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In Vivo CAR-T(体内 CAR-T 细胞)治疗血液系统恶性肿瘤:I 期临床试验

英文原题:Safety and Efficacy of DIT101 in Relapsed or Refractory Hematologic Malignancies

ClinicalTrials.gov 2026/03/20(首次登记) I 期注册临床试验 · 尚未开始招募

简要介绍

这是一项 I 期注册临床试验,评估体内 CAR-T 细胞治疗血液系统恶性肿瘤的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 15 例。试验地点:中国 · 天津(共 1 个中心,其中中国 1 个)。登记号:NCT07485504。

入组条件决定能不能参加

不限性别 · ≥ 18 Years 且 ≤ 70 Years

纳入标准:

• 成年人,年龄18至<70岁,性别不限。
• 自愿签署书面知情同意,并愿意遵守全部研究程序。
• 确诊复发/难治性B细胞急性淋巴细胞白血病/淋巴瘤(B-ALL/LBL),或研究者判断并经合作机构确认的其他复发/难治性血液系统恶性肿瘤。
• 免疫表型证实肿瘤细胞表达目标抗原。
• 筛选时骨髓原始细胞≥5%和/或存在髓外病灶。
• B-ALL/LBL患者须符合复发/难治标准之一:接受≥2个周期标准化疗后仍为原发难治,或多种挽救方案后未达完全缓解;完全缓解后12个月内复发,或完全缓解≥12个月后复发并在后续标准治疗后未缓解;造血干细胞移植后复发;或既往接受靶向同一抗原的CAR-T治疗后复发。
• ECOG体能状态0–2分;预期生存期>3个月。
• 器官功能充分:肌酐清除率>45 mL/min;总胆红素≤ULN的3倍、ALT/AST≤ULN的5倍;PT、APTT或INR≤ULN的1.5倍;1个月内LVEF≥50%;室内空气静息SpO₂≥92%;血液及免疫功能经评估足以耐受研究治疗。
• 有生育能力女性妊娠试验阴性。绝经≥12个月或已接受手术绝育(子宫切除或双侧卵巢切除)者视为无生育能力。

排除标准:

• 妊娠或哺乳期。
• 已知遗传性骨髓衰竭综合征,如范可尼贫血、Kostmann综合征、Shwachman综合征或其他已知骨髓衰竭综合征。
• 未控制的活动性中枢神经系统白血病(CNS2或CNS3)。
• 筛选前接受抗肿瘤治疗且尚未达到规定间隔:全身化疗距筛选不足1周;全身免疫/靶向治疗(单抗、双特异性抗体、抗体偶联药物等)末次给药不足5个半衰期或4周(取较短者);供者淋巴细胞输注不足6周;CAR-T治疗或造血干细胞移植不足3个月;放疗不足4周(若骨髓储备>5%且研究者认为不影响资格,可例外)。既往治疗的临床显著毒性未恢复至CTCAE≤1级者也排除,脱发除外。
• 未控制的严重活动性感染。
• 有显著心脏病史,包括NYHA III–IV级心衰、12个月内心肌梗死或PCI/支架置入、不稳定型心绞痛、QTc>480 ms,或研究者判断有临床意义的其他心律失常。
• 过去6个月内有需治疗的中枢神经系统损伤、癫痫发作、卒中或脑出血。
• 活动性病毒感染:HIV抗体阳性、梅毒血清学阳性、HBsAg>10⁶ IU/mL、HCV抗体阳性,或EBV阳性(EBER阳性或病毒拷贝数高于正常)。
• DIT-101输注期间需要长期全身糖皮质激素治疗(局部或吸入激素允许)。
• 需治疗的活动性自身免疫病、免疫缺陷或正在使用免疫抑制治疗。
• 筛选前4周内有急性或中重度慢性移植物抗宿主病(GVHD)。
• 已知对DIT-101任一成分严重过敏。
• 有生育能力的女性或男性无法在DIT-101输注期间及输注后1年内采取有效避孕措施;受试者本人或伴侣计划在输注后1年内妊娠。
• 既往血液系统恶性肿瘤以外的其他恶性肿瘤,但以下情况除外:经根治性治疗且无病≥2年;或非黑色素瘤皮肤癌已充分治疗且目前无病。
• 研究者认为可能增加风险或干扰研究结局的任何情况。
核对登记原文(英文)
Inclusion Criteria:

