAR-T therapy), at 6, 12 and 24 months after CAR-T infusion (from the beginning of the study at least 24 months after CAR-T infusion);Quality of Life (QoL) · Quality of life will be evaluated through EORTC QLQ-C30 questionnaire (European Organisation for Research and Treatment of Cancer-Quality of life Questionnaire-Core 30). The EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30) is a 30-item instrument used to assess health-related quality of life in people with cancer. All scales and single items are linearly transformed to a 0-100 scale (Minimum: 0 and Maximum: 100). · The endpoint wil be evaluated at screening (before starting CAR-T therapy), at 6, 12 and 24 months after CAR-T infusion (from the beginning of the study at least 24 months after CAR-T infusion);Psychological status · Psychological status will be evaluated through HADS questionnaire (Hospital Anxiety and Depression Scale). The Hospital Anxiety and Depression Scale consists of two subscales: anxiety (HADS-A) and depression (HADS-D). Each subscale ranges from 0 to 21, with higher scores indicating worse psychological outcomes (greater anxiety or depression symptoms). · The endpoint wil be evaluated at screening (before starting CAR-T therapy), at 6, 12 and 24 months after CAR-T infusion (from the beginning of the study at least 24 months after CAR-T infusion);Resilience · Resilience will be evaluated through RS-14 questionnaire (Resilience scale-14 questionnaire). The Resilience Scale-14 produces a total score ranging from 14 to 98, with higher scores indicating a better outcome (greater resilience). · The endpoint wil be evaluated at screening (before starting CAR-T therapy), at 6, 12 and 24 months after CAR-T infusion (from the beginning of the study at least 24 months after CAR-T infusion);Adverse events · CRS (Cytokine Release Syndrome), ICANS (Immune Effector Cell-Associated Neurotoxicity Syndrome) and IEC-HS (Immune Effector Cell associated HLH-like Syndrome) will be graded according to ASBMT (American Society for Blood and Marrow Transplantation ) consensus grading, ICAHT (Immune effector cell-associated hematotoxicity) will be graded according to EHA/EBMT (European Hematology Association/European Society for Blood and Marrow Transplantation) consensus grading, other extrahematological toxicities will be graded according to the latest version of CTCAE criteria (Common Terminology Criteria for Adverse Events). · The endpoint wil be evaluated at 6, 12 and 24 months after CAR-T infusion (from the beginning of the study at least 24 months after CAR-T infusion)
既往确诊弥漫性大B细胞淋巴瘤或高级别B细胞淋巴瘤(DLBCL/HGBL),包括新发或由惰性亚型(转化性滤泡性淋巴瘤或边缘区淋巴瘤)转化者,或原发纵隔B细胞淋巴瘤(PMBCL),并计划按照意大利药品管理局(AIFA)适应证及药品说明书接受CAR-T细胞产品治疗。
这是一项在意大利中心开展的多中心、前瞻性观察队列研究,连续纳入符合条件并接受CAR-T治疗的患者。研究纵向收集CAR-T治疗前(T0)及输注后6个月(T1)、12个月(T2)和24个月(T3)的患者数据。
This is an observational, multicenter, prospective cohort study including patients treated with CAR-T in Italian centers. Patients eligible for enrollment in the study will be consecutively included in Italian FIL centers. A longitudinal survey will be carried out by collecting patients' data before starting CAR-T (T0) and after 6 (T1), 12 (T2) and 24 (T3) months after CAR-T infusion.
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