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:Exploratory Clinical Study of Targeted Activated DC and CAR-T Therapy in Advanced Solid Cancers
Exploratory Clinical Study of Targeted Activated DC and CAR-T Therapy in Advanced Solid Cancers
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,评估活化树突状细胞治疗恶性肿瘤的疗效与安全性。当前状态:招募中。计划入组 10 例。试验地点:中国 · 海口(共 1 个中心,其中中国 1 个)。登记号:NCT07475182。
不限性别 · ≥ 18 Years 且 ≤ 75 Years
纳入标准: 1. 年龄≥18岁且≤75岁,性别不限; 2. 病理明确诊断晚期实体瘤,包括但不限于胃癌、结直肠癌、胰腺癌、前列腺癌等;至少有一个符合RECIST 1.1的可测量病灶(螺旋CT测量病灶最长径≥10 mm,或病理性淋巴结短径≥15 mm); 3. 免疫组化(IHC)证实肿瘤组织Claudin 18.2、GCC、TROP2或PSMA靶点阳性(表达强度≥2+;阳性细胞比例≥40%); 4. 符合PBMC采集指征且无细胞采集禁忌证; 5. 标准二线治疗失败、无标准治疗方案,或拒绝化疗(须有签字文件); 6. ECOG体能状态评分0–1分; 7. 预期生存期≥3个月; 8. 既往化疗或其他抗肿瘤治疗毒性经洗脱期后已恢复(残留脱发除外),且各器官功能符合入选要求; 9. 器官功能充分:免疫功能:淋巴细胞绝对计数(ALC)≥0.5×10⁹/L、中性粒细胞绝对计数(ANC)≥1.0×10⁹/L、单核细胞计数≥0.1×10⁹/L;造血功能:血小板≥75×10⁹/L、血红蛋白≥90 g/L,血常规检查前14天内未输血或接受G-CSF、血小板生成素、促红细胞生成素等治疗;肝功能:总胆红素<2×ULN、AST和ALT<2.5×ULN;肾功能:肌酐≤1.5×ULN;凝血功能:PT或APTT<1.5×ULN,INR<1.5; 10. 有生育能力者同意研究期间采取有效避孕措施; 11. 能够理解并愿意签署书面知情同意书; 12. 愿意且能够遵守计划访视、治疗方案、实验室检查和其他研究程序。 排除标准: 1. 有需立即处理的肿瘤急症,如恶性心包积液或心包填塞、上腔静脉综合征或脊髓压迫; 2. 有显著心血管疾病,包括:过去6个月内发生心肌梗死、心绞痛、心力衰竭、严重心律失常,或接受血管成形术、支架植入、冠状动脉旁路移植术;临床显著QT间期延长(女性QTcF>470 ms,男性QTcF>450 ms); 3. 有临床意义的出血倾向或凝血障碍(如血友病); 4. HIV、梅毒、乙型肝炎病毒(HBV)或丙型肝炎病毒(HCV)活动性感染; 5. 曾因精神疾病被非自愿收治,或研究者认为不适合试验的任何精神疾病; 6. 合并自身免疫性疾病,或长期使用免疫抑制剂/全身性皮质类固醇; 7. 研究者评估依从性差; 8. 本次CAR-T 输注前3个月内接受过靶向CAR-T 细胞治疗; 9. 未控制的活动性细菌或真菌感染; 10. 研究者认为不符合研究资格的任何其他情况。
Inclusion Criteria: 1. Age ≥ 18 years and ≤ 75 years, regardless of gender; 2. Advanced solid tumors with clear pathological confirmation, including but not limited to gastric cancer, colorectal cancer, pancreatic cancer, prostate cancer, etc.; at least one measurable lesion meeting RECIST 1.1 criteria (according to RECIST 1.1, the longest diameter of a measurable lesion on spiral CT scan ≥ 10 mm, or the short diameter of a pathological lymph node ≥ 15 mm); 3. Tumor tissue positive for Claudin 18.2, GCC, TROP2, or PSMA targets by immunohistochemistry (IHC) (expression intensity ≥ 2+; percentage of positive cells ≥ 40%); 4. Meets the indications for PBMC collection and has no contraindications for cell collection; 5. Failure of standard second-line treatment, or lack of a standard treatment regimen; or refusal to receive chemotherapy (with signed documentation); 6. ECOG performance status: 0-1; 7. Life expectancy: ≥ 3 months; 8. Toxicities from prior chemotherapy or other anti-tumor therapies must have resolved after a washout period (except for residual alopecia), ensuring that all organ functions meet the inclusion criteria; 9. Adequate organ function, including: 1. Adequate immune function: absolute lymphocyte count (ALC) ≥ 0.5 × 10⁹/L, absolute neutrophil count (ANC) ≥ 1.0 × 10⁹/L, monocyte count ≥ 0.1 × 10⁹/L. 2. Adequate hematopoietic function: platelet count ≥ 75 × 10⁹/L, hemoglobin ≥ 90 g/L. Patients must not have received blood transfusions or treatments such as granulocyte colony-stimulating factor, thrombopoietin, or erythropoietin within 14 days prior to the blood count assessment. 