* Adults aged 18 to \<70 years, any gender.
* Voluntarily provide written informed consent and willing to comply with all study procedures.
* Diagnosed with relapsed or refractory B-cell acute lymphoblastic leukemia/lymphoma (B-ALL/LBL), or other relapsed/refractory hematologic malignancies as judged by the investigator and confirmed by the collaborating institution.
* Tumor cells confirmed positive for the target antigen by immunophenotyping.
* Bone marrow blast ≥5% at screening and/or presence of extramedullary disease.
* For B-ALL/LBL patients, meets criteria for relapsed/refractory disease, including:

  * Primary refractory after ≥2 cycles of standard chemotherapy or not achieving CR after multiple salvage regimens;
  * Relapse within 12 months after CR or ≥12 months relapse after CR not achieving CR after subsequent standard therapy;
  * Relapse after hematopoietic stem cell transplantation;
  * Relapse after prior CAR-T therapy targeting the same antigen.
* ECOG performance status 0-2.
* Expected survival \>3 months.
* Adequate organ function, including:

  * Renal: creatinine clearance \>45 mL/min;
  * Hepatic: total bilirubin ≤3×ULN, ALT/AST ≤5×ULN;
  * Coagulation: PT, APTT, or INR ≤1.5×ULN;
  * Cardiac: LVEF ≥50% within 1 month;
  * Pulmonary: SpO₂ ≥92% at rest on room air;
  * Hematologic and immune function considered sufficient to tolerate study treatment.
* Women of childbearing potential must have a negative pregnancy test; women considered not of childbearing potential include those who are postmenopausal for ≥12 months or have undergone surgical sterilization (hysterectomy or bilateral oophorectomy).

Exclusion Criteria:

* Pregnant or breastfeeding women.
* Known hereditary bone marrow failure syndromes (e.g., Fanconi anemia, Kostmann syndrome, Shwachman syndrome, or other known marrow failure syndromes).
* Uncontrolled active central nervous system leukemia (CNSL; CNS2 or CNS3).
* Prior anti-cancer therapy before screening, including:

  * Systemic chemotherapy within 1 week;
  * Systemic immunotherapy/targeted therapy (monoclonal antibodies, bispecific antibodies, ADCs, etc.) with last dose \<5 half-lives or \<4 weeks (whichever is shorter);
  * Donor lymphocyte infusion within 6 weeks;
  * CAR-T therapy or hematopoietic stem cell transplantation within 3 months;
  * Radiotherapy within 4 weeks (unless bone marrow reserve \>5% and investigator judges it does not affect eligibility);
  * Persistent clinically significant toxicity from prior therapy not recovered to ≤CTCAE Grade 1 (except alopecia).
* Uncontrolled severe active infection.
* History of significant cardiac disease, including: severe heart failure (NYHA class III-IV), myocardial infarction or PCI/stent within 12 months, unstable angina, QTc \>480 ms, or other clinically significant arrhythmia per investigator judgment.
* History of CNS injury, seizure, stroke, or brain hemorrhage requiring treatment within 6 months.
* Active viral infections:

  * HIV antibody positive, syphilis serology positive;
  * HBsAg \>10⁶ IU/mL;
  * HCV antibody positive;
  * EBV positive (EBER or copy number above normal).
* Need for long-term systemic corticosteroid therapy during DIT-101 infusion (local or inhaled steroids allowed).
* Active autoimmune disease requiring treatment, immunodeficiency, or use of immunosuppressive therapy.
* Acute or moderate-to-severe chronic graft-versus-host disease (GvHD) within 4 weeks prior to screening.
* Known severe allergy to any component of DIT-101.
* Women of childbearing potential or men unable to use effective contraception during DIT-101 infusion and for 1 year post-infusion; plans for pregnancy within 1 year post-infusion in male or female subjects or their partners.
* Any condition that, in the investigator's opinion, may increase risk or interfere with study outcomes.
* Prior malignancy other than hematologic malignancy, except:

  * Malignancy treated with curative intent and disease-free ≥2 years;
  * Non-melanoma skin cancer adequately treated with no current evidence of disease.

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。

研究终点衡量什么算有效

  • 主要终点安全性:不良事件(AE)的发生率和严重程度DIT101输注完成后2年内,或至死亡(以先发生者为准)
  • 主要终点安全性:剂量限制性毒性(DLT)发生率首次DIT101输注后28天
  • 次要终点缓解持续时间(DOR)
  • 次要终点无事件生存期(EFS)
  • 次要终点无白血病生存期(LFS)
  • 次要终点接受造血干细胞移植(HSCT)的应答者比例
  • 次要终点总生存期(OS)
  • 次要终点外周血CAR-T细胞峰浓度(Cmax)
核对登记原文(英文)

主要终点:Safety#Incidence and severity of adverse events (AEs) · To evaluate the possible adverse events after DIT101 infusion, including the incidence, and severity of AEs · 2 years after completion of the DIT101 infusion or until death, whichever occurs first.;Safety#Incidence of Dose Limiting Toxicity (DLT) · Incidence of dose limiting toxicities (DLTs) within 28 days after the first DIT101 infusion. · 28 days after the first DIT101 infusion.
次要终点:Duration of Remission (DOR);Event-Free Survival (EFS);Leukemia-Free Survival (LFS);Proportion of Responding Subjects Receiving HSCT;Overall Survival (OS);Maximum Concentration (Cmax) of CAR-T Cells in Peripheral Blood

研究设计怎么做的

研究类型
干预性研究
入组人数
15 人(预计)
分组方式
不适用(单臂)
  • 复发或难治性血液系统恶性肿瘤体内CAR-T治疗试验组

    复发或难治性血液系统恶性肿瘤患者接受1–2次DIT101静脉给药。

核对分组登记原文(英文)
  • In Vivo CAR-T Therapy for Relapsed or Refractory Hematologic Malignancies · EXPERIMENTAL · Participants with relapsed or refractory hematologic malignancies will receive 1-2 intraveneous administrations of in Vivo CAR-T (DIT101).

关键日期

开始日期
2026-04-15
主要完成日期
2028-10-15
全部完成日期
2028-10-15
登记状态核实于
2026-03

联系与责任方

申办方
Tcelltech Inc.
联系邮箱
fengrui@tcelltech.com
联系电话
+(86)13509312934

登记简述

这是一项单组、开放标签临床试验,旨在评估DIT101在复发或难治性血液系统恶性肿瘤成人患者中的安全性和耐受性,并探索其潜在抗肿瘤作用。DIT101是一种静脉输注的研究性体内CAR-T细胞疗法,给药后拟在患者体内生成能够识别并攻击肿瘤细胞的CAR-T细胞。与已获批的自体CAR-T疗法不同,DIT101无需采集受试者自身细胞并在体外进行基因改造。研究包括筛选期、DIT101输注治疗期、约6个月的治疗后密集随访期,以及最长2年的长期随访(每3–6个月访视)。

核对登记原文(英文)

This study is a single-arm, open-label clinical trial designed to evaluate the safety and tolerability of DIT101 in adults with relapsed or refractory hematologic malignancies and to explore its potential anti-tumor effects. DIT101 is an investigational in vivo CAR-T cell therapy administered by intravenous infusion. After administration, it is intended to generate CAR-T cells within the patient's body that can recognize and attack tumor cells. Unlike approved autologous CAR-T therapies, DIT101 does not require collection and ex vivo genetic modification of the participant's own cells. The study includes a screening period, DIT101 infusion treatment, a post-treatment intensive follow-up period of approximately 6 months, and a long-term follow-up period of up to 2 years, with visits every 3-6 months.

登记原文与核验信息

试验登记号
NCT07485504
试验期别
I 期
试验状态
尚未开始招募
中国试验中心(1 个)
Hematology Hospital of Chinese Academy of Medical Sciences (Hematology Research Center of Chinese Academy of Medical Sciences) · 天津 · 中国
适应症(原文)
Relapsed or Refractory Hematologic Malignancies
干预方式(原文)
In Vivo CAR-T Therapy