工程化益生菌用于肿瘤靶向联合化学免疫治疗
Engineered probiotics for tumor-targeted combination chemoimmunotherapy.
英文原题:An Antibody-armored Dendritic Cell in Patients With Solid Tumors
An Antibody-armored Dendritic Cell in Patients With Solid Tumors
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 期、非随机的注册临床试验,评估树突状细胞治疗恶性肿瘤的疗效与安全性。研究设计:非随机。当前状态:招募中。计划入组 8 例。试验地点:中国 · 上海(共 1 个中心,其中中国 1 个)。登记号:NCT07479667。
不限性别 · ≥ 18 Years 且 ≤ 80 Years
纳入标准: * 年龄18–80岁,体重≥40 kg,男女不限; * ECOG体能状态评分0–1分; * 组织病理学确诊实体瘤,包括胰腺癌、结直肠癌(CRC)、胃癌等恶性肿瘤; * 已接受R0或R1切除,并完成至少4个周期标准术后辅助化疗; * TERT、P53、KRAS和Survivin中至少一种表达阳性; * 静脉通路充分,且无外周血单个核细胞采集禁忌证; * 器官和骨髓功能充分:血小板≥90×10⁹/L;血红蛋白≥90 g/L(过去7天内无输血或依赖促红细胞生成素);单核细胞计数≥1.0×10⁹/L;INR或PT≤1.5×ULN;血清肌酐≤1.5×ULN;AST、ALT≤2.5×ULN;总胆红素≤2×ULN;入组前1个月内超声心动图测得LVEF≥50%; * 能够理解研究要求和注意事项,并按研究要求签署知情同意书; * 同意在树突状细胞(DC)注射后至少6个月内采取有效避孕措施。 排除标准: * 妊娠期或哺乳期女性; * HIV抗体或梅毒抗体阳性;HBsAg、乙肝核心抗体(anti-HBc)或乙肝e抗体(anti-HBe)阳性,且HBV DNA高于检测下限(LLOD)或≥1000 copies/mL;或HCV RNA高于LLOD; * 既往接受过树突状细胞(DC)或其他免疫细胞治疗; * 对免疫治疗或相关药物有超敏反应史,或有严重过敏反应史; * 未控制的活动性感染; * 活动性自身免疫性疾病且正在接受相关治疗;器官移植后仍使用免疫抑制剂;或需要长期使用免疫抑制剂(泼尼松>15 mg/日或等效糖皮质激素剂量),且筛查前4周内使用过此类药物; * 存在中枢神经系统(CNS)转移或有临床意义的CNS疾病; * 筛查前4周内接受全身抗肿瘤治疗; * 筛查发现有残留病灶或未切除病灶(辅助化疗/手术后),影像学提示局部复发或已确认远处转移; * 过去5年内有其他活动性恶性肿瘤史(已治愈的皮肤基底细胞癌、宫颈原位癌等除外); * 有临床意义的重大心血管疾病,包括有症状的充血性心力衰竭、不稳定型心绞痛、需药物治疗的严重心律失常、未控制高血压,或筛查前6个月内心肌梗死/室性心律失常; * 研究者认为不适合参加临床研究的其他情况。
Inclusion Criteria: * Aged 18 to 80 years, body weight ≥ 40 kg; male or female, no gender restriction; * ECOG performance status score of 0 to 1; * Histopathologically confirmed solid tumors including pancreatic cancer, colorectal cancer (CRC), gastric cancer and other such malignancies; * Having undergone R0 or R1 resection with completion of at least 4 cycles of standard postoperative adjuvant chemotherapy; * Positive expression for at least one of TERT, P53, KRAS and Survivin; * Sufficient venous access with no contraindications to peripheral blood mononuclear cell collection; * Adequate organ and bone marrow function: * a) Platelet count ≥ 90×10⁹/L; * b) Hemoglobin ≥ 90 g/L (no blood transfusion or erythropoietin dependence within 7 days); * c) Mononuclear cell count ≥ 1.0×10⁹/L; * d) International Normalized Ratio (INR) or Prothrombin Time (PT) ≤ 1.5 × upper limit of normal (ULN); * e) Serum creatinine ≤ 1.5 × upper limit of normal (ULN); * f) Aminotransferases (AST, ALT) ≤ 2.5 × upper limit of normal (ULN); * g) Total bilirubin ≤ 2 × upper limit of normal (ULN); * h) Cardiac function: Left Ventricular Ejection Fraction (LVEF) ≥ 50% as assessed by echocardiography within 1 month prior to enrollment; * Able to understand the study requirements and considerations and provide informed consent to participate in the clinical study in accordance with the study requirements * Subjects agree to use effective contraceptive measures for at least 6 months following dendritic cell (DC) injection. Exclusion Criteria: * Women who are pregnant or breastfeeding; * Positive for human immunodeficiency virus (HIV) antibody or syphilis antibody; positive for hepatitis B surface antigen (HBsAg), positive for hepatitis B core antibody (anti-HBc) or hepatitis B e antibody (anti-HBe) with hepatitis B virus (HBV) DNA copy number above the lower limit of detection (LLOD) or ≥ 1000 copies/mL; or hepatitis C virus (HCV) RNA copy number above the LLOD; * Prior treatment with any dendritic cell (DC) or other immune cell therapy; * History of hypersensitivity to immunotherapy and related drugs, or history of severe allergic reactions; * Uncontrolled active infection; * Subjects with active autoimmune disease receiving relevant treatment; subjects with organ transplantation who are still on immunosuppressive agents; or subjects requiring long-term use of immunosuppressive agents (\> 15 mg/day prednisone or equivalent glucocorticoid dose) and who have used them within 4 weeks prior to screening; * Presence of central nervous system (CNS) metastases and clinically significant CNS diseases; * Received systemic anti-tumor therapy within 4 weeks prior to screening; * Presence of residual lesions or unremoved foci on screening examinations (post-adjuvant chemotherapy / post-surgery), with imaging indicating local recurrence or confirmed distant metastasis; * History of other active malignancies within 5 years (excluding cured basal cell carcinoma of the skin, carcinoma in situ of the cervix, etc.); * Clinically significant major cardiovascular diseases including: * a) Symptomatic congestive heart failure * b) Unstable angina pectoris * c) Severe arrhythmia requiring pharmacotherapy * d) Uncontrolled hypertension * e) Myocardial infarction or ventricular arrhythmia within 6 months prior to screening; * Any other conditions deemed by the investigator to render the subject ineligible for participation in the clinical 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:Maximum Tolerated Dose · Day 0-Month 5;Evaluate the incidence and severity of adverse events · Adverse events (AEs), serious adverse events (SAEs) and laboratory abnormalities (including their types, frequencies and severity) will be collected. This includes the types, incidence and severity of adverse events, as well as clinically significant abnormal laboratory test results and abnormal physical examination findings that emerge after treatment. Clinical and laboratory adverse events will be primarily graded using Version 6.0 of the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE). The causal relationship between adverse events and the dendritic cell (DC) product will be assessed by investigators in accordance with the causality evaluation criteria specified in the study protocol. · Day 0-Month 24
次要终点:Cmax;antigen-specific T-cell responses;RFS;Tmax;Tlast;concentration of tumor markers
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。
这是一项单臂、开放标签、单次给药的剂量递增研究。
This study is a single-arm, open-label, single-administration dose-escalation study.
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