3. Adequate liver function: total bilirubin (TBIL) \< 2 × upper limit of normal (ULN), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 2.5 × ULN. 4. Adequate renal function: creatinine (Cr) ≤ 1.5 × ULN. 5. Adequate coagulation function: prothrombin time (PT) or activated partial thromboplastin time (APTT) \< 1.5 × ULN, and international normalized ratio (INR) \< 1.5. 10. Individuals of childbearing potential must agree to use effective contraception during the study; 11. Ability to understand and willingness to sign a written informed consent form; 12. Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures. Exclusion Criteria: 1. Oncological emergencies requiring immediate intervention, such as malignant pericardial effusion or tamponade, superior vena cava syndrome, or spinal cord compression; 2. Significant cardiovascular disease, including: 1. Documented major cardiovascular events within the past 6 months, such as myocardial infarction, angina pectoris, heart failure, severe arrhythmia, or prior angioplasty, stent implantation, or coronary artery bypass grafting; 2. Clinically significant QT interval prolongation (QTcF \> 470 ms for women or QTcF \> 450 ms for men); 3. Clinically significant bleeding tendency or coagulation disorders (e.g., hemophilia); 4. Active infection with HIV, syphilis, hepatitis B virus (HBV), or hepatitis C virus (HCV); 5. History of involuntary commitment due to mental illness, or any psychiatric condition deemed by the investigator to make the patient unsuitable for the trial; 6. Concurrent autoimmune diseases, or long-term use of immunosuppressants or systemic corticosteroids; 7. Poor compliance, as assessed by the investigator; 8. Prior treatment with any targeted CAR-T cell therapy within 3 months before this CAR-T infusion; 9. Uncontrolled active bacterial or fungal infections; 10. Any other condition that, in the opinion of the investigator, makes the patient ineligible for the study.
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:Adverse Events (AEs) · To evaluate adverse events following infusion of targeted activated dendritic cells (DC) and CAR-T cells, with an assessment of the incidence and severity of treatment-related toxicities, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), hematological abnormalities, infections, autoimmune reactions, and secondary malignancies. · 2 years post cell infusion
次要终点:Objective Response Rate (ORR);Disease Control Rate (DCR);Progression-free survival (PFS);Changes in the Immune Microenvironment
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。
这是一项开放标签、单臂临床研究,旨在评估靶向激活树突状细胞(DC)联合CAR-T 治疗晚期实体瘤患者的安全性和初步疗效。联合治疗激活DC并使其精准靶向肿瘤部位,重塑肿瘤免疫微环境、突破免疫抑制屏障,使CAR-T 细胞能够更有效地深入肿瘤并精准、持续地杀伤癌细胞。
This is an open-label, single-arm clinical study designed to evaluate the safety and preliminary efficacy of Targeted Activated DC combined with CAR-T therapy in patients with Advanced Solid Cancers.This combination therapy activates dendritic cells (DCs) to precisely target the tumor site, reshaping the tumor immune microenvironment, breaking down the immunosuppressive barrier, and allowing CAR-T cells to penetrate deeper into the tumor more efficiently, precisely and persistently killing cancer cells.
MEMBER ACCOUNT
登录成功会直接打开下一